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As the fifth generation (5G) mobile communication systems are commercially deployed, they bring new services, enhance user experiences, and offer various opportunities to different industries. Despite its advancements, 5G encounters several challenges. To tackle these issues, global industrial, academic, and standards organizations are actively researching on sixth generation (6G) wireless communication systems. 6G networks are envisioned as a transformative shift in the interactions between the physical, digital, and human realms, paving the way for a pervasive human-centered cyber-physical world. 6G is positioned to be a platform that offers communication and beyond communication services considering both performance and value centric technological development approaches. In this paper, we present the way forward towards the design of 6G endto-end (E2E) system as a consolidated view of leading industry stakeholders and academia in the European level 6G flagship project Hexa-X-II. We discuss the key challenges with 5G and how 6G is expected to tackle those by introducing new technological innovations and supporting novel use case requirements. We provide a comprehensive methodology for the design of a 6G E2E system including ten principles, a blueprint, and a structured design process. The architecture design principles prioritize environmental sustainability, digital inclusiveness, and trustworthiness, considering their impact on the 6G E2E system. The blueprint is described corresponding to the infrastructure, network centric application, and application layers, as well as the pervasive functionalities and the relevant technological innovations. Following the design principles and the system blueprint, the design process is demonstrated as two-way approaches (i.e., 1) key performance and value indicators based design process. 2) top-down versus bottom-up alignment process) through the lens of a collaborative robot use case. Through this use case, a special attention is given to the technological enablers that cover management and orchestration functionalities and their 6G enhancement to go beyond the limitations characterizing the previous network generation. In addition, virtual modelling aspects related to digital twining and simulations for 6G E2E system design are also discussed.

Power production, as well as transportation, are two sectors mainly contributing to global warming and pollution. These effects can be lessened through the use of biofuels. However, biofuels are plagued due to low calorific value and high viscosity compared to diesel. However, this can be overcome by proper adjustment of the operating parameters (Compression ratio, Fuel injection timing, Fuel injection Pressure, Engine load). The present study tries to unravel the influence of fuel injection pressure on the performance, combustion, emission, and exergy analysis of the Nahar biodiesel run diesel engine. Five fuel injection pressure (200 bar, 220 bar, 240 bar, 260 bar, 280 bar) and five engine loading conditions (20 %, 40 %, 60 %, 80 %, 100 %) at injection timing of 23° BTDC and compression ratio of 17.5 are considered. The results indicate that the performance, combustion, emission, and exergy parameters improve with the use of higher fuel injection pressure. The maximum BTEs are found to be 24.86 %, 27 %, 28.11 %, 29.22 %, and 31.13 % in biodiesel mode at FIPs of 200 bar, 220 bar, 240 bar, 260 bar, and 280 bar, respectively in comparison to 27.76 % for diesel at standard settings (FIP = 200 bar, CR = 17.5, IT = 23° BTDC) at 100 % load. Furthermore, the effect of addition of nanoparticles and variation of other operating parameters such as injection timing and compression ratio of the engine may enhance the performance and emissions of Nahar biodiesel run diesel engine.

Abstract The influence of humans on the environment is growing drastically and is pervasive. If this trend continues for a longer time, it can cost humankind, social and economic challenges. Keeping this situation in mind, renewable energy has paved the way as our saviour. This shift will not only help in reducing pollution but will also provide immense opportunities for the youth to work. This work discusses about various waste management strategies and discusses the pyrolysis process in details. Simulations were done keeping pyrolysis as the base process and by varying parameters like feeds and reactor materials. Different feeds were chosen like Low-Density Polyethylene (LDPE), wheat straw, pinewood, and a mixture of Polystyrene (PS), Polyethylene (PE), and Polypropylene (PP). Different reactor materials were considered namely, stainless steel AISI 202, AISI 302, AISI 304, and AISI 405. AISI stands for American Iron and Steel Institute. AISI is used to signify some standard grades of alloy steel bars. Thermal stress and thermal strain values and temperature contours were obtained using simulation software called Fusion 360. These values were plotted against temperature using graphing software called Origin. It was observed that these values increased with increasing temperature. LDPE got the lowest values for stress and stainless steel AISI 304 came out to be the most feasible material for pyrolysis reactor having the ability to withstand high thermal stresses. RSM was effectively used to generate a robust prognostic model with high efficiency, R2 (0.9924–0.9931), and low RMSE (0.236 to 0.347). Optimization based on desirability identified the operating parameters as 354 °C temperature and LDPE feedstock. The best thermal stress and strain responses at these ideal parameters were 1719.67 MPa and 0.0095, respectively.

Background: Epistaxis is a common condition but with diverse etiology dependent on geography, season, climate, and demography. Aims and Objectives: To describe the demographic, clinical, and etiological profile and management strategies of epistaxis cases at a tertiary center in U.P. (west). Materials and Methods: Patients were identified from the emergency and outpatient department, and their demographic and clinical details were noted. Local examination was performed, and necessary investigations were carried out. Management strategies were noted. Duration of hospital stay and mortality, if any, was documented. Descriptive analytics were used. Data were represented as numbers and percentages, mean±standard deviation, and median. Results: A total of 189 epistaxis patients were enrolled in the study. The mean age of patients was 32.89±17.92 (range 1–85 years). The sex ratio (M: F) was 2.71. Majority of patients presented to the emergency department (60.3%) within 1 day (64.6%), had single episode (66.7%), the presence of old clot (72%) and the anterior location of bleeding (91.5%). 119 (63%) cases required admission. Nasal endoscopy and computed tomography scan were performed in 49 (25.9%) and 24 (12.7%) cases, respectively. The most common etiology was trauma (49.2%), followed by idiopathic cause (14.8%), hypertension (12.7%), and others. Nasal packing and cauterization were required in 16.4% and 15.9% of cases, respectively. Surgery was required in 5 (2.6%) cases. A minuscule percentage of cases required blood transfusion. There was no mortality. Conclusion: Epistaxis is a common emergency with males predominating over females. Causes are varied. Most patients can be managed conservatively with favorable outcomes if timely intervention is done.

Category: Hindfoot; Other Introduction/Purpose: The Malerba calcaneal osteotomy is a step cut Z-type osteotomy with a lateral wedge resection used to treat hindfoot varus deformity. The osteotomy allows for lateral translation while the wedge resection enables lateral rotation of the calcaneal tuberosity. The technique enables a more powerful correction of hindfoot varus without excessive lateral translation of the calcaneus, which has been shown to cause tarsal tunnel syndrome. Thus far, there have been few published clinical and radiographic outcomes on the Malerba osteotomy. The purpose of this article is to report on patient reported outcome scores (PROMIS), complications, and radiographic improvement in a series of patients treated with this osteotomy. Methods: A prospectively collected foot and ankle registry was queried to retrospectively identify patients who underwent a Malerba osteotomy from February 2016 through January 2022. Patients were included if they were over 18 years of age, underwent a Malerba osteotomy, had preoperative and minimum 1-year postoperative PROMIS scores, and preoperative and postoperative radiographs. 40 patients met the inclusion criteria (average age 54.3 years). PROMIS scores from 6 domains including physical function, pain interference, pain intensity, global physical health, global mental health, and depression were compared preoperatively and postoperatively. Radiographic measures including talonavicular coverage angle (TNCA), calcaneal pitch (CP), and lateral talus-1st metatarsal angle (Meary’s angle) were measured and compared preoperatively and postoperatively. Complications and radiographic union were also recorded. Results: At a mean of 22 months, PROMIS domains including physical function, pain interference, pain intensity, global physical health, and global mental health improved significantly; the depression scale did not significantly change (Table 1). Calcaneal pitch and Meary’s angle significantly improved from 22.9 to 19.1 (p

At the start of the COVID-19 pandemic, the Jim Pattison Diabetes and Pregnancy (JP DAP) clinic quickly switched from in-person to virtual care for patients with gestational diabetes (GDM) to reduce the risk of viral transmission. Poor glycaemic control in pregnancies increases the risk of maternal–fetal complications and thus women with GDM require education, frequent follow-up and treatment to reduce these risks. Delays in care could potentially result in increased maternal–fetal complications. We conducted a prospective, single-centre quality improvement (QI) study of women with GDM who attended the JP DAP clinic and delivered between 1 September 2019 and 31 March 2021. 2123 singleton pregnancies between 1 September 2019 and 31 March 2021 with GDM were analysed for this study. The time of referral to see the endocrinologist was lower than baseline in the first wave but rose significantly in the second wave. No-shows for appointments increased in the first wave but were lower than baseline after the implementation of time slots. There was no special cause variation for maternal–fetal complications pre pandemic, first wave or during the second wave. A patient satisfaction survey reported that 93% of respondents strongly agreed or agreed with the statement ‘I was satisfied with the care provided to me over the telephone appointments’. The GDM education package, online educational videos in Hindi and English and the glucometer smartphone application helped to maintain the time of referral to first endocrinologist appointment in the first wave and therefore were considered an effective substitute for in-person education. Despite the delays in care seen in the second wave, there was no increase in maternal-fetal complications. Our clinic plans to continue using virtual tools for the foreseeable future.

Introduction: The smell dysfunction in COVID-19 patients has remained an unexplained topic. The blood parameters' variability in COVID-19 patients with anosmia has been studied in few literatures. The study is aimed to find the association of anosmia with the blood grouping and C-reactive protein (CRP) levels in coronavirus-infected patients. Materials and Methods: Database from Medical Records Department of a Tertiary Care Teaching Hospital in Northern India was searched from July 2020 to December 2020. Every fifth file was selected using the stratified random sampling. Laboratory-confirmed COVID-19 cases by reverse transcription-polymerase chain reaction files were included. Blood grouping and CRP levels were assessed and statistically correlated. Results: A total of 103 patients of coronavirus-associated infection with anosmia were included among which 52 (50.48%) patients were from moderate category of AIIMS-ICMR joint task Force's clinical guidelines. A total of 44 (42.71%) patients had moderate levels of elevated CRP. The blood Group B-type was found most commonly in 35 (33.98%) patients. The correlation of severity of COVID-19 infection with CRP was found to be statistically significant (Chi-square test statistic was 31.203 and P = 0.00023) in patients presenting with smell dysfunction. Conclusion: Anosmia was found to a suggestive symptom for the early identification of coronavirus-infected cases. In this study, CRP levels showed statistically significant association with anosmia in COVID-19 patients. Predilection for specific blood groups serves as platform for further research.

Shigellosis (bacillary dysentery) is a severe gastrointestinal infection with a global incidence of 90 million cases annually. Despite the severity of this disease, there is currently no licensed vaccine against shigellosis. Shigella’s primary virulence factor is its type III secretion system (T3SS), which is a specialized nanomachine used to manipulate host cells. A fusion of T3SS injectisome needle tip protein IpaD and translocator protein IpaB, termed DBF, when admixed with the mucosal adjuvant double-mutant labile toxin (dmLT) from enterotoxigenic E. coli was protective using a murine pulmonary model. To facilitate the production of this platform, a recombinant protein that consisted of LTA-1, the active moiety of dmLT, and DBF were genetically fused, resulting in L-DBF, which showed improved protection against Shigella challenge. To extrapolate this protection from mice to humans, we modified the formulation to provide for a multivalent presentation with the addition of an adjuvant approved for use in human vaccines. Here, we show that L-DBF formulated (admix) with a newly developed TLR4 agonist called BECC438 (a detoxified lipid A analog identified as Bacterial Enzymatic Combinatorial Chemistry candidate #438), formulated as an oil-in-water emulsion, has a very high protective efficacy at low antigen doses against lethal Shigella challenge in our mouse model. Optimal protection was observed when this formulation was introduced at a mucosal site (intranasally). When the formulation was then evaluated for the immune response it elicits, protection appeared to correlate with high IFN-γ and IL-17 secretion from mucosal site lymphocytes.

Power production through combustion of fuels plays a vital role in the progress of a nation. In liquid fuels, biodiesel has emerged as a potential replacement of fossil fuel. In this regard, the improvement of fuel properties or adjustment of the operating parameters can improve the efficiency and lower the emission for a biodiesel run diesel engine. In this regard, the current study focuses on the use of novel nano blended biodiesel, prepared by blending titanium dioxide nano particles along Eichhornia Crassipes biodiesel. Three different biodiesel blends are prepared having composition of titanium dioxide by 50 ppm, 100 ppm and 150 ppm which is tested in a four stroke, single cylinder, naturally aspirated water cooled diesel engine of 3.5 kW rated power for different loading conditions for performance, emission, and combustion evaluation. Further, at the same engine conditions, the biodiesel blend having 150 ppm of titanium dioxide is tested at fuel injection pressure of 220 bar. The findings suggests that the brake thermal efficiency improves and emissions lowers with the addition of nano particles at high fuel injection pressure. The maximum improvement of brake thermal efficiency of 1.01% in comparison to diesel mode has been found for nano blended biodiesel composition of 150 ppm of titanium dioxide at fuel injection pressure of 220 bar under full loading condition. For the same fuel injection pressure of 220 bar and same nano blended biodiesel composition, the hydrocarbon and carbon monoxide emission were found to minimum at 60% load.

Lateral flow assay (LFA) is emerging as one of the most popular paper-based biosensors in the field of the diagnostic industry. LFA fills all the gaps between diagnosis and treatment as it provides beneficial qualities to users such as quick response, Point-of-care appeal, early detection, low cost, and effective and sensitive detections of various infectious diseases. These benefits increase LFA’s dependability for disease management because rapid and accurate disease diagnosis is a prerequisite for effective medication. Only 2% of overall healthcare expenditures, according to Roche Molecular Diagnostics, are spent on in vitro diagnostics, even though 60% of treatment choices are based on this data. To make LFA more innovative, futuristic plans have been outlined in many reports. Thus, this review reports on very knowledgeable literature discussing LFA and its development along with recent futuristic plans for LFA-based biosensors that cover all the novel features of the improvement of LFA. LFA might therefore pose a very significant economic success and have a significant influence on medical diagnosis.

Immunotherapy using monoclonal antibodies targeting the PD-1/PD-L1 interaction has shown enormous success for various cancers. Despite their encouraging results in clinics, antibody-based checkpoint inhibitors have several limitations, such as poor tumor penetration. To address these limitations of monoclonal antibodies, there is a growing interest in developing low-molecular-weight checkpoint inhibitors, such as antibody fragments. Several antibody fragments targeting PD-1/PD-L1 were recently discovered using phage libraries from camel or alpaca. However, animal-derived antibody fragments may elicit unwanted immune responses, which limit their therapeutic applications. For the first time, we used a human domain antibody phage library and discovered anti-human PD-L1 human single-domain antibodies (dAbs) that block the PD-1/PD-L1 interaction. Among them, the CLV3 dAb shows the highest affinity to PD-L1. The CLV3 dAb also exhibits the highest blocking efficacy of the PD-1/PD-L1 interaction. Moreover, the CLV3 dAb significantly inhibits tumor growth in mice implanted with CT26 colon carcinoma cells. These results suggest that CLV3 dAb can be potentially used as an anti-PD-L1 inhibitor for cancer immunotherapy.

Explanations for police misconduct often center on a narrow notion of "problem officers," the proverbial "bad apples." Such an individualistic approach not only ignores the larger systemic problems of policing but also takes for granted the group-based nature of police work. Nearly all of police work is group-based and officers' formal and informal networks can impact behavior, including misconduct. In extreme cases, groups of officers (what we refer to as, "crews") have even been observed to coordinate their abusive and even criminal behaviors. This study adopts a social network and machine learning approach to empirically investigate the presence and impact of officer crews engaging in alleged misconduct in a major U.S. city: Chicago, IL. Using data on Chicago police officers between 1971 and 2018, we identify potential crews and analyze their impact on alleged misconduct and violence. Results detected approximately 160 possible crews, comprised of less than 4% of all Chicago police officers. Officers in these crews were involved in an outsized amount of alleged and actual misconduct, accounting for approximately 25% of all use of force complaints, city payouts for civil and criminal litigations, and police-involved shootings. The detected crews also contributed to racial disparities in arrests and civilian complaints, generating nearly 18% of all complaints filed by Black Chicagoans and 14% of complaints filed by Hispanic Chicagoans.

Objective To study and document the epidemiological data, various morphological expressions, and causative medications for tinea incognito, to identify the causative agent, and also to evaluate the laboratory methods' efficacy in substantiating the diagnosis clinically. Methods It was conducted over a period of two years with a sample size of hundred cases of tinea incognito who had used topical or systemic steroids, topical immunosuppressants, and other indigenous preparations for a period of at least four weeks. Skin scrapings from the patients were examined for fungal elements under KOH mount, and fungal cultures were performed for species identification, and the derived results were analyzed. Patients at the end of three weeks and six weeks were re-assessed. Results In our study, clinical presentation mimicked various dermatoses, of which eczematous like was the most common type, followed by psoriasiform. KOH was positive among 69% of the patients, and positivity for fungal culture was seen in 48%, out of which Trichophyton mentagrophytes constituted 56.25% of the cases, followed by Trichophyton rubrum (25%). Conclusion Although this entity has been known for years, it still causes perplexity in diagnosis and treatment. Health education in order to create public awareness about dermatophytosis is indeed the need of the hour. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effectiveness of intralesional Bacille Calmette Guerin (BCG) immunotherapy in the treatment of warts in immunocompetent patients. Methods In our study, the sample size included 30 patients with multiple, recalcitrant, and recurrent warts. After taking informed consent, the patients were injected intralesionally with 0.1 ml BCG vaccine into the oldest wart at an interval of 3 weeks for a maximum of three sessions. Patients were evaluated every three weeks for a response, side effects and were followed up to 6 months for recurrences. For assessment of response, the grading scale was used. Results In our study, out of 30 patients, a good response was seen in 80%, while a partial response in 6.7%, and poor response in 13.3% of patients, and no recurrence was seen in 80% of patients in a follow-up of 6 months. In our study, 90% of patients had pain, 70% flu-like symptoms, 6.7% abscess, 6.7% ulceration, and 10% no adverse effects. Conclusion Intralesional BCG immunotherapy is a promising, simple, safe, and cost-effective modality for multiple, recalcitrant, and recurrent warts. [ABSTRACT FROM AUTHOR]