In this paper we propose a new routing protocol called virtual sink rotation (VSR) routing for large-scale sensor networks. VSR can efficiently handle a large number of sources as well as a large number of sinks with potential mobility. Each sensor node is not required to know the global network topology nor the location awareness. The main ideas underlying the VSR are two folds. First, to alleviate the frequent location updates associated with multiple mobile sinks, the algorithm introduces a virtual sink, which acts as a data collection and dissemination center to collect the data from all the sources and forward them to the actual sinks. This virtual sink can easily support multiple sinks as well as the mobility of the sinks. Second, to address the excessive energy consumption among the sensor nodes around a sink, VSR employs virtual sink rotation, which distributes the role of the virtual sink over all the participating sensor nodes, thus achieving a uniform energy distribution across the entire sensor field and prolonging the lifetime of the network. Experimentation results confirm that the VSR routing can significantly save energy while it can also reduce both the message delay and the message delivery failures compared to previous schemes.

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AAS is a frequent complication, and the progression of AADI was more rapid in cases with AAS. The presence of peripheral arthritis, or high disease activity with elevated CRP level or refractory to conventional NSAID/DMARD, independently increased the risk of AAS, suggesting that clinicians should focus on the detection and monitoring of AAS, especially in cases with associated risk factors.