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A dilated native right ventricular outflow tract (RVOT) presents unique challenges for transcatheter management using balloon-expandable valves. The Alterra Adaptive Prestent was designed to expand transcatheter therapy to treat patients with dilated RVOTs. The aim of this study was to report 2-year outcomes of the main cohort of the ALTERRA (Multicenter Study of Congenital Pulmonic Valve Dysfunction Studying the SAPIEN 3 THV With the Alterra Adaptive Prestent) pivotal trial using the prestent with transcatheter pulmonary valve replacement. The prestent device used with the 29 mm SAPIEN 3 transcatheter heart valve (THV) was evaluated for the management of patients with moderate or greater pulmonary valve regurgitation (PR). The primary endpoint was THV dysfunction at 6 months, defined as a nonhierarchical composite of RVOT/pulmonary valve reintervention, moderate or greater total PR on transthoracic echocardiography, and mean RVOT/pulmonary valve gradient 35 mm Hg or greater on transthoracic echocardiography. The primary endpoint and outcomes through 2 years are presented in this analysis. Of 97 patients screened, 60 underwent prestent and THV implantation. There was 1 staged procedure. No patients had THV dysfunction at 6 months. At 2 years, the majority of patients (92.5%) had mild or less PR, with no reports of coronary compression, stent fractures warranting reintervention, or endocarditis. Of the 21 patients (34.4%) who experienced early (days 0-1) arrhythmias, 12 had episodes of nonsustained ventricular tachycardia that resolved with medication. One patient underwent reintervention secondary to an iatrogenic RVOT obstruction; there were no deaths or explantations through 2 years. The Alterra prestent in combination with the SAPIEN 3 THV has excellent outcomes at 2 years, with no significant valve dysfunction in the main pivotal cohort. [Display omitted] [ABSTRACT FROM AUTHOR]

To address the molecular markers linked to the development and progression of oral squamous cell carcinoma (OSCC), we sought to analyze the expression of vasodilator-stimulated phosphoproteins (VASP) in OSCC samples. This study used 51 OSCC patients and The Cancer Genome Atlas-Head and Neck Squamous Cell Carcinoma (TCGA-HNSC) dataset to analyze VASP expression. The association between VASP mRNA expression and HNSCC clinicopathological features, tumor infiltration, functional roles, and gene co-expression of VASP also were evaluated. Our study observed increased VASP mRNA expression in OSCC tumor tissues compared to normal tissues, supported by TCGA-HNSC dataset analysis. Elevated VASP levels correlated with advanced tumor stage, higher grade, nodal metastasis, and poor survival, indicating its potential as a prognostic marker. Protein analysis and immunohistochemistry confirmed these findings, and in silico analysis revealed VASP involvement in key cancer-related processes and its correlation with IL8, RAP1A expression, and tumor infiltration levels. In conclusion, VASP emerges as a promising diagnostic and prognostic marker for OSCC within HNSCC, emphasizing the importance of exploring its regulatory mechanisms and therapeutic applications. The revealed pathways present avenues for targeted treatment in OSCC. Despite limitations, this study provides valuable insights with potential implications for improving patient outcomes. [ABSTRACT FROM AUTHOR]

Long-term clinical outcomes of catheter ablation (CA) compared to thoracoscopic surgical ablation (SA) to treat patients with long-standing persistent atrial fibrillation (LSPAF) are not known. The purpose of this study was to compare the long-term (36-month) clinical efficacy, quality of life, and cost-effectiveness of SA and CA in LSPAF. Participants were followed up for 3 years using implantable loop recorders and questionnaires to assess the change in quality of life. Intention-to-treat analyses were used to report the findings. Of the 115 patients with LSPAF treated, 104 (90.4%) completed 36-month follow-up [CA: n = 57 (95%); SA: n = 47 (85%)]. After a single procedure without antiarrhythmic drugs, 7 patients (12%) in the CA arm and 5 (11%) in the SA arm [hazard ratio 1.22; 95% confidence interval (CI) 0.81–1.83; P =.41] were free from atrial fibrillation/tachycardia (AF/AT) ≥30 seconds at 36 months. Thirty-three patients (58%) in the CA arm and 26 (55%) in the SA arm (hazard ratio 1.04; 95% CI 0.57–1.88; P =.91) had their AF/AT burden reduced by ≥75%. The overall impact on health-related quality of life was similar, with mean quality-adjusted life year estimates of 2.45 (95% CI 2.31–2.59) for CA and 2.32 (95% CI 2.13–2.52) for SA. Estimated costs were higher for SA (mean £24,682; 95% CI £21,746–£27,618) than for CA (mean £18,002; 95% CI £15,422–£20,581). In symptomatic LSPAF, CA and SA were equally effective at achieving arrhythmia outcomes (freedom from AF/AT ≥30 seconds and ≥75% burden reduction) after a single procedure without antiarrhythmic drugs. However, SA is significantly more costly than CA. [ABSTRACT FROM AUTHOR]

With improved survival of adults with congenital heart disease (CHD) comes a need to understand the lifelong outcomes of this population. The aim of this paper is to describe the rationale and design of Congenital Heart Disease Project to Understand Lifelong Survivor Experience (CHD PULSE), a study to determine long-term medical, neurocognitive, and psychosocial outcomes among adults with a history of intervention for CHD and to identify factors associated with those outcomes. CHD PULSE is a cross-sectional survey conducted from September 2021 to April 2023 among adults aged 18 and older with a history of at least 1 intervention for CHD at 1 of 11 participating U.S. centers in the Pediatric Cardiac Care Consortium. Participants with CHD were asked to complete a 99-question survey on a variety of topics including: demographics, surgeries, health insurance, health care, heart doctors, general health, height and weight, education and work history, reproductive health (for women only), and COVID-19. To construct a control group for the study, siblings of survey respondents were invited to complete a similar survey. Descriptive statistics for demographics, disease severity, center, and method of survey completion were computed for participants and controls. Comparisons were made between participants and non-participants to assess for response bias and between CHD participants and sibling controls to assess for baseline differences. Among the 14,322 eligible participants, there were 3,133 respondents (21.9%) from 48 U.S. states with surveys returned for inclusion in the study. Sibling contact information was provided by 691 respondents, with surveys returned by 326 siblings (47.2%). The median age of participants was 32.8 years at time of survey completion, with an interquartile range of 27.2 years to 39.7 years and an overall range of 20.1 to 82.9 years. Participants were predominantly female (55.1%) and of non-Hispanic White race/ethnicity (87.1%). There were no differences between participants and non-participants regarding severity of CHD. Compared to nonparticipants, participants were more likely to be female, of older age, and be of non-Hispanic White race/ethnicity. Enrolled siblings were more likely to be female and slightly younger than participants. With surveys from 3,133 participants from across the U.S., CHD PULSE is poised to provide keen insights into the lifelong journey of those living with CHD, extending beyond mere survival. These insights will offer opportunities for informing strategies to enhance and improve future outcomes for this population of patients. [ABSTRACT FROM AUTHOR]

Chronic wounds, defined as wounds that do not heal in a logical set of stages, impact patients' quality of life by disrupting their self-esteem, sleep, social interaction, work capacity, and psychological well-being. Chronic wounds are a prevalent problem in Oman due to the high number of patients with diabetes, sickle cell disease, road traffic accidents, and decubitus ulcer. Therefore, it is paramount to analyse the health-related quality of life (HRQOL) of these patients with chronic wounds. An observational, cross-sectional, descriptive study with a quantitative approach was conducted among 275 adult patients with chronic wounds in three tertiary hospitals of Muscat from June to December 2021 using a self-reported Cardiff life wound impact questionnaire and the Bates-Jensen wound assessment tool. Data were analysed with IBM SPSS version 23 using inferential statistics and chi-square test. We found that the majority of participants were men (178; 64.7 %), aged between 41 and 60 years (107; 38.9 %), predominantly with diabetic wounds (80; 29.1 %). Respondents reported poor HRQOL across all domains: well-being (63.24 ± 18.092), physical (53.24 ± 18.387), and social (59.54 ± 19.025). Statistically significant poorer HRQOL was observed among the elderly above 60 years, illiterates, those with traumatic wounds, and those receiving medication and dressing as treatment. Our findings indicate that Omani patients with chronic wounds experience low HRQOL. It is imperative for healthcare providers to offer comprehensive care to these patients. To enhance their quality of life and alleviate suffering, evaluating both the wounds and HRQOL is essential. Such assessments will enable the optimisation of treatment and coping strategies for patients. [Display omitted] • Majority of Omani patients with chronic wounds are men aged 41–60 with diabetic wounds. • Chronic wounds notably diminish health-related quality of life in wellbeing, physical, and social domains. • Elderly, illiterates, and those with traumatic wounds face lower health-related quality of life. • Medication and dressing treatments linked to significant health-related quality of life decline. [ABSTRACT FROM AUTHOR]

Apoptosis is an orchestrated phenomenon that regulates cell populations in physiological and pathological conditions. Carcinogenesis involves a state of disequilibrium between cell proliferation and cell death. The resistance to conventional therapeutic modalities of cancer, including surgery, radiotherapy, and chemotherapy, can be explained by the compensatory repair and regeneration that occurs in the tumor microenvironment following apoptosis through the apoptotic compensatory proliferation signaling microvesicles (ACPSVs) or apoptotic extracellular microvesicles (ApoEVs). These microvesicles provide proliferative signals and act as mutagens, triggering cell proliferation, angiogenesis, immune evasion, metastasis, and invasion. This review discusses the phenomenon of apoptosis-induced proliferation and the role of ApoEVs in establishing an oncoregenerative niche, resulting in therapeutic resistance and recurrence of malignancies. [Display omitted] [ABSTRACT FROM AUTHOR]

Fatigue is prevalent, problematic, and co-occurs in chronic low back pain. When left untreated, fatigue can increase depressive mood, and intensify pain burden and disability in patients with chronic low back pain. The purpose of this study was to examine the relationship of fatigue to depressive mood, pain severity, and pain interference in patients with chronic low back pain. A cross-sectional design was used to enroll and evaluate adults (n = 67) with chronic low back pain (>6 months) during their visit to an outpatient pain clinic. Participants completed psychometric instruments for fatigue, depressive mood, pain severity, and pain interference. Participants were primarily women (73%), White (59%), with a median age of 59 years (range 22-70 years). Multiple regression models showed significant positive associations between fatigue and depressive mood (SD: 0.025 p = 0.017) with a coefficient of 0.069; fatigue and pain interference (SD: 0.123 p = 0.010) with a coefficient of 0.652; fatigue and pain severity (SD: 0.125 p-value <0.05) with a coefficient of 0.359. After adjusting for demographic factors (age, sex, and race/ethnicity) the associations remained significant. The findings suggest that fatigue is associated with greater depressive mood, pain severity, and pain interference in adults with chronic low back pain. Assessing the extent of fatigue and depressive mood as part of pain management may benefit patients with chronic low back, thereby reducing symptom burden. [ABSTRACT FROM AUTHOR]

A highly accurate automated approach using a deep structured neural network was proposed to detect Parkinson's disease through voice samples. This cost-effective and non-invasive method aims to enhance diagnostic precision and assess the disease's stage of progression. The study addresses two classification problems: binary and multi-category classification. The binary classification deep structured neural network achieved a diagnostic accuracy of 97.6%. For multiclass classification, a Deep Convolution Neural Network (DCNN) and a K- nearest neighbor technique for benchmarking, were utilized using a shared database. Nature Inspired Algorithm (NIA)-Genetic Algorithm was employed to optimize the initial feature set. The suggested deep structure neural network demonstrated a 93.7% accuracy in estimating the disease's stage, showing promising results. Further investigations are encouraged to explore the model's adaptability and pursue improved outcomes. [ABSTRACT FROM AUTHOR]

• Few studies examined appropriate training methods for older adults to use smart tablets to access reliable health information. • Little research specifically on older adults in terms of accessibility and digital literacy. • Future research needed to create interventions that are tailor-made to address barriers, including providing access to smart technology devices and reliable health information. Older adults are becoming more accepting and interested in using digital technologies, but difficulties and barriers remain for accessing reliable health-related information. The purpose of this focused pilot intervention study was to: (1) understand older adults' firsthand experiences and challenges while using smart tablets post-COVID-19 pandemic, and (2) gather suggestions for age-appropriate training materials, preference of training materials, and resources to access reliable online health information. A focused pilot intervention study that involved training older adults to use smart tablets followed by focus group of a convenience sample of 13 older adults (65–85 years old; 91.6% female) on their experiences of using smart tablets. Thematic analysis revealed three themes: tablets are convenient to access online information and older adults reported technical, security concerns, emotional and cognitive challenges regarding use of smart tablets. Older adults also requested one-on-one support, assistance, and topic specific learning for future training sessions. Future studies should focus on providing detailed, clear instructions at an acceptable pace for older adults. [ABSTRACT FROM AUTHOR]

Sexual minority men (SMM) in Zambia face significant challenges including stigma, discrimination, and mental health issues, which further impact their HIV-related risk behaviors. This study aimed to investigate the associations between enacted stigma, substance abuse, HIV-related behaviors, and mental health (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD] symptoms) among SMM in Zambia. SMM aged 18–35 years who reported having multiple and/or concurrent sexual partners or low and/or inconsistent condom use in the past three months were recruited from four districts in Zambia between February and November 2021. Participants completed an anonymous interviewer-administered survey. Key variables of interest were compared between participants with higher vs. lower levels of enacted stigma. Independent samples t -tests were used for continuous variables, and chi-squared tests were used for categorical variables. A total of 197 eligible SMM participated in the study (mean age = 24.41 years). Participants with a higher level of enacted stigma showed a higher level of anxiety symptoms (χ2 = 12.91, p ≤.001), PTSD symptoms (χ2 = 7.13, p <.01), tobacco use (χ2 = 10.47, p <.01), cannabis use (χ2 = 5.90, p <.05), and a higher number of sexual partners (t = 1.99, p <.05) in the past three months. Stigma reduction interventions may help mitigate substance abuse, HIV-related behaviors, and adverse mental health outcomes among SMM in Zambia. Health care providers, especially psychiatric-mental health nurses, can incorporate strategies for recognizing and addressing stigma into their practice through training and integrate multiple resources to create an inclusive and non-judgmental environment for SMM to improve their well-being. • In Zambia, enacted stigma among SMM is associated with mental health issues. • Enacted stigma relates to tobacco use, cannabis use, and a higher number of sexual partners. • Stigma reduction interventions are needed to reduce substance abuse and HIV-related risk behaviors. [ABSTRACT FROM AUTHOR]

Control of antimicrobial resistance (AMR) relies on local knowledge and local intervention implementation. Effective antibiotic stewardship requires locally-suitable prescribing guidelines. We aimed to use a novel digital tool (the ZARIApp) and a participatory approach to help develop locally-relevant empiric antibiotic prescribing guidelines for two hospitals in Lusaka, Zambia. We produced an AMR report using samples collected locally and routinely from adults within the prior two years (April 2020 – April 2022). We developed the ZARIApp, which provides prescribing recommendations based on local resistance data and antibiotic prescribing practices. We used qualitative evaluation of focus group discussions among healthcare professionals to assess the feasibility and acceptability of using the ZARIApp and identify the barriers to and enablers of this stewardship approach. Resistance prevalence was high for many key pathogens: for example, 73% of 41 Escherichia coli isolates were resistant to ceftriaxone. We identified that high resistance rates were likely due to low levels of requesting and processing of microbiology samples from patients leading to insufficient and unrepresentative microbiology data. This emerged as the major barrier to generating locally-relevant guidelines. Through active stakeholder engagement, we modified the ZARIApp to better support users to generate empirical antibiotic guidelines within this context of unrepresentative microbiology data. Qualitative evaluation of focus group discussions suggested that the resulting ZARIApp was useful and easy to use. New antibiotic guidelines for key syndromes are now in place in the two study hospitals, but these have substantial residual uncertainty. Tools such as the free online ZARIApp can empower local settings to better understand and optimise how sampling and prescribing can help to improve patient care and reduce future AMR. However, the usability of the ZARIApp is severely limited by unrepresentative microbiology data; improved routine microbiology surveillance is vitally needed. [ABSTRACT FROM AUTHOR]

The knowledge and skills of pain management nurses positions them well to manage people's pain and provide critical services to patients with COVID-19. To understand the personal and professional experiences and the support pain management nurses received during the COVID-19 pandemic. Between July 2020 and 2021, data were collected through semi-structured telephone interviews from members of the American Society for Pain Management Nursing. Content analysis was used. Eighteen pain management nurses who worked during the early stages of the pandemic were interviewed. Three main categories were identified: experiencing stress and burden, pain management strategies changed, learning to cope with support. Pain management nurses reported fear of exposure, difficulties with staff shortages, the complex social milieu, and how pain management took a backseat to other symptoms of COVID-19. They coped through support from their colleagues, organizational leaders, and community members. Pain management nurses provided recommendations for future care of patients' pain during a pandemic. Pain management nurses shared their professional and personal experiences and the support they received while managing patients' pain during the COVID-19 pandemic. Their experiences provided findings on the importance of pain management and to support nurses during personal and professional vulnerabilities during crises. Key recommendations on the care of patients' pain in future pandemics included developing expertise in pain management and health-related emergencies; engaging nurses in supportive mental health services, infectious disease testing, and vaccine efforts; and planning for surge capacity to reach out to underserved people living with pain. [ABSTRACT FROM AUTHOR]

To promote the rational use of cardiovascular imaging in patients with congenital heart disease, the American College of Cardiology developed Appropriate Use Criteria (AUC), but its clinical application and pre-release benchmarks have not been evaluated. We aimed to evaluate the appropriateness of indications for cardiovascular magnetic resonance (CMR) and cardiovascular computed tomography (CCT) in patients with conotruncal defects and to identify factors associated with maybe or rarely appropriate (M/R) indications. Twelve centers each contributed a median of 147 studies performed prior to AUC publication (01/2020) on patients with conotruncal defects. To incorporate patient characteristics and center-level effects, a hierarchical generalized linear mixed model was used. Of the 1753 studies (80% CMR, and 20% CCT), 16% were rated M/R. Center M/R ranged from 4 to 39%. Infants accounted for 8.4% of studies. In multivariable analyses, patient- and study-level factors associated with M/R rating included: age <1 year (OR 1.90 [1.15–3.13]), truncus arteriosus (vs. tetralogy of Fallot, OR 2.55 [1.5–4.35]), and CCT (vs. CMR, OR 2.67 [1.87–3.83]). None of the provider- or center-level factors reached statistical significance in the multivariable model. Most CMRs and CCTs ordered for the follow-up care of patients with conotruncal defects were rated appropriate. However, there was significant center-level variation in appropriateness ratings. Younger age, CCT, and truncus arteriosus were independently associated with higher odds of M/R rating. These findings could inform future quality improvement initiatives and further exploration of factors resulting in center-level variation. This multicenter study evaluates the appropriateness of cardiovascular magnetic resonance (CMR) and cardiovascular computed tomography (CCT) in patients with conotruncal defects prior to the release of the Appropriate Use Criteria (AUC). Of the 1753 studies (80% CMR, and 20% CCT), 16% were for maybe or rarely appropriate (M/R) indications. Center M/R ranged from 4 to 39%. The patient- and study-level factors associated with M/R rating included: age <1 year, truncus arteriosus, and CCT. Though most CMRs and CCTs were rated appropriate, there were significant center-level variations in appropriateness ratings that need further exploration. [ABSTRACT FROM AUTHOR]

The lateralization can influence the choice of occlusion scheme, patient comfort and success of the prosthesis. The existence of favored masticatory side in complete denture patients and its influence with various occlusal schemes is less analyzed in the literature. The study objective was to compare the masticatory and hemispheric laterality in complete denture subjects rehabilitated with 2 different occlusal schemes at different time intervals. The cohort study recruited 26 patients in each group of balanced and non-balanced occlusion with definitive criteria. Conventional procedures were followed in denture fabrication. The hemispheric and masticatory laterality for all participants were established at 0,1,3- and 6-month intervals. The laterality was categorized as preferred chewing side (CPCS), predominant preferred chewing side (PPCS) and observed preferred chewing side (OPCS). The data on chewing side preference was analyzed by chi square test. (α = 0.05). Right side preference was predominant in 86.1% of non-balanced and 60.1% of balanced occlusion participants. The side preference among the 2 laterality and across time interval decreased in masticatory laterality of balanced occlusion participants (P <.05) when compared to non-balanced occlusion. (P >.05) The balanced occlusion dentures had lesser masticatory side preference when compared to non-balanced occlusion complete denture. [ABSTRACT FROM AUTHOR]

Music plays a significant role in evoking human emotions. Thanks to the quick proliferation of smartphones and mobile internet, music streaming applications and websites have made the music emotion recognition task even more active and exciting. However, music emotion recognition faces significant challenges too. These include inaccessibility of data, unavailability of large data volume, and the lack of other emotionally relevant features. While emotionally relevant features can be identified by analyzing lyrics and audio signals, the availability of datasets annotated with a lyrical emotion remains a constant challenge. This study uses the Music4All dataset to evaluate the lyrical features relevant for the identification of four important human emotions - happy, angry, relaxed, and sad. This was done with the help of several machine learning algorithms based on a semantic psychometric model. A transfer learning approach was also used to understand the feelings of the lyrics from an in-domain dataset and then predict the emotion of the target dataset. Further, it was observed that the BERT model improves the overall accuracy of the model (92%). A simple lyrics recommender system is also built using the Sentence Transformer model. [ABSTRACT FROM AUTHOR]

Using the novel reflux-thermal method, a novel nanocomposite was prepared from activated carbon of Zea mays L. waste with copper-nickel-oxide (ZMCN). Nickel sulfate (NiSO4 ) and copper sulfate (CuSO4 ) were used as metal sources with NaBH4 and NaOH as a precursor. The composite was characterized by Brunauer–Emmett–Teller, Fourier-transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy (SEM), high-resolution transmission electron microscopy, and thermogravimetric analysis/differential thermal analysis. The morphological characteristics of the synthesized ZMCN have been characterized using SEM. The XRD analysis showed the crystalline nature of ZMCN nanocomposite. In addition, FT-IR and energy-dispersive X-ray spectroscopy analyses were also carried out to investigate the particle size, chemical functional group, and elemental composition of ZMCN. The ZMCN was subsequently used for the dye degradation of Rhodamine B (RhB) at room temperature. RhB degradation was found to be 98.7% in 50 mg/L solution. [ABSTRACT FROM AUTHOR]

Land Use and Land Cover (LULC) classification is the process of locating and classifying regions of the Earth's surface (land cover) based on their physical attributes and human utilization (land use purpose). It is essential for mapping and monitoring changes in ecosystems, facilitating effective resource management and informed decision-making in land-use planning. Convolutional Neural Network (CNN's) is incapable of capturing long-range dependencies. The effectiveness of transformers relies on extensive training datasets, yet many satellite datasets have comparatively limited sample sizes. Moreover, due to the numerous factors influencing visual prominence, it is challenging to obtain abundant features from a single-color space. To overcome these limitations, we introduce an innovative bicolor architecture Downstream Lingering Attention Transformer Network (DsLATNet). DsLATNet characterizes remote sensing images on two color spaces viz RGB and HSV by processing the information using Residual Network −50(ResNet-50) backbone network.Extracted features of backbone network are further refined to acquire detailed aware features through Downstream Lingering Feature Pyramid Network (DsLFPN).This is further integrated with a DuoTransformer that utilizes attention mechanisms to obtain long-range dependencies. Eventually, the features are aggregated using residual connections that are dilated in-depth multiple times to produce class labels. The efficacy of the algorithm is evaluated through standard classification accuracy metrics. Experimental results on both the Wuhan Dense Labeling Dataset (WHDLD) and the Gaofen Image Dataset (GID) exhibit that the suggested technique exceeds cutting-edge classification methods. WHDLD achieved an Overall Accuracy (OA) of 86.34 %, Average Accuracy (AA) of 75.62 %, and Kappa coefficient (K) of 80.75, while the GID exhibited superior performance with an OA of 86.43 %, AA of 88.13 %, and K of 81.25. • We put forward bi-color integrated feature pyramid Duo Transformer network. • We integrate residual network with Duo transformer to capture local and global features to lessen gradient dispersion issues. • Feature pyramid attention module is incorporated to improve the aggregation of contextual details. • Transformer effectively merges bi-color features from lower to higher levels to enhance model's discriminative capability. [ABSTRACT FROM AUTHOR]

In the present work, Iron (Fe) ions are detected and removed from an aqueous medium using a green emissive polyethylenimine functionalized carbon dots (GPC), which are produced hydrothermally and have high adsorption efficiency and sensitivity. As prepared, GPC uses an adsorption approach to remove iron ions and a Turn-Off mechanism to detect iron ions. A UV-Vis and photoluminescence spectroscopy are used to evaluate the results of several experiments, including those involving the interference of other ions, changing the concentration of metal ions, pH, reaction time, and the dosage of adsorbent in the sensor, in an attempt to achieve high sensitivity (with a lower limit of detection of 0.08 ppm) and high adsorption efficiency of approximately 98 % (8 µM of Fe and 1 ppm of GPC) towards iron ions. The isotherm and kinetic analyses of adsorption show that pseudo-second-order kinetics and Freundlich isotherm suits the experimental data better. With a removal percentage of roughly 89 percent after three cycles, desorption analysis highlights its regeneration efficiency. The mechanism of adsorption and quenching are extensively investigated; The static and dynamic quenching mechanisms are supported by high static constant value of approximately 23.5 ×103 M and the lifetime decay declination of 2.42 ns, respectively. Zeta potential measurements and XPS analysis are used to examine the electrostatic interaction between GPC and Fe in the adsorption mechanism. Ultimately, the prepared material's contentment results illustrate its potential for practical applicability with five actual water samples. [Display omitted] • Polyethylenimine carbon dots are employed to sense and eliminate Fe ions. • As prepared material has green emission under UV light of 360 nm. • The fluorescence turn-off mechanism contributes to the sensing of Fe ions. • The removal of Fe ions is accomplished by the adsorption method. • Material has a detection limit of 0.08 ppm and adsorption efficiency of about 98 %. [ABSTRACT FROM AUTHOR]

The integration of sensors in the monitoring of essential bodily measurements, air quality, and energy consumption in buildings demonstrates the importance of the Internet of Things (IoT) in everyday life. These security breaches are caused by rudimentary and immature security protocols that are implemented on IoT devices. An intrusion detection system is used to detect security threats and system-level applications to detect malicious activities. This paper introduces Tachyon, a combination of various statistical and tree-based Artificial Intelligence (AI) techniques, such as Extreme Gradient Boosting (XGBoost), Random Forest (RF), Bidirectional Auto-Regressive Transformers (BART), Logistic Regression (LR), Multivariate Adaptive Regression Splines (MARS), Decision Tree (DT), and a top k stack ensemble to distinguish between normal and malicious attacks in a binary classification setting. The IoTID2020 dataset used in this study consists of 6,25,783 samples with 83 features. An initial examination of the data reveals its unbalanced nature. To create a balanced dataset, a range of sampling techniques were used, including Oversampling, Undersampling, Synthetic Minority Oversampling Technique (SMOTE), Random Oversampling Examples (ROSE), Borderline Synthetic Minority Oversampling Technique (b-SMOTE), and Adaptive Synthetic (ADASYN). In addition, principal component analysis (PCA) and partial least squares (PLS) were used to determine the most significant features. The experimental results demonstrate that the stacked ensemble achieved a performance of 99.8%, which is better than the baseline approaches. An ablation study of ensemble models was also conducted to assess the performance of the proposed model in various scenarios. [ABSTRACT FROM AUTHOR]

Autoinjectors are self-injectable devices; they are important class of medical devices which can deliver drugs through subcutaneous or intramuscular route. They enclose prefilled syringes or cartridges which are driven by a spring system. The major benefits of this device are easy self-administration, improved patient compliance, reduced anxiety, and dosage accuracy. Immediate treatment during emergency conditions such as anaphylaxis, migraine, and status epilepticus or for chronic conditions like psoriasis, diabetes, multiple sclerosis, and rheumatoid arthritis, Reformulation of first-generation biologics, technical advancements, innovative designs, patient compliance, overwhelming interest for self-administration all these made entry of more and more autoinjectors into use. In this review, intensive efforts have been made for exploring the different types of currently available autoinjectors for the management of emergency and chronic diseases. [ABSTRACT FROM AUTHOR]

Overordering of blood has been a challenge faced by the blood bank staff. The present study addresses the role of maximum surgical blood ordering schedule (MSBOS) in optimizing the blood inventory management. The blood requests for elective surgical procedures from various surgical departments were reviewed to constitute MSBOS. Transfusion profile was assessed using crossmatch to transfused units (C/T) ratio, transfusion probability (TP), and transfusion index (TI). A cutoff of 0.3 and 5% value of TI and TP, respectively, was considered to decide on the type of crossmatch. The efficacy of MSBOS implementation has been determined prospectively by unpaired t test using SPSS software, version 20 (IBM, USA). A total of 2674 patients were studied. Overall red cell usage rate was 15%. The comprehensive C/T ratio was 4.57. The C/T ratios for the various departments ranged from 1 to 8.5 (adjusted C/T ratio). Highest C/T ratio was observed for surgical procedures performed in the specialties of otorhinolaryngology and urology. A C/T ratio greater than 5 was noted in 30.4% of different types of surgical procedures. Of the 176 different types of elective surgical procedures studied, type and screen protocol was applicable for 75.5% (133) of the procedures. After implementation of MSBOS, the number of crossmatches reduced by 2152 and total working time saved in our laboratory is close to 75,320 man hours. MSBOS helps in identifying the common surgical procedures with low TP and is one of the efficient tools in preventing the overordering of the blood. [ABSTRACT FROM AUTHOR]

A crucial parameter in determining the prognosis of oral cavity cancer is depth of invasion (DOI). This research aimed to correlate pathological DOI at different intra-oral anatomical sites for oral squamous cell carcinoma (OSCC) with the risk of regional lymph node metastasis (LNM). This study also investigated the correlation of 3-year overall survival (OS) and disease-specific survival (DSS) with tumor depth. DOI measurement of the primary tumor at different intra-oral anatomic sites of clinically node negative patients who underwent curative surgery with elective neck dissection (END) was carried out as per AJCC 8th Edition staging guidelines in 3 DOI groups of ≤5 mm(A), >5 to ≤10 mm(B) and >10 mm(C). Association of groupwise DOI values with histopathological parameters including LNM and 3 years survival was evaluated. Univariate and multivariate logistic regression analysis (Odds ratio (OR) = 1.1 95 % CI: 1.0–1.2, p < 0.05) showed DOI to be a significant predictor for sub-clinical nodal metastasis observed in 136/382 OSCC patients. Receiver operating curve suggested that at 5 mm DOI (4 mm for early-stage OSCC), the risk of occult LNM was >20 % for all intra-oral sites combined. DOI <5 mm group demonstrated a superior 3-year OS (OR = 19.8 % CI: 7.8–49.9) and DSS (OR = 14.7 % CI: 5.9–37.0). Thus, DOI is an independent predictor of nodal metastasis and has significant association with LNM, OS and DSS. Our findings suggest that a DOI of ≥4 mm is an accurate cut-off value for performing END in early-stage OSCC and > 5 mm for advanced cases across all evaluated oral anatomic sites. • DOI shows significant correlation with lymph node metastasis in both early and advanced OSCC. • DOI >10mm corresponded with poor OS and DSS. • Optimal cut-off of ≥4mm and >5mm is recommended for END decision in early and advanced OSCC respectively. [ABSTRACT FROM AUTHOR]

The shallow hydrothermal vents (HVs) of Kueishan Island are considered as a template for studying the extremes of sulfide-polluted and acidified water. The present study examined the biological and spatiotemporal aspects of mesozooplankton mortality in waters around this extreme HV environment. Zooplankton sample collection was carried out in three monsoonal periods and the results revealed that there was a significant decrease in the mortality of total mesozooplankton with increasing distance from the HVs. The overall mortality of mesozooplankton showed a significant negative correlation with sea surface temperature and pH. Particularly, mortality of copepods showed a significant negative correlation with pH, whereas it was significantly positive correlated with sea surface temperature in the southwest monsoon prevailing period. Overall, the results may imply a situation that zooplankton will encounter in the more acidified environment of a future ocean. • Hydrothermal vents exert different mortalities on different mesozooplankton taxa. • Low pH significantly increases mesozooplankton mortality. • Lethal mesozooplankton effects decrease with increasing distance from hydrothermal vents. • Mesozooplankton mortalities differ with monsoonal periods. [ABSTRACT FROM AUTHOR]

The excessive use of smartphones and its association with adverse outcomes has been widely reported, with several studies showing an association between smartphone overuse, depression, anxiety, and sleep-related problems. The study used data from the Health and Lifestyle Survey, a nationwide population survey. It examined the prevalence of Problematic Smartphone Use (PSU) and its association with mental health outcomes among Singapore residents aged 15–65 years. Participants were assessed for PSU using the Smartphone Addiction Scale-Short Version, psychological distress with the Patient Health Questionnaire-9, and Generalised Anxiety Disorder −7 questionnaire, sleep problems using the Insomnia Severity Index, and positive mental health with Rapid Positive Mental Health Instrument. In all, 6509 participants completed the survey, giving a survey response rate of 73.2 %. The prevalence of PSU was 30.2 % in the population. Individuals with PSU were more likely to have symptoms of moderate or severe depression (OR: 3.2, 95 % CI: 2.4–4.4), anxiety (OR: 3.4, 95 % CI: 2.4–4.8), insomnia (OR: 3.4, 95 % CI: 2.8–4.2), and poorer positive mental health (β: −0.3, 95 % CI: −0.4 to −0.2). The study is the first to examine PSU in a national sample of Singaporeans across a wide age range. It provides valuable insights into mental health comorbidities among those with PSU, which is useful for practitioners. • The first nationwide study to highlight the extent of PSU among Singaporeans aged 15–65 years. • Individuals with PSU were more likely to have symptoms of moderate or severe depression, anxiety, and insomnia. • Problematic smartphone use was more likely to be associated with poorer positive mental health. [ABSTRACT FROM AUTHOR]

Organometallic compounds, including Ruthenium complexes, have been widely developed as anti-cancer chemotherapeutics, but have also attracted much interest as potential anti-parasitic drugs. Recently hybrid drugs composed of organometallic Ruthenium moieties that were complexed to different antimicrobial agents were synthesized. One of these compounds, a trithiolato-diRuthenium complex (RU) conjugated to sulfadoxine (SDX), inhibited proliferation of Toxoplasma gondii tachyzoites grown in human foreskin fibroblast (HFF) monolayers with an IC 50 < 150 nM, while SDX and the non-modified RU complex applied either individually or as an equimolar mixture were much less potent. In addition, conjugation of SDX to RU lead to decreased HFF cytotoxicity. RU-SDX did not impair the in vitro proliferation of murine splenocytes at concentrations ranging from 0.1 to 0.5 μM but had an impact at 2 μM, and induced zebrafish embryotoxicity at 20 μM, but not at 2 or 0.2 μM. RU-SDX acted parasitostatic but not parasiticidal, and induced transient ultrastructural changes in the mitochondrial matrix of tachyzoites early during treatment. While other compounds that target the mitochondrion such as the uncouplers FCCP and CCCP and another trithiolato-Ruthenium complex conjugated to adenine affected the mitochondrial membrane potential, no such effect was detected for RU-SDX. Evaluation of the in vivo efficacy of RU-SDX in a murine T. gondii oocyst infection model comprised of non-pregnant outbred CD1 mice showed no effects on the cerebral parasite burden, but reduced parasite load in the eyes and in heart tissue. [Display omitted] [ABSTRACT FROM AUTHOR]

• Few studies examined non-pharmacological interventions for pain management with comorbidities. • Little research specifically on older adults with chronic pain/chronic conditions worsening pain. • Future research to test multilevel interventions re: risk factors in managing multimorbidity. Chronic pain frequently exists with other comorbid conditions in older adults, yet little is known about the effectiveness of non-pharmacologic interventions. A scoping review was conducted to provide an overview of the nature of the published evidence on the nonpharmacological interventions for chronic pain in communitydwelling older adults with comorbid conditions. A literature search of relevant databases was conducted using PRISMA guidelines. Studies were included if they were intervention studies, used a randomized controlled trial design, and met criteria of the critical appraisal. Eleven studies were identified as high quality. Most studies did not quantify a comorbidity index and/or burden, nor reported the specific comorbid conditions of participants with chronic pain. In addition, none of the identified studies measured change in participant comorbidity and/or burden. Future research should address the effects of non-pharmacological interventions on pain, comorbidities, and other health outcomes. [ABSTRACT FROM AUTHOR]

Biodiversity is under enormous pressure from multiple threats including climate change, land use change, habitat alterations and hunting pressure. One way to ease this pressure on biodiversity and to mitigate the effects of above-mentioned threats, is to establish protected areas. Importance of protected increases many folds in regions that are considered as biodiversity poor regions i.e. deserts. Protected areas have long been a major pillar of biodiversity conservation strategies; the Houbara Protected Area (HPA) is one of the 13 terrestrial protected areas in Abu Dhabi Emirate officially declared in 2017. However, no information regarding the status of biodiversity in the HPA has been communicated to the research fraternity. During the present study, surveys were conducted to fill this gap. The survey area was divided in to 50 grids of 5 × 5 km2 and monitoring surveys were undertaken from January to December 2016. A total of 14 bi-monthly to monthly surveys were conducted within HPA and 196 species of different taxonomical groups were recorded. A year-long survey yielded highly diversified fauna and flora from 19 different habitat types (H) 1.32, (E) 2.28, Shannon Diversity Index). We looked at the influence of habitat breadth and temperature on the species richness and abundance, results shows that in desert setup heterogeneity of habitat is not an important factor in maintaining the biodiversity as total number of individuals as well as species were similar in the grids that have different number of habitat types (df = 34.3, t = -0.472, P = 0.640). However, we did find a positive impact of mean monthly temperature on species richness (df = 154, t = 2.53, P = 0.012). Our study highlights the importance of temperature in driving species abundance and richness in protected area. Abundance and species richness are similar in protected areas indicating that protection is allowing species to explore the heterogenous habitats. Overall, we can conclude that protection is beneficial for species. [ABSTRACT FROM AUTHOR]

Web services are moving toward a new emerging technology lead to the migration of SOAP to RESTful API, which is an Architectural Style that holds Lightweight, Stateless, Uniform Interface, etc., as its constraints. Various sources of clusters of resources, entity, database relations are access throughout the distributed environment across the internet. Generative Power of the RESTful API witnesses the emergence of many companies whose whole business process is based upon the building applications. Since the Syntactic essentials of RESTful Web Services are mainly concerned with the RESTful API, there is a need for evaluation of those essentials whether they are computable or not. The proposed work is carried out on taking resources as simple and effective using Primitive Recursive Function (PRF). Primitive Recursive Function (PRF) uses Turing Machine for REST API capability evaluation and the Service Invocation along with the Application Logic and AppState Logic in order to handle manageability of the RESTful resources via computability evaluation with or without security. To demonstrate the effectiveness of our evaluation process, we conduct a case study on the available REST web services using Primitive Recursive Resources (PRR). The results of our case study show that our evaluation process achieves greater portability, reliability, scalability, etc., which in turn results in high performance. [ABSTRACT FROM AUTHOR]

Millions of people globally have been affected by the Covid-19 pandemic. It's impact on pain management nurses roles' remains unknown. To explore role changes among pain management nurses performing patient care during the Covid-19 pandemic. Qualitative descriptive research study. The American Society for Pain Management Nursing's listserv, E-News Brief postings, and snowball sampling. English-speaking registered nurses or advanced practice registered nurses who provided direct patient care since 2020 were eligible. Data were collected through individual, semi-structured telephone interviews. An interview guide was used and included questions about participants' characteristics and the effect of the Covid-19 pandemic on their roles in clinical work. Data were analyzed using qualitative content analysis. A homogenous sample of eighteen nurses from the United States was interviewed. Their normal roles, roles during the pandemic, and surges in patients with Covid-19 as the condition for role changes emerged from their descriptions. Most participants did not experience significant changes in their normal roles, but all described how their normal functions were impacted by the pandemic. As the infectious variants of this disease evolve or other disastrous conditions occur, further changes to roles may occur. The skill sets of pain management nurses, including understanding assessment of pain across the lifespan, administration of opioids and multimodal analgesia, monitoring of patients, and communicating by educating and consultations, reinforce the significant contribution pain management nurses have as valued team members in times of crisis. [ABSTRACT FROM AUTHOR]

Background: A novel aggregated multiposition noncontact mapping (AMP-NCM) algorithm is proposed to diagnose cardiac arrhythmias.Objective: The purpose of this study was to computationally determine an accuracy threshold and to compare the accuracy and clinical utility of AMP-NCM to gold standard contact mapping.Methods: In a cellular automata model, the number of catheter positions and chamber coverage were varied to establish accuracy requirements for clinically relevant AMP-NCM. This guided the clinical study protocol. In a prospective cohort of patients with atrial tachycardia (AT), noncontact mapping (NCM) recordings from a single position (SP) and multiple positions were compared to contact mapping with a high-density multipolar catheter using morphology and timing differences of reconstructed signals. Identification of AT mechanisms and ablation targets using both AMP-NCM and contact mapping were randomly evaluated by 5 blinded reviewers.Results: AMP-NCM accuracy was asymptotic at 60 catheter positions in computational modeling. Twenty patients (age 65 ± 12 years; 19 male) with 26 ATs (5 focal, 21 reentrant) were studied. Morphologic correlation of signals derived from AMP-NCM was significantly better than those from SP-NCM compared to contact signals (median 0.93 vs 0.76; P <.001). AMP-NCM generated maps more rapidly than contact mapping (3 ± 1 minutes vs 13 ± 6 minutes; P <.001) and correctly diagnosed AT mechanisms in 25 of 26 maps (96%). Overall, 80% of arrhythmia mechanisms were correctly identified using AMP-NCM by blinded reviewers.Conclusion: Once 60 catheter positions were achieved, AMP-NCM successfully diagnosed mechanisms of AT and identified treatment sites equal to gold standard contact mapping in 3 minutes of procedural time. [ABSTRACT FROM AUTHOR]

• Computational imaging of the heart source localization is demonstrated. • Forward problem of the heart is solved for Magnetocardiography. • A novel spatial matrix is proposed and constructed based on Vectorcardiography. • Multi start downhill simplex search is utilized to localize the cardiac sources. • Comparison of the proposed approach with the standard model is studied. The muscles of the heart are associated with the flow of currents on tissue in the volume conductor formed inside the human body. The electrical currents of the human heart generate a tiny magnetic field beyond the thorax surface. The functional waves generated in terms of the field are detected using Magnetocardiogram (MCG) at the detector level. One of the challenging tasks in the research area is to compute algorithms which help in visualizing/localizing the cardiac anomalies non-invasively at the heart level. In order to localize, a generic model based on prior assumptions is designed which is known as a forward problem. This model depicts the spatial relation between the heart locations and the detectors. In this paper, a novel method is proposed in the construction of the forward matrix; where the prior heart vectors are constrained with vectorcardiography (VCG) signals. The spatial matrix is subsequently used to estimate the desired position on the myocardium in an inverse way. To evaluate the model, several true prior dipoles are placed on desired positions of the heart each at a time and the inverse problem is solved using multi-start downhill simplex search. The spatial matrices are updated based on VCG during each movement of the test dipoles' positions in the inverse search. The inverse studies are computed and compared between the proposed and the existed methods for the entire cardiac cycle. The performance of the inverse model with unit VCG orientations exhibited an improvement of 3.027 ± 0.17 mm average localization error than the conventional one. [ABSTRACT FROM AUTHOR]

How different methods of recording posterior palatal seal affect removable complete-denture retention and oral health quality of life is unclear. The purpose of this clinical study was to compare the retention and oral health quality of life (OHIP-14) between conventional and arbitrary posterior palatal seal techniques in participants with removable complete dentures. Edentulous patients were recruited according to definitive criteria. The participants were randomly divided into conventional and arbitrary seal. After the delivery of the denture, the retention was evaluated with a force gauge dynamometer and at 3, 6, 9, and 12 months. Denture satisfaction was evaluated with the OHIP-14 questionnaire. Data were statistically analyzed by using the t test and repeated measure ANOVA (α=.05). The mean ±standard deviation values (N) for conventional seal at 0, 3, 6, 9, and 12 months by dynamometer in the anterior region ranged from 4.73 ±0.78 to 4.90 ±0.81 and in the posterior region between 5.07 ±0.84 and 5.31 ±0.99. Dynamometer values for arbitrary seal in the anterior region were from 4.56 ±0.77 to 4.88 ±0.81, and in the posterior, it varied between 4.74 ±0.74 and 5.15 ±0.81. Force gauge values (N) for conventional and arbitrary seal were in the range of 18.35 ±2.84 to 20.69 ±3.89. The general mean ±SD OHIP-14 was higher for the conventional seal at 3.12 ±0.25 than for the arbitrary seal at 2.73 ±0.23 The difference between the conventional and arbitrary seal techniques was not statistically significant (P >.05) No significant difference in complete denture retention was detected between the 2 posterior palatal seal techniques. Oral health quality of life was higher with the conventional seal technique. [ABSTRACT FROM AUTHOR]

Pitfall trapping is an efficient self-sampling method for capturing epigeal arthropods for ecological and faunistic studies. During the present study, conducted between March 2009 and March 2015, pitfall trapping was undertaken in five study sites of different habitats in Abu Dhabi Emirate. During the study period a total of 94 monitoring visits were made to collect data from the pitfall traps at five sites in Abu Dhabi. A total of 36,238 individuals of ground-dwelling arthropods of 121 different species belonging to 14 orders and 46 families were recorded from all the study sites using pitfall traps. The order Coleoptera (beetles) was recorded to be the most dominant order with 46 species followed by Hymenoptera (ants, bees & wasps) with 24 species. On average 37.5 ± 3 (mean ± SE) species were recorded every month from all the study sites and number of species did not vary significantly across the months (df = 11, F = 0.48, p = 0.91 one-way – ANOVA). The arthropod fauna was recorded to be highly diversified in different habitat types, but the number of individuals were not evenly distributed across the study sites (H) 1.10, (E) 0.53, Shannon Diversity Index). The highest diversity of arthropods was recorded from a site Wadi Tarabat, followed by Al Wathba Wetland Reserve (AWWR) and Abu Al Abyed. Our findings indicate that to study ground dwelling invertebrate species, pitfall trapping is an efficient method. Moreover, capture efficiency of pitfall traps can be affected by climatic factors and habitat types of Abu Dhabi Emirate. The ideal period to encounter the highest number of species is between March to April and September to November across all the habitat types. [ABSTRACT FROM AUTHOR]