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This paper investigates the global asymptotic stability problem for a class of Takagi-Sugeno fuzzy Clifford-valued delayed neural networks with impulsive effects and leakage delays using the system decomposition method. By applying Takagi-Sugeno fuzzy theory, we first consider a general form of Takagi-Sugeno fuzzy Clifford-valued delayed neural networks. Then, we decompose the considered $ n $-dimensional Clifford-valued systems into $ 2^mn $-dimensional real-valued systems in order to avoid the inconvenience caused by the non-commutativity of the multiplication of Clifford numbers. By using Lyapunov-Krasovskii functionals and integral inequalities, we derive new sufficient criteria to guarantee the global asymptotic stability for the considered neural networks. Further, the results of this paper are presented in terms of real-valued linear matrix inequalities, which can be directly solved using the MATLAB LMI toolbox. Finally, a numerical example is provided with their simulations to demonstrate the validity of the theoretical analysis.

A radio communication sensor system is a collection of sensor modules that are connected to one another through wireless communication. It is common for them to be battery-powered and responsive to a nearby controller, referred to as the base station. They are capable of doing basic computations and transferring information to the base station in most scenarios. They are also in charge of transporting data from distant nodes, putting a burden on nodes with limited resources, and contributing to the quick depletion of energy in these nodes in the process. Nodes in close proximity to the base station are responsible for more than only detecting and sending data to the base station; they are also responsible for transmitting data from faraway nodes. To reward nodes that perform well, a protocol known as the Improved Fuzzy Inspired Energy Effective Protocol (IFIEEP) employs three separate sorts of nodes in order to provide more energy to those who do not. It takes into account the remaining node energy, the node's proximity to the base station, the node's neighbor concentration, and the node's centrality in a cluster when determining node viability. All of these assumptions are founded on a shaky understanding of the situation. Adaptive clustering must be applied to the most viable nodes in order to identify cluster leaders and transmit data to the base station, in addition to disseminating data across the rest of the network, in order to achieve success. In addition, the research provides proper heterogeneity parameters, which describe, among other things, the number of nodes as well as the starting energy of each node. The percentage gain in-network lifetime when compared to current approaches is minor for smaller numbers of supernodes; however, the percentage gain in the area covered 12.89 percent and 100% when more significant numbers of super nodes are used. These improvements in stability, residual energy, and throughput are accomplished by combining these improvements while also taking into consideration the previously neglected energy-intensive sensing energy aspect. The protocol that has been presented is meant to be used in conjunction with applications that make use of blockchain technology.

Rationale: The ability of peripheral blood biomarkers to assess COPD risk and progression is unknown. Genetics and gene expression may capture important aspects of COPD-related biology that predict...

Aim: There is an association between heart failure with preserved ejection fraction (HFpEF) and insulin resistance, but less is known about the diabetic continuum, and in particular about pre-diabetes, in HFpEF. We examined characteristics and outcomes of participants with diabetes or pre-diabetes in PARAGON-HF.Methods and results: Patients aged ≥50 years with left ventricular ejection fraction ≥45%, structural heart disease and elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) were eligible. Patients were classified according to glycated haemoglobin (HbA1c): (i) normal HbA1c, Conclusion: Pre-diabetes is common in patients with HFpEF and is associated with worse clinical status and greater risk of HFH. Clinical Trial Registration: ClinicalTrials.gov Identifier NCT01920711.

The IoT sensor applications have grown in extreme numbers, generating a large amount of data, and it requires very effective data analysis procedures. However, the different IoT infrastructures and IoT sensor device layers possess protocol limitations in transmitting and receiving messages which generate obstacles in developing the smart IoT sensor applications. This difficulty prohibited existing IoT sensor implementations from adapting to other IoT sensor applications. In this article, we study and analyze how IoT sensor produces data for big data analytics, and it also highlights the existing challenges of intelligent solutions. IoT sensor applications required big data classification and analysis in a Fog computing (FC) environment using computation intelligence (CI). Our proposed Fog big data analysis model (FBDAM) and BPNN analysis model for IoT sensor application using fusion deep learning (FDL) pose new obstacles for potential machine-to-machine communication practices. We have applied our proposed FBDAM on the most significant Fog applications developed on smart city datasets (parking, transportation, security, and sensor IoT dataset) and got improving results. We compared different deep and machine learning algorithms (SVM, SVMG-RBF, BPNN, S3VM, and proposed FDL) on different smart city dataset IoT application environments.

BACKGROUND: Smokers manifest varied phenotypes of pulmonary impairment. RESEARCH QUESTION: Which pulmonary phenotypes are associated with coronary artery disease (CAD) in smokers? STUDY DESIGN AND METHODS: We analyzed data from the University of Pittsburgh COPD Specialized Center for Clinically Oriented Research (SCCOR) cohort (n = 481) and the Genetic Epidemiology of COPD (COPDGene) cohort (n = 2,580). Participants were current and former smokers with > 10 pack-years of tobacco exposure. Data from the two cohorts were analyzed separately because of methodologic differences. Lung hyperinflation was assessed by plethysmography in the SCCOR cohort and by inspiratory and expiratory CT scan lung volumes in the COPDGene cohort. Subclinical CAD was assessed as the coronary artery calcium score, whereas clinical CAD was defined as a self-reported history of CAD or myocardial infarction (MI). Analyses were performed in all smokers and then repeated in those with airflow obstruction (FEV(1) to FVC ratio, < 0.70). RESULTS: Pulmonary phenotypes, including airflow limitation, emphysema, lung hyperinflation, diffusion capacity, and radiographic measures of airway remodeling, showed weak to moderate correlations (r < 0.7) with each other. In multivariate models adjusted for pulmonary phenotypes and CAD risk factors, lung hyperinflation was the only phenotype associated with calcium score, history of clinical CAD, or history of MI (per 0.2 higher expiratory and inspiratory CT scan lung volume; coronary calcium: OR, 1.2; 95% CI, 1.1-1.5; P = .02; clinical CAD: OR, 1.6; 95% CI, 1.1-2.3; P = .01; and MI in COPDGene: OR, 1.7; 95% CI, 1.0-2.8; P = .05). FEV(1) and emphysema were associated with increased risk of CAD (P < .05) in models adjusted for CAD risk factors; however, these associations were attenuated on adjusting for lung hyperinflation. Results were the same in those with airflow obstruction and were present in both cohorts. INTERPRETATION: Lung hyperinflation is associated strongly with clinical and subclinical CAD in smokers, including those with airflow obstruction. After lung hyperinflation was accounted for, FEV(1) and emphysema no longer were associated with CAD. Subsequent studies should consider measuring lung hyperinflation and examining its mechanistic role in CAD in current and former smokers.

A one-step synthesis of cytotoxic 2-aroylpyrimidines by the denitrogenative reaction of 1-tosyl-1,2,3-triazoles with isoxazoles under rhodium catalysis has been developed. According to the density functional theory calculations and control experiments, the disclosed reaction proceeds via the rearrangement of an oxadiazatetraene intermediate involving a cascade of intramolecular aza-Diels-Alder and retro-aza-Diels-Alder reactions. The presence of a substituent at C4 of the isoxazole is a prerequisite for the formation of the pyrimidines.

BACKGROUND The incidence of pneumonia and subsequent outcomes has not been compared in patients with heart failure and reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).OBJECTIVES This study aimed to examine the rate and impact of pneumonia in the PARADIGM-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) and PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in Heart Failure with Preserved Ejection Fraction) trials.METHODS The authors analyzed the incidence of investigator-reported pneumonia and the rates of HF hospitalization, cardiovascular death, and all-cause death before and after the occurrence of pneumonia, and estimated risk after the first occurrence of pneumonia in unadjusted and adjusted analyses (the latter including N-terminal pro-B-type natriuretic peptide).RESULTS In PARADIGM-HF, 528 patients (6.3%) developed pneumonia after randomization, giving an incidence rate of 29 (95% CI: 27 to 32) per 1,000 patient-years. In PARAGON-HF, 510 patients (10.6%) developed pneumonia, giving an incidence rate of 39 (95% CI: 36 to 42) per 1,000 patient-years. The subsequent risk of all trial outcomes was elevated after the occurrence of pneumonia. In PARADIGM-HF, the adjusted hazard ratio (HR) for the risk of death from any cause was 4.34 (95% CI: 3.73 to 5.05). The corresponding adjusted HR in PARAGON-HF was 3.76 (95% CI: 3.09 to 4.58).CONCLUSIONS The incidence of pneumonia was high in patients with HF, especially HFpEF, at around 3 times the expected rate. A first episode of pneumonia was associated with 4-fold higher mortality. (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF], NCT01035255; Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] With ARB [Angiotensin Receptor Blocker] Global Outcomes in Heart Failure With Preserved Ejection Fraction [PARAGON-HF], NCT01920711) (J Am Coll Cardiol 2021;77:1961-73) (c) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

The internet has become one of the main sources of news spread as it unleashed the information dissemination space, where the news websites express opinions on entities while also reporting on recent or unusual security risks. Recently, many research studies have focused on sentimental reflection on the views and impressions of people utilising natural language processing and analytical linguistics. Therefore, we have collected corpus from popular Arabic websites that publish articles related to recent security issues, and we provide light weight preprocessing techniques where data is term matrix is transformed. We also present an intensive lexical‐driven data analysis with visualised data views, as our topic modelling technique can effectively extract significant topics from all the collected text from different websites. Our experiments validate the k‐means clustering algorithm with and without the latent Dirichlet allocation topic modelling method, and we adopted various validation techniques to measure the topic clustering internally and externally. As shown in the experiments' results, our proposed combined method has a high round index rate of 87.2%, with a large number of topics and clusters.

Transmission of multimedia data such as images, videos, and audio over the Internet is risky due to cyberattacks. To overcome the security issues, several encryption schemes are proposed over the last few decades which also possess few vulnerabilities such as time inefficiency and weak security. In this research, to provide the highest level of security to the digital data, chaos is incorporated for the scrambling of rows and columns of the plaintext image. Further, a noisy image is generated based on the chaotic logistic map and the suitable initial conditions which are selected based on the analysis performed. For the reduction of the encryption computational time, a Discrete Wavelet Transform (DWT) is used in which only low-frequency bands are encrypted because most of the plaintext information lies in such frequency bands. To gauge the performance of the proposed encryption scheme, several security tests such as entropy, correlation, energy, peak signal to noise ratio, mean square error, keyspace, and key sensitivity analysis, noise-resistant, and cropping attack analyses are performed. From the cropping and noise attack analysis, we have found that the proposed encryption algorithm can decrypt the plaintext image with negligible loss of information but the content of the plaintext image can be visualized.

In this paper, we show how to approximate the solution to the generalized time-fractional Huxley-Burgers’ equation by a numerical method based on the cubic B-spline collocation method and the mean value theorem for integrals. We use the mean value theorem for integrals to replace the time-fractional derivative with a suitable approximation. The approximate solution is constructed by the cubic B-spline. The stability of the proposed method is discussed by applying the von Neumann technique. The proposed method is shown to be conditionally stable. Several numerical examples are introduced to show the efficiency and accuracy of the method.

Background/Aim: Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. This clinical study was designed to compare the intraoperative median nerve distal motor latency (DML) versus the distal sensory latency (DSL) and sensory nerve conduction velocity (SNCV) during surgical treatment of CTS. Patients and Methods: A total number of 36 wrists in 30 patients with CTS diagnosed by preoperative median MNCS who underwent surgical intervention for median nerve release. Intraoperative measurements of motor distal latency (DML) and proximal latency, amplitude, and conduction velocity and distal sensory latency (DSL), amplitude, and conduction velocity of both the median and ulnar nerves before and after division of the flexor retinaculum (FR). Results: A significant decrease of the intraoperative median nerve distal motor latency (DML) after release (8.89 ± 0.93) in comparison with the preoperative median nerve DML (6.24 ± 1.06) with (p < 0.001*). But intraoperative distal sensory latency (DSL) and sensory nerve conduction velocity (SNCVM) show non-significant decrease (p = 0.161). Conclusion: Intraoperative monitoring of median nerve show rapidly improve Intraoperative motor nerve conduction than the sensory nerve conduction after release the FR during carpal tunnel surgery.

Many encryption algorithms are designed to decrease the probability of cyberattacks by assuring data security as well as system and participant authentication. However, in the development of computer resources cryptanalytical techniques have been developed and performed competitively in information security with good results. In this paper, we reported security flaws in the recently offered encryption technique based on a chaotic map for Internet of Health Things (IoHT) security. The scheme was based on a new chaotic map, modified Mandelbrot set, and conditional shift algorithm asserting the encryption algorithm is secure. We have performed some cryptographic attacks to retrieve the key from the understudy cryptosystem. The key was retrieved in little computation by using a chosen-plaintext attack and one known plaintext ciphertext pair. The minimum execution time of performed attacks indicates the vulnerability of the diffusion-based encryption algorithm. To enhance the security of the understudy cryptographic algorithm, we have also suggested certain improvements.

In this approximation study, a nonlinear singular periodic model in nuclear physics is solved by using the Hermite wavelets (HW) technique coupled with a numerical iteration technique such as the Newton Raphson (NR) one for solving the resulting nonlinear system. The stimulation of offering this numerical work comes from the aim of introducing a consistent framework that has as effective structures as Hermite wavelets. Two numerical examples of the singular periodic model in nuclear physics have been investigated to observe the robustness, proficiency, and stability of the designed scheme. The proposed outcomes of the HW technique are compared with available numerical solutions that established fitness of the designed procedure through performance evaluated on a multiple execution.

Fixed-time artificial insemination (FTAI) provides a practical and feasible option for commercial and stud breeders to implement AI into their herds, as 100% of the herd can be inseminated at a predetermined time. FTAI can suit many herds, whether they are inseminating small numbers or the whole herd. We investigated the effects of sire and inseminator on pregnancy and birth outcomes following FTAI of Angus cows. Three Angus sires; namely GAR Quantum 7AN560, Square B True North 8052, and Tehama Tahoe B767, and two inseminators (1 and 2) were evaluated for differences in pregnancy outcomes and birth rates from 24 inseminations. Angus cows (N = 24) were synchronized with CIDR plus GnRH injection. After 7 days, CIDR was removed and each cow received 25 mg PGF2α. AI was conducted within 72 h from PGF2α injection. Cows were randomly assigned for AI between inseminators (12 cows inseminated by inseminator 1 and 12 cows by inseminator 2) and sires (6, 8, and 10 cows were inseminated by GAR Quantum, Tehama Taho, and True North semen, respectively. Pregnancy was diagnosed at 4-5 months after AI by transrectal ultrasonography. Percentage of re-cycling cows 21 days after AI was 45.8% (11/24). Pregnancy rate was 54.2% (13/24). Pregnancy rate was higher (P

Infertility is a major cause of economic losses in livestock production systems. Parasitic infections are a significant cause of infertility in small ruminants. Sericea lespedeza (SL; Lespedeza cuneata) is a potent anthelmintic in sheep and goats. Positive impacts of lespedeza on male fertility have been reported in rats and rabbits; however, no studies have been conducted on goats. Here, we investigated the effects of feeding male goats with SL or annual lespedeza (AL; Kummerowia stiulacea) on their semen quality and fertility. Forty-nine mature intact Spanish bucks were randomly assigned into three groups and fed diets of 60% hay and 40% concentrate in an 8-week pen study. The treatment hays were SL (n=16), AL (n=17), and bermudagrass (Cynodon dactylon) as a control (n=16). At the end of the trial, scrotum circumferences (SC) were measured and the animals were transported to a processing facility for slaughtering. Testicles and epididymides were collected after slaughter for measuring their weights and lengths. Epididymal spermatozoa were retrieved and evaluated for their motility, concentration, viability, abnormalities, and membrane integrities. Sections from testicles and epididymides were also prepared for histopathological examination. Results showed that SC was higher (P≤ 0.05) in SL than AL groups. Testicular and epididymal weights were comparable (P > 0.05) among the three groups. Sperm motility, concentration, viability, and membrane integrities were higher (P≤ 0.05) in SL compared with the AL and control groups. Sperm abnormalities were higher (P≤ 0.05) in control and AL groups than in the SL group. Histopathological examination revealed mild focally extensive seminiferous tubular degeneration and necrosis in AL group. These results suggest that feeding of male goats on SL enhances their sperm quality and fertility parameters.

Goats have the ability for genetic improvement. Artificial insemination (AI) is a significant technique used to increase genetic gain. Low fertility in goats with AI was attributed to semen quality, which can be affected by cooling/freezing procedures. Cooling of spermatozoa causes reduction in viability, and loss of fertility, mainly because of oxidative stress. L-carnitine (LC) is important for fatty acid metabolism and acts as antioxidant. Many studies have reported positive impact of LC on quality of cooled spermatozoa in different species; however, no research has been done on goats. Here, we investigated the impacts of dietary supplementation of LC on the quality of cooled goat semen. Six mature Alpine bucks were allocated into two groups; control (three bucks were fed a regular diet without LC supplementation), and treatment (three bucks were fed the normal diet plus 0.022 g/kg of BW, LC). Bucks were fed their respective diet for sixty days from January to March (non-breeding season). Semen was collected once/week and evaluated for color, consistency, volume and sperm concentrations. Diluted semen was then stored at 4 °C for 72 h. Sperm motility, viability, and membrane integrity were assessed at 0, 24, 48, and 72 h post-cooling. Results showed that colors of samples collected from the two groups were white to yellow, consistency ranged from watery to creamy, and sperm concentrations ranged from 8.1 to 12.2 x 109 sperm/ml. Sperm motility, viability and membrane integrity reduced (P≤ 0.05) in a time dependent manner in both groups. At 72 h, motility decreased by one-half as compared with 0 h (48.9% vs. 91.4% and 32.5% vs. 80.8%, in LC and control groups, respectively). In conclusion, under our experimental conditions, goat spermatozoa can be stored at 4°C for 72 h without severe loss in their quality. LC treatment has less impact on the quality of cooled goat semen.

Sources and levels of heavy metals (HMs) in soil and dust of urban and suburban areas in Riyadh (industrial city) and Mahad AD’Dahab (mining area) cities in Saudi Arabia were reported in this study. Additionally, the concentrations of HMs in different soil particle size fractions (> 250, 63–250 and 2). The hazard index values of dust and soil ( 1, suggesting non-carcinogenic risk. Therefore, the dust and soil samples from the mined area of Mahad AD’Dahab had a higher pollution levels, as well as ecological and human health risks than those from Riyadh. Hence, the pollution of such residential environments with HMs (especially Cd, Cu, Zn, and Pb) needs to be monitored.

This work introduces a computational method for solving the linear two-dimensional fuzzy Fredholm integral equation of the second form (2D-FFIE-2) based on triangular basis functions. We have used the parametric form of fuzzy functions and transformed a 2D-FFIE-2 with three variables in crisp case to a linear Fredholm integral equation of the second kind. First, a method based on the use of two m-sets of orthogonal functions of triangular form is implemented on the integral equation under study to be changed to coupled algebraic equation system. In order to solve these two schemes, a finite iterative algorithm is then applied to evaluate the coefficients that provided the approximate solution of the integral problems. Three examples are given to clarify the efficiency and accuracy of the method. The obtained numerical results are compared with other direct and exact solutions.

International audience; Background: Myocardial fibrosis may contribute to the pathophysiology of heart failure with preserved ejection fraction. Given the biochemical targets of sacubitril/valsartan, this study hypothesized that circulating biomarkers reflecting the mechanisms that determine extracellular matrix homeostasis are altered by sacubitril/valsartan compared with valsartan alone.Objectives: This study investigated the effects of sacubitril/valsartan on biomarkers of extracellular matrix homeostasis and the association between biomarkers and the primary endpoint (total heart failure hospitalizations and cardiovascular death).Methods: N-terminal propeptide of collagen I and III, tissue inhibitor of matrix metalloproteinase 1, carboxyl-terminal telopeptide of collagen type I, and soluble ST2 were measured at baseline (n = 1,135) and 16 (n = 1,113) and 48 weeks (n = 1,016) after randomization. The effects of sacubitril/valsartan on these biomarkers were compared with those of valsartan alone. Baseline biomarker values and changes from baseline to 16 weeks were related to primary endpoint.Results: At baseline, all 5 biomarkers were higher than published referent control values. Sixteen weeks after randomization, sacubitril/valsartan decreased tissue inhibitor of matrix metalloproteinase 1 by 8% (95% confidence interval [CI]: 6% to 10%; p < 0.001), soluble ST2 by 4% (95% CI: 1% to 7%; p = 0.002), and N-terminal propeptide of collagen III by 3% (95% CI: 0% to 6%; p = 0.04) and increased carboxyl-terminal telopeptide of collagen type I by 4% (95% CI: 1% to 8%; p = 0.02) compared with valsartan alone, consistently in men and women and patients with left ventricular ejection fraction above or below the median of 57%. Higher levels of tissue inhibitor of matrix metalloproteinase 1 and soluble ST2 at baseline and increases in these markers at 16 weeks were associated with higher primary endpoint event rates.Conclusions: Biomarkers reflecting extracellular matrix homeostasis are elevated in heart failure with preserved ejection fraction, favorably altered by sacubitril/valsartan, and have important prognostic value. (Prospective Comparison of ARNI With ARB Global Outcomes in HF With Preserved Ejection Fraction [PARAGON-HF]; NCT01920711).

The present investigation used Galleria mellonella larvae as an infection model to describe the virulence of Escherichia coli, the most frequent causes of several common bacterial infections in humans and animals. Some hemolymph physical properties such as hemolymph volume - and its relation to body water content, hemolymph density, and pH, along with a quantitative estimation of hemolymph proteins, lipids and carbohydrates were recorded in G. mellonella larvae at different time intervals post-injection with a sub-lethal dose (LD20) of E. coli into the larval hemocoel.A decrease in fresh body weight and body water content with an increase in the hemolymph volume was observed at all time intervals post-larval treatment. This may be due to the loss of tissue water and gained it into the hemolymph. At the same time, bacterial injection decreased the hemolymph density and pH immediately following injection, while the viscosity and acidity of the hemolymph restored its original level with time. The bacterial injection also recorded an obvious decrease in the hemolymph proteins and lipids of the treated larvae at all time intervals post-treatment. This may be due to their elimination and/or their involvement in immune defence reactions or may be due to the intensive consumption and depletion of nutrition during infection. On the contrary, the levels of hemolymph carbohydrates increased at all-time intervals post bacterial injection into larvae. This increase may be due to the release of stored sugars (treehouse) which is responded strikingly due to bacterial infection causing an increase in the level of glucose and glycogen in the hemolymph. These results may lead to a better understanding of the regulatory events and the physiology of infected insects.

The performance of surface plasmon resonance (SPR) sensors has great dependence on its plasmonic material’s frequency response, which is described by the complex dielectric function. Through history, researchers developed and enhanced mathematical models to accurately describe the material dielectric function. Although many papers compared the accuracy of different dielectric function models and stated its limitations, none of it addressed the effect of dielectric function model on the SPR sensor’s characteristics. In this paper, we investigated the performance of the three most used dielectric function models (Drude, Lorentz-Drude, and Brendel-Bormann) and their effect on the theoretically obtained sensor parameters when used in a gold SPR sensor’s model and validated it with the experimentally measured dielectric function. The result showed that using less accurate dielectric function’s model has a drastic effect on the theoretically obtained sensor’s parameters. Among the three models, the widely used Drude model was not the most accurate; alternatively, Brendel-Bormann model was the most accurate.

COPD is a heterogeneous syndrome. Many COPD subtypes have been proposed, but there is not yet consensus on how many COPD subtypes there are and how they should be defined. The COPD Genetic Epidemiology Study (COPDGene), which has generated 10-year longitudinal chest imaging, spirometry, and molecular data, is a rich resource for relating COPD phenotypes to underlying genetic and molecular mechanisms. In this article, we place COPDGene clustering studies in context with other highly cited COPD clustering studies, and summarize the main COPD subtype findings from COPDGene. First, most manifestations of COPD occur along a continuum, which explains why continuous aspects of COPD or disease axes may be more accurate and reproducible than subtypes identified through clustering methods. Second, continuous COPD-related measures can be used to create subgroups through the use of predictive models to define cut-points, and we review COPDGene research on blood eosinophil count thresholds as a specific example. Third, COPD phenotypes identified or prioritized through machine learning methods have led to novel biological discoveries, including novel emphysema genetic risk variants and systemic inflammatory subtypes of COPD. Fourth, trajectory-based COPD subtyping captures differences in the longitudinal evolution of COPD, addressing a major limitation of clustering analyses that are confounded by disease severity. Ongoing longitudinal characterization of subjects in COPDGene will provide useful insights about the relationship between lung imaging parameters, molecular markers, and COPD progression that will enable the identification of subtypes based on underlying disease processes and distinct patterns of disease progression, with the potential to improve the clinical relevance and reproducibility of COPD subtypes.

Aims The PARADIGM-HF and PARAGON-HF trials tested sacubitril/valsartan against active controls given renin–angiotensin system inhibitors (RASi) are ethically mandated in heart failure (HF) with reduced ejection fraction and are used in the vast majority of patients with HF with preserved ejection fraction. To estimate the effects of sacubitril/valsartan had it been tested against a placebo control, we made indirect comparisons of the effects of sacubitril/valsartan with putative placebos in HF across the full range of left ventricular ejection fraction (LVEF). Methods and results We analysed patient-level data from the PARADIGM-HF and PARAGON-HF trials (n = 13 194) and the CHARM-Alternative and CHARM-Preserved trials (n = 5050, candesartan vs. placebo). The rate ratio (RR) of sacubitril/valsartan vs. putative placebo was estimated by the product of the RR for sacubitril/valsartan vs. RASi and the RR for RASi vs. placebo. Total HF hospitalizations and cardiovascular death were analysed using the negative binomial method. Treatment effects were estimated using cubic spline methods by ejection fraction as a continuous measure. Across the range of LVEF, sacubitril/valsartan was associated with a RR 0.54 [95% confidence interval (CI) 0.45–0.65] for the recurrent primary endpoint compared with putative placebo (P Conclusion This putative placebo analysis reinforces the treatment benefits of sacubitril/valsartan on risk of adverse cardiovascular events across the full range of LVEF, with most pronounced effects observed at a LVEF up to 60%.

Background: While disease-modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF (>40%). Sacubitril/valsartan has been compared with a renin-angiotensin-aldosterone–system inhibitor alone in 2 similarly designed clinical trials of patients with reduced and preserved LVEF, permitting examination of its effects across the full spectrum of LVEF. Methods: We combined data from PARADIGM-HF (LVEF eligibility≤40%; n=8399) and PARAGON-HF (LVEF eligibility≥45%; n=4796) in a prespecified pooled analysis. We divided randomized patients into LVEF categories: ≤22.5% (n=1269), >22.5% to 32.5% (n=3987), >32.5% to 42.5% (n=3143), > 42.5% to 52.5% (n=1427), > 52.5% to 62.5% (n=2166), and >62.5% (n=1202). We assessed time to first cardiovascular death and HF hospitalization, its components, and total heart failure hospitlizations, all-cause mortality, and noncardiovascular mortality. Incidence rates and treatment effects were examined across categories of LVEF. Results: Among 13 195 randomized patients, we observed lower rates of cardiovascular death and HF hospitalization, but similar rates of noncardiovascular death, among patients in the highest versus the lowest groups. Overall sacubitril/valsartan was superior to renin-angiotensin-aldosterone–system inhibition for first cardiovascular death or heart failure hospitalization (Hazard Ratio [HR] 0.84 [95% CI, 0.78–0.90]), cardiovascular death (HR 0.84 [95% CI, 0.76–0.92]), heart failure hospitalization (HR 0.84 [95% CI, 0.77–0.91]), and all-cause mortality (HR 0.88 [95% CI, 0.81–0.96]). The effect of sacubitril/valsartan was modified by LVEF (treatment-by-continuous LVEF interaction P =0.02), and benefit appeared to be present for individuals with EF primarily below the normal range, although the treatment benefit for cardiovascular death diminished at a lower ejection fraction. We observed effect modification by LVEF on the efficacy of sacubitril/valsartan in both men and women with respect to composite total HF hospitalizations and cardiovascular death, although women derived benefit to higher ejection fractions. Conclusions: The therapeutic effects of sacubitril/valsartan, compared with a renin-angiotensin-aldosterone–system inhibitor alone, vary by LVEF with treatment benefits, particularly for heart failure hospitalization, that appear to extend to patients with heart failure and mildly reduced ejection fraction. These therapeutic benefits appeared to extend to a higher LVEF range in women compared with men. Clinical Trial Registration: https://www.clinicaltrials.gov . Unique identifiers: NCT01920711 (PARAGON-HF), NCT01035255 (PARADIGM-HF).

Carbon nanodots (CNDs)-embedded pullulan (PUL) nanofibers were developed and successfully applied for sulfathiazole (STZ) removal from wastewater streams for the first time. The CNDs were incorporated into PUL at 0.0%, 1.0%, 2.0%, and 3.0% (w/w) to produce M1, M2, M3, and M4 nanofibers (PUL-NFs), respectively. The produced PUL-NFs were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction analysis (XRD), thermal gravimetric analysis (TGA) and Differential scanning calorimetry (DSC) and applied for STZ removal from aqueous solutions through pH, kinetics, and equilibrium batch sorption trials. A pH range of 4.0–6.0 was observed to be optimal for maximum STZ removal. Pseudo-second order, intraparticle diffusion, and Elovich models were suitably fitted to kinetics adsorption data (R2 = 0.82–0.99), whereas Dubinin–Radushkevich, Freundlich, and Langmuir isotherms were fitted to equilibrium adsorption data (R2= 0.88–0.99). STZ adsorption capacity of PUL-NFs improved as the amount of embedded CNDs increased. Maximum STZ adsorption capacities of the synthesized PUL-NFs were in the order of: M4 > M3 > M2 > M1 (133.68, 124.27, 93.09, and 35.04 mg g−1, respectively). Lewis acid–base reaction and π-π electron donor–acceptor interactions were the key STZ removal mechanisms under an acidic environment, whereas H-bonding and diffusion were key under a basic environment. Therefore, CNDs-embedded PUL-NFs could be employed as an environmentally friendly, efficient, and non-toxic adsorbent to remove STZ from wastewater streams.

The article is devoted to studying the solvent and catalyst nature influence on the 2-chloro-4-nitroaniline hydrogenation kinetic regularities on supported palladium and platinum catalysts in an aqueous solution of azeotropic composition and ethyl acetate. It is known that the halogen-substituted nitrobenzenes reduction may be accompanied by a secondary stage of hydrogenolysis. In this regard, the development of objective ideas about the selective control methods of the studied reaction the transformations staging is an extremely important task. The paper discusses the influence of the solvent and catalyst nature on the chlorine substituted amine yield. It should be noted that the form of kinetic curves for hydrogen in hydrogenation in ethyl acetate and 2-propanol indicates a significant influence of the solvent nature and a complex relationship between the catalyst structure and the solvent. It was established that a side-effect process that reduces the selectivity of the reaction with respect to 2-chloro-1,4-phenylenediamine is its dehalogenation. In the case of using ethyl acetate as a solvent, the absence of the 2-chloro-1,4-phenylenediamine dehalogenate product in the hydrogenation during the process, on both palladium and platinum catalysts, is noted. It is established that the hydrogen absorption rate in ethyl acetate on a palladium catalyst is eight times higher than on platinum. This effect may be associated with a smaller contribution of diffusion braking on a palladium catalyst. It is obvious that such effects may be due to the structure of the carriers. Probably, platinum, when applied to a substrate, is distributed on the inner surface of the carrier deep pores, while the distribution of the palladium phase is more likely to correspond to the crust distribution. This assumption also explains the fact of the palladium catalyst higher activity, which is accompanied by dehalogenation high degrees in 2-propanol.

Auscultation, the listening process for lung sound using acoustic stethoscope, is the first physical examination used to detect any disorder in heartbeat system. Unlike sophisticated tools, stethoscope is not beyond the reach of rural hospitals and clinics. However, the use of acoustic stethoscope needs specialized and well-experienced physicians. This is mainly due to limited sound amplification of the stethoscope to the extent that the human ears may fail to recognize the pathological sound, and hence, the diagnosis may be erroneously classified. Models that make use of screened digital, instead of acoustic, stethoscope, in which heart sound is digitized and stored, becomes one of the most popular techniques because it allows computer-aided software to perform automated analysis. In this paper, a complete algorithm for automatic heartbeat detection and disorder discrimination is presented. The technique takes the advantage of spectral analysis to separate the first and second heart sounds (S1 and S2) using a power threshold. The frame duration is dynamically estimated, according to duration of the sound to be analyzed (S1 or S2). As typical recordings of heart sounds are periodic with several cycles, two methods to combine MFCC estimates are proposed. Using 450 cardiac ausculatory with both pathological and normal heartbeats, the proposed methods were examined using a cross-validation strategy based on tenfold. More than 90%, at best, sensitivity and specificity, respectively, were obtained for the two methods using an artificial neural network classifier with multilayer perceptron. The solution takes the advantage of recent technology and digital advances, in which it is possible to connect the digital stethoscope to any digital device to conduct further analysis using computer-aided applications. The technique is practical as it can be available at different hospitals and clinics, including those in rural areas, with limited resources.

This article presents a latency-optimized implementation of the SIMECK lightweight block cipher on a field-programmable-gate-array (FPGA) platform with a block and key lengths of 32 and 64 bits. The critical features of our architecture include parallelism, pipelining, and a dedicated controller. Parallelism splits the digits of the key and data blocks into smaller segments. Then, we use each segmented key and data block in parallel for encryption and decryption computations. Splitting key and data blocks helps reduce the required clock cycles. A two-stage pipelining is used to shorten the critical path and to improve the clock frequency. A dedicated controller is implemented to provide control functionalities. For the performance evaluation of our design, we report implementation results for two different cases on Xilinx 7-series FPGA devices. For our case one, the proposed architecture can operate on 382, 379, and 388 MHz frequencies for Kintex-7, Virtex-7, and Artix-7 devices. On the same Kintex-7, Virtex-7, and Artix-7 devices, the utilized Slices are 49, 51, and 50. For one encryption and decryption computation, our design takes 16 clock cycles. The minimum power consumption is 172 mW on the Kintex-7 device. For the second case, we targeted the same circuit frequency of 50 MHz for synthesis on Kintex-7, Virtex-7, and Artix-7 devices. With minimum hardware resource utilization (51 Slices), the least consumed power of 13.203 mW is obtained for the Kintex-7 device. For proof-of-concept, the proposed SIMECK design is validated on the NEXYS 4 FPGA with the Artix-7 device. Consequently, the implementation results reveal that the proposed architecture is suitable for many resource-constrained cryptographic applications.

This study aimed to investigate the moderation role of technology accessibility (ACC) in the relationship between Performance expectancy (PE), Effort expectancy (EE), Social influence (SI), and Facilitating conditions (FC)as a predictor variables and behavioral intention (BI) to adapt with the technological change on the e-banking services. A sample of 545 users of e-banking services collected randomly from Sohag, Qina, Luxor, and Aswan cities in Egypt. The authors relied on (Goularte and Zilber 2019; Lichtenstein and Williamson 2006; Paim, Delafrooz, and Taleghani 2014) to measure the study variables. The study findings referred to a significant relationsp between the customer’s adaptive behavior dimensions and accepting the technological change. Only the facilitating conditions –as one of these dimentions- have no effect on the adapting behavior. The findings ,also, supported the moderating role of ACC in affecting the model interpretation for the customers' BI. This study aimed to integrate ACC as one of 4A’s e-banking with the UTAUT on users of e-banking services. The results of the study may help guide the banking mangers in Egypt for improving the level of e-services quality and the readiness to adopt the technological changes of their customers. &nbsp