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Aiming at the problem that the classical blockchain consensus mechanism is under the threat of quantum computing attacks,a quantum-secured Byzantine fault tolerant consensus mechanism is proposed.Firstly,to solve the security threat of public key digital signature,this paper proposes a multilinear hash-unconditionally secure signature(MH-USS) signature scheme based on quantum key distribution (QKD) and multilinear hash function family.In this scheme,quantum keys are distributed through QKD network,messages and signatures are transmitted through classical network,and the simplified USS signature scheme is adopted as the main framework,combined with the family of multiple linear hash functions,to generate a new USS scheme.This signature scheme has the characteristics of unforgeability,non-repudiation and transferability.Moreover,this scheme can be implemented on existing equipment and has high practical value.Secondly,in view of the relatively low consensus efficiency of the classical Byzantine fault-tolerant consensus mechanism PBFT,this paper proposes the quantum secured-byzantine fault tolerance(QS-BFT) consensus mechanism.By adding “fast-normal” consensus mode and allowing nodes to vote on empty blocks,the system communication times are reduced and the view conversion process is avoided.It has been proved that this scheme not only guarantees the safety and liveness,but also effectively reduces message complexity and improves consensus efficiency.The simulation and performance test for this scheme indicate that the throughput of this scheme is higher and the delay is lower compared with the PBFT consensus mechanism which is based on the MH-USS signature scheme.

Background: Acute pancreatitis (AP) is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs. Enteral nutrition plays a vital role in the treatment of AP because it can meet the nutritional needs of patients, promote the recovery of intestinal function, and maintain the barrier and immune functions of the intestine. However, the risk of aspiration during enteral nutrition is high; once aspiration occurs, it may cause serious complications, such as aspiration pneumonia, and suffocation, posing a threat to the patient's life. This study aims to establish and validate a prediction model for enteral nutrition aspiration during hospitalization in patients with AP., Aim: To establish and validate a predictive model for enteral nutrition aspiration during hospitalization in patients with AP., Methods: A retrospective review was conducted on 200 patients with AP admitted to Chengdu Shangjin Nanfu Hospital, West China Hospital of Sichuan University from January 2020 to February 2024. Clinical data were collected from the electronic medical record system. Patients were randomly divided into a validation group ( n = 40) and a modeling group ( n = 160) in a 1:4 ratio, matched with 200 patients from the same time period. The modeling group was further categorized into an aspiration group ( n = 25) and a non-aspiration group ( n = 175) based on the occurrence of enteral nutrition aspiration during hospitalization. Univariate and multivariate logistic regression analyses were performed to identify factors influencing enteral nutrition aspiration in patients with AP during hospitalization. A prediction model for enteral nutrition aspiration during hospitalization was constructed, and calibration curves were used for validation. Receiver operating characteristic curve analysis was conducted to evaluate the predictive value of the model., Results: There was no statistically significant difference in general data between the validation and modeling groups ( P > 0.05). The comparison of age, gender, body mass index, smoking history, hypertension history, and diabetes history showed no statistically significant difference between the two groups ( P > 0.05). However, patient position, consciousness status, nutritional risk, Acute Physiology and Chronic Health Evaluation (APACHE-II) score, and length of nasogastric tube placement showed statistically significant differences ( P < 0.05) between the two groups. Multivariate logistic regression analysis showed that patient position, consciousness status, nutritional risk, APACHE-II score, and length of nasogastric tube placement were independent factors influencing enteral nutrition aspiration in patients with AP during hospitalization ( P < 0.05). These factors were incorporated into the prediction model, which showed good consistency between the predicted and actual risks, as indicated by calibration curves with slopes close to 1 in the training and validation sets. Receiver operating characteristic analysis revealed an area under the curve (AUC) of 0.926 (95%CI: 0.8889-0.9675) in the training set. The optimal cutoff value is 0.73, with a sensitivity of 88.4 and specificity of 85.2. In the validation set, the AUC of the model for predicting enteral nutrition aspiration in patients with AP patients during hospitalization was 0.902, with a standard error of 0.040 (95%CI: 0.8284-0.9858), and the best cutoff value was 0.73, with a sensitivity of 91.9 and specificity of 81.8., Conclusion: A prediction model for enteral nutrition aspiration during hospitalization in patients with AP was established and demonstrated high predictive value. Further clinical application of the model is warranted., Competing Interests: Conflict-of-interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)