In this paper, we show that the distributed maximum log-likelihood (DMLL) algorithm, which was originally proposed in (Denis, 2005) as a positioning solution for ultra wideband (UWB) indoor ad hoc networks, exhibits fine flexibility. Indeed, distinct implementation options are offered regarding the integration of range measurements or the distribution of required calculi. One important point is the use of synergetic cooperative protocol transactions that can handle simultaneously ranging, local contributions to the iterative optimization of a global objective, as well as the exchange of positional information. In addition, depending on the retained underlying models and the amount of prior statistical information, either a "blind" approach or more advanced options (e.g. aided by a preliminary channel identification step) could be adopted within a unique generic framework. This algorithm also proves to mitigate the harmful effects of non line of sight (NLOS) ranging biases by incorporating refined time of arrival (TOA) models. Finally, it claims to benefit from redundancy and spatial diversity as network completeness increases. At first, we make a short description of possible algorithmic embodiments. Then, we provide new simulation results obtained under realistic indoor scenarios with various ranging models. Subsequently, we discuss the impact of a few critical parameters on positioning precision and/or reliability.
Abstract Background Chinese herbal medicine is one of the most popular Chinese medicine (CM) therapies for primary insomnia. One of the important characteristics of CM is that different Chinese clinicians give different prescriptions even for the same patient. However, there must be some fixed drug patterns in every clinician’s prescriptions. This study aims to screen the effective core drug patterns in primary insomnia treatment of three prestigious Chinese clinicians. Methods/design A triple-blind, randomized, placebo-controlled, parallel-group clinical trial will be performed. Three clinicians will diagnose and treat every eligible patient individually and independently, producing three prescriptions from three clinicians for every patient. Patients will equally be randomized to one of four groups – medical group A, medical group B, medical group C, or placebo group – and observed for efficacy of treatment. The sample will include primary insomnia patients meeting DSM IV-TR criteria, Spiegel scale score >18, and age 18 to 65 years. A sequential design is employed. Interim analysis will be conducted when between 80 and 160 patients complete the study. The interim study could be stopped and treated as final if a statistically significant difference between treatment and placebo groups can be obtained and core effective drug patterns can be determined. Otherwise, the study continues until the maximum sample size reaches 300. Treatment of the CM group is one of three Chinese clinicians’ prescriptions, who provide independently prescriptions based on their own CM theory and the patient’s disease condition. Assessment will be by sleep diary and Pittsburgh sleep quality index, and CM symptoms and signs will be measured. Primary outcome is total sleep time. Assessment will be carried out at the washout period, weeks 1, 2, 3, and 4 and 4th week after the end of treatment. Effectiveness analysis will be per intent to treat. A multi-dimension association rule and scale-free networks method will be used to explore the effective core drug patterns. Discussion The effective core drug patterns will be found through analyzing several prestigious CM clinicians’ treatment information. Screening the effective core drug patterns from prestigious clinicians can accelerate the development of new CM drugs. Trial registration NCT01613183
In China, heat-clearing and detoxifying Chinese medicines combined with conventional therapy are commonly applied to treat the mild hand, foot, and mouth disease (HFMD). However, there is lack of solid evidence on the efficacy and safety of such therapies.We conducted a pooled analysis with individual patient data from 5 strictly randomized controlled clinical trials to assess the efficacy and safety of this combination therapy for mild HFMD. An intention-to-treat analysis was performed. A 2-stage meta-analysis method was adopted to analyze the pooled effect size.In total, 947 patients were included. Compared with conventional therapy, the combination therapy significantly reduced the progression rate of HFMD from mild to severe (odds ratio [OR] 0.43, 95% confidence interval [CI]: 0.22 to 0.83, P = .01). Meanwhile, the healing time of skin rash and oral ulcer in the combination therapy group was significantly shorter than that of conventional therapy. The overall hazard ratio (HR) of healing time of the skin rash or oral ulcer was 1.22 (95%CI: 1.04 to 1.43; P = .02). However, except Jinlianqingre effervescent tablets, the combination therapy cannot shorten the time to fever resolution (HR 1.12, 95%CI: 0.97 to 1.29, P = .14). Because of the heterogeneity, Jinlianqingre effervescent tablets were analyzed separately and the HRs of the time to fever resolution and the healing time of skin rash or oral ulcer were 3.88 (95%CI: 3.19 to 4.72; P < .0001) and 3.79 (95%CI: 2.81 to 5.11; P < .0001), respectively. There were 30 adverse events reported in total; 2 cases were related to Chinese medicines.In conclusion, the heat-clearing and detoxifying Chinese medicines on top of conventional therapy can effectively reduce the progressive rate of mild HFMD and improve healing of skin and oral mucosal lesions. More studies are needed for the time to fever resolution.
Acupuncture is developing rapidly in the world, and more attention is paid on acupuncture in various countries. Because of the cultural differences, there are different views on acupuncture between China and the west, which has brought influence and challenge to the development of acupuncture in the world. Acupuncture-related research is becoming increasingly extensive and complex, but the definition of acupuncture is lack of unified standards. The definition of acupuncture is in urgent need. Based on the analysis of acupuncture definition in the 201 international organizations of 48 countries on five continents and legislation of representative countries, this paper summarized the development status of acupuncture in foreign countries, and put forward that the definition of acupuncture should adopt the model of small connotation and large extension, integrate discipline superiority, expand the scope of acupuncture, and focus on the overall situation.
Clinical pathway aims to improve the quality of clinical treatment and reduce medical costs.At present,clinical pathway has been introduced into a few countries and regions.They have been actively exploring and developing clinical pathway and have put it into practice and achieved positive results.There are a number of problems need to be solved for the establishment of TCM clinical path:① Individualization of treatment based on syndrome differentiation and standardization of clinical pathway's implementation;②Individualization of TCM prescriptions and standardization of clinical interventions in the clinical pathway;③The capability of syndromes and prescriptions to be measured and evaluated;etc.The establishment of clinical pathway is based on evidence.Therefore,strengthening of researches on TCM diagnosis,evaluation index system's establishment and evaluation of clinical therapeutic effect is the key to the establishment of clinical pathway.
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