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This study investigates weakly singular nonlinear functional Volterra integral equations (WSNFVIEs) of Urysohn type involving Riemann–Liouville operator. By imposing specific smoothness conditions on the involved functions, we establish both the existence and uniqueness of the solution using a fixed point approach. Subsequently, we employ discretization methods such as the trapezoidal and Euler methods to approximate the solution, resulting in a system of nonlinear algebraic equations. To ascertain the convergence order of the Euler method (first order) and the trapezoidal method (second order), we utilize the Grönwall inequality and its discrete counterpart. Additionally, we introduce a novel Grönwall inequality to establish the convergence of the trapezoidal method. Thoroughly we examine the Hyers–Ulam–Rassias and Hyers–Ulam stability of the integral equations within the specified domain. Finally, the efficacy of the proposed methods is validated through numerical examples accompanied by comparative analyses. [ABSTRACT FROM AUTHOR]

Long-intergenic non-protein coding gene 01140 (LINC01140) a long non-coding RNA is highly expressed in various cancers. However, its biological functions in gastric cancer progression is still unknown. To elucidate LINC01140 function, 70 GC tumor samples and 30 normal gastric tissues were collected. LINC01140 expression level were determined by qRT-PCR analysis and correlated with different clinico-pathological parameters. Then we tried to see the impact of LINC01140 on gastric cell line aggressiveness by knocking down the target gene and performing cell viability assay, migration assay and invasive capacity of the cell lines along with immunoblotting to check several protein levels. LINC01140 RNA is found to be positively correlated with FGF9 and significantly up regulated in GC tissues. LINC01140 knockdown inhibited the viability, migratory capacity and invasive capacity of AGS cells. LINC01140 targets miR-140–5p, while miR-140–5p targeted FGF9 to form lncRNA–miRNA-mRNA axis. The affect of miR-140–5p inhibition on gastric cancer cell aggressiveness were opposite to those of LINC01140 or FGF9 knockdown. Additionally, inhibition partially reversed the effects of LINC01140 knockdown on FGF9 protein levels, gastric cancer cell phenotypes. LINC01140, miR-140–5p and FGF9 form a lncRNA-miRNA-mRNA axis that modulates the gastric cancer phenotypes and in turn affects gastric cancer cell aggressiveness. [ABSTRACT FROM AUTHOR]

Quality of chronic care for cardiovascular disease (CVD) remains suboptimal worldwide. The Collaborative Quality ImProvement (C-QIP) trial aims to develop and test the feasibility and clinical effect of a multicomponent strategy among patients with prevalent CVD in India. The C-QIP is a clinic-based, open randomized trial of a multicomponent intervention vs usual care that was locally developed and adapted for use in Indian settings through rigorous formative research guided by Consolidated Framework for Implementation Research (CFIR). The C-QIP intervention consisted of 5 components: 1) electronic health records and decision support system for clinicians, 2) trained nonphysician health workers (NPHW), 3) text-message based lifestyle reminders, 4) patient education materials, 5) quarterly audit and feedback reports. Patients with CVD (ischemic heart disease, ischemic stroke, or heart failure) attending outpatient CVD clinics were recruited from September 2022 to September 2023 and were randomized to the intervention or usual care arm for at least 12 months follow-up. The co-primary outcomes are implementation feasibility, fidelity (ie, dose delivered and dose received), acceptability, adoption and appropriateness, measured at multiple levels: patient, provider and clinic site-level, The secondary outcomes include prescription of guideline directed medical therapy (GDMT) (provider-level), and adherence to prescribed therapy, change in mean blood pressure (BP) and LDL-cholesterol between the intervention and control groups (patient-level). In addition, a trial-based process and economic evaluations will be performed using standard guidelines. We recruited 410 socio-demographically diverse patients with CVD from 4 hospitals in India. Mean (SD) age was 57.5 (11.7) years, and 73.0% were males. Self-reported history of hypertension (48.5%) and diabetes (41.5%) was common. At baseline, mean (SD) BP was 127.9 (18.2) /76.2 (11.6) mm Hg, mean (SD) LDLc: 80.3 (37.3) mg/dl and mean (SD) HbA1c: 6.8% (1.6%). At baseline, the GDMT varied from 62.4% for patients with ischemic heart disease, 48.6% for ischemic stroke and 36.1% for heart failure. This study will establish the feasibility of delivering contextually relevant, and evidence-based C-QIP strategy and assess whether it is acceptable to the target populations. The study results will inform a larger scale confirmatory trial of a comprehensive CVD care model in low-resource settings. Clinical Trials Registry India: CTRI/2022/04/041847; Clinicaltrials.gov number: NCT05196659. [Display omitted] [ABSTRACT FROM AUTHOR]

This comprehensive manuscript endeavors to furnish orthodontic researchers with the necessary tools and knowledge to adeptly navigate the multifaceted landscape of academic publishing, thereby enhancing the efficacy and reach of their scholarly endeavors. It meticulously imparts critical insights and methodologies for comprehending and leveraging publication metrics, such as citation counts, the h-index, and Journal Impact Factors, to strategically plan research trajectories. Furthermore, it offers guidance on adeptly engaging with evaluation agencies such as the American Dental Association (ADA) and the National Institute of Dental and Craniofacial Research (NIDCR), thereby optimizing alignment with grant opportunities. Through the adept utilization of orthodontic bibliometrics, researchers can gain invaluable insights into prevailing collaboration trends and emerging research domains, thus facilitating informed decision-making and prioritization of scholarly pursuits. Additionally, the manuscript delves into the nuanced optimization of publication guidelines to maximize research impact. Spanning both established domains such as biomechanics, anchorage control, and aligner therapy, as well as burgeoning frontiers including 3D printing and artificial intelligence applications in aligner treatment, this manuscript equips orthodontic researchers with the requisite acumen to embark upon a journey of impactful scholarly contributions, thereby catalyzing advancements in patient care within the discipline. [ABSTRACT FROM AUTHOR]

There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants. Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features. In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P <.001) and very low food security (P <.001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P =.009) were less likely to report screening. In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening. [Display omitted] [ABSTRACT FROM AUTHOR]

Because of the established contribution of social factors to health outcomes, approaches that address upstream determinants of health have increasingly been recognized as cost-effective means to improve population health. Understanding and usage of precise terminology is important to facilitate collaboration across disciplines. Social determinants of health affect everyone, not just the socially and economically disadvantaged, whereas health-related social risks (HRSR) are specific adverse conditions at the individual or family level that are associated with poor health and related to the immediate challenges individuals face. Health-related social needs account for patient preference in addressing identified social risks. The use of validated screening tools is important to capture risk factors in a standardized fashion to support research and quality improvement. There is a paucity of studies that address HRSR in the context of radiology. This review provides an understanding of HRSR and outlines various ways in which radiologists can work to mitigate them. [ABSTRACT FROM AUTHOR]

Accelerated orthodontics (AO) is emerging as a revolutionary approach in achieving desired orthodontic results in a shorter timeframe. AO modalities, both invasive and non-invasive promise to bring about rapid orthodontic tooth movement (OTM) transformations through targeted bone remodeling. From micro-osteoperforations facilitating bone remodeling to photobiomodulation enhancing cellular activity, the armamentarium of accelerated orthodontics promises to not only shorten treatment times but also potentially unlock novel therapeutic avenues for complex malocclusions. This burgeoning field, however, necessitates rigorous scientific scrutiny to optimize protocols, mitigate potential iatrogenic effects, and ultimately deliver on the promise of a faster, more efficacious, and patient-centric orthodontic experience. This paper offers a comprehensive review of AO, exploring its potential benefits and drawbacks, analysing the effectiveness of popular techniques, and providing insights for informed decision-making by delving into the science behind AO, evaluating clinical evidence, such as, transient pain, root resorption, and periodontal considerations. Also, this paper aims to equip patients and Orthodontists with a deeper understanding of this evolving field. [ABSTRACT FROM AUTHOR]

To evaluate outcomes after intraoperative radiation therapy (IORT) in high-risk neuroblastoma (NB), including local control, overall survival, and toxicity. This was a single institution retrospective study of 92 pediatric patients with NB treated with IORT from 1995 to 2022. Each IORT application was considered a separate event for a total of 110 sites treated. Local failure was calculated using the cumulative incidence function and survival by Kaplan-Meier method from the day of surgery. All patients had high-risk relapsed or treatment refractory disease. Median age was 6 years (range, 2-34 years). Median follow-up for all patients and surviving patients was 16 months and 4 years, respectively. All patients previously received chemotherapy, 93% had prior external beam radiation therapy to the site of IORT (median dose, 21.6 Gy; range, 10-36 Gy), and 94% had a prior surgery for tumor resection. The median IORT dose was 12 Gy (range, 8-18 Gy) and median area treated was 18 cm2 (range, 2.5-60 cm2). The cumulative incidence of local failure was 23% at 2 years and 29% at 5 years. The overall survival (OS) was 44% at 2 years and 29% at 5 years. Local failure after IORT was associated with worse OS (hazard ratio, 1.74; 95% CI, 1.07-2.84; P =.0267). Toxicity from IORT was rare, with postoperative complications likely related to IORT seen in 7 (8%) patients. Our study represents the largest, most recent analysis of the efficacy and safety of IORT in patients with relapsed or refractory NB. Less than one-third of patients failed locally at 5 years, and achieving local control affected overall survival. Minimal toxicities directly related to IORT were observed. Overall, IORT is an effective and safe technique to achieve local control in high-risk relapsed or refractory neuroblastoma. [ABSTRACT FROM AUTHOR]

To examine associations between perceived stress and cardiometabolic risk factors in South Asians with prediabetes and assess whether a diabetes prevention program mitigates the impact of stress on cardiometabolic health. We conducted a secondary analysis of the Diabetes Community Lifestyle Improvement Program, a lifestyle modification trial for diabetes prevention in India (n = 564). Indicators for cardiometabolic health (weight, waist circumference, blood pressure, glucose, HbA1c, and lipids) were measured at each visit while perceived stress was assessed via questionnaire at baseline. Multivariable linear regression assessed associations between stress and cardiometabolic parameters at baseline and 3-year follow up. At baseline, perceived stress was associated with higher weight (b=0.16; 95% CI: 0.04, 0.29) and waist circumference (b=0.11; 95% CI: 0.01, 0.21) but lower 30-minute postload glucose (b=−0.44; 95% CI: −0.76, −0.14) and LDL cholesterol (b=−0.40; 95% CI: −0.76, −0.03). Over the study period, perceived stress was associated with weight gain (b=0.20; 95% CI: 0.07, 0.33) and increased waist circumference (b=0.14; 95% CI: 0.04, 0.24). Additionally, higher perceived stress was associated with lower HDL cholesterol among the control arm (p interaction = 0.02). Baseline stress was associated with negative cardiometabolic risk factor outcomes over time in those with prediabetes. [Display omitted] ● Nearly two-thirds of South Asian adults with prediabetes develop type 2 diabetes. ● No studies have examined stress and cardiometabolic risk in South Asians over time. ● Stress was associated with increased weight and waist circumference over time. ● Lifestyle interventions should consider integrating stress management techniques. [ABSTRACT FROM AUTHOR]

The noble metal NPs that are currently applied to photothermal therapy (PTT) have their photoexcitation location mainly in the NIR-I range, and the low tissue penetration limits their therapeutic effect. The complexity of the tumor microenvironment (TME) makes it difficult to inhibit tumor growth completely with a single therapy. Although TME has a high level of H 2 O 2 , the intratumor H 2 O 2 content is still insufficient to catalyze the generation of sufficient hydroxide radicals (‧OH) to achieve satisfactory therapeutic effects. The AuPd-GOx-HA (APGH) was obtained from AuPd bimetallic nanodumbbells modified by glucose oxidase (GOx) and hyaluronic acid (HA) for photothermal enhancement of tumor starvation and cascade catalytic therapy in the NIR-II region. The CAT-like activity of AuPd alleviates tumor hypoxia by catalyzing the decomposition of H 2 O 2 into O 2. The GOx-mediated intratumoral glucose oxidation on the one hand can block the supply of energy and nutrients essential for tumor growth, leading to tumor starvation. On the other hand, the generated H 2 O 2 can continuously supply local O 2 , which also exacerbates glucose depletion. The peroxidase-like activity of bimetallic AuPd can catalyze the production of toxic ‧OH radicals from H 2 O 2 , enabling cascade catalytic therapy. In addition, the high photothermal conversion efficiency (η = 50.7 %) of APGH nanosystems offers the possibility of photothermal imaging-guided photothermal therapy. The results of cell and animal experiments verified that APGH has good biosafety, tumor targeting, and anticancer effects, and is a precious metal nanotherapeutic system integrating glucose starvation therapy, nano enzyme cascade catalytic therapy, and PTT therapy. This study provides a strategy for photothermal-cascade catalytic synergistic therapy combining both exogenous and endogenous processes. AuPd-GOx-HA cascade nanoenzymes were prepared as a potent cascade catalytic therapeutic agent, which enhanced glucose depletion, exacerbated tumor starvation and promoted cancer cell apoptosis by increasing ROS production through APGH-like POD activity. The designed system has promising photothermal conversion ability in the NIR-II region, simultaneously realizing photothermal-enhanced catalysis, PTT, and catalysis/PTT synergistic therapy both in vitro and in vivo. The present work provides an approach for designing and developing catalytic-photothermal therapies based on bimetallic nanoenzymatic cascades. [Display omitted] [ABSTRACT FROM AUTHOR]

Software-Defined Networking (SDN) simplifies network administration as well as reduces the need for manual configuration on individual devices. SDN is expected to remain a crucial technology in shaping the future of network infrastructure. However due to key vulnerabilities like Open Flow Protocol Weaknesses, Flow Table Poisoning, Weak authentication and authorization mechanisms, it is prone to intrusion attacks. In this paper, authors aim to build framework based on various machine learning models (ML) to capture anomaly packets. Four models Decision tree, Support Vector Classifier, Naïve Bayes Classifier and artificial neural networks are designed and trained to capture anomaly packets. While SVC achieved an impressive accuracy of 99%, Artificial Neural Networks (ANN) demonstrated satisfactory speed and efficiency, despite their accuracy being slightly lower than SVM's. ANN is then deployed in SDN simulated using Mininet. The model is able to detect all DOS traffic. Other types of attacks SQL Injection, U2R Attack, Buffer Overflow Attack, Probe Attack, Brute Force Attack could not be tested as there is provision to simulated these using Mininet. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the incidence of micrometastasis (MMs) and isolated tumor cells (ITCs) in node-negative early-stage oral tongue squamous cell carcinoma (T1–T2 N0). The secondary objective was to correlate the incidence with the clinicopathologic parameters of age, sex, depth of invasion, pattern of invasion, host lymphocytic response, and size and grade of primary tumor. Micrometastasis and ITCs in cervical nodes of 30 patients with early-stage oral tongue squamous cell carcinoma were detected and compared using 3 methods: routine hematoxylin and eosin staining, serial-sectioning at intervals of 150 microns employing hematoxylin and eosin, and serial sectioning pan-cytokeratin immunostaining. Associations with clinicopathological variables were analyzed. Metastatic tumor cells were detected in the cervical nodes of 2 patients using serial sectioning and immunohistochemistry, resulting in upstaging of 6.6% of all cases. Level I and II lymph nodes were primarily involved. Early-stage oral tongue squamous cell carcinoma has a significant potential for MMs that frequently go undetected in routine histopathologic examination. However, laborious and technique-sensitive, serial sectioning in combination with pan-cytokeratin staining (AE1/AE3) may aid in detecting MMs and ITCs in patients with early-stage OTSCC. [ABSTRACT FROM AUTHOR]

• Climate risk has a detrimental impact on the ESG performance of Chinese firms. • The negative effect of CRI on firms' ESG is most pronounced for state-owned firms, growing and declining firms, and firms with higher institutional investor shareholders. • Financing constraints, corporate diversification and media attention have enhanced the negative effect of CRI on ESG. • Firms and relevant capital market regulators should pay particular attention to the impact of climate risks on the ESG performance of firms, particularly in years when climate risks are more severe. Owing to its devastating nature, climate risk has become one of the top concerns of the world community. The literature on the effects of climate risk on environmental, social, and governance (ESG) performance is scarce. Using data from Chinese A-share listed firms from 2010 to 2019, this study aims to determine whether climate risk affects firms' ESG performance. The findings show that climate risk has a detrimental effect on the ESG performance of Chinese firms. A heterogeneity analysis shows that the negative effect of climate risk on firms' ESG performance is most pronounced for state-owned firms, growing and declining firms, and firms with more institutional investor shareholders. Furthermore, a mechanistic analysis shows that financing constraints, corporate diversification, and media attention enhance the negative effect of climate risk on ESG. In addition, after addressing several robustness checks and endogeneity issues, our conclusions remain valid. Thus, this study indicates the need to develop a comprehensive policy to achieve development goals by considering and valuing the impact of climate risk on firm's ESG performance. [ABSTRACT FROM AUTHOR]

The increasing complexity of cloud computing has prompted a greater emphasis on protecting the privacy, integrity, and security of data stored and processed in the cloud. Data privacy is safeguarded through access control, but existing models such as Role Based Access Control (RBAC) and Attribute Based Access Control (ABAC) rely on a centralized server. If this server is compromised, it poses significant risks to data security. To address this issue, there is a need for Distributed ABAC (DABAC) system for OpenStack services based on blockchain. The unique features of blockchain enables access control systems which ensures data integrity and privacy. Additionally, blockchain offers a level of transparency for both the resource owner and a user. In this work, we propose a smart contract based ABAC system. We implemented the proposed work using an Ethereum blockchain and OpenStack cloud. Furthermore, we evaluated two consensus algorithms for scalability analysis of DABC mechanism. The results demonstrate that DABAC performs better than ABAC in ensuring fine-grade access control with proof of stake consensus algorithm providing better scalability. [ABSTRACT FROM AUTHOR]

Intestinal parasitic infections such as amoebiasis, ascariasis, hookworm infection, and trichuriasis are the most common infections among non-human primates (NHPs). There are always the possibilities of transmission these parasites between humans and NHPs. Multiple groups of rhesus macaques (Macaca mulatta) live in the urban area of Kathmandu Valley near human settlements, however the gastrointestinal (GI) parasitic infections in those macaques are understudied. This study aimed to explore the GI parasites in free-ranging macaques from Pashupatinath, Swayambhunath, Tripureshwor, Nilbarahi temples and a group of captive rhesus macaques in the Central Zoo, Kathmandu. Fecal samples were collected from the macaques between October 2021 to September 2022 and assessed for parasites by the both wet mount method and concentration technique. There is high prevalence of GI parasite infection; out of 121 fecal samples examined, 87.6% of samples were positive. Six species of protozoans and eight species of helminths were identified from the fecal samples including the first report of Iodamoeba butschlii in monkeys of Nepal. Among the protozoan parasites, Entamoeba coli (54.71%) showed the highest prevalence followed by Balantioides coli (44.33%), E. histolytica (19.81%), and Iodamoeba butschlii (10%). Among the helminths, Trichuris spp. (31.13%) and Strongyloides spp. (31.13%) showed the highest prevalence followed by Hookworm (24.52%), and Strongyle spp. (23.58%). The likelihood ratio test suggested that the prevalence differed significantly with the seasons for Iodamoeba butschlii , Giardia spp., Strongyles spp., Hookworm, and Trichostrongylus spp. The prevalence of E. histolytica , E. coli , Iodamoeba. butschlii, Trichuris spp. , Trichostrongylus spp. , and Unknown spp.1 differed with sampling localities. The high prevalence of GI parasites found in the macaques living in the densely urbanized Kathmandu presents a potential threat to humans and warrants further study as well as increased education of the public and management of the human-macaque interface in the urban landscape of the Valley. [Display omitted] • 87.6% of fecal samples of rhesus macaques (Macaca mulatta) were positive for GI parasite species. • The prevalence of GI parasites is significantly different with the seasons. • 2.47% of the samples had a parasite species richness more than six. • The first report on presence of Iodamoeba butschlii in non-human primates of Nepal. [ABSTRACT FROM AUTHOR]

Hepatitis A is the most prevalent viral hepatitis in India and rarely can lead to life-threatening complications such as acute liver failure (ALF). Glucose 6 phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency in the world, and in the setting of acute viral hepatitis, it can cause massive intravascular hemolysis, resulting in acute kidney injury. Here, we report a case of a 12-year-old male child who had hepatitis A–associated ALF, which was complicated by massive hemolysis due to underlying G6PD deficiency, manifesting as acute renal failure requiring renal replacement therapy with other supportive management. He had a prolonged, protracted stormy clinical course, which was further complicated by dialysis disequilibrium syndrome, posterior reversible encephalopathy syndrome, and nosocomial sepsis, which improved over 4 weeks. Our case highlights the importance of having high index of clinical suspicion for G6PD deficiency in a child with acute viral hepatitis with complications. [ABSTRACT FROM AUTHOR]

To determine imaging utilization rates in outpatient primary care visits and factors influencing likelihood of imaging use. We used 2013 to 2018 National Ambulatory Medical Care Survey cross-sectional data. All visits to primary care clinics during the study period were included in the sample. Descriptive statistics on visit characteristics including imaging utilization were calculated. Logistic regression analyses evaluated the influence of a variety of patient-, provider-, and practice-level variables on the odds of obtaining diagnostic imaging, further subdivided by modality (radiographs, CT, MRI, and ultrasound). The data's survey weighting was accounted for to produce valid national-level estimates of imaging use for US office-based primary care visits. Using survey weights, approximately 2.8 billion patient visits were included. Diagnostic imaging was ordered at 12.5% of visits with radiographs the most common (4.3%) and MRI the least common (0.8%). Imaging utilization was similar or greater among minority patients compared with White, non-Hispanic patients. Physician assistants used imaging at higher rates than physicians, in particular CT at 6.5% of visits compared with 0.7% for doctors of medicine and doctors of osteopathic medicine (odds ratio 5.67, 95% confidence interval 4.07-7.88). Disparities in rates of imaging utilization for minorities seen in other health care settings were not present in this sample of primary care visits, supporting that access to primary care is a path to promote health equity. Higher rates of imaging utilization among advanced-level practitioners highlight an opportunity to evaluate imaging appropriateness and promote equitable, high-value imaging among all practitioners. [ABSTRACT FROM AUTHOR]

In the present study, an attempt is made to perform a comparative assessment between the conventional friction stir welding (C-FSW) and two auxiliary energy-assisted FSW (AE-FSW) techniques, namely plasma arc-assisted FSW (P-FSW) & induction-assisted FSW (I-FSW) of high strength DH36 steel to 6061-T6 aluminum alloy. The study is carried out with an intention to realize the advancement of AE-FSW techniques by preheating the harder material, i.e., DH36 steel. For the reliable evaluation & comparison, two different preheating conditions based on the peak temperature were chosen for both AE-FSW techniques: low peak temperature at around 400 °C, and high peak temperature at about 600 °C. It is observed that the induction preheating improved the joint efficiency, grain refinement, and hardness magnitudes due to its superior heat generation capabilities than the corresponding plasma preheating. A significant decrease in tool degradation is observed in I-FSW at high peak temperature compared to C-FSW and P-FSW, along with reductions of 27.8% in axial force and 21.7% in tool torque. The lamellar intercalated features exhibited the highest hardness due to the substantial formation of different intermetallic compounds (IMCs), namely Fe 3 Al + FeAl 3 in P-FSW and I-FSW at low peak temperature, and FeAl + Fe 3 Al + FeAl 3 at high peak temperature. By maintaining the superior corrosion resistance, I-FSW at high peak temperature produced the highest joint efficiency of 77.2% with the binary-phased (i.e., Fe 2 Al 5 + FeAl 3) IMC layer thickness of 4.21 ± 0.4 µm and the 4.13% area fraction of FeAl 3 in the stir zone. [ABSTRACT FROM AUTHOR]

To estimate the proportion of patients visiting urgent care centers or emergency departments or being hospitalized who were not up to date with recommended mammography screening to assess the potential impact of non-primary care–based cancer screening interventions. Adult participants from the 2019 National Health Interview Survey were included. Among participants not up to date with breast cancer screening guidelines based on ACR recommendations, the proportion of patients reporting an urgent care, emergency department visit, or hospitalization within the last year was estimated accounting for complex survey sampling design features. Multiple variable logistic regression analyses were then conducted to evaluate the association between sociodemographic characteristics and mammography screening adherence. The study included 9,139 women between the ages of 40 and 74 years without history of breast cancer. Of these respondents, 44.9% did not report mammography screening within the last year. Among participants who did not report mammography screening, 29.2% reported visiting an urgent care center, 21.8% reported visiting an emergency room, and 9.6% reported being hospitalized within the last year. The majority of patients receiving non-primary care–based services, who were not up to date with mammography screening, were from historically underserved groups including Black and Hispanic patients. Nearly 10% to 30% of participants who have not obtained recommended breast cancer screening have visited non-primary care–based services including urgent care centers or emergency rooms or have been hospitalized within the last year. [Display omitted] [ABSTRACT FROM AUTHOR]

Mortality after reoperative aortic valve surgery continues to decline but remains high compared with primary isolated replacement. We sought to examine temporal trends, morbidity, and mortality among patients undergoing isolated first-time reoperative aortic valve surgery. The study included all patients undergoing reoperative aortic valve surgery in the United Kingdom between January 2007 and March 2019. Patients undergoing isolated reoperative aortic valve replacement (AVR) were compared with a propensity matched cohort of patients undergoing isolated primary AVR. Outcomes measured included inhospital mortality, neurologic dysfunction, postoperative dialysis, deep sternal wound infections, and hospital length of stay. During the study period, 40,858 primary isolated AVRs and 3015 first-time isolated reoperative AVRs were carried out in the United Kingdom. In the propensity matched reoperative group, median age of participants was 69.8 years (60.8-76.2) with median duration between the initial surgery and the reoperation being 7.69 years. Overall mortality was 3.1% (94) for reoperative AVR compared with 1.9% (56) for primary AVR. Mortality of both primary and reoperative AVR declined during the study period. Reoperation, age, New York Heart Association class, and chronic kidney disease were independently associated with early mortality. Reoperative isolated AVR can be performed with acceptable inhospital mortality and provides a benchmark against which alternative strategies should be compared. [Display omitted] [ABSTRACT FROM AUTHOR]

[Display omitted] • Renewable energy and green technology lower carbon emissions over the long and short run. • Renewable energy has a greater environmental impact than green technology. • Green technology moderates the relation between renewable energy and carbon emission. • The nonlinear effect of green technology positively affects carbon-emission. • The non-linear effect of renewable energy reduces carbon emission in the long run. Recently, various initiatives are being taken to attain environmental sustainability by reducing the carbon footprint of major emerging economies. The carbon-neutrality target has become a vital goal in this direction. This study examines the importance of green technology and renewable-energy in achieving the target of carbon-neutrality for 18 emerging countries from 1990 to 2018. We have used Cross-sectional auto-regressive distributed lag (CS-ARDL) estimator to investigate the short-run and long-run association among the variables. Further, Augmented Mean Group (AMG) and Common correlated effects mean group (CCEMG) estimators have been used to get robust results. The findings confirm that green technology, renewable energy consumption, urbanization, and corruption-control significantly mitigate carbon emission in both the short-run and the long-run. In contrast, Gross-Domestic Product (GDP), trade, non-renewable energy, energy-import, and energy-intensity are found to increase carbon emission. Further, it is found that renewable energy reduces carbon emission monotonically whereas green technology exhibits a U-shaped effect on carbon emission. Additionally, green technology effectively moderates the relationship between renewable-energy and carbon emission reduction in the long-run. The results of the Dumitrescu-Hurlin causality test indicate a bidirectional causality between green technology innovation and carbon emission while a unidirectional causality is found to exist from renewable energy to carbon emission. Based on these empirical findings, it is suggested that policymakers should strengthen eco-friendly policies, promote green technology and renewable energy, and invest in sustainable sources to achieve the carbon neutrality target. [ABSTRACT FROM AUTHOR]

The (2 + 1) -dimensional combined Zakharsov-Kuznetsov-modified Zakarsov-Kuznetsov (ZK-mZK) equation with constant co-efficients are solved by employing the complete discrimination system for polynomial Method (CDSPM). Use of it reduces the key Nonlinear Differential Equation (NLPDE) to an Ordinary Differential Equation (ODE) in the integral form under the traveling wave transformation, and the solutions are classified. Exact traveling wave solutions are derived using CDSPM of order four. Based on CDSPM, Liu's approach provides a set of new solutions including Jacobi elliptic functions for the Combined-(ZK-mZK) equation. These analytic solutions exhibit different nonlinear wave structures viz., solitary wave, shock wave, and periodic wave. Among them, the finite amplitude periodic solutions are very important wave features for Combined-(ZK-mZK) equation and their existence is confirmed from the phase portrait of the said equation. Especially the finite amplitude periodic solutions are acquired from the system with the inclination of Jacobean elliptic functions. Numerical results confirm the reliability and effectiveness of the method. Finally, the phase portrait of the dynamical system ensures the entity and exactness of different topological structures of the solutions. Based on this analysis, we conclude that this method is appropriate one to classify the solutions, and can be expanded throughout the vast areas of application. [ABSTRACT FROM AUTHOR]

This study aimed to understand current treatment patterns and healthcare resource utilization (HRU) of women with locally advanced or metastatic breast cancer (advanced breast cancer [ABC]) in Taiwan overall and within the subgroup of patients who were postmenopausal women with no previous systemic therapy in the ABC setting. A chart review of anonymized data on patient characteristics, treatment patterns, and HRU was conducted via an online physician survey including 118 patient charts from women ≥ 18 years old with hormone receptor positive/human epidermal growth receptor negative ABC, diagnosed between 2015 and 2017. The mean age of all patients was 56.6 years (range 29-83). Among the 118 patients, the most common first-line systemic therapy group after diagnosis of ABC was endocrine-based therapy (39.0%) or endocrine therapy (ET) plus chemotherapy (ChT) combinations (38.1%). In the postmenopausal subgroup (n = 56), ET-based therapy was the most common (44.6%). Oncologist visits, at annual rate of 9.20 (95% confidence interval 8.81-9.60), and hospitalizations, at annual rate of 1.08 (95% confidence interval 0.96-1.22), were key drivers of HRU. Of the 118 patients, the 72 with at least one ChT agent in their first-line regimen had an annual hospitalization rate of 1.4 versus 0.45 admissions compared with the 46 patients on first-line ET-based therapy. Current treatment patterns suggest an unmet need for new medications that lead to reduction in high rate of ChT use. Results can inform future evaluations of new ABC treatments that estimate the health economic impact of their adoption in Taiwan. • This study presents an up-to-date overview of the current treatment patterns and healthcare resource utilization in patients with advanced breast cancer (ABC) in the real-world setting in Taiwan. Anticancer treatments since diagnosis of ABC included a variety of therapies, including hormonal therapy, chemotherapy (ChT), other targeted and biologic therapies, ovarian suppression, ovarian ablation, and other radiation and surgery. • Healthcare resource utilization data indicated that oncologist visits and hospitalizations were the key drivers of health resource utilization. These results can inform future evaluations of new ABC treatments that estimate the health economic impact of their adoption in Taiwan. • The study also highlighted that current treatment patterns suggest an unmet need for new medications, including for the overall patient population and the subgroups of patients based on postmenopausal status, presence of visceral disease, and first-line ChT use, that can lead to reduction in high rate of ChT use and frequent severe adverse events associated with them. [ABSTRACT FROM AUTHOR]

To evaluate geographic accessibility of ACR mammographic screening (MS), lung cancer screening (LCS), and CT colorectal cancer screening (CTCS) centers among US federally recognized American Indian and Alaskan Native (AI/AN) tribes. Distances from AI/AN tribes' ZIP codes to their closest ACR-accredited LCS and CTCS centers were recorded using tools from the ACR website. The FDA's database was used for MS. Persistent adult poverty (PPC-A), persistent child poverty (PPC-C), and rurality indexes (rural-urban continuum codes) were from the US Department of Agriculture. Logistic and linear regression analyses were used to assess distances to screening centers and relationships among rurality, PPC-A, and PPC-C. Five hundred ninety-four federally recognized AI/AN tribes met the inclusion criteria. Among all closest MS, LCS, or CTCS center to AI/AN tribes, 77.8% (1,387 of 1,782) were located within 200 miles, with a mean distance of 53.6 ± 53.0 miles. Most tribes (93.6% [557 of 594]) had MS centers within 200 miles, 76.4% (454 of 594) had LCS centers within 200 miles, and 63.5% (376 of 594) had CTCS centers within 200 miles. Counties with PPC-A (odds ratio [OR], 0.47; P <.001) and PPC-C (OR, 0.19; P <.001) were significantly associated with decreased odds of having a cancer screening center within 200 miles. PPC-C was associated with decreased likelihood of having an LCS center (OR, 0.24; P <.001) and an CTCS center (OR, 0.52; P <.001) within the same state as the tribe's location. No significant association was found between PPC-A and PPC-C and MS centers. AI/AN tribes experience distance barriers to ACR-accredited screening centers, resulting in cancer screening deserts. Programs are needed to increase equity in screening access among AI/AN tribes. [Display omitted] [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the presence or absence of accredited breast imaging facilities in ZIP codes with high or low neighborhood socioeconomic deprivation. A retrospective ecological study design was used. Neighborhood socioeconomic disadvantage rankings at the ZIP code level were defined by the University of Wisconsin Neighborhood Atlas Area Deprivation Index. Outcomes included the presence or absence of FDA- or ACR-accredited mammographic facilities, accredited stereotactic biopsy or breast ultrasound facilities, and ACR Breast Imaging Centers of Excellence. US Department of Agriculture rural-urban commuting area codes were used to define urban and rural status. Access to breast imaging facilities in high-disadvantage (≥97th percentile) and low-disadvantage (≤3rd percentile) ZIP codes was compared using χ2 tests, stratified by urban or rural status. Among 41,683 ZIP codes, 2,796 were classified as high disadvantage (1,160 rural, 1,636 urban) and 1,028 as low disadvantage (39 rural, 989 urban). High-disadvantage ZIP codes were more likely rural (P <.001) and less likely to have FDA-certified mammographic facilities (28% versus 35%, P <.001), ACR-accredited stereotactic biopsy (7% versus 15%, P <.001), breast ultrasound (9% versus 23%, P <.001), or Breast Imaging Centers of Excellence (7% versus 16%, P <.001). Among urban areas, high-disadvantage ZIP codes were less likely to have FDA-certified mammographic facilities (30% versus 36%, P =.002), ACR-accredited stereotactic biopsy (10% versus 16%, P <.001), breast ultrasound (13% versus 23%, P <.001), and Breast Imaging Centers of Excellence (10% versus 16%, P <.001). People living in ZIP codes with high socioeconomic disadvantage are less likely to have accredited breast imaging facilities within their ZIP codes, which may contribute to disparities in access to breast cancer care experienced by underserved groups living in these areas. [ABSTRACT FROM AUTHOR]

While the American College of Radiology recommends annual screening mammography starting at age 40 years, the US Preventive Services Task Force (USPSTF) recommends that screening mammography in women younger than age 50 years should involve shared- decision making (SDM) between clinicians and patients, considering benefits and potential harms in younger women. Using a nationally representative cross-sectional survey, we aimed to evaluate patient-reported reasons and predictors of screening mammography utilization in this age group. Respondents aged 40-49 years from the 2018 National Health Interview Survey (NHIS) without a history of breast cancer were included (response rate 64%). Participants reported sociodemographic variables and reasons they did not engage in mammography screening within the last two years. Multiple variable logistic regression analyses were performed to evaluate the association between sociodemographic characteristics and patient-reported screening mammography use, accounting for complex survey sampling design elements. 1,948 women between the ages of 40-49 years were included. Of this group, (758/1948) 46.6% reported receiving a screening mammogram within the last year, and 1196/1948 (61.4%) reported receiving a screening mammogram within the last two years. The most common reasons for not undergoing screening included: "No reason/never thought about it" 744/1948 (38.2%), "Put it off" 343/1948 (17.6%), "Didn't need it" 331/1948 (16.9%), "Doctor didn't order it" 162/1948 (8.3%), and "I'm too young" 63/1948 (5.3%). Multiple variable analyses demonstrated that lack of health insurance was the strongest predictor of mammography non-engagement (p < 0.001). Deficits in shared- decision-making in women younger than 50 years related to mammography utilization exist. Radiologists may be key in addressing this issue among ambulatory care providers and patients, educating about the benefits and harms of screening younger women, particularly in racial/ethnic minorities and uninsured patients, who experience additional barriers to care and SDM discussions. [ABSTRACT FROM AUTHOR]

Both milrinone and levosimendan have been used in patients undergoing surgical closure of ventricular septal defects (VSD) with pulmonary artery hypertension (PAH); however, the evidence base for their use is limited. In the present study, the authors sought to compare the role of levosimendan and milrinone in the prevention of low-cardiac-output syndrome in the early postoperative period. A prospective, randomized, controlled trial. At a tertiary-care center. Children between 1 month and 12 years presenting with VSD and PAH between 2018 and 2020. A total of 132 patients were randomized into the following 2 groups: Group L (levosimendan group) and Group M (milrinone group). In addition to conventional hemodynamic parameters, the authors also included a myocardial performance index assessment to compare the groups. The levosimendan group had significantly lower mean arterial pressure while coming off cardiopulmonary bypass, after shifting to intensive therapy unit, as well as at 3 and 6 hours postoperatively. The duration of ventilation (29.6 ± 13.9 hours v 23.2 ± 13.3 hours; p = 0.012), as well as postoperative intensive care unit stay, were significantly prolonged in the levosimendan group (5.48 ± 1.2 v 4.7 ± 1.3 days, p = 0.003). There were 2 (1.6%) in-hospital deaths in the entire cohort, 1 in each arm. There was no difference in the myocardial performance index of the left or right ventricle. In patients undergoing surgical repair for VSD with PAH, levosimendan does not confer any additional benefit compared to milrinone. Both milrinone and levosimendan appear to be safe in this cohort. [ABSTRACT FROM AUTHOR]

Previously, we have reported that PARP1 rs1136410 is significantly associated with increased the risk of gallbladder cancer. We aimed to investigate the association of PARP1 rs1805405 and rs3219088 polymorphisms with risk of GBC and also association of the haplotype and combined effect of PARP1 SNPs (rs1805405 G/A, rs3219088 G/T and rs1136410 A/G). We have also investigated the expression profile of PARP1 and its correlation with polymorphisms, clinical parameters and overall survival. PARP1 polymorphisms were genotyped by PCR-RFLP and the expression profile of PARP1 at mRNA level was analyzed by semi-quantitative PCR. Overall survival was analyzed using Kaplan-Meier plot and Cox-regression analysis. Haplotype analysis of the PARP1 polymorphisms revealed that AGG, AAG and GGT haplotypes are significantly associated with decreased risk of GBC, while AAT, AGT, GGG and GAG haplotypes are significantly associated with increased risk of GBC. Patients with T1+T2 and treated with chemotherapy having risk genotypes of rs1805405 have decreased overall survival. Upregulation of PARP1 is significantly associated with longer overall survival in patients with GBC with different clinical parameters. SNPs rs1136410 and rs1805405 genotypes are significantly associated with PARP1 expression. Haplotype analysis suggests that PARP1 may have a potential role in gallbladder carcinogenesis. [ABSTRACT FROM AUTHOR]

Phase I (early) orthodontic treatment is intended to correct developing skeletal, dentoalveolar, and muscular imbalances, and to improve the orofacial environment before the permanent teeth eruption. The orthodontic intervention in mixed dentition provides orthodontist a unique opportunity to apply their reasoning and understanding in addressing an impending malocclusion and avoid or limit the use of Phase II treatment. This paper describes the application of clear aligner therapy (CAT) in growing individuals. The use of clear aligner treatment in addressing early transverse discrepancy (inter- and intra-arch), Class III and Class II malocclusion are discussed in the light of current available evidence, and through case discussion. The authors propose treatment options for the correction of vertical and transverse malocclusion during early and late mixed dentition stage. Furthermore, the barriers and enablers of compliance in Phase I therapy are explored and possible resolutions are discussed. In summary, Phase I orthodontic treatment using CAT lack a large body of credible evidence, nonetheless, it is proving to be an exciting field regarding its sheer scope and expanse. [ABSTRACT FROM AUTHOR]

This study models (consumer price) inflation for an open small island state of Fiji. We introduce, within a hybrid open-economy version of the New Keynesian Phillips Curve (NKPC) model, the effects of development in the stock market, and frequent sources of economic and political uncertainty on inflation. Using monthly data over the period for the period February 1996 to December 2020, we show that a model with expectations of forward- and backward-looking economic agents alone can explain 85% inflation. Other NKPC variables have explanatory power of 10% boost this to 27% relationships in the hybrid NKPC model. Overall, the study implies that inflation expectations of economic agents, if managed effectively, can avoid persistently high inflation rates. [ABSTRACT FROM AUTHOR]

This paper examines the effectiveness of the monetary policies undertaken by the central bank on economic growth during COVID-19 uncertainty in case of India and Indonesia. We use an innovative framework of Growth-at-Risk as oppose to standard macroeconomic models, which can predict the growth in a much robust way particularly when an economy is facing shocks like COVID-19. The empirical results based on Growth-at-Risk model clearly reveal that effect of COVID-19 pandemic on economic growth is much adverse in comparison to actual declines. Further, this study shows the effectiveness of monetary and financial policies undertaken by the central banks of both India and Indonesia, which have actually subsided the adverse impact of COVID-19. [ABSTRACT FROM AUTHOR]

Perioperative atrial fibrillation (AF) is associated with increased mortality, morbidity, and excess healthcare costs. The objective of our study was to assess if preoperative AF in patients undergoing coronary artery bypass grafting is a predictor of operative mortality, postoperative stroke, and need for postoperative dialysis by interrogating a large registry database. We included all isolated procedures performed between February 1996 and March 2019. We used a generalized linear mixed model to assess the effect of preoperative AF on mortality stroke and the need for postoperative dialysis after adjusting for the relevant confounders derived from EuroSCORE 2. Confounders considered included age, gender, neurological dysfunction, renal dysfunction, recent myocardial infarction, pulmonary disease, unstable angina, NYHA class, pulmonary hypertension, diabetes on insulin and peripheral vascular disease, and urgency of the operation. We treated the hospital and operating consultant as random effect variables. We also performed LV function subgroup analyses to assess the effect of preoperative AF on the outcomes of interest. The incidence of pre-existent AF in the cohort of patients we analyzed (N = 356,040 patients) was 3.5% (N = 12,664). In the unadjusted baseline characteristics, preoperative AF patients had more associated comorbidities. After adjustment, preoperative AF remained a significant predictor of increased mortality (odds ratio [OR]: 1.63, confidence interval [CI] 1.48–1.79, p < 0.001), stroke (OR: 1.33, CI 1.16–1.54, p = 0.001), and need for renal dialysis (OR:1.61, CI 1.46–1.78, p < 0.001). Preoperative AF was a significant predictor of adverse outcomes in patients with moderate and good LV function but not in patients with poor LV function (EF <30%). Our study suggests that preoperative AF is associated with an increased risk for perioperative mortality and stroke in patients undergoing coronary artery bypass grafting. [ABSTRACT FROM AUTHOR]

Acute kidney disease is a serious complication characterized by poor short- and long-term outcomes in the intensive care unit. Impairment in renal function of the kidney significantly increases the mortality rate. Early detection of acute kidney disease could lead to preventive interventions, therefore deep learning systems can detect it before its symptoms and consequences appear. We developed a novel deep learning architecture like Stacked long short-term memory network with pattern mixture approach for kidney injury prediction. A total of 33,754 patients encountered were retrospectively analyzed from the MIMIC-III database. A selection and pattern mixture model was used for preprocessing the time-series data. We compared the proposed result with conventional algorithms like gradient boosted trees and long short-term memory model. Our model was trained on patient time-series data for different time windows and obtained the highest accuracy of 92.4% for 12 h and 92.6% for 24 h. A novel stacked long short-term memory model outperforms the machine learning model, revealing superior performance in predicting kidney injury 24 h before onset. [ABSTRACT FROM AUTHOR]

The reliability of the result significantly affects the use of the Coefficient of Variation (within the test variation), which reflects the variability of the concrete properties rather than the standard deviation. For the estimation of reliability and precision, comprehensive statistical analysis (within test variation) is conducted on 534 test samples using a rebound hammer. Different standards, like BIS, EN, ACI, and ASTM, are used in this study to compare the test results. Empirical research revealed that there are contradictions in literature as well as the standards used in many countries. The present paper focuses on detailed investigations of uncertainty measurements of the surface hardness test by statistical parameters (range of rebound index, standard deviation, and Coefficient of Variation). The unbiased estimate of the variability parameters from the published results has been verified concerning to the European standard. Concrete parameters namely cement type, water to cement ratio, compaction deficiency, curing condition, and elevated temperature have an impact on the output of the rebound hardness in terms of the variability of the compressive strength. Based on the results, the authors are willing to propose amendments to the Indian code graciously in compliance with the variability of the rebound hammer. [ABSTRACT FROM AUTHOR]

In recent years, radiology departments have increasingly recognized the extent of health care disparities related to imaging and image-guided interventions. The goal of this article is to provide a framework for developing a health equity initiative in radiology and to articulate key defining factors. This article leverages the experience of three academic radiology departments and explores key principles that emerged when observing the experiences of these departments that have begun to engage in health equity–focused work. A four-component framework is described for a health equity initiative in radiology consisting of (1) environmental scan and blueprint, (2) design and implementation, (3) initiative evaluation, and (4) community engagement. Key facilitators include a comprehensive environmental scan, early stakeholder engagement and consensus building, implementation science design thinking, and multitiered community engagement. All radiology organizations should strive to develop, pilot, and evaluate novel initiatives that promote equitable access to high-quality imaging services. Establishing systems for high-quality data collection is critical to success. An implementation science approach provides a robust framework for developing and testing novel health equity initiatives in radiology. Community engagement is critical at all stages of the health equity initiative time line. [ABSTRACT FROM AUTHOR]