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Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder often treated with inhaled corticosteroids (ICS). While ICS are effective in managing COPD, prolonged use may have psychological side effects, including anxiety and depression. Objective: This study explores the impact of the duration of inhaled steroid use on psychological symptoms, specifically anxiety and depression, in COPD patients. Methods: A cross-sectional study was conducted with 160 COPD patients from outpatient respiratory clinics. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) scales, respectively. The duration of ICS use was categorized into three groups: <5 years, 6-10 years, and 11-15 years. Spearman's rank correlation coefficient was used to analyze the relationship between ICS duration and psychological symptoms. Results: The prevalence of anxiety increased with longer ICS use, though not statistically significant (Spearman's rho = 0.152, P = 0.056). Depression showed a significant positive correlation with ICS duration (Spearman's rho = 0.243, P < 0.01). Conclusion: Prolonged use of inhaled corticosteroids in COPD patients is associated with increased prevalence of depression. Regular monitoring and timely intervention for psychological symptoms are recommended for COPD patients undergoing long-term ICS therapy. [ABSTRACT FROM AUTHOR]

Glucocorticoids (GCs) have revolutionized the management of SLE, providing patients with rapid symptomatic relief and preventing flares when maintained at low dosages. However, there are increasing concerns over GC-associated adverse effects and organ damage, which decrease patients' quality of life (QOL) and increase healthcare costs. This highlights the need to balance effective GC use and minimize toxicity in patients with SLE. Herein, we provide an overview of the theoretical considerations and clinical evidence, in addition to the variations and similarities across nine national and eight international recommendations regarding the use of GCs across SLE manifestations and how these compare with real-world usage. In line with this, we propose possible actions toward the goal of GC Stewardship to improve the QOL for patients with lupus while managing the disease burden. [ABSTRACT FROM AUTHOR]

Certain applications requires a scalable cost effective storage and execution system with facility to store data and have feature to analyze data to its finest granularity level in future. This increase the quality and accuracy of result analysis. Wireless sensor Network (WSN) nodes deployed for certain data intensive applications such as surveillance, war zone monitoring etc. generates a massive amount of raw data. There is an essential requirement of storing this data in its native format for analytics purpose in anticipation of future requirements. In present work, a data lake implemented on Amazon AWS is presented for storage of data in original version for future reference. Data Lake implementation service is utilized for storing the data generated in big volumes, high speed and in variety. The data in Data Lake is stored in three zones i.e. raw, reformed and curated. This paper proposes an efficient method of storing structured, unstructured and semi-structured, data in to Data Lake for future retrieval and analytics purpose. The results are comprehensively presented highlighting the advantages of using Data Lake in place of data warehouses.

Objective: Given fibromyalgia (FM) frequently co‐occurs with autoimmune disease, this study was initiated to objectively evaluate FM in a multiracial/ethnic cohort of patients with systemic lupus erythematosus (SLE). Methods: Patients with SLE were screened for FM using the 2016 FM classification criteria during an in‐person rheumatologist visit. We evaluated hybrid Safety of Estrogens in Lupus National Assessment (SELENA)‐SLE Disease Activity Index (SLEDAI) scores, SLE classification criteria, and Systemic Lupus International Collaborating Clinics damage index. We compared patients with and without FM and if differences were present, compared patients with FM with patients with non‐FM related chronic pain. Results: 316 patients with SLE completed the FM questionnaire. 55 (17.4%) met criteria for FM. The racial composition of patients with FM differed from those without FM (P = 0.023), driven by fewer Asian patients having FM. There was no difference in SLE disease duration, SELENA‐SLEDAI score, or active serologies. There was more active arthritis in the FM group (16.4%) versus the non‐FM group (1.9%) (P < 0.001). The Widespread Pain Index and Symptom Severity Score did not correlate with degree of SLE activity (r = −0.016; 0.107) among patients with FM or non‐FM chronic pain (r = 0.009; −0.024). Regarding criteria, patients with FM had less nephritis and more malar rash. Systemic Lupus International Collaborating Clinics damage index did not differ between groups. Conclusion: Except for arthritis, patients with SLE with FM are not otherwise clinically or serologically distinguishable from those without FM, and Widespread Pain Index and Symptom Severity Score indices do not correlate with SLEDAI. These observations support the importance of further understanding the underlying biology of FM in SLE. [ABSTRACT FROM AUTHOR]

The promise of university-public school partnerships as contexts for mutually beneficial learning, or "simultaneous renewal," has been well established (Goodlad, 1994, 1999). However, difficulties in creating and sustaining these kinds of collaborative contexts for teacher education are also well known, including practical challenges such as time and distance, as well as the nuanced and layered tensions between institutional missions, cultures, and practices (Mantle-Bromley, 2002; Teitel, 1997). Contemporary efforts to create and sustain university-public school partnerships are further complicated by dramatically increased accountability pressures arising from No Child Left Behind (NCLB). Discretionary time for public educators is a scarce and dwindling resource. As high stakes testing and related accountability pressures increase on institutions of higher education, chronic shortages of resources to support collaborative work with public school partners are a widely acknowledged fact of life in partnership work. In the context of these kinds of institutional pressures it is clear that collaborative partnership work must be carefully designed to yield visible and valued benefits for both university and public school-based educators (Yendol-Hoppey, League, Gregory, Ohlson, & Jackson, 2006). In this article, the authors describe a design strategy aimed at creating shared opportunities for teacher learning and development, including the learning of university faculty, that may be embedded in practical activities related to the analysis of P-12 student work. The authors offer three illustrations of how they have used this strategy to design shared contexts for learning that are relevant to the (differing) needs of teacher candidates, public school colleagues and university faculty. (Contains 1 table and 1 figure.)

The gate-all-around (GAA) silicon-on-insulator (SOI) Schottky barrier (SB) nano-wire (NW) MOSFET was recently proposed for low-power and high-frequency analog and radio frequency (RF) circuits. But their use in low-power and high-frequency analog/RF circuits is still under investigation. In this work, basic analog signal processing circuits using gate-all-around SOI-SB-NW MOSFETs are designed for low-power and high-frequency applications. These basic and necessary analog processing circuits are designed for ± 0.3 V and ± 0.25 V power supplies to work on frequencies up to 10 GHz. The analog/RF characteristics of the GAA SOI-SB MOSFET are compared with those of the GAA SB NW MOSFET. The SOI-SB NW MOSFET shows improvements in early voltage, output resistance, and transconductance generation factor. The Silvaco TCAD simulator is used to obtain the results and perform numerical simulations. Simulation results show good analog/RF performance of the analog processing circuits. [ABSTRACT FROM AUTHOR]

N,N‐Dimethylaniline.borane (DMAB) is a stable, multifaceted electrophilic boron agent that displays hydroboration of C = C as well as selective reduction of functional groups under reflux, microwave, and ultrasound conditions. Natural products contain a plethora of functional groups that govern the specific bioactivity. It will be interesting to correlate the change in a functional group with the concern for change in bioactivity. Current research emphasizes the influence of microwave irradiation on moderately reactive DMAB reagent towards the functional group modification of selected limonoid‐phytochemicals of Meliaceae family viz. cedrelone, azadirone, nimbin, and azadiradione. DMAB conveniently reduces the ketone, epoxide group into alcohol, and does a hydroboration reaction on the C = C bond. It does not show interest to reduce the ester group irrespective of 30 min of MW irradiation. Except for these reducing properties, the reagent DMAB unveils chemo‐selective nature in respect of different functional groups and utilizes in an asymmetric synthesis. The coalescence of amine.borane with microwave irradiation brings forth a commodious and prompt method for the selective reduction of functional groups. The bioactive efficacy of modified phytochemicals is further taken for the antimicrobial studies. [ABSTRACT FROM AUTHOR]

Background: Neonatal sepsis significantly contributes to neonatal mortality and morbidity in developing countries. The delay in diagnosis due to the time-consuming gold standard blood culture necessitates rapid, accessible, and cost-effective diagnostic markers. Aims: This study aimed to evaluate the sensitivity and specificity of Micro-ESR for early neonatal sepsis diagnosis and compare its effectiveness with other standard markers. Methodology: Conducted at D.Y. Patil Hospital's Department of Pediatrics in Navi Mumbai, this prospective observational study included 200 neonates suspected of sepsis. Blood samples were analyzed for CBC, CRP, Micro-ESR, and bacterial culture before antibiotic initiation. Micro-ESR's diagnostic performance was assessed against other markers based on confirmed sepsis cases via blood culture. Results: Among 200 neonates, 16 had a positive blood culture. Micro-ESR showed a sensitivity of 87.5% and specificity of 28.80%. In comparison, Total Leucocyte Count (TLC) and Absolute Neutrophil Count (ANC) demonstrated higher specificity (91.25% and 70% respectively) but lower sensitivity. Platelet count and CRP indicated high specificity (94.56%) and sensitivity (100%) respectively, albeit with low predictive values. Conclusions: While CRP exhibited the highest sensitivity, TLC and platelet count showed superior specificity. Despite its lower specificity, Micro-ESR's high sensitivity suggests its utility as a supportive early diagnostic marker alongside CBC, CRP, and ANC. Blood culture remains the definitive diagnostic standard. [ABSTRACT FROM AUTHOR]

Industrial waste locks are used as raw materials to reduce harmful effects on the environment and improve environmental performance. Marble clay powder can be used as a filling aid and can fill voids in concrete structures. This article will show you how to use a maximum natural sand alternative in concrete with marble powder and quarry dust. The challenge of the 21st century is to change to a new form that can support the natural system. This necessitates a radical rethinking of how to give the community infrastructure and housing. Making a concerted effort to develop novel, innovative, and alternative construction materials may be necessary. Jungles of concrete around cause's impact on the Environment and it would result in climate change. Mankind must avoid the use of things that are detrimental to the environment. So in this paper, it is decided to address the issue by adopting the use of the green concrete concept which is environmentally friendly. Green concrete is concrete made up using industrial wastes such as marble powder, quarry dust, wood ash, paper pulp, etc. Green concrete, which is capable of sustainable development, helps to reduce the consumption of natural resources, energy use, and environmental pollution. Green concrete is more cost‐effective than ordinary concrete and reduces the cost of resultant concrete by 14%–20%. It is also observed that the alkali‐aggregate reaction and sulfate attack resistance of concrete are both significantly improved. Green concrete is a useful tool for lowering environmental pollution and enhancing concrete's resistance to harsh conditions. All stages of infrastructure construction and rehabilitation will follow this trend of using new cement and techniques. Green concrete's adaptability and its performance derivatives will meet a variety of future needs. [ABSTRACT FROM AUTHOR]

The current research focuses on the design, method development, characterization, and clinical assessment of novel irbesartan medication compounds. The objective of synthetic modification of a drug molecule is to achieve the desired properties such as enhancing the pharmacological properties and minimizing the side effects. It is a biphenyl tetrazole and an aza‐spiro compound, a highly selective, potent nonpeptide compound that belongs to the sartan group, an authorized type‐1 angiotensin II receptor (AT1), dilates the blood vessels and is used in curing of to treat high blood pressure, cardiac arrest, and renal disease in diabetics. To achieve the structural modification of the irbesartan drug, the researcher prepared the FeCl3/SiO2 catalyst and successfully used it for the acetylation, chloro acetylation reaction of irbesartan with acetyl chloride and chloroacetyl chloride. Further, the reaction is performed in presence of the catalyst and without a catalyst to elucidate the role of the catalyst. With the aid of TLC, FT‐IR, and UV–visible spectral methods, the structural interpretation of synthesized derivatives is completed. The present work illustrates a novel method of synthesis of irbesartan derivatives through safe and convenient procedures. The pharmacological evaluation of synthetic derivatives and green chemistry protocol of synthesis is under progress. [ABSTRACT FROM AUTHOR]

The use of ordinary Portland cement (OPC) in the construction industry is inevitable. The huge production of OPC and its use in infrastructural development pose an environmental impact. Greenhouse gas emitted increases the global temperature and it is an alarming sign to everybody on the planet. Concrete is the most consuming material which is produced by using OPC and it is proven that OPC contributes a lot to CO2 emission. Hence in this study attempt is made to produce concrete by using environment‐friendly material like fly ash along with alkaline activators, which is termed Geo polymer concrete. The by‐product fly ash is widely available worldwide. It is a by‐product of thermal power plants. The use of fly ash in concrete produces less expensive and more cost‐effective concrete than concrete made up using OPC. Due to its high silicate and alumina content, fly ash reacts with an alkaline solution to create an aluminosilicate gel that binds the aggregate and results in high‐quality concrete. Fly ash is finer than cement, it occupies the pores of cement after hydration. This would result in denser concrete which gives higher strength. In comparison to ordinary concrete, fly ash‐based geopolymer concrete offers better resistance to aggressive environments and high temperatures. In the present study, an alkaline activator of molarity 8 is used to prepare geopolymer concrete. The test specimens are cast and cured for 28 days. Test results indicate that an alkaline liquid fly‐ash ratio (0.4) produces higher mechanical properties. Hence, geopolymer concrete produced in this study is found to be cost‐effective and environment friendly. [ABSTRACT FROM AUTHOR]

Objective: AURORA 2 evaluated the long‐term safety, tolerability, and efficacy of voclosporin compared to placebo in patients with lupus nephritis (LN) receiving an additional two years of treatment following completion of the one‐year AURORA 1 study. Methods: Enrolled patients continued their double‐blinded treatment of voclosporin or placebo randomly assigned in AURORA 1, in combination with mycophenolate mofetil and low‐dose glucocorticoids. The primary objective was safety assessed with adverse events (AEs) and biochemical and hematological assessments. Efficacy was measured by renal response. Results: A total of 216 patients enrolled in AURORA 2. Treatment was well tolerated with 86.1% completing the study and no unexpected safety signals. AEs occurred in 86% and 80% of patients in the voclosporin and control groups, respectively, with an AE profile similar to that seen in AURORA 1, albeit with reduced frequency. Investigator reported AEs of both glomerular filtration rate (GFR) decrease and hypertension occurred more frequently in the voclosporin than the control group (10.3% vs 5.0%, and 8.6% vs 7.0%, respectively). Mean corrected estimated GFR (eGFR) was within the normal range and stable in both treatment groups. eGFR slope over the two‐year period was −0.2 mL/min/1.73 m2 (95% confidence interval [CI] −3.0 to 2.7) in the voclosporin group and −5.4 mL/min/1.73 m2 (95% CI −8.4 to −2.3) in the control group. Improved proteinuria persisted across three years of treatment, leading to more frequent complete renal responses in patients treated with voclosporin (50.9% vs 39.0%; odds ratio 1.74; 95% CI 1.00–3.03). Conclusion: Data demonstrate the safety and efficacy of long‐term voclosporin treatment over three years of follow‐up in patients with LN. [ABSTRACT FROM AUTHOR]

In oil and gas exploration, it is vital to acquire information about the bottom hole conditions. This is done in the field using wireline logging. The sonic log is one of the most prolific logs as it assists in porosity determination, cement evaluation and identification of lithology and gas‐bearing intervals. However, sonic logging tools are not always a part of the wireline logging arrangement. Still, there are sections where the logging data are missing, and in some cases, these are dependent upon old tools. The tool is incapable of recording shear wave transit times. This study explores the possibility of substituting the sonic log using machine learning and artificial intelligence techniques. These techniques can also predict the sonic log data in sections where these are missing or unreliable. Artificial neural networks, decision tree regression, random forest regression, support vector regression and extreme gradient boosting are the most popular tools available at our disposal for making these estimations. This study has compared these different techniques for their effectiveness and accuracy in making sonic transit time predictions based on other available well logs. The obtained results suggest that despite all the attention on artificial neural networks, eXtreme gradient boosting and the random forest regression outperform it for the given purpose. In the case of missing shear transit time data, random forest regression made predictions with a root mean squared error of 1.03 × 10–4 and a root mean squared error of 0.97 while eXtreme gradient boosting regression did so with a root mean squared error of 1.36 × 10–4 and the same regression coefficient (0.97). When no sonic data were available, random forest regression estimated shear transit time with a root mean squared error of 6.41×10–4 and a regression coefficient of 0.95, and compressional transit time with a root mean squared error of 9.06×10–5 and a root mean squared error of 0.94. The root mean squared error of shear transit time and compressional transit time predictions made using eXtreme gradient boosting were found to be the same as those of random forest regression. The root mean squared error, however, was observed to be slightly less for the compressional transit time predictions and somewhat more for the shear transit time predictions. As data analysis, in general, is a better method for estimation than the use of empirical correlations, these machine learning‐based predictions can serve as powerful tools in the oil and gas exploration industry. [ABSTRACT FROM AUTHOR]