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Setting up an integrated service for PSC-IBD patients:A quality improvement project

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iLIVER 2024年第2期3卷 11-15页

作者： Sreelakshmi Kotha Ioannis Koumoutsos Ben Warner Eleni Theocharidou Joel Mawdsley Philip Berry Department of Gastroenterology Guy's and St Thomas'Foundation TrustLondon SE17EHUnited Kingdom

Background and aims:Primary sclerosing cholangitis(PSC)often co.exists with inflammatory bowel disease(IBD)and together they are associated with increased risk of co.plications,including cancer(hepatobiliary,co.orectal,gallbladder)and *** for follow up and surveillance vary,but our local guidelines advise annual surveillance with magnetic resonance cholangiopancreatography(MRCP),co.onosco.y and ultrasound(US)(6 monthly if cirrhotic).We aimed to assess the quality of care in our PSC-IBD patients,including adherence to local surveillance guidelines,and resultant detection of co.plications,before and after the introduction of an integrated PSC and IBD out-patient ***:Data on management of PSC-IBD patients was co.lected retrospectively before,and prospectively following,the introduction of an integrated *** co.parisons of diagnoses,adherence to planned surveillance and outco.es were made between co.orts pre-and post-service ***:Prior to the service re-design there was significant variability in care and poor adherence to *** of an integrated PSC-IBD service led to 89 referrals with possible PSC-IBD at 36 months after service *** review led to appropriate identification of 68 PSC-IBD *** was significant improvement in surveillance with annual co.onosco.y in 90%,MRI/MRCP in 81%,US in 35%,co.pared to 55%,55%and 7%respectively in the baseline *** translated to diagnosis and appropriate treatment of co.onic dysplasia in 4 patients,co.orectal cancer(CRC)in 4 patients and cholangiocarcinoma(CCA)in 2 ***:Establishment of an integrated out-patient service for PSC-IBD patients results in better co.pliance with guidelines,effective detection of co.plications,and appropriate management.

关键词： Endosco.y Hepato-biliary disease Inflammatory bowel disease

Security Architecture on the trusting Internet of Things

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Journal of Electronic Science and Technology 2011年第4期9卷 364-367页

作者： Bing Zhang Xin-Xin Ma Zhi-Guang Qin with JiuZhou co. with 78046 Unit of PLA with the Department of co.puter Science and Engineering University of Electronic Science and Technology of China

By analyzing existed Internet of Things＇ system security vulnerabilities, a security architecture on trusting one is co.structed. In the infrastructure, an off-line identity authentication based on the co.bined public key （CPK） mechanism is proposed, which solves the problems about a mass amount of authentications and the cross-domain authentication by integrating nodes＇ validity of identity authentication and uniqueness of identification. Moreover, the proposal of co.structing nodes＇ authentic identification, valid authentication and credible co.munication co.nection at the application layer through the perception layer impels the formation of trust chain and relationship among perceptional nodes. co.sequently, a trusting environment of the Internet of Things is built, by which a guidance of designing the trusted one would be provided.

关键词： co.bined public key elliptic curves cryptography Internet of Things radio frequency identification security system trusting system.

Diet shift in bank voles induced by co.petition from grey-sided voles?

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Integrative Zoology 2019年第4期14卷 376-382页

作者： Magnus MAGNUSSON Gustaf SAMELIUS Birger HÖRNFELDT Frauke ECKE Department of Wildlife Fishand Environmental StudiesSwedish University of Agricultural SciencesUmeåSweden 2Snow Leopard trust SeattleUSA Department of Eco.ogy Swedish University of Agricultural SciencesRiddarhyttanSweden

Grey-sided voles(Myodes rufocanus)and bank voles(Myodes glareolus)co.exist in boreal forests in northern *** studies suggest that the 2 species interact interspecifically,the grey-sided vole being the dominant *** tested the hypothesis that bank voles shift their diet due to co.petition with the dominant grey-sided vole by studying stable isotope ratios in both *** samples were taken from voles in patches of old forest occupied by only bank voles and patches of old forest occupied by both grey-sided voles and bank *** found that:(i)stable isotope ratios of bank voles differed in areas with and without grey-sided voles;and that(ii)the stable isotope ratios of bank voles were more similar to those of grey-sided voles in areas where grey-sided voles were *** data suggests that grey-sided voles forced bank voles to change their diet due to interspecific co.petition.

关键词： co.petition diet shift Myodes glareolus Myodes rufocanus stable isotopes

Return to sport after lower limb arthroplasty-why not for all?

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World Journal of Orthopedics 2019年第2期10卷 90-100页

作者： Shivan S Jassim Jenni Tahmassebi Fares S Haddad Angus Robertson Trauma and Orthopaedics Royal London Hospital Trauma and Orthopaedics University College London Hospital Trauma and Orthopaedics Cardiff and Vale NHS Trust

BACKGROUND Total hip and knee replacements are being performed in increasing numbers in progressively younger patients with higher activity demands. Many such patients have expectations of returning to athletic activity post-operatively yet are not always able to do so and the reasons behind this have not been extensively examined. We hypothesise that any reasons for a failure to return to athletic activity post-operatively are *** To quantify the return to athletic activity following lower limb joint arthroplasty and understand qualitative reasons for altered activity *** A single centre, single surgeon retrospective questionnaire for hip and knee arthroplasty patients under age 60 years, minimum two years post-surgery with exclusion criteria of multiple degenerative joint involvement and multiple medical co.morbidities. Outco.es were validated joint-specific(Oxford hip and knee) and lifestyle questionnaires [short form 12(SF-12) and University of California, Los Angeles(UCLA)] and an activity questionnaire assessing ability participation in athletic activity post-operatively. Statistical analysis was performed on the validated outco.e data, including co.parison between hip and knee replacements. Frequency tables were produced to quantify the different athletic activities participated in by *** Responses were received from 64 patients(80% response rate). There was a statistically significant improvement in Oxford hip and knee sco.es following surgery. SF-12 sco.es also improved for all patients, but no statistically significant difference was seen between joints(P = 0.88). Mean UCLA sco.es pre-operatively were 7.67 and at two years post-operatively were 7.69, with no statistically significant change(P = 0.91). All patients reported high satisfaction and improved ability to perform athletic activity at a higher frequency co.pared to pre-operatively. The most co.mon reasons for changing activity participation were not wa

关键词： Joint replacement Athletic activity Sport Outco.es

Ambient Backco. in beyond 5G NOMA networks: A multi-cell resource allocation framework

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Digital co.munications and Networks 2022年第6期8卷 1005-1013页

作者： Wali Ullah Khan Fida Hussain Memon Kapal Dev Muhammad Awais Javed Dinh-Thuan Do Nawab Muhammad Faseeh Qureshi Interdisciplinary Centre for Security Reliability and Trust(SnT)University of Luxembourg1855 Luxembourg CityLuxembourg Department of Electrical Engineering Sukkur IBA University Pakistan Department of Institute of Intelligent Systems University of JohannesburgSouth Africa Department of Electrical and co.puter Engineering COMSATS University Islamabad44000IslamabadPakistan Electrical Engineering Department University of Colorado DenverDenverCO80204USA Department of co.puter Education Sungkyunkwan UniversitySeoulSouth Korea

The research of Non-Orthogonal Multiple Access (NOMA) is extensively used to improve the capacity of networks beyond the fifth-generation. The recent merger of NOMA with ambient Backscatter co.munication (Backco.), though opening new possibilities for massive co.nectivity, poses several challenges in dense wireless networks. One such challenge is the performance degradation of ambient Backco. in multi-cell NOMA networks under the effect of inter-cell interference. Driven by providing an efficient solution to the issue, this article proposes a new resource allocation framework that uses a duality theory approach. Specifically, the sum rate of the multi-cell network with backscatter tags and NOMA user equipment is maximized by formulating a joint optimization problem. To find the efficient base station transmit power and backscatter reflection co.fficient in each cell, the original problem is first divided into two subproblems, and then the closed form solution is derived. A co.parison with the Orthogonal Multiple Access (OMA) ambient Backco. and pure NOMA transmission has been provided. Simulation results of the proposed NOMA ambient Backco. indicate a significant improvement over the OMA ambient Backco. and pure NOMA in terms of sum-rate gains.

关键词： Beyond fifth-generation Non-orthogonal multiple access Ambient Backco. Spectrum efficiency optimization

Epilepsy versus non-epileptic attack disorder: A diagnostic and therapeutic challenge

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Case Reports in Clinical Medicine 2013年第1期2卷 1-4页

作者： Catherine Smith Jason Ramtahal South Devon Healthcare NHS Foundation trust Torquay UK South Devon Healthcare NHS Foundation trust Torquay UK

Epilepsy and non-epileptic attack disorder (NEAD) share a vast number of clinical features, however the aetiology and management are very different. Video-EEG is the gold standard diagnostic tool and relies on the occurrence of seizure activity during assessment to make a diagnosis. Added co.plexity arises from the co.existence of epilepsy and NEAD, occurring in a significant proportion of patients. co.prehensive assessment and investigation is therefore required to prevent gross mistreatment in this diagnostically difficult subgroup. We present a case of NEAD with co.existing epilepsy and the challenges that this may present in clinical practice.

关键词： Epilepsy Non-Epileptic Attack Disorder NEAD Seizure Video-EEG

Role of fast-setting cements in arthroplasty: A co.parative analysis of characteristics

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World Journal of Orthopedics 2017年第12期8卷 881-890页

作者： Neil Ayron Caraan Reinhard Windhager Jason Webb Nadine Zentgraf Klaus-Dieter Kuehn Department of Orthopaedics and Orthopaedic Surgery Medical University of Vienna Avon Orthopaedic Centre North Bristol NHS TrustSouthmead Hospital Heraeus Medical GmbH

AIM To evaluate the behaviour of two fast-setting polymethylmethacrylate(PMMA) cements CMW~? 2 G and Palaco.~? fast R + G, as reference: Standard-setting Palaco.~? R + *** The fast-setting cements CMW~? 2 G and Palaco.~? fast R + G were studied, using standard-setting high visco.ity Palaco.~? R + G as a reference. Eleven units(of two batch numbers) of each cement were tested. All cements were mixed as specified by the manufacturer and analysed on the following parameters: Handling properties(mixing, waiting, working and hardening phase) acco.ding to Kuehn, Mechanical properties acco.ding to ISO 5833 and DIN 53435, Fatigue strength acco.ding to ISO 16402, Benzoyl Peroxide(BPO)-co.tent by titration, powder/liquid-ratio by weighing, antibiotic elution profile by High Performance Liquid Chromatography. All tests were done in an acclimatised laboratory with temperatures set at 23.5 ℃± 0.5 ℃ and a humidity of > 40%. RESULTS Palaco.~? fast R + G showed slightly shorter handling properties(doughing, hardening phase, n = 12) than CMW~? 2 G, allowing to reduce operative time and to optimise cemented cup implantation. Data of the quasistatic properties of ISO 5833 and DIN 53435 of both cements tested was co.parable. The ISO co.pressive strength(MPa) of Palaco.~? fast R + G was significantly higher than CMW~? 2 G, resulting in ANOVA(P co.~? fast R + G showed a higher fatigue strength of about 18% mean(ISO 16402) of 15.3 MPa instead of 13.0 MPa for CMW~? 2 G(n = 5 × 10~6 cycles). Palaco.~? fast R + G and CMW~? 2 G differed only by 0.11%(n = 6) with the former having the higher co.tent. The BPO-co.tent of both cements were therefore co.parable. CMW~? 2 G had a powder/liquid ratio of 2:1, Palaco.~? fast R + G of 2.550:1 due to a higher powder co.tent. Despite its higher gentamicin co.tent, CMW~? 2 G showed a significantly lower antibiotic elution over time than Palaco.~? fast R + G(n = 3). co.

关键词： Polymethylmethacrylate Elution Fastsetting Visco.ity Antibiotic Fatigue Arthroplasty

co.Administration of Risperidone and Sodium Valproate Causing Bilateral Chronic Exertional Lower Leg co.partment Syndrome

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Open Journal of Orthopedics 2014年第4期4卷 101-103页

作者： Ravi K. Ray Muhammad A. Bashir Sudhir Rao Guy’s & St Thomas’ NHS Foundation trust London UK Princess Royal University Hospital NHS trust Farnborough Kent UK

We present the case of a 24-year-old man, who was a keen runner, developing chronic bilateral lower leg co.partment syndrome following co.administration of Risperidone and Sodium Valproate. Having had failed medical and physical therapies, he underwent surgical deco.pression of his more problematic left lower leg co.partments. In the interval between sequential fasciotomies, co.trol of his psychiatric symptoms allowed the dose of his Risperidone to be reduced, resulting in a greater exercise tolerance. Ultimately he no longer required the co.tra-lateral lower leg co.partments to be deco.pressed surgically. He had returned to his original level of activity with no further psychotic episodes.

关键词： Risperidone co.partment Syndrome

An Algebraic Detection Approach for co.trol Systems under Multiple Stochastic Cyber-attacks

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IEEE/CAA Journal of Automatica Sinica 2015年第3期2卷 258-266页

作者： Yumei Li Holger Voos Mohamed Darouach Changchun Hua the Interdisciplinary Centre for Security Reliability and trust(SnT) University of Luxembourg the Centre de la Recherche en Automatique de Nancy(CRAN) Universite de Lorraine the Institute of Electrical Engineering Yanshan University

In order to co.promise a target co.trol system successfully, hackers possibly attempt to launch multiple cyberattacks aiming at multiple co.munication channels of the co.trol system. However, the problem of detecting multiple cyber-attacks has been hardly investigated so far. Therefore, this paper deals with the detection of multiple stochastic cyber-attacks aiming at multiple co.munication channels of a co.trol system. Our goal is to design a detector for the co.trol system under multiple cyberattacks. Based on frequency-domain transformation technique and auxiliary detection tools, an algebraic detection approach is proposed. By applying the presented approach, residual information caused by different attacks is obtained respectively and anomalies in the co.trol system are detected. Sufficient and necessary co.ditions guaranteeing the detectability of the multiple stochastic cyber-attacks are obtained. The presented detection approach is simple and straightforward. Finally, two simulation examples are provided, and the simulation results show that the detection approach is effective and feasible. © 2014 Chinese Association of Automation.

关键词： Algebra co.munication channels (information theory) co.trol systems Crime Frequency domain analysis Personal co.puting Stochastic systems