A Multi-layer Guidance Approach for Submerged Sensor Networks Integrating Acoustic and Optical Technologies

Over the previous decade, there has been a significant focus on researching underwater acoustic sensor networks (UW-ASNs) for a diverse range of underwater applications, which in turn has facilitated human exploration of the expansive underwater environment. This research introduces an innovative architectural approach that signifies a noteworthy advancement. By combining both acoustic and optical components, it establishes an underwater wireless sensor network. Additionally, the research introduces an innovative multiple levels Q learning-grounded direction-finding procedure, denoted as the proposed system Multi-layer Guidance Approach (MLGA) which is meticulously tailored for such underwater networks. The network\u27s architecture encompasses both physical grouping and logical division into two tiers: the upper tier is overseen by group leaders responsible for managing routing within the lower tier, where group members execute the actual data packet routing. This design capitalizes on the wider viewpoint of upper-tier group leaders and the concurrent learning processes occurring across all groups, resulting in a substantial enhancement in routing efficiency in comparison with traditional methodologies. The empirical results obtained from experimental tests underscore the robustness of the proposed system when confronted with changes in network topology. Moreover, it showcases the system\u27s ability to achieve higher delivery rates and reduced delays in dynamic networks compared to the established approach of flat Q-learning routing. This innovative strategy holds the potential to significantly push the boundaries of underwater sensor networks, surpassing the constraints of conventional communication methods and providing a more effective and dependable means of transmitting data underwater. This advancement not only contributes to the technical aspects but also holds promise for fostering greater exploration and understanding of underwater environments

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Efficient Intelligent Smart Ambulance Transportation System using Internet of Things

This research is significant, as traffic jam has become the main challenge in current metropolitan cities. Both in developed and developing nations, it is a concern for an ambulance to carry an emergency patient. Despite the fact, ambulance receives special traffic protocols, it is still challenging that the ambulance reaches the hospital on time. In the context of a smart city, this proposal suggests a smart ambulance management system. If the patient needs an ambulance, the operator finds the nearest emergency vehicle and points it in the patient\u27s direction. The programme dynamically tracks the positions of the ambulances to determine the quickest path to the injured person using maps provided by Google as an external service. Here we are tracking the ambulance with an IR transmitter and the road nearby speed breaker will have IR Receiver. Arduino Node MCU sends the alert message through the Internet of Things (IoT) and Global Positioning System (GPS). Then the necessary action can be taken after conforming to the location at a time. If an ambulance is on a nearby speed breaker, then it will turn automatically to the bottom and the even space will come up. It will give the chance for no need to reduce the speed of ambulance. During system analysis and experimentation, the system\u27s efficiency, and dependability can be enhanced as well as a significant reduction in healthcare costs, a reduction in the number of intermediaries and timely and efficient service, and the avoidance of wasting time. This paper is to examine different IoT techniques for movement control and the different approaches to assist the emergency vehicle to reach nearby healing facility on time. The main focus is on finding the best techniques to reduce the traffic congestion

A Comprehensive Review on Printed Electronics: A Technology Drift towards a Sustainable Future

Printable electronics is emerging as one of the fast-growing engineering fields with a higher degree of customization and reliability. Ironically, sustainable printing technology is essential because of the minimal waste to the environment. To move forward, we need to harness the fabrication technology with the potential to support traditional process. In this review, we have systematically discussed in detail the various manufacturing materials and processing technologies. The selection criteria for the assessment are conducted systematically on the manuscript published in the last 10 years (2012–2022) in peer-reviewed journals. We have discussed the various kinds of printable ink which are used for fabrication based on nanoparticles, nanosheets, nanowires, molecular formulation, and resin. The printing methods and technologies used for printing for each technology are also reviewed in detail. Despite the major development in printing technology some critical challenges needed to be addressed and critically assessed. One such challenge is the coffee ring effect, the possible methods to reduce the effect on modulating the ink environmental condition are also indicated. Finally, a summary of printable electronics for various applications across the diverse industrial manufacturing sector is presented

A Comprehensive Review on Bio-Nanomaterials for Medical Implants and Feasibility Studies on Fabrication of Such Implants by Additive Manufacturing Technique

Nanomaterials have allowed significant breakthroughs in bio-engineering and medical fields. In the present paper a holistic assessment on diverse biocompatible nanocomposites are studied. Their compatibility with advanced fabrication methods such as additive manufacturing for the design of functional medical implants is also critically reviewed. The significance of nanocomposites and processing techniques is also envisaged comprehensively in regard with the needs and futures of implantable medical device industries