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Aims: It is unclear whether mortality outcomes differ for patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery who are readmitted to the index hospital where their surgery was performed, or to another hospital. Methods: We analyzed linked hospital and death records for residents of New South Wales, Australia, aged ≥ 18 years who had an emergency readmission within 90 days following THA or TKA surgery between 2003 and 2022. Multivariable modelling was used to identify factors associated with non-index readmission and to evaluate associations of readmission destination (non-index vs index) with 90-day and one-year mortality. Results: Of 394,248 joint arthroplasty patients (THA = 149,456; TKA = 244,792), 9.5% (n = 37,431) were readmitted within 90 days, and 53.7% of these were admitted to a non-index hospital. Non-index readmission was more prevalent among patients who underwent surgery in private hospitals (60%). Patients who were readmitted for non-orthopaedic conditions (62.8%), were more likely to return to a non-index hospital compared to those readmitted for orthopaedic complications (39.5%). Factors associated with non-index readmission included older age, higher socioeconomic status, private health insurance, and residence in a rural or remote area. Non-index readmission was significantly associated with 90 day (adjusted odds ratio (aOR) 1.69; 95% confidence interval (CI) 1.39 to 2.05) and one-year mortality (aOR 1.31; 95% CI 1.16 to 1.47). Associations between non-index readmission and mortality were similar for patients readmitted with orthopaedic and non-orthopaedic complications (90-day mortality aOR 1.61; 95% CI 0.98 to 2.64, and aOR 1.67; 95% CI 1.35 to 2.06, respectively). Conclusion: Non-index readmission was associated with increased mortality, irrespective of whether the readmission was for orthopaedic complications or other conditions. Cite this article: Bone Jt Open 2024;5(1):60–68.

Traditional healers have used the shrub Calotropis procera (CP) for many years for various therapies. The present study investigated the bioactive constituents of ethanolic extract of CP leaf and dried latex using gas chromatography-mass spectrometry and Fourier transforms infrared spectroscopy. The identification and characterization of the compounds were confirmed by examining the constituents' mass spectrum fragmentations and FT-IR spectra and comparing the results with those in the literature. The tail-flick method was used to investigate the analgesic properties of the extract and its anti-inflammatory activities using a rat model of formalin-induced oedema. Acute oral toxicity in rats was studied per OECD recommendations. Twenty male rats were divided into four groups and received an ethanolic extract of the leaves and dried milky sap of CP (200 mg/Kg) in groups 1, 2, and 3. Group 4 rats were administered aspirin 50 mg/kg as a positive control. The CP dried latex extract has the highest content of lupeol and its acetate derivative compared to its leaf extract. The CP dried latex extract inhibited inflammation more significantly than the ethanolic leaf extract and the drug indomethacin at a higher dosage (200 mg/kg). The ethanolic extracts showed analgesia comparable to aspirin. It suggests that fatty acids and their esters, particularly ethyl linoleate (8.96%), ethyl palmitate (7.99%), ethyl linoleate (6.98%), and palmitic acid (5.18%), may be valuable biomarkers for characterizing leaf and latex samples and describing the medicinal potential of CP.

Hepatocellular carcinoma (HCC) is the primary liver cancer that occurs the most frequently. The risk of developing HCC is highest in those with chronic liver diseases, such as cirrhosis brought on by hepatitis B or C infection and the most common type of liver cancer. Knowledge-based interpretations are essential for understanding the HCC microarray dataset due to its nature, which includes high dimensions and hidden biological information in genes. When analyzing gene expression data with many genes and few samples, the main problem is to separate disease-related information from a vast quantity of redundant gene expression data and their noise. Clinicians are interested in identifying the specific genes responsible for HCC in individual patients. These responsible genes may differ between patients, leading to variability in gene selection. Moreover, ML approaches, such as classification algorithms, are similar to black boxes, and it is important to interpret the ML model outcomes. In this paper, we use a reliable pipeline to determine important genes for discovering HCC from microarray analysis. We eliminate redundant and unnecessary genes through gene selection using principal component analysis (PCA). Moreover, we detect responsible genes with the random forest algorithm through variable importance ranking calculated from the Gini index. Classification algorithms, such as random forest (RF), naïve Bayes classifier (NBC), logistic regression, and k-nearest neighbor (kNN) are used to classify HCC from responsible genes. However, classification algorithms produce outcomes based on selected genes for a large group of patients rather than for specific patients. Thus, we apply the local interpretable model-agnostic explanations (LIME) method to uncover the AI-generated forecasts as well as recommendations for patient-specific responsible genes. Moreover, we show our pathway analysis and a dendrogram of the pathway through hierarchical clustering of the responsible genes. There are 16 responsible genes found using the Gini index, and CCT3 and KPNA2 show the highest mean decrease in Gini values. Among four classification algorithms, random forest showed 96.53% accuracy with a precision of 97.30%. Five-fold cross-validation was used in order to collect multiple estimates and assess the variability for the RF model with a mean ROC of 0.95±0.2. LIME outcomes were interpreted for two random patients with positive and negative effects. Therefore, we identified 16 responsible genes that can be used to improve HCC diagnosis or treatment. The proposed framework using machine-learning-classification algorithms with the LIME method can be applied to find responsible genes to diagnose and treat HCC patients.

Fuel cell holds the promise of being environmentally friendly and becomes one of the alternatives for renewable energy. Solid acids have super–protonic behavior which allows them to become conductors. It can function at high temperatures. Hydration, on the other hand, may be used to improve the performance of the solid acid. Moreover, the conductivity, stability, and crystal structure of the solid acid compounds of the fuel cell are all influenced by the size of the electrolyte membrane. Very few works have been done on solid acid fuel cells which are still under investigation to make it one viable as well as a reliable alternative to clean, renewable energy. In general, this work will provide an overview of the variables or characteristics that affect the technical effectiveness and performance of the unique super–protonic conductors for solid acid fuel cells.

Synchronously Amplified Photoacoustic Image Recovery (SAPhIRe) offers improved background suppression using non-linear properties of modulatable contrast agents. Using SAPhIRe, multiple contrast agents in the same absorption window can be detected independently based on their unique triplet-state lifetimes. Here, we have demonstrated the unmixing of rose bengal and eosin Y signals from solution based on triplet-state lifetime mapping using both fluorescence and photoacoustics. Varying the pump-probe delay enables resolution and recovery of fast-decaying rose bengal and of slowly decaying eosin Y modulated photoacoustic signals, resulting from optically gated triplet state residence. Distinct images were reconstructed within tissue-mimicking phantom using the fitting coefficients of triplet-state lifetimes. Fluorescence was used to screen for modulation prior to photoacoustic imaging. The results suggest that lifetime unmixing can be utilized to simultaneously detect multiple pathologies with overlapping spectra using photoacoustic imaging.

The growing number of divorces and separations induces the frequency of single mothers facing challenges in the mainstream socio-economic realities in Bangladesh. Past studies focused on structural aspects, economic hardship, and psychological issues of single mothers, mainly in the urban context. Nevertheless, the challenges in rural settings vary from urban single motherhood, and this aspect remains understudied. This qualitative narrative aims to analyse the challenges of single mothers in rural settings in Bangladesh. Twenty-eight in-depth interviews and ten key informant interviews were conducted using semi-structured interview guidelines. Thematic analysis identified four major themes of the rural single mothers’ challenges, social, economic, cultural, and psychological, leading a single mother to become dependent on other family members or relatives. The underlying factor of the challenges was the deprivation of property, patriarchal social structure, and social stigma. Rural single mothers face more complex challenges than urban ones because of the lack of income opportunities, insecurity, and self-dependencies. Findings will contribute to recommending and formulating a policy for the single mother considering the local realities of the rural single mothers in Bangladesh.

In this paper, we develop a new point-of-entry security measure for smartphone users. We devise a concept, the “Quad Swipe Pattern”, which includes four swipes from a user in four directions and utilizes the user’s swipe behavior for authentication. The Quad Swipe Pattern overcomes several shortcomings present in current point-of-entry security measures. We performed several experiments to demonstrate the effectiveness of the Quad Swipe Pattern in smartphone user authentication. We evaluated the Quad Swipe Pattern using five machine learning classifiers, three datasets of different sizes, and five different fingers. In addition, we studied how fusion of information from multiple fingers and multiple classifiers can improve the performance of Quad Swipe Pattern. All of our experimental results show significant promise of the Quad Swipe Pattern as a new point-of-entry security measure for smartphones. With a Neural Network model, the Quad Swipe Pattern achieves the Accuracy of 99.7%, False Acceptance Rate of 0.4%, and False Rejection Rate of 0%. With Support Vector Machine, the Quad Swipe Pattern achieves the Accuracy of 99.5%, False Acceptance Rate of 0.4%, and False Rejection Rate of 1.7%. With fusion of two best fingers, the Quad Swipe Pattern demonstrates an excellent performance of a zero Equal Error Rate.

الملخص: أهداف البحث: على الرغم من الانتشار المتزايد للغرق، فإن سلوكيات البحث عن الرعاية الطبية بين ضحايا الغرق لا تزال غير مستكشفة في بنغلاديش. تهدف هذه الدراسة إلى استكشاف سلوكيات البحث عن الرعاية الطبية بين ضحايا الغرق في بنغلاديش. طرق البحث: أجريت هذه الدراسة المقطعية المستندة إلى السكان باستخدام طريقة أخذ العينات الجماعية متعددة المراحل. تم تجميع المعلومات باستخدام استبانة منظمة من ٢٩٩,٢١٦ من سكان القرى والمدن. النتائج: في هذا الاستطلاع، وجدنا ١٩١ من حالات الغرق; ٤٠.٨٤٪ (عدد=٧٨) كانت مميتة و٥٩.١٦٪ (عدد=١١٣) كانت غير مميتة. كان بين حالات الغرق هذه، ٧١.٢٪ (عدد=١٣٦) تم تحويلهم إلى مقدمي الرعاية الصحية، بينما تلقت ٦٢.٨٪ (عدد= ١٢٠) من هذه الحالات الرعاية الطبية من مختلف مقدمي الخدمات الصحية. أظهر المزيد من التحليل أن ٦٦.٦٪ (عدد= ١١٦) كانوا من الأطفال و٢٦.٦٪ (عدد=٤) من البالغين بحثوا عن الرعاية الصحية. سعى أكثر عدد ممكن ٧٨.٩٪ (عدد= ١٢٠ /١٥٢) من سكان القرى للحصول على الرعاية الصحية بالمقارنة ب ٦١.٥٪ (عدد = ٢٤ /٣٩) من سكان المدن. تلقى ٣١.٧٪ (عدد=٣٨) من بين ضحايا الغرق رعاية صحية من مقدمي الرعاية الصحية المؤهلين; بينما تلقى ٦٨.٣٪ (عدد= ٨٢) رعاية صحية من مقدمي الرعاية الصحية غير المؤهلين. تلقى تقريبا ٥٩ (٤٩٪) من الضحايا رعاية من الصيدلية و٣٤ (٢٨٪) من مستشفى معروف. كان معدل الدخول إلى المستشفى بسبب الغرق ١١.٧٪. تم إحضار ١٤ (١١.٧٪) من ضحايا الغرق إلى المستشفى بواسطة المركبات الآلية وغير الآلية. وسعى ما يقارب ٩٧ (٨٠.٨٪) من المرضى للرعاية الصحية وتمكنوا من البقاء على قيد الحياة. الاستنتاجات: سعى عدد كبير من ضحايا الغرق إلى الحصول على رعاية طبية من مقدمي الرعاية الصحية المؤهلين وغير المؤهلين. هناك حاجة لوضع قواعد إرشادية بشأن توفير الرعاية الطبية لضحايا الغرق في بنغلاديش. Abstract: Objective: Despite the high magnitude of drowning, medical care-seeking behaviours among drowning casualties remain unexplored in Bangladesh. This study aimed to explore this behaviour among drowning casualties in Bangladesh. Methods: A population-based cross-sectional study was conducted using a multi-stage cluster sampling method. Data were collected using a structured questionnaire from 299,216 rural and urban residents. Results: From the survey, we found 191 drowning cases: 40.84% (n = 78) were fatal and 59.16% (n = 113) were non-fatal. Among the drowning cases, 71.2% (n = 136) were referred to healthcare providers, while 62.8% (n = 120) received medical care from different health service providers. Further analysis showed that 66.6% (n = 116) of children and 26.6% (n = 4) of adults sought healthcare. As many as 78.9% (n = 120/152) of rural residents sought healthcare, as compared to 61.5% (n = 24/39) of urban residents. Among all drowning casualties, 31.7% (n = 38) received healthcare from a qualified healthcare provider, whereas 68.3% (n = 82) received it from non-qual]ified healthcare providers. About 59 (49%) casualties received care from a pharmacy and 34 (28%) from a recognised hospital. The hospital admission rate for drowning was 11.7%. About 14 (11.7%) drowning casualties were brought to hospitals in motorised or non-motorised vehicles. As many as 97 (80.8%) patients sought healthcare attention and managed to survive. Conclusion: A significant number of drowning casualties sought medical care from qualified and non-qualified healthcare providers. In Bangladesh, it is necessary to develop guidelines for providing medical care for drowning casualties.

Abstract The total sugarcane (Saccharum L.) production has increased worldwide; however, the rate of growth is lower compared with other major crops, mainly due to a plateauing of genetic gain. Genomic selection (GS) has proven to substantially increase the rate of genetic gain in many crops. To investigate the utility of GS in future sugarcane breeding, a field trial was conducted using 432 sugarcane clones using an augmented design with two replications. Two major diseases in sugarcane, brown and orange rust (BR and OR), were screened artificially using whorl inoculation method in the field over two crop cycles. The genotypic data were generated through target enrichment sequencing technologies. After filtering, a set of 8,825 single nucleotide polymorphic markers were used to assess the prediction accuracy of multiple GS models. Using fivefold cross‐validation, we observed GS prediction accuracies for BR and OR that ranged from 0.28 to 0.43 and 0.13 to 0.29, respectively, across two crop cycles and combined cycles. The prediction ability further improved by including a known major gene for resistance to BR as a fixed effect in the GS model. It also substantially reduced the minimum number of markers and training population size required for GS. The nonparametric GS models outperformed the parametric GS suggesting that nonadditive genetic effects could contribute genomic sources underlying BR and OR. This study demonstrated that GS could potentially predict the genomic estimated breeding value for selecting the desired germplasm for sugarcane breeding for disease resistance.

In molecular and cellular photoacoustic imaging with exogenous contrast agents, image contrast is plagued by background resulting from endogenous absorbers in tissue. By using optically modulatable nanoparticles, we develop ultra-sensitive photoacoustic imaging by rejecting endogenous background signals and drastically improving signal contrast through time-delayed pump-probe pulsed laser illumination. Gated by prior pump excitation, modulatable photoacoustic (mPA) signals are recovered from unmodulatable background through simple, real-time image processing to yield background-free photoacoustic signal recovery within tissue mimicking phantoms and from ex-vivo tissues. Inherently multimodal, the fluorescence and mPA sensitivity improvements demonstrate the promise of Synchronously Amplified Photoacoustic Image Recovery (SAPhIRe) for PA imaging in diagnosis and therapy.

Angiopoietins 1−4 (Ang1−4) represent an important family of growth factors, whose activities are mediated through the tyrosine kinase receptors, Tie1 and Tie2. The best characterized are angiopoietin-1 (Ang1) and angiopoietin-2 (Ang2). Ang1 is a potent angiogenic growth factor signaling through Tie2, whereas Ang2 was initially identified as a vascular disruptive agent with antagonistic activity through the same receptor. Recent data demonstrates that Ang2 has context-dependent agonist activities. Ang2 plays important roles in physiological processes and the deregulation of its expression is characteristic of several diseases. In this review, we summarize the activity of Ang2 on blood and lymphatic endothelial cells, its significance in human physiology and disease, and provide a current view of the molecular signaling pathways regulated by Ang2 in endothelial cells.

Objective: Traumatic brain injury (TBI) proves to be an obstacle for Bangladeshi patients due to the lack of facilities and specialist doctors in regional sections of the country. This study aimed to record different attributes of Bangladeshi TBI patients over a year i.e., their injury characteristics, treatments received and understand their impacts on the severity of TBI. Method: This cross-sectional study was carried out among 280 TBI patients treated in a tertiary care hospital in Dhaka. The physicians determined TBI's severity and prognosis as per the Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS) respectively. Results: Most TBI patients were male (76.1%) and aged between 18 and 50 years (52.2%), as in previous studies in South Asian countries. However, the prevalence of TBI due to road traffic accidents (RTAs) was much higher (67.9%) than in the earlier studies in South Asia. Additionally, more patients suffered from severe TBI (29.3%) and moderate TBI (35.7%), and a higher percentage of patients went through surgery (56.8%) compared to previous studies. A significant association of demographic (residence) and clinical characteristics (consciousness after injury, CT scan findings and treatment type) with the severity of TBI was found in bivariate analysis. It also revealed the significant dependence of clinical characteristics (TBI etiology, post-injury consciousness, treatment type and TBI severity) on TBI prognosis. Multivariate analysis showed that patients who were unconscious after TBI and with evident brain injury observed in CT scans have a substantially higher risk of having moderate or severe TBI than mild TBI. Moreover, patients with TBI due to RTAs or falls, evident brain injury in CT scans, post-surgical seizure, and moderate or severe TBI have a significantly higher risk of getting a more unfavorable TBI prognosis than moderate disability. Conclusions: In this study, RTAs were found to be the major cause of TBI. Additionally, some variables were identified as possible determinants of TBI severity and prognosis among Bangladeshi patients. The correlation of these variables with TBI should be further studied with the hopes that steps will be taken to reduce TBI incidents and improve its management to reduce the overall burden. [ABSTRACT FROM AUTHOR]

Brown rust (caused by Puccinia melanocephala H. & P. Sydow) is one of the most devastating diseases in commercial sugarcane production. It could reduce sugarcane yield by up to 50% depending on the susceptibility levels of cultivars. Breeding disease‐resistant cultivars is the most effective, economical, and environmentally friendly option to control brown rust. A genome‐wide association study was conducted on a field trial using 432 sugarcane clones following an augmented design with two replications. Brown rust was screened using the whorl inoculation method over two crop cycles. The genotype data were obtained through target enrichment sequencing technologies. The gene actions considering six different models and marker dosage effects were included during the marker‐trait analysis. A total of seven, nine, and seven nonredundant marker‐trait associations were identified for plant cane, first ratoon, and across two crop cycles, respectively. The most significant (p‐value 6.17E−20) marker (chr01p59833543) has the additive effect of −0.63 for the diplo‐additive model and reduced disease severity the most (41.35%) due to heterozygote (AG) over homozygote allele (AA) combination in the tested clones. Gene annotation of the monoploid sugarcane genome R570 suggested that six putative candidate genes were co‐located with significant markers associated with brown rust resistance in sugarcane. The putative candidate genes regulated the formation of a cell wall barrier that plays a crucial role in controlling brown rust pathogen infection. The results of this study will open the path to exploiting new resistance sources for brown rust resistance in commercial sugarcane. [ABSTRACT FROM AUTHOR]

Purpose: Environment-friendly pest management techniques are safer, sustainable over the years, better for ecosystem services, and more convenient with lower risks. Netting and or bagging is one of the most suitable tools for pest management. To develop environmentally friendly management techniques against the common cutworm (Spodoptera litura Fab.), we compared the cost-effectiveness of netting and bagging for the production of bell peppers in Bangladesh. Research Method: The study was undertaken in the field of Entomology, at Sylhet Agricultural University, Bangladesh, from October 2018 to April 2019. Netting and bagging significantly improved plant morphology, fruit quality, and yield and managed the insect pests. Findings: In this paper, we tried to bring forth different prospects of netting and bagging in bell peppers to manage the common cutworm. Superior-quality fruits were harvested from the netting/bagging treatment compared to the control. Netting and bagging treatment increased yield by more than 10-fold over control and decreased fruit infestation to 10.67%. The maximum marginal benefit-cost ratio (MBCR = 18.06) was achieved from the netting/bagging treatment, while the lowest MBCR (7.29) was obtained from bagging only. Superior-quality fruits were obtained using white paper bags compared to brown paper bags. The common cutworm first appeared in February and gradually increased with the progress of the season, indicating that netting and bagging need to be applied at the early fruiting stage of bell pepper. Research Limitations: The study focused on the environment-friendly management of common cutworms in bell peppers, revealing impressive results, but these need to be validated across the locations. Originality/Value: Albeit labor-intensive, combining nylon netting with fruit bagging is a cost-effective, eco-friendly management technique against the common cutworm of bell pepper. [ABSTRACT FROM AUTHOR]

Background: The growing use of primary human papillomavirus (HPV) cervical cancer screening requires determining appropriate screening intervals to avoid overtreatment of transient disease. This study examined the long-term risk of cervical precancer after HPV screening to inform screening interval recommendations. Methods: This longitudinal cohort study (British Columbia, Canada, 2008 to 2022) recruited women and individuals with a cervix who received 1 to 2 negative HPV screens (HPV1 cohort, N = 5,546; HPV2 cohort, N = 6,624) during a randomized trial and women and individuals with a cervix with 1 to 2 normal cytology results (BCS1 cohort, N = 782,297; BCS2 cohort, N = 673,778) extracted from the provincial screening registry. All participants were followed through the registry for 14 years. Long-term risk of cervical precancer or worse [cervical intraepithelial neoplasia grade 2 or worse (CIN2+)] was compared between HPV and cytology cohorts. Results: Cumulative risks of CIN2+ were 3.2/1,000 [95% confidence interval (CI), 1.6-4.7] in HPV1 and 2.7/1,000 (95% CI, 1.2-4.2) in HPV2 after 8 years. This was comparable with the risk in the cytology cohorts after 3 years [BCS1: 3.3/1,000 (95% CI, 3.1-3.4); BCS2: 2.5/1,000 (95% CI, 2.4-2.6)]. The cumulative risk of CIN2+ after 10 years was low in the HPV cohorts [HPV1: 4.7/1,000 (95% CI, 2.6-6.7); HPV2: 3.9 (95% CI, 1.1-6.6)]. Conclusions: Risk of CIN2+ 8 years after a negative screen in the HPV cohorts was comparable with risk after 3 years in the cytology cohorts (the benchmark for acceptable risk). Impact: These findings suggest that primary HPV screening intervals could be extended beyond the current 5-year recommendation, potentially reducing barriers to screening. [ABSTRACT FROM AUTHOR]

The most labor-intensive and time-consuming part of warehouse operations is order picking. This paper proposes a correlation-based storage location assignment (CBSLA) approach to minimize the travel distance of the picker in a picker-to-parts warehouse. At first, the proposed CBSLA approach forms some groups of stock-keeping units (SKUs) for different warehouse aisles. Then these groups of SKUs are assigned to the storage locations considering both the correlations between SKUs in a group and the correlation between groups of SKUs for efficient order picking. The effectiveness of the proposed method is measured for various warehouse configurations using simulation and compared with other well-known storage allocation methods. [ABSTRACT FROM AUTHOR]

Traditional healers have used the shrub Calotropis procera (CP) for many years for various therapies. The present study investigated the bioactive constituents of ethanolic extract of CP leaf and dried latex using gas chromatography-mass spectrometry and Fourier transforms infrared spectroscopy. The identification and characterization of the compounds were confirmed by examining the constituents' mass spectrum fragmentations and FT-IR spectra and comparing the results with those in the literature. The tail-flick method was used to investigate the analgesic properties of the extract and its anti-inflammatory activities using a rat model of formalin-induced oedema. Acute oral toxicity in rats was studied per OECD recommendations. Twenty male rats were divided into four groups and received an ethanolic extract of the leaves and dried milky sap of CP (200 mg/Kg) in groups 1, 2, and 3. Group 4 rats were administered aspirin 50 mg/kg as a positive control. The CP dried latex extract has the highest content of lupeol and its acetate derivative compared to its leaf extract. The CP dried latex extract inhibited inflammation more significantly than the ethanolic leaf extract and the drug indomethacin at a higher dosage (200 mg/kg). The ethanolic extracts showed analgesia comparable to aspirin. It suggests that fatty acids and their esters, particularly ethyl linoleate (8.96%), ethyl palmitate (7.99%), ethyl linoleate (6.98%), and palmitic acid (5.18%), may be valuable biomarkers for characterizing leaf and latex samples and describing the medicinal potential of CP. [ABSTRACT FROM AUTHOR]