Reliable Route Selection for Wireless Sensor Networks with Connection Failure Uncertainties.

For wireless sensor networks (WSN) with connection failure uncertainties, traditional minimum spanning trees are no longer a feasible option for selecting routes. Reliability should come first before cost since no one wants a network that cannot work most of the time. First, reliable route selection for WSNs with connection failure uncertainties is formulated by considering the top-k most reliable spanning trees (RST) from graphs with structural uncertainties. The reliable spanning trees are defined as a set of spanning trees with top reliabilities and limited tree weights based on the possible world model. Second, two tree-filtering algorithms are proposed: the k minimum spanning tree (KMST) based tree-filtering algorithm and the depth-first search (DFS) based tree-filtering algorithm. Tree-filtering strategy filters the candidate RSTs generated by tree enumeration with explicit weight thresholds and implicit reliability thresholds. Third, an innovative edge-filtering method is presented in which edge combinations that act as upper bounds for RST reliabilities are utilized to filter the RST candidates and to prune search spaces. Optimization strategies are also proposed for improving pruning capabilities further and for enhancing computations. Extensive experiments are conducted to show the effectiveness and efficiency of the proposed algorithms.

First case of Stevens-Johnson syndrome after rabies vaccination.

We describe the first case of Stevens-Johnson syndrome (SJS) occurring 8 days after the first dose of a three-dose rabies vaccination series. She had no history of vaccine-related rash or other adverse drug reactions, nor had she received any other drug therapy. The temporal relationship between the development of SJS and the vaccination suggests that the rabies vaccination probably was the causal agent. This case serves as a warning of a distinct cutaneous reaction of rabies vaccination.

A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial.

PURPOSE: The aim of the study was to evaluate the efficacy of three different surgical procedures in the treatment of type A thoracolumbar fractures. MATERIALS AND METHODS: Between September 2012 and January 2015, a total of 90 patients with type A thoracolumbar fractures were randomly assigned into three groups of 30 each. Patients in group A, B, and C were treated with three-level percutaneous fixation, two-level percutaneous fixation, and three-level open fixation, respectively. Blood loss, duration of surgery, VAS scores, Cobb angles, and anterior height ratios of fractured vertebrae were collected for statistical analysis. RESULTS: The average follow-up was 17.7 months. Post-operative Cobb angles were significantly corrected and anterior height ratios of fractured vertebrae were well restored in all three groups (p < 0.01). Back pain was efficiently relieved according to VAS score change (p < 0.01). There were significant differences in values of blood loss and post-operative VAS scores (at three months) between group A and group C (p < 0.01). No significant difference concerning post-operative anterior height ratios of fractured vertebrae, Cobb angles and correction losses was observed between group A and group B (p = 0.580, 0.840, 0.215, respectively). CONCLUSION: Percutaneous fixation not only provides the same reduction effect as open fixation, but also has an advantage of causing less operation related trauma which is beneficial to post-operative rehabilitation. The efficacy of three-level percutaneous fixation and two-level percutaneous fixation in the treatment of type A thoracolumbar fractures is not significantly different.

Hip arthroplasty following failure of internal fixation in intertrochanteric femoral fractures: classification decision-making for femoral stem selection and clinical validation.

AIMS: Following Failed Internal Fixation of Intertrochanteric Fractures (FIF-ITF), the choice of treatment remains a clinical challenge. This study introduces a novel classification system to guide the selection of femoral prostheses in hip arthroplasty (HA) and validates its clinical efficacy. METHODS: Retrospectively, we analyzed 108 cases from three university-affiliated hospitals between December 2012 and February 2023 involving patients who underwent hip arthroplasty due to Failed Internal Fixation of Intertrochanteric Fractures (FIF-ITF). Patients were classified into three categories based on fracture healing, proximal femoral support, and the severity of femoral cortical defects, with subtypes identified. Surgical outcomes and complication rates were compared between the Classification-based Decision Group and the Non-classification Decision Group. RESULTS: The Classification-based Decision Group did not differ significantly from the Non-classification Decision Group in operation time, blood loss, or the use of cemented stems. However, the classification system markedly reduced the risk of periprosthetic fractures intraoperatively from 22.5 to 4.4% and postoperatively from 10 to 1.4%. The Classification-based Decision Group also demonstrated higher postoperative Harris Hip Score (HHS) and Visual Analog Scale (VAS) scores. CONCLUSION: The proposed classification system serves as an innovative clinical tool for femoral prosthesis selection in hip arthroplasty post-FIF-ITF, effectively reducing complications and enhancing hip function in the Classification-based Decision Group, underscoring its significant clinical utility.

Detection of rare microorganisms in bone and joint infections by metagenomic next-generation sequencing.

Aims: This aim of this study was to analyze the detection rate of rare pathogens in bone and joint infections (BJIs) using metagenomic next-generation sequencing (mNGS), and the impact of mNGS on clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on 235 patients with BJIs who were treated at our hospital between January 2015 and December 2021. Patients were divided into the no-mNGS group (microbial culture only) and the mNGS group (mNGS testing and microbial culture) based on whether mNGS testing was used or not. Results: A total of 147 patients were included in the no-mNGS group and 88 in the mNGS group. The mNGS group had a higher detection rate of rare pathogens than the no-mNGS group (21.6% vs 10.2%, p = 0.016). However, the mNGS group had lower rates of antibiotic-related complications, shorter hospital stays, and higher infection control rates compared with the no-mNGS group (p = 0.017, p = 0.003, and p = 0.028, respectively), while there was no significant difference in the duration of antibiotic use (p = 0.957). In culture-negative cases, the mNGS group had lower rates of antibiotic-related complications, shorter hospital stays, and a higher infection control rate than the no-mNGS group (p = 0.036, p = 0.033, p = 0.022, respectively), while there was no significant difference in the duration of antibiotic use (p = 0.748). Conclusion: mNGS improves detection of rare pathogens in BJIs. mNGS testing reduces antibiotic-related complications, shortens hospital stay and antibiotic use duration, and improves treatment success rate, benefits which are particularly evident in culture-negative cases.

Kinetics of thermal degradation of raw lacquer enhanced by formaldehyde urea prepolymer.

In this study, formaldehyde-urea prepolymer (FUP) were synthesized, which were used to modify the raw lacquer (RL) and this composition named LF, while the basic properties of the RL were tested. Thermal gravimetric (TG) analysis and scanning electron microscopy (SEM) were used to analyze the degradative characteristics and the surface morphology of RL before and after modification. The result indicated that FUP can significantly improve the performance of RL. The drying time of the LF is significantly shortened, the gloss, the pencil hardness, and the impact performance are significantly enhanced at the same time. TG analysis and thermal decomposition kinetics analysis illustrated that the thermal stability and the activation energy of LF2 were stronger than that of RL. In addition, SEM analysis illustrated that the surface smoothness of RL were also improved.

Efficacy and safety of a parylene-coated occluder for atrial septal defect: a prospective, multi-center, randomized controlled clinical trial.

BACKGROUND: Nitinol-containing devices are widely used in clinical practice. However, there are concerns about nickel release after nitinol-containing device implantation. This study aimed to compare the efficacy and safety of a parylene-coated occluder vs. a traditional nitinol-containing device for atrial septal defect (ASD). METHODS: One-hundred-and-eight patients with ASD were prospectively enrolled and randomly assigned to either the trial group to receive a parylene-coated occluder (n = 54) or the control group to receive a traditional occluder (n = 54). The plugging success rate at 6 months after device implantation and the pre- and post-implantation serum nickel levels were compared between the two groups. A non-inferiority design was used to prove that the therapeutic effect of the parylene-coated device was non-inferior to that of the traditional device. The Cochran-Mantel-Haenszel chi-squared test with adjustment for central effects was used for the comparison between groups. RESULTS: At 6 months after implantation, successful ASD closure was achieved in 52 of 53 patients (98.11%) in both the trial and control groups (95% confidence interval (CI): [-4.90, 5.16]) based on per-protocol set analysis. The absolute value of the lower limit of the 95% CI was 4.90%, which was less than the specified non-inferiority margin of 8%. No deaths or severe complications occurred during 6 months of follow-up. The serum nickel levels were significantly increased at 2 weeks and reached the maximum value at 1 month after implantation in the control group (P < 0.05 vs. baseline). In the trial group, there was no significant difference in the serum nickel level before vs. after device implantation (P > 0.05). CONCLUSIONS: The efficacy of a parylene-coated ASD occluder is non-inferior to that of a traditional uncoated ASD occluder. The parylene-coated occluder prevents nickel release after device implantation and may be an alternative for ASD, especially in patients with a nickel allergy.