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Boosting Adversarial Training with Learnable Distribution

Computers, Materials & Continua 2024年第3期78卷 3247-3265页

作者： Kai Chen Jinwei Wang james Msughter Adeke Guangjie Liu Yuewei Dai School of Electronics and Information Engineering Nanjing University of Information Science and TechnologyNanjing210044China Key Laboratory of Intelligent Support Technology for Complex Environments Ministry of EducationNanjing210044China School of Computer and Software Nanjing University of Information Science and TechnologyNanjing210044China Nanjing Center for Applied Mathematics Nanjing211135China

In recent years,various adversarial defense methods have been proposed to improve the robustness of deep neural *** training is one of the most potent methods to defend against adversarial ***,the difference in the feature space between natural and adversarial examples hinders the accuracy and robustness of the model in adversarial *** paper proposes a learnable distribution adversarial training method,aiming to construct the same distribution for training data utilizing the Gaussian mixture *** distribution centroid is built to classify samples and constrain the distribution of the sample *** natural and adversarial examples are pushed to the same distribution centroid to improve the accuracy and robustness of the *** proposed method generates adversarial examples to close the distribution gap between the natural and adversarial examples through an attack algorithm explicitly designed for adversarial *** algorithm gradually increases the accuracy and robustness of the model by scaling ***,the proposed method outputs the predicted labels and the distance between the sample and the distribution *** distribution characteristics of the samples can be utilized to detect adversarial cases that can potentially evade the model *** effectiveness of the proposed method is demonstrated through comprehensive experiments.

关键词： Adversarial training feature space learnable distribution distribution centroid

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The Making of a Health Profession:How Chinese Medicine Became a Nationally registered Allied Health Profession in Australia

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Chinese Medicine and Culture 2024年第1期7卷 51-62页

作者： John L McDonald Judy B james School of Chinese Medicine Endeavour College of Natural HealthSouthport 4215Australia Acupuncture Now Australia Brisbane 4120Australia

In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans

关键词： Acupuncture Chinese medicine registration regulation Education Standards Australia TCM

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Acute worsening of microvascular complications of diabetes mellitus during rapid glycemic control:The pathobiology and therapeutic implications

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World Journal of Diabetes 2024年第3期15卷 311-317页

作者： Dania Blaibel Cornelius james Fernandez Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

While chronic hyperglycaemia resulting from poorly controlled diabetes mellitus(DM)is a well-known precursor to complications such as diabetic retinopathy,neuropathy(including autonomic neuropathy),and nephropathy,a paradoxical intensification of these complications can rarely occur with aggressive glycemic management resulting in a rapid reduction of glycated ***,acute onset or worsening of retinopathy and treatment induced neuropathy of diabetes are more common among these complications,rarely other problems such as albuminuria,diabetic kidney disease,Charcot’s neuroarthropathy,gastroparesis,and urinary bladder dysfunction are also *** World Journal of Diabetes recently published a rare case of all these complications,occurring in a young type 1 diabetic female intensely managed during pregnancy,as a case report by Huret et *** is essential to have a comprehensive understanding of the pathobiology,prevalence,predisposing factors,and management strategies for acute onset,or worsening of microvascular complications when rapid glycemic control is achieved,which serves to alleviate patient morbidity,enhance disease management compliance,and possibly to avoid medico-legal issues around this rare clinical *** editorial delves into the dynamics surrounding the acute exacerbation of microvascular complications in poorly controlled DM during rapid glycaemic control.

关键词： Diabetes mellitus Microvascular complications Diabetic retinopathy Treatment induced neuropathy of diabetes Diabetic nephropathy Charcot’s neuropathy

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Diabetes and tuberculosis:An emerging dual threat to healthcare

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World Journal of Diabetes 2024年第7期15卷 1409-1416页

作者： Sahana Shetty Joseph M Pappachan Cornelius james Fernandez Department of Endocrinology Kasturba Medical CollegeManipalManipal Academy of Higher EducationManipal 576104KarnatakaIndia Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom

Tuberculosis(TB)remains a huge global healthcare challenge even in the 21^(st) century though the prevalence has dropped in developed countries in recent *** mellitus(DM)is an important risk factor for the development and perpetuation of TB owing to the immune dysfunction in patients with *** coexistence of both diseases in the same individual also aggravates disease severity,complications,and chance of treatment failure because of gross immune alterations posed by DM as well as *** complex cellular and humoral immunological factors are involved in the dangerous interaction between TB and DM,some of which remain unknown even *** is highly important to identify the risk factors for TB in patients with DM,and vice versa,to ensure early diagnosis and management to prevent complications from this ominous *** their research study published in the recent issue of the World Journal of Diabetes,Shi et al elaborate on the factors associated with the development of TB in a large cohort of DM patients from *** such research output from different regions of the world is expected to improve our knowledge to fight the health devastation posed by TB in patients with diabetes.

关键词： Tuberculosis Diabetes mellitus Immune dysfunction Treatment failure Multi-drug resistant tuberculosis

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Non-pharmacological interventions for diabetic peripheral neuropathy:Are we winning the battle?

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World Journal of Diabetes 2024年第4期15卷 579-585页

作者： Dania Blaibel Cornelius james Fernandez Joseph M Pappachan Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Department of Endocrinology&Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine&HealthThe University of ManchesterManchester M139PLUnited Kingdom

Despite the advent of relatively reliable modalities of diagnosing diabetic peripheral neuropathy(DPN),such as nerve conduction studies,there is still a knowledge gap about the pathophysiology,and thus limited available in-terventions for symptom control and curtailing disease *** pharma-cologic aspect of management is mainly centred on pain control,however,there are several important aspects of DPN such as loss of vibration sense,pressure sense,and proprioception which are associated with risks to lower limb health,which pharmacotherapy does not ***,published evidence suggests non-pharmacologic interventions such as glycaemic control through dietary modification and exercise need to be combined with other measures such as psychotherapy,to reach a desired,however modest *** is emerging as an important treatment modality for several chronic medical conditions including neuropathic and other pain *** their study published in the World Journal of Diabetes on the potential of acupuncture to reduce DPN symptoms and enhance nerve conduction parameters,Hoerder et al have been able to demonstrate that acupuncture improves sensory function and that this effect is likely sustained two months after treatment *** previous studies also support these findings,larger multi-center randomized control trials including a sham-controlled arm accounting for a placebo effect are ***,given the satisfactory safety profile and the positive results found in these studies,it is likely that acupuncture may become an important aspect of the repertoire of effective DPN management.

关键词： Diabetic peripheral neuropathy Diabetes mellitus Pharmacotherapy Acupuncture Neuropathic pain Nonpharmacological intervention

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Commentary on“Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients”

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Asian Journal of Andrology 2024年第3期26卷 333-334页

作者： james F Jiang Narmina K Onder Akhil K Das Department of Urology University of California Irvine Orange CA 92868 USA.

Laser enucleation of the prostate is a proven and effectivesize-independent method for the surgical management of symptomaticbenign prostatic hyperplasia(BPH)and is considered as the“goldstandard”by many *** major hurdles that stand in theway of this becoming a universally used procedure for BPH are thesteep learning curve associated with mastering the procedure andpossibility of perioperative transient *** advances inteaching methodologies have helped tackle the difficulty in learning itand increased the number of urologists utilizing the *** forthe second hurdle,transient incontinence rates postlaser enucleationof the prostate have improved with the advent of newer techniques *** et al.1 assesses the incidence of stress,urge,andmixed urinary incontinence following laser enucleation of the prostateby comparing en-bloc and non-en-bloc techniques in a multicenterseries of 5068 men with BPH.

关键词： urinary incontinence transient

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First experience in laparoscopic surgery in low and middle income countries: A systematic review

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 546-553页

作者： rebekka Troller Jasmine Bawa Olivia Baker james Ashcroft Department of Surgery Medway Maritime HospitalGillingham ME75NYKentUnited Kingdom Department of Surgery University Hospital CambridgeCambridge CB20QQUnited Kingdom

BACKGrOUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open *** is routine practice in high-income countries and is becoming increasingly common in countries with limited ***,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and *** To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and *** MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in *** studies were published between 1996 and 2022 with full text available in *** criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric *** Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 *** reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical ***-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre *** benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/*** introduction of laparoscopic surgery also provided training opportunities for junior *** Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for *** many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critical

关键词： Laparoscopic surgery Low and middle income country First experience Training in laparoscopic surgery

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Handheld bedside ultrasound in the diagnosis of myocarditis

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World Journal of Emergency Medicine 2024年第1期15卷 73-74页

作者： Frank Wheeler robin Lahr james Espinosa Alan Lucerna Henry Schuitema Department of Emergency Medicine Rowan University School of Osteopathic MedicineStratford 08084USA Emergency Medicine residency Program Jeff erson HealthStratford 08084USA Department of Emergency Medicine and Associate Chief Medical Offi cer Stratford 08084USA

Myocarditis is a disease process that every emergency physician fears *** severity can be mild to life-threatening,and many cases are likely undetected because they are subclinical with nonspecifi c signs.[1]Subtle cardiac signs may be overshadowed by systemic symptoms of the underlying infectious ***,myalgias,lethargy,symptoms commonly associated with viral syndrome,can mask the life-threatening myocarditis that may be *** fact,in the United States Myocarditis Treatment Trial,almost 90%of patients reported symptoms consistent with a viral prodrome.[2]Ammirati et al[3]reported that 27%of patients with myocarditis had either reduced left ventricular ejection fraction,ventricular arrhythmias,or low cardiac ***,we present a case report,in which handheld point-of-care ultrasound was utilized at the bedside to aid in the critical diagnosis of *** the additional information provided through this imaging modality,this patient was able to be transferred to the appropriate tertiary care facility in an expeditious manner and receive possible defi nitive treatment.

关键词： diagnosis myocarditis Fever

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Exploring the mass gap:Black holes in green pea galaxies

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Science China(Physics,Mechanics & Astronomy) 2024年

作者： james E.rhoads School of Earth and Space Exploration Arizona State University

We know about black holes primarily on two mass scales(e.g., see Figure 22 of ref.[1]). Supermassive black holes inhabit the centers of galaxies, where they sometimes power active galactic nuclei (AGN). Their populations can be probed through AGN surveys, tidal disruption event surveys, and (in the closest galaxies) stellar and gas dynamics in the innermost regions where the black hole dominates the gravitational potential.

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A holistic approach to improving safety for battery energy storage systems

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Journal of Energy Chemistry 2024年第5期92卷 422-439页

作者： james Close Jonathan E.Barnard Y.M.John Chew Semali Perera Department of Chemical Engineering Centre for DigitalManufacturing&DesignUniversity of BathBath BA27AYUK ioMosaic International Limited 16-18 Queen SquareBath BA12HNUK

The integration of battery energy storage systems(BESS)throughout our energy chain poses concerns regarding safety,especially since batteries have high energy density and numerous BESS failure events have *** spread adoption will only increase the prevalence of these failure events unless there is a step change in the management and design of *** understand the causes of failure,the main challenges of BESS safety are *** consequences and failure events are discussed,including specific focus on the chain of events causing thermal runaway,and a case study of a BESS explosion in Surprise Arizona is *** on the technology and past events,a paradigm shift is required to improve BESS *** this review,a holistic approach is *** combines currently adopted approaches including battery cell testing,lumped cell mathematical modelling,and calorimetry,alongside additional measures taken to ensure BESS safety including the requirement for computational fluid dynamics and kinetic modelling,assessment of installation level testing of the full BESS system and not simply a single cell battery test,hazard and layers of protection analysis,gas chromatography,and composition *** holistic approach proposed in this study aims to address challenges of BESS safety and form the basis of a paradigm shift in the safety management and design of these systems.

关键词： Energy storagesystems Process safety Battery safety Thermal safety

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