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The material extrusion process (MEX), also known as the fused filament fabrication process, has attracted attention in the manufacturing industry. A major obstacle to further application of the technology is the lack of mechanical strength due to the weak interlayer strength and poor coalescence between the adjacent beads. Understanding the effect of printing parameters on the coalescence of the adjacent beads is a step toward the improvement of the process. In this study, a novel two-phase flow numerical simulation approach coupled with heat transfer simulation has been applied to the high-viscosity polymers to determine the coalescence in the MEX process. The influence of printing temperature, substrate temperature, and the temperature of the printing chamber, as well as material deposition strategy (unidirectional and bidirectional) on the coalescence of the beads, has been investigated by numerical simulation and validated by experimental study. The modeling approach is applied to Glycerol, Polyether ether ketone (PEEK) and Polylactic acid (PLA). The results show that increasing temperature points (substrate temperature, chamber temperature, and printing temperature), increase the coalescence between the beads in the MEX process. The heat transfer model reveals that the cooling rate of the deposited bead in the MEX process is relatively high, and hence, the time window for reaching the coalescence between beads/layers is short. The heat transfer model also indicates that deposition of the further layers and beads does not influence the coalescence. The coalescence in the bidirectional deposition is higher compared to the unidirectional all conditions remaining similar. Unidirectional deposition leads to a uniform coalescence between the beads. However, the coalescence is not uniform for bidirectional deposition. The main novelty of this research is to simultaneously model heat transfer, shear rate and coalescence for numerical simulation to study the effect of printing parameters on the coalescence in the MEX process. Since the modeling of coalescence is time-consuming, two empirical equations based on obtained results have been proposed to predict the coalescence for PLA and PEEK separately. publishedVersion

Objectives: This research was conducted to evaluate the surface topography, elemental composition and manufacturing defects of two brands of mini-implants commonly used in India. Clinical significance was derived based on the data of this research. Materials and methods: This research was conducted on 15 orthodontic mini-implants each from two brands commonly used in India. Scanning electron microscope imaging of the head, transmucosal neck, body, and tip was done to assess mini-implant topography and manufacturing defects (n=15/group). Analysis of elemental composition was done using an X-ray Powder Diffractor (n=1/group). Results: The results showed significant differences in both groups. Differences in structural topography of the implant body and tip were observed in both brands. Tip defects were detected in one brand. X-ray Powder Diffraction analyses revealed an alpha and alpha-beta titanium grain structure in both the groups. Conclusions: All the mini-implants tested were composed of titanium alloy. Significant differences were found in the surface area of the threaded parts. We conclude that differences in surface topography and presence of manufacturing defects impact the primary stability of the implants thereby influencing the efficacy of orthodontic anchorage.

Kleine Levin syndrome (KLS) is a rare neurological disorder characterized by excessive sleep with or without associated symptoms such as hyperphagia, abnormal behavior, cognitive dysfunction. Symptoms are cyclical and usually affect adolescents. Onset of symptoms is usually rapid and may last for days or weeks. The exact cause of KLS is unknown though it shows features of affection of hypothalamus that controls sleep, appetite and body temperature. There have been reports of viral infections preceding KLS raising a possibility of autoimmune response. Presented here is a six years old patient who had features of KLS. The FDG PET CT scan revealed hypometabolism in the thalami quite characteristic of the entity. F-DOPA scan revealed physiologic expression of dopaminergic activity in the neostriatum. However, the over-expression of dopaminergic activity in the right basi-frontal cortex and medial temporal lobe was also noted. The nigrostriatal, mesocortical, mesolimbic, tuberomammillary pathways are known dopamine transmitters. This case report attempts to explain the reason for dopaminergic expression in these regions in KLS.

Haemophilic ankle arthropathy (HAA) causes major morbidity. When conservative treatment fails, major surgical interventions are indicated. An alternative treatment to maintain joint mobility and postpone these interventions is desired.To gather prospective data on clinical/structural changes after ankle joint distraction (AJD) in HAA.This study includes patients with severe HAA insufficiently responding to conservative treatment. AJD was performed during 8-10 weeks by use of an external frame. Questionnaires, physical examination and radiology were used to evaluate pain, function and structural changes before and 6, 12, 24 and 36 months after distraction. Mixed effect models were used for analysis.This study includes eight cases (21-53 years). The fixed effects estimates of the visual analogue score (0-10) improved from 7.5 at baseline to 3.4 (p = .023) 3 years after distraction. The Haemophilia Activities List (HAL, 0-100) for basic/complex lower extremities functions improved from respectively 29.6 and 31.5 to 54.3 (p = .015) and 50.7 (p = .031). Joint mobility was maintained. Magnetic resonance imaging (MRI) showed thickened cartilage and reduced bone marrow oedema and subchondral cysts. Pin tract infections (n = 6) were effectively treated and no adverse bleeding events occurred. At 3-year follow-up, in none of the patients the originally indicated arthrodesis was performed.This first prospective study showed that AJD in HAA results in decreased pain, improved function and decreased arthropathy-related MRI findings in the majority of patients for prolonged time. Although the study population is small and follow-up is relatively short, AJD may be promising to postpone invalidating interventions and might be a breakthrough treatment.

Being a bioactive material, hydroxyapatite (HAp) is regarded as one of the most attractive ceramic biomaterials for bone and hard-tissue replacement and regeneration. Despite its substantial biocompatibility, osteoconductivity, and compositional similarity to that of bone, the employment of HAp is still limited in orthopedic applications due to its poor mechanical (low fracture toughness and bending strength) and antibacterial properties. These significant challenges lead to the notion of developing novel HAp-based composites via different fabrication routes. HAp, when efficaciously combined with functionally graded materials and antibacterial agents, like Ag, ZnO, Co, etc., form composites that render remarkable crack resistance and toughening, as well as enhance its bactericidal efficacy. The addition of different materials and a fabrication method, like 3D printing, greatly influence the porosity of the structure and, in turn, control cell adhesion, thereby enabling biological fixation of the material. This article encompasses an elaborate discussion on different multifunctional HAp composites developed for orthopedic applications with particular emphasis on the incorporation of functionally graded materials and antibacterial agents. The influence of 3D printing on the fabrication of HAp-based scaffolds, and the different in vitro and in vivo studies conducted on these, have all been included here. Furthermore, the present review not only provides insights and broad understanding by elucidating recent advancements toward 4D printing but also directs the reader to future research directions in design and application of HAp-based composite coatings and scaffolds.

Background: CHA2DS2-VASc score is a scientifically proven risk assessment score for patients with atrial fibrillation. It may be a good predictor of in-hospital death in COVID-19 patients. The present study aimed to evaluate the association between CHA2DS2-VASc score and in-hospital mortality in the prognosis of intensive care unit (ICU) patients with COVID-19. Methods: Eighty-four COVID-19 patients who were hospitalized in the ICU were retrospectively analyzed in a tertiary health care center, and the CHA2DS2-VASc score was determined. All analyses were performed using SPSS statistical software (SPSS Inc., Chicago, IL, USA, 20.0). A p-value

With the modern and rapid development of the internet, people's connections are more important than ever, and they're looking for new ways to communicate with one another in real time. WebRTC is a futuristic technology that enables realtime communication in audio, video, and data transmission through web browsers without the need for a plugin by using JavaScript APIs (Application Programming Interface). In this paper, we present a web peer-to-peer real-time communication system that allows users to communicate across a communication channel with high-speed data transmission using WebRTC technology, HTML5, and a Node.js server address. The outcome demonstrates that the system is stable, fully functioning, and secure. Keywords: WebRTC, Vide o Conferencing Application, Peer to Peer

The material extrusion process is one of the most popular additive manufacturing processes. The presence of porosity in the MEX printed parts, which ultimately deteriorates the mechanical properties, is one of the main drawbacks of the MEX process. The porosity in the structure is related to the shape of the adjacent beads and overlapping during the material deposition. Due to the deposition nature of the MEX process, the porosity cannot be entirely removed from the printed parts. Understanding the influence of process parameters on material deposition and the rheological properties is crucial to improving the quality of the final product. In this study, the two-phase-flow numerical approach with the level-set equations has been used for the first time to model the material deposition on the moving platform in 3D. The influence of the viscosity and printing parameters, including travel speed, inlet velocity, viscosity, nozzle diameter, and layer height, on the width of the deposited bead has been investigated. The simulation results are validated against experimental measurements with an average error of 5.92%. The width measured by the experimental study shows good agreement with the results of the numerical simulation. The comparison between the results of the 3D numerical simulation and 2D simulation reveals that the 2D simulation is not appropriate and accurate enough to predict the geometry of the deposited bead with the given set of parameter settings. The key novelty of this research paper is the application of the level-set method in a 3D context for material deposition on a moving substrate. publishedVersion

Aim of the Study: Aim of endodontic therapy is to restore the natural tooth functionally as well as esthetically. The success of the treatment depends predominantly on the reduction or complete eradication of pathogens and their byproducts (mechanically and chemically) along with adequate seal. Studies have concluded that chemo mechanical instrumentation alone will only render 50-70% of infected canals free of microorganisms therefore, an effective antimicrobial agent as intracanal medication should be used to improve treatment outcome. Moreover Improper apical seal has been reported as most common cause of endodontic treatment failure in different studies Therefore it is essential to know the effect of most commonly used intracanal medicament Ca (OH) 2 on apical seal, in order to reduce the chances of endodontic failure. The aim of this study is to evaluate the effect of intracanal medicament on apical seal. Study Design: Quasi Experimental study. Place of the Study: The samples were prepared at Ziauddin University and was analyzed at Karachi University. Methodology: Mandibular premolars were prepared using step back technique and were divided into two groups. In Group A, no intracanal medicament was placed and in Group B intracanal medicament was placed. Samples were placed in Indian ink dye for 7 days and were then cleaned in running water before sectioning up to 5 mm (1 mm each) using Microtome and analyzed under stereomicroscope. Shapiro-Wilks test and Mann Whitney U test was used for data analysis. Results: Group with intracanal medicament showed least amount of dye penetration with mean value 2.30±1.832 as compared to non-medicated group mean value (2.96 ±1.69) but the results were not statically significant p value 0.072. Conclusion: The results of this study concluded that there is no statistically significant difference in leakage between group A and group B (non-medicated and medicated group).

Although P40 and P63 are both sensitive and specific for routine esophageal squamous cell carcinoma (SCC) diagnosis, we recently showed that P40 and P63 immunoreactivities were significantly lower in well-differentiated SCC than those in higher grade tumors. Therefore, a novel esophageal SCC marker, ideally performing better in well-differentiated SCC, is still needed. We characterized desmoglein 3 (DSG3) immunohistochemistry in esophageal SCC, esophageal adenocarcinoma, small-cell lung carcinoma, and large B-cell lymphoma, alongside P40 and CK5/6. The World Health Organization classification was used to grade tumors as well-differentiated (WD), moderately differentiated (MD), or poorly differentiated (PD). There were 20 WD, 26 MD, and 17 PD components among 39 esophageal SCC cases. All esophageal SCC components showed significant DSG3 immunoreactivity (mean, 80%; range, 30%–100%), and the proportions of DSG3 immunoreactive cells were higher in the WD and MD components than in the PD components. No esophageal adenocarcinoma cases showed more than 10% DSG3 immunoreactivity with only weak cytoplasmic staining. With a 5% immunoreactivity cutoff, DSG3 positivity was 100% in all 63 SCC components, 18% in adenocarcinoma cases, and 0% in small-cell lung carcinoma or large B-cell lymphoma cases. The overall DSG3 specificity was 94%. To the best of our knowledge, this is the first study to characterize DSG3 as a sensitive and specific marker for esophageal SCC.

PurposeTo report a case of dupilumab induced ocular surface disease (DIOSD) managed with intense pulsed light (IPL) as an effective adjunct therapy to topical steroids and topical immunomodulator lifitegrast.MethodsDiscussion of a patient’s case with accompanying anterior segment and meibography photos with diagnosed DIOSD for which adjunct therapy with IPL was an effective treatment after limited relief from and difficulty with adherence to traditional treatment with topical steroids and lifitegrast ophthalmic solutions. ConclusionThis case demonstrates the complexity of management required to treat patients with DIOSD and its chronic nature. IPL as a nonpharmaceutical adjunct therapy to topical steroids and immunomodulators in the treatment of DIOSD showed improved signs and symptoms of DIOSD.

Introduction: Assessment of sagittal jaws relation is a vital procedure in establishing a good diagnosis for all orthodontic cases. Various analyses have been introduced over the years with varying degrees of reliability and validity. Orthodontist should be aware of a range of analyses to be used in diagnosing different cases. This review provides a brief information about the various cephalometrics parameters i.e angular & linear which are used for assessing sagittal jaw discrepancy in their chronologic order.

The College of American Pathologists Cancer Protocols have offered guidance to pathologists for standard cancer pathology reporting for more than 35 years. The adoption of computer readable versions of these protocols by electronic health record and laboratory information system (LIS) vendors has provided a mechanism for pathologists to report within their LIS workflow, in addition to enabling standardized structured data capture and reporting to downstream consumers of these data such as the cancer surveillance community. This paper reviews the history of the Cancer Protocols and electronic Cancer Checklists, outlines the current use of these critically important cancer case reporting tools, and examines future directions, including plans to help improve the integration of the Cancer Protocols into clinical, public health, research, and other workflows.

In this research paper we will discuss the latest technologies that the automobile sector introduces in India but main focus will be on electric vehicles or e-vehicles. Now a days automotive sector lays special emphases electric vehicles which is very challenging role for this sector as well as for the economy also. No doubt with the introduction of electric vehicles, environment will be saved a lot. It is eco-friendly as well as the cost of batteries of these vehicles will be very less as compared to the cost of fuel importing from foreign countries. Not only this but the automotive sector has introduced other technical changes also like digital marketing and sales, Biometric Seat Technology, In-vehicle Infotainment and Telematics, Road Condition Analytics and Navigation, Smart Parking, etc.

Introduction: The Accurate estimation of foetal weight is of paramount importance in modern obstetrics for management of labour and delivery. During the past two decades estimated foetal weight is incorporated into the standard routine antepartum evaluation of high-risk pregnancy & deliveries. Present study was conducted to estimation fetal weight by clinical method and by ultrasonography and to nd out its correlation with actual birth weight in term pregnancy. The cross-sectional Material and Methods: observational study was conducted in outpatient or inpatient Obstetric section of Department of Obstetrics & Gynaecology and USG section of Department of Radio-diagnosis of A.C.P.M. Medical College and Hospital, Dhule, Maharashtra. Most of the study Observations & Results: subjects were between 24-28 years of age 53.5% with mean age of 24.71 years. The mean Hadlock weight was 2705 ± 469 gm, while the actual birth weight was 2805 ± 465 gm. The difference was found to be statistically signicant (p

Background Bariatric surgery (BS) is a relatively novel surgical field and is in continuous expansion and evolution. Purpose Aim of this study was to report changes in Italian surgical practice in the last decade. Methods The Società Italiana di Chirurgia dell’Obesità (SICOB) conducted annual surveys to cense activity of SICOB centers between 2011 and 2021. Primary outcome was to detect differences in frequency of performance of adjustable gastric banding (AGB), sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), bilio-pancreatic diversion (BPD), and gastric plication (GP). Secondary outcome was to detect differences in performance of main non-malabsorptive procedures (AGB + SG) and overall bypass procedures (RYGB + OAGB). Geographical differences were also investigated. Results Median response rate was 92%. AGB declined from 36% of procedures in 2011 to 5% in 2021 (p p p p p Conclusions BS in Italy evolved significantly during the past 10 years. AGB underwent a decline, as did BPD and GP which are disappearing and RYGB which is giving way to OAGB. The latter is rising and is the second most-performed procedure after SG which has been confirmed as the preferred procedure by Italian bariatric surgeons. Graphical Abstract

Human cytomegalovirus (CMV) remains one of the most common opportunistic infections following solid organ transplantation in children. CMV causes morbidity and mortality through direct tissue-invasive disease and indirect immunomodulatory effects. In recent years, several new agents have emerged for the prevention and treatment of CMV disease in solid organ transplant recipients. However, pediatric data remain scarce, and many of the treatments are extrapolated from the adult literature. Controversies exist about the type and duration of prophylactic therapies and the optimal dosing of antiviral agents. This review provides an up-to-date overview of treatment modalities used to prevent and treat CMV disease in solid organ transplant (SOT) recipients.

In this paper, we describe and analyze the spectral properties of a number of exact block preconditioners for a class of double saddle point problems. Among all these, we consider an inexact version of a block triangular preconditioner providing extremely fast convergence of the FGMRES method. We develop a spectral analysis of the preconditioned matrix showing that the complex eigenvalues lie in a circle of center (1,0) and radius 1, while the real eigenvalues are described in terms of the roots of a third order polynomial with real coefficients. Numerical examples are reported to illustrate the efficiency of inexact versions of the proposed preconditioners, and to verify the theoretical bounds., Comment: 19 pages, 3 Figures

Storing the key administrative documents related to the project (as a backup, in addition to Teams)

Since the outbreak of the COVID-19 pandemic, the need for computerized tests for web-based cognitive psychology experiments has risen (O'Connor et al., 2020). Additionally, it is a status quo that there is a lack of open-source, validated cognitive tasks for online administration in psycholinguistic research. Particularly in measuring Morphological Awareness (MA), an important predictor of spelling and literacy development, the multitudes of the construct’s definitions and task designs reflect the disunity in psychometric assessments. To provide more options for validated measures, the aim of our study is to adapt a battery of most applied MA tasks, which are suitable for online administration. We will evaluate the psychometric qualities of our adapted MA tests and investigate the aptitude of such tests in online assessment.

ObjectivesThis study explores the interrelationship among the current sustainability agenda of the pharmaceutical industry, based on the United Nation sustainable development goals (SDGs), the elements of the Joint External Evaluation (JEE) tool, and the triad components of the One Health approach.MethodsA cross-walk exercise was conducted to identify commonalities among SDGs, JEE assessment tool, and One Health approach. An in-depth study of 10 global pharmaceutical firms' corporate sustainability reports and COVID-19 response plan for 2019–2020 was also conducted.ResultsThe result of the exercise showed the existence of a direct and indirect relationship among the SDGs, elements of JEE assessment tool, and One Health approach. For example, both no poverty (SDG 1) and zero hunger (SDG 2) are linked with food safety targets under the JEE and with human and animal health under the One Health approach.ConclusionThis study adds a new dimension emphasizing the possibility of tailoring the pharmaceutical industry's activities under the sustainability agenda to strengthen global health security while remaining consistent with the One Health approach.

In this work, we utilize the generalized AOR (GAOR) and CG (GCG) methods for constructing iteration methods to solve the block two-by-two linear systems which arise from the solution of the complex symmetric linear systems of equations. In order to compare the GAOR and GCG methods with some existing methods, we present some numerical examples to illustrate the performance of these methods.

Sheryl Ker,1,* Jennifer Hsu,2,* Anisha Balani,1,* Sankha Subhra Mukherjee,1 A John Rush,3– 5 Mehreen Khan,2 Sara Elchehabi,2 Seth Huffhines,2 Dustin DeMoss,2,6 Miguel E Rentería,1 Joydeep Sarkar1 1Holmusk Technologies, Inc., New York, NY, USA; 2John Peter Smith Health Network, Fort Worth, TX, USA; 3Department of Psychiatry, Duke-National University of Singapore (NUS), Singapore; 4Duke University School of Medicine, Durham, NC, USA; 5Texas Tech Health Sciences Center, Odessa, TX, USA; 6University of North Texas Health Science Center/Texas Christian University, Fort Worth, TX, USA*These authors contributed equally to this workCorrespondence: Miguel E Rentería; Joydeep SarkarHolmusk Technologies, Inc., 4th Floor, 54 Thompson St, New York, NY, 10012, USAEmail miguel.renteria@holmusk.com; joydeep.sarkar@holmusk.comPurpose: To describe attrition patterns of opioid use disorder (OUD) patients treated with buprenorphine (BUP) and to assess how clinical, sociodemographic, or BUP medication dosing features are associated with attrition.Patients and Methods: Electronic health records of adults (16+ year-olds) with OUD treated with BUP from 23 different substance use or mental health care programs across 11 US states were examined for one year following BUP initiation in inpatient (IP), intensive outpatient (IOP), or outpatient (OP) settings. Treatment attrition was declared at > 37 days following the last recorded visit. Survival analyses and predictive modelling were used.Results: Retention was consistently 2– 3 times higher following BUP initiation in OP (n = 2409) than in IP/IOP (n = 2749) settings after 2 (50% vs 25%), 6 (27% vs 9%) and 12 months (14% vs 4%). Retention was higher for females, whites (vs blacks), and those with less severe OUD, better global function, or not using non-psychotropic medications. Comorbid substance use, other psychiatric disorders, and the number of psychotropic medications were variously related to retention depending on the setting in which BUP was initiated. Predictive modelling revealed that a higher global assessment of functioning and a smaller OUD severity based on the Clinical Global Impression – Severity led to longer retentions, a higher initial BUP dose led to higher retention in a few cases, an OP setting of BUP initiation led to longer retentions, and a lower total number of psychotropic and non-psychotropic medications led to longer retentions. These were the most important parameters in the model, which identified 75.2% of patients who left BUP treatment within three months post-initiation, with a precision of 90.5%.Conclusion: Of all the OUD patients who began BUP, 50– 75% left treatment within three months, and most could be accurately identified. This could facilitate patient-centered management to better retain OUD patients in BUP treatment.Keywords: opioids, buprenorphine, buprenorphine dosing, treatment engagement, treatment retention, treatment dropout, predictors

A frequent complication in kidney transplantation is post-transplant diabetes mellitus (PTDM). The primary goal of this study is to review the risk factors and preventive methods and compare the different available anti-diabetic medications for the management of PTDM. We searched databases like Pubmed and Google Scholar for related articles using specific terms and phrases. Following a thorough investigation, we applied the inclusion and exclusion criteria and completed a quality assessment. Modifiable risk factors have a significant role in the development of PTDM. The combinations of immunosuppressive treatment tacrolimus (TAC), cyclosporine A (CYC), and everolimus (EVL), steroids increase the incidence of PTDM significantly. Insulin is the most effective treatment for PTDM in the early transplant period; however, oral anti-diabetic medications look promising. Further clinical trials are required to determine the optimum treatment method for reducing the occurrence of PTDM and treating the existing condition with novel anti-hyperglycemic medications.

Este artigo propõe refletir sobre a atuação do psicólogo na re-orientação profissional de estudantes universitários, considerando os motivos pelos quais necessitam refazer sua escolha. Os dados foram coletados mediante o Focus Group com nove acadêmicos do ensino superior da Universidade Paranaense (UNIPAR) que já haviam realizado a re-opção de curso. Para a análise, utilizou-se a metodologia da Análise de Conteúdo de Bardin. Os resultados foram divididos em três categorias: fatores que influenciam a primeira opção/escolha, motivos para a re-opção/re-escolha e condições necessárias para a facilitar a identificação da nova profissão. Os resultados obtidos apontaram que a influência da primeira escolha profissional, referem-se a fatores econômicos, a influência da família e identificação com o curso. Além disso, os participantes relataram que os principais motivos de insatisfação com o curso foram a falta de identificação com as matérias, com os professores e os colegas de curso, e seguido com o fator econômico como o deslocamento da moradia até a Universidade. Contudo os entrevistados expressaram sobre como os fatores de identificação e o apoio da família, auxiliaram para identificar uma nova profissão. Por fim os participantes relataram que para fazer uma escolha mais consciente, precisam desenvolver o autoconhecimento, refletir a respeito, necessitando buscar auxílio de psicólogos para ajudar na tomada de decisão profissional.

Grid Forming (GFM) Inverters and their capabilities are critical to enable growing penetration of Distributed Energy Resources (DER) into the electrical grid. The electrical inertia brought by GFM inverters to the network can replace or supplement the inertia of rotating machines that is a key element for power system stability. The German research project "Netzregelung 2.0" ("Grid Control 2.0") investigated the operation of power systems with GFM inverters and developed inverter controls and possible grid code compliance testing approaches. First outcomes regarding the testing approaches for inertia provision are presented. A major portion of grid-forming control approaches can be described following the well-known equations of synchronous machines and thus can also be characterized in their frequency behaviour with reference to the first order swing equation of a rotating system, mainly characterized by the acceleration time constant (Ta) and damping (D). The accurate determination of these values is important for system operators and future ancillary service markets. Measurements were performed based on existing and upcoming standards and guidelines with a special focus on parameter determination and measurement uncertainty.