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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]

We report a case of chronic myeloid leukemia (CML), which was diagnosed during the management of proliferative retinopathy (PR) in a patient with type I diabetes mellitus due to the fulminant nature of the PR. This case highlights the importance of vigilance on the part of the ophthalmologist in the diagnosis of co-existing systemic disorders, notably hematological malignancy, which aggravates the posterior segment vasculopathy of the eye and the management of which is crucial for the patient. We also describe a short literature review on the clinical features, mechanism of the posterior segment vasculopathy of the eye, and management of PR co-existing in a patient with CML. [ABSTRACT FROM AUTHOR]

The heart's study holds paramount importance in human physiology, driving valuable research in cardiovascular health. However, assessing Electrocardiogram (ECG) analysis techniques poses challenges due to noise and artifacts in authentic recordings. The advent of machine learning systems for automated diagnosis has heightened the demand for extensive data, yet accessing medical data is hindered by privacy concerns. Consequently, generating artificial ECG signals faithful to real ones is a formidable task in biomedical signal processing. This paper introduces a method for ECG signal modeling using parametric quartic splines and generating a new dataset based on the modeled signals. Additionally, it explores ECG classification using three machine learning techniques facilitated by Orange software, addressing both normal and abnormal sinus rhythms. The classification enables early detection and prediction of heart-related ailments, facilitating timely clinical interventions and improving patient outcomes. The assessment of synthetic signal quality is conducted through power spectrum analysis and cross-correlation analysis, power spectrum analysis of both real and synthetic ECG waves provides a quantitative assessment of their frequency content, aiding in the validation and evaluation of synthetic ECG signal generation techniques. Cross-correlation analysis revealing a robust correlation coefficient of 0.974 and precise alignment with a negligible time lag of 0.000 s between the synthetic and real ECG signals. Overall, the adoption of quartic spline interpolation in ECG modeling enhances the precision, smoothness, and fidelity of signal representation, thereby improving the effectiveness of diagnostic and analytical tasks in cardiology. Three prominent machine learning algorithms, namely Decision Tree, Logistic Regression, and Gradient Boosting, effectively classify the modeled ECG signals with classification accuracies of 0.98620, 0.98965, and 0.99137, respectively. Notably, all models exhibit robust performance, characterized by high AUC values and classification accuracy. While Gradient Boosting and Logistic Regression demonstrate marginally superior performance compared to the Decision Tree model across most metrics, all models showcase commendable efficacy in ECG signal classification. The study underscores the significance of accurate ECG modeling in health sciences and biomedical technology, offering enhanced accuracy and flexibility for improved cardiovascular health understanding and diagnostic tools. [ABSTRACT FROM AUTHOR]

EMR and endoscopic submucosal dissection (ESD) are minimally invasive endoscopic techniques, developed for the removal of benign and early malignant lesions throughout the GI tract. Submucosal injection of a marking agent can help to identify lesions during surgery. Endoscopic resection frequently involves "lifting" of the lesions by injection of a substance within the submucosal space to create a cushion for safe resection. This review summarizes the current techniques and agents available for endoscopic marking and lifting of GI tract lesions. The MEDLINE database was searched through April 2023 for relevant articles related to the lifting and marking aspect of EMR by using key words such as "endoscopy" or "endoscopic" combined with "marking," "tattoo," and "lifting." The report was drafted, reviewed, and edited by the American Society for Gastrointestinal Endoscopy Technology Committee and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy. This technology review describes the techniques for endoscopic tattoo placement and submucosal lifting, along with currently available agents, safety, and costs. Endoscopists performing EMR and ESD have several choices in submucosal injection materials for lifting and marking agents for tattoos. These may be commercially prepared agents or off-the-shelf materials with or without additives to facilitate visualization. A thorough understanding of the indications, techniques, properties of various agents, costs, and adverse events is necessary in choosing the appropriate materials and technique to optimize lesion resection in EMR and ESD. [ABSTRACT FROM AUTHOR]

The present examination focuses on the Falkner-Skan flow of micropolar hybridized nanofluid via a wedge surface. The proposed study examines thermal radiative fluxing and heat dissipation in hybridized nanoparticle aqueous solutions. Simulations of uni-directional radiative transport in optically dense fluids use Rosseland's diffusion model. This study created a Cu-TiO 2 /water hybrid nanofluid by mixing Cu and TiO 2 nanomolecules with H 2 O. Partial differential equations from Naiver-Stokes theory are used to generate the regulating flow phenomena, then convert them into ordinary differentiation equations using an appropriate similarity approach. Additionally, the three-stage Lobatto IIIA method is used to compute the formulae. Calculations are done using MATLAB's built-in bvp5c function. We found that increasing material characteristics slows fluid flow because micropolar nanofluids minimize drag. These alterations alter fluid flow and boost temperature. However, boosting thermal radiation and Eckert number slows heat movement but improves temperature profiles. Much prior research ignored thermal radiative fluxing and heat dissipation in the aqueous solution of hybrid nanomolecules (Cu and TiO 2) in Falkner-Skan micropolar flow via a wedge surface. Tables show wall frictional factor and Nusselt quantity results. Micropolar fluid characteristic decreases velocity but increases micro-rotational velocity. Power-law parameters, volume fractions, radiation, heat source, and Eckert amount affect thermal contours. [ABSTRACT FROM AUTHOR]

There is accumulating evidence of the presence of Cancer Stem Cells (CSCs) within meningiomas (MGs). In the present study, we assessed the Immunohistochemistry (IHC) expression of stem cell markers SOX2, OCT4, CD133 in different grades of MGs and their correlation with Ki 67 index. A cross-sectional analytical study where 140 MGs cases were graded and classified according to WHO-2021 classification. IHC for SOX2, OCT4, CD133 and Ki-67 was carried out. Out of 140 cases, 59 cases (42.1%) showed OCT4 positivity, 38 cases (27.1%) showed CD133 positivity and only 21 cases (15%) showed SOX2 positivity. Ki 67 index ranged from 1-30%. Statistically significant difference (Chi Square p-value <0.001) was found between SOX 2, OCT4 and CD133 expressions (positive/negative) and the grades of MG cases. As the grades of MG cases increased, the positive expression of SOX2, OCT 4 and CD 133 also increased. The Mean Ki 67 index value was significantly raised when SOX2, OCT 4 and CD 133 IHC expressions were positive (Student t Test p-value <0.001). Our results strongly support the hypothesis of presence of CSCs, in MGs regardless of their grade. We recommend that CSCs IHC markers (SOX2, OCT4 and CD133) to be used on initial diagnosis in all cases of MGs along with Ki-67 index. It can help quantitate CSCs and in turn, recommend closer follow up in patients with high percentage of CSCs to predict early recurrence. [ABSTRACT FROM AUTHOR]

This paper introduces a novel droop-based decentralized control scheme to address the power-sharing challenges within a PV-fed islanded AC microgrid. This novel approach integrates both conventional (P-f/Q-V) and virtual impedance concepts to optimize and manage the precise distribution of active and reactive power among parallel operating inverters posing a significant research challenge. The conventional droop control methods encounter limitations such as voltage and frequency deviations and inaccuracies in power-sharing due to line impedance disparities. To overcome these limitations, the proposed solution integrates an enhanced virtual impedance control loop alongside the conventional control loop (P-f/Q-V). The efficacy of this approach is showcased through simulations conducted using the OPAL-RT OP4510 simulator within the MATLAB/Simulink platform. The Real-time simulation outcomes confirm the efficiency of the suggested control strategy, guaranteeing precise distribution of both active and reactive power while upholding stable voltage and frequency profiles within the system. • A novel virtual impedance structure for improved power sharing capability among parallel inverters. • PCC voltage stability under load change and line impedance mismatch scenarios. • Restoration of AC MG frequency under load transient condition. • An analytical solution for choosing the equivalent output virtual impedance. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate postoperative pupil distortion following small pupil cataract surgeries performed using B-HEX and Malyugin rings (MR). A randomized control trial was conducted from June 2020 to June 2023 at a tertiary eye-care hospital. The study consisted of 64 participants for cataract surgery with small pupil. There were two groups, one undergoing surgery with the use of B-HEX pupil expander and other with MR intraoperatively and the rest of the surgery was proceeded as per the convention. Areas of preoperative and postoperative images was calculated, put into an online software and pupil distortion was calculated in percentage. Two-tailed t-test was used to see the difference between the two groups. Mean age at presentation was 70.5 ± 10.12 years. Most common cause for small pupil was tamsulosin therapy. Mean size of small-pupil was 3.0 ± 1.1 mm. With the application of two rings, mean pupillary area preoperatively was 4178.23 ± 1589.46 and postoperatively was 6100.44 ± 2658.28 following the use of MR, respectively and 30,002.93 ± 13,193.40 preoperatively and 37,648.26 ± 15,207.01 postoperatively following the use of B-Hex ring respectively. Comparing baseline area from pupillary area at 1-month follow-up, a significant increase was noted for both the rings. Also, MR caused significantly more pupillary distortion compared to B-HEX ring (p < 0.05). MR causes significantly more pupillary distortion in the postoperative period compared to B-HEX ring. Though, both the rings cause pupillary distortion, these devices expand the surgical area adequately, ease the procedure, decrease risk of complications achieving good functional visual outcomes. [ABSTRACT FROM AUTHOR]

Iris fixated intraocular lens (IOLs) have been used for Aphakia and capsular bag instability. The IOLs cause a postoperative non dilating pupil in most cases. We encountered such a case which presented with rhegmatogenous retinal detachment. We describe a novel technique of operating for retinal reattachment in such a case using iris hooks passing in the potential plane between the IOL optic and the iris. The technique had advantages of obviating the need for IOL explantation, associated large corneal entry wound, allowing silicone oil tamponade by retaining an IOL-iris diaphragm, early visual rehabilitation, reduced surgical time, and avoiding multiple surgeries. [ABSTRACT FROM AUTHOR]

Ocular dirofilariasis is no longer a rare disease as more cases are being reported across the world and in India as awareness about this disease among health care professionals has increased. It is a helminthic infection which is caused by filarial parasite of the genus dirofilaria. It has a varied clinical presentation and the definitive diagnosis is based on microbiological and histopathological examination of the parasite. Herein, we report a unique case of ocular dirofilariasis in which a patient initially presented with features mimicking orbital cellulitis. Subsequently, the patient developed a subconjunctival lesion when orbital cellulitis subsided after three days of broad-spectrum antibiotics. The live worm was found when the lesion was incised, which was removed in toto and sent for microbiological examination. The nematode in our case was identified as dirofilaria repens. There was complete resolution of symptoms following surgical extraction of worm and no sign of recurrence was seen at 6 months follow-up. [ABSTRACT FROM AUTHOR]

Lockdown during COVID-19 led to teachers and children shifting to online classes, using visual display terminals (VDTs) for education, resulting in increased screen time. The present study was done to assess and understand the nature and magnitude of the problem and to suggest preventive or remedial measures. A questionnaire-based cross-sectional study was conducted. The questionnaire was prepared for an online survey (using Google Forms) and circulated among school children belonging to different schools across India using multiple groups on social media. A total of 3327 participants from 46 schools across India participated in the survey. We found a marked rise in cumulative screen time for both teachers and students before and during the lockdown. There was a threefold increase in the number of participants with a cumulative screen time 6 h or more compared to the pre-COVID era. Teachers (older participants) had worse symptom scores than students. Larger screens, like televisions, were better VDTs compared to smartphones, tablets, or laptops. School administrators and policymakers should pay due attention to institutionalizing the guidelines about class duration, appropriate screens, and stipulating break duration during online classes, which will continue to remain the predominant mode of education for teachers and students alike, at least in the near future. [ABSTRACT FROM AUTHOR]

Hallux amputations have long been performed for the definitive treatment of hallux osteomyelitis resulting from ulcerations. These amputations have been performed at various levels of the hallux. The aim of this study is to assess the long-term outcomes in patients with hallux amputations performed at these various levels and to determine whether there is an ideal anatomic level that would limit post-operative complications and need for revisional surgery. An Institutional Review Board (IRB)-approved retrospective chart review of 148 feet with hallux amputations performed at various levels from July 1, 2013 to July 16, 2020 at an academic medical center was conducted. A 2-year minimum follow up was required for inclusion in the study. Incidence of re-ulceration, need for further amputation, healing of index procedure, and revascularization status were evaluated. Statistical analysis utilizing chi square analysis was performed to calculate p -values where <.05 was statistically significant. In this retrospective study with a minimum of 2-year follow-up, there was a tendency for amputations performed at the level of the head of the proximal phalanx (21%) to have a lower rate of reulceration (24%) followed by amputations performed at the level of the metatarsophalangeal joint and interphalangeal joints (36%). However, neither proved to be statistically significant. [ABSTRACT FROM AUTHOR]

The principal intention of the currently analysis is to investigate the impacts of the naturally convective nanofluid using a model of Carreau fluid with engine oil (C n H 2 n + 2) as the base fluid and Manganese Zinc Ferrite (M n Z n Fe 2 O 4) as the nanoparticle, the fluid flowing through a stretched cylinder in a fuzzy ambient. It examines the impact of assorted parameters, Weissenberg number (We) , Prandtl numeral (Pr) , Schmidt numeral (Sc) , and curvature (k) with magnetic field (B) and nanoparticle parameter, in order to manipulate an analogous conversion, the regulating equations of velocity, energy, and concentration profiles permute from a set of partial differential equations stand to ordinary differential equations. The present analysis focuses on the no slip assumption, which gives rise to a nonlinear Dirichlet boundary condition in axial velocity. The bvp5c approach was utilized to solve the resulting series of equations by the MATLAB. This is a highly effective approach with minimal computing expenditure. The volume quantity of nanoparticles in M n Z n Fe 2 O 4 is considered an uncertain parameter respect to TFNs (triangular fuzzy numbers) ranging [0, 0.5, 0.1]. Triangular membership function (TMF) is used to study the uncertainty variability while α − cut controls the TFNs. Fuzzy linear regression analysis makes use of TFNs to determine the middle (crisp), left, and right values of the fuzzy velocity profile. In comparison to the crisp velocity profile (mid value), the study's result and the fuzzy velocity profile have the maximum rate of flow. Tables and graphs are used to illustrate the outputs. [ABSTRACT FROM AUTHOR]

To compare the acute healing outcomes of Biobrane® and Epiprotect® in paediatric partial thickness (PT) burns. All paediatric patients (age <18 years) with PT burns managed using either Biobrane® or Epiprotect® over a 5-year period at our burns unit were included. The primary outcome was time to complete healing. Secondary outcomes included adherence, infection rates, length of hospital stay, duration of acute follow-up and return to the theatre. Among the 99 patients included, 38 received Epiprotect® and 61 received Biobrane®. The mean total body surface area (TBSA) was 6% (range 1%−15%) and median age was 21 months (range 5–169 months). Median time to healing in the Epiprotect® group was 19.5 days and 16 days in the Biobrane® group (P =.14). The median hospitalisation length was the same for both products (2 days, P =.85). Infection rate was lower in the Epiprotect® group (2.6% vs 16.4%, P =.048). There was no difference in adherence rate. These trends were preserved when depth sub-groups were analysed. Adherence and infection rates were not affected by post-operative antibiotics (P >.99 and P =.65, respectively) in either group. The rate of return to the theatre for further surgery was 13.2% for both products (P >.99). Our findings demonstrate that acute healing outcomes with Epiprotect® in paediatric PT burns are comparable to those with Biobrane®, with significantly lower infection rates for Epiprotect®. These results suggest that Epiprotect® is a viable alternative to Biobrane®. Nevertheless, further prospective randomised studies are required to investigate the short- and long-term outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The utilization of lattice structure in engineering components by additive manufacturing (AM) is gaining attention due to its lightweight design, high strength-to-weight ratio, and effective material utilization. Producing holes in additively manufactured lattice structures with dimensional accuracy is challenging. In the current study, we fabricate near circular through-holes on deterministic lattice structured components fabricated by laser powder bed fusion by utilizing electric discharge machining (EDM). In the additively manufactured Inconel 718 (IN718) lattice structure, nodes are connected by strut leaving voids/pores amongst different nodal points. Due to EDM, the nodes at the boundary of the hole experience concentration plasma interaction, heating, and rapid cooling, which causes a substantial change in the microstructure. The selective removal of material from different nodal positions causes uncharacteristic recast layers, partial damages, and uncontrolled cracking of the struts. In the present study, we investigated and characterized the differential behaviour and mechanism of various surface integrity issues associated with the selective material removal of LPBF IN718 lattice structures and their elements (nodes and struts). [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) is a routinely used imaging modality for pre-treatment radiologic evaluation of tongue carcinoma, providing accurate information regarding the extent of the disease. To investigate the role of MRI-derived depth of invasion and tumor thickness evaluation in squamous cell carcinoma of the tongue, and to assess if any correlation exists between depth of invasion, tumor thickness, nodal metastasis, muscles, and space involved. Thirty-three patients with oral squamous cell carcinoma of the tongue who had undergone pre-treatment MRI and excisional biopsy were included. The tumor thickness (TT) and depth of invasion (DOI) were evaluated on MRI and histopathologic images. The relation between different methodologies for assessing showed a very high correlation for the tumor tissue thickness (r = 0.99, p < 0.05) and depth of invasion (r = 0.82, p < 0.05). The tumor thickness and the depth of invasion increased with the loss of differentiation in the carcinoma histopathologically. As the depth of invasion increases, the extent of the spread of the carcinoma to tongue musculature, lingual septum, and spaces also increases. The present study has depicted a high correlation between the tumor thickness and the depth of invasion between MRI and histopathological findings and is the first of its kind to correlate DOI to the invasiveness of the disease. [Display omitted] [ABSTRACT FROM AUTHOR]

This article presents a robust finite control set predictive scheme for a stand-alone squirrel cage induction generator (SCIG) drive. This technique is considered an alternative to the drive system due to the inclusion of system nonlinearities and fast dynamic response. The control objective in the distributed generation environment is to fix the output voltage to follow the stand-alone requirement. The strategy establishes optimized switching instants for cost function minimization for both source and load converter control and diminished cross-coupling amid active and reactive power during transient scenarios. The scheme is designed to achieve the minimal effect caused by the parameter uncertainties. During source and load changes, this work will also address the maintenance of dc-link voltage, machine, and load variables at the set value, supported by machine and load-end converter control to achieve stand-alone load objectives. In addition, the presented scheme is also tested with random variation of speed to check the efficacy of the control configuration. The drive performance is evaluated by simulation using MATLAB/Simulink environment. Comprehensive real-time findings obtained from a scaled laboratory test bench using dSPACE-1104 are provided to verify the feasibility of the predictive solution. • Distinct design approach of predictive control for SCIG based drive system feeding stand-alone load. • The developed generator side converter strategy controls the active power flow from the SCIG by regulating the dc-link voltage. • The performance of the control scheme is found to be much superior under load transients, and input power variation. • The uncertainty in the values of the machine parameters is also tested and system offer better dynamic performance. • Demonstration of MATLAB Simulation and, then validation with Real-Time results. [ABSTRACT FROM AUTHOR]

The advancement of theranostics, which combines therapeutic and diagnostic capabilities in oncology, has significantly impacted cancer management. This review explores fibroblast activation protein (FAP) expression in the tumor microenvironment (TME) and its association with various malignancies, highlighting its potential as a theranostic marker for PET/CT imaging using FAP-targeted tracers and for FAP-targeted radiopharmaceutical therapy. We examine the development and clinical applications of FAP inhibitors (FAPIs) and peptides, providing insights into their diagnostic accuracy, initial therapeutic efficacy, and clinical impact across diverse cancer types, as well as the synthesis of novel FAP-targeted ligands. This review aims to showcase the promising outcomes and challenges in integrating FAP-targeted approaches into cancer management. [ABSTRACT FROM AUTHOR]

On average, aging is associated with unfavorable changes in cellular metabolism, which are the processes involved in the storage and expenditure of energy. However, metabolic dysregulation may not occur to the same extent in all older individuals as people age at different rates. Those who are aging rapidly are at increased risk of adverse health outcomes and are said to be "frail." Here, we explore the links between frailty and metabolism, including metabolic contributors and consequences of frailty. We examine how metabolic diseases may modify the degree of frailty in old age and suggest that frailty may predispose toward metabolic disease. Metabolic interventions that can mitigate the degree of frailty in people are reviewed. New treatment strategies developed in animal models that are poised for translation to humans are also considered. We suggest that maintaining a youthful metabolism into older age may be protective against frailty. Detrimental changes in metabolism are associated with aging, especially in people who are aging rapidly and are frail. In this perspective, Mishra et al. explore the bidirectional relationship between frailty and metabolism and highlight how interventions designed to improve metabolism may reduce frailty in older individuals. [ABSTRACT FROM AUTHOR]

Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden. We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates. These variables were measured at baseline and during the intervention, specifically during the second month, third month, 4 to 16 months, and 17 to 29 months. Comparisons were conducted using a two-sample t test. To explore the exposure-outcome relationship, we used a generalized linear mixed model with a Poisson distribution to model the number of CLABSIs. During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. CLABSI per 1,000 CL-days rates decreased from 15.34 at the baseline period to 7.97 in the 2nd month (relative risk (RR) = 0.52; 95% confidence interval [CI] = 0.48-0.56; P <.001), 5.34 in the 3rd month (RR = 0.35; 95% CI = 0.32-0.38; P <.001), and 2.23 in the 17 to 29 months (RR = 0.15; 95% CI = 0.13-0.17; P <.001). In-ICU all-cause mortality rate decreased from 16.17% at baseline to 13.68% (RR = 0.84; P =.0013) at 17 to 29 months. The implemented approach was effective, and a similar intervention could be applied in other ICUs of low- and middle-income countries to reduce CLABSI and in-ICU all-cause mortality rates. • The objective of this study is to implement a strategy to reduce CLABSI rates. • An intervention was conducted in 316 ICUs in 30 countries. • During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. • CLABSI per 1,000 CL-days rates decreased from 15.34 at baseline to 2.23 in the 17-29 months. • In-ICU all-cause mortality rate decreased from 16.17% at baseline to 13.68% at 17-29 months. [ABSTRACT FROM AUTHOR]

• Aphasia outcome is better in subcortical stroke as compared to cortical. • Intracerebral Hemorrhage has better aphasia outcome than Acute Ischemic Stroke. • FA of Arcuate Fasciculus has positive correlation with aphasia score while MD has negative correlation with the same. • Improvements in modified Rankin Scale and Aphasia scores are positively correlated. Aphasia is a language disorder acquired secondary to brain damage. This study aims to evaluate clinical and radiological profile of patients with post stroke aphasia and factors affecting its recovery. We conducted a prospective study of patients with first left Middle or Anterior Cerebral Artery infarct or Intracerebral Hemorrhage (ICH) with aphasia admitted within 14 days of stroke onset. Aphasia Quotient (AQ) was assessed at 2 weeks (AQ1) and 3 months (AQ2) using Western Aphasia Battery-Hindi version. Magnetic Resonance Imaging of brain with Diffusion Tensor Imaging (DTI) of bilateral Arcuate Fasciculus (AF) and Corticospinal Tract was done at admission, and stroke volume, Laterality Indices of Fractional Anisotropy (LI-FA), Mean Diffusivity (LI-MD), Radial Diffusivity (LI-RD), Axial Diffusivity (LI-AD) and Apparent Diffusion Coefficient (LI-ADC) were obtained. 36 patients [8 ICH and 28 Acute Ischemic Stroke (AIS)] were included. AQ1 and AQ2 were significantly higher in subcortical stroke than cortical. AQ2 and increase in AQ scores (including its subscores) were significantly higher in ICH than AIS. National Institutes of Health Stroke Scale score at admission and volume of stroke had significant negative correlation with AQ1 and AQ2. Laterality Index of Fractional Anisotropy of Arcuate Fasciculus [LI-FA (AF)] had significant positive correlation with AQ2 and naming score at 3 months. Laterality Index of Mean Diffusivity of Arcuate Fasciculus [LI-MD (AF)] had significant negative correlation with AQ1, AQ2 and all subcomponents of AQ2. Significant positive correlation was seen between improvements in Modified Rankin Scale score and AQ. The study shows that DTI can be used to predict severity of aphasia at follow up and recovery in language and motor functions occur in parallel [ABSTRACT FROM AUTHOR]

Dental Agenesis is the usual developmental dental anomaly involving both primary and permanent dentition but most commonly it affects the permanent teeth. Genetic mutations in genes like MSX, PAX9,TGFA and AXIN2 are the likely primary contributors to tooth agenesis. Identifying the prevalence and distribution of congenital missing teeth allows for early detection and intervention which is crucial for preventing or mitigating potential dental issues that may arise due to missing teeth. To assess the prevalence and distribution of congenitally missing teeth across different quadrants of the jaw among patients visiting to the Dental out patient department at Tertiary Care Centre of Lucknow city. A Questionnaire and orthopantomogram based cross-sectional study was conducted on both male and female patients aged between 15 and 30 years, coming for evaluation of their dental health problems to the hospital. Written informed consent was obtained. The overall prevalence of CMT was found to be 33.3 %. The significant difference was observed in proportion of CMT between Maxilla and Mandible sites (p = 0.008). Higher prevalence was in females compared to males for both maxillary and mandibular congenital missing teeth. (p = 0.020). The most common CMT were third molars followed by lateral incisors. The insights derived from the study would aid dental professional in gaining a deeper comprehension of tooth agenesis. [Display omitted] [ABSTRACT FROM AUTHOR]

Bacteria commonly adhere to surfaces and produce polymeric material to encase the attached cells to form communities called biofilms. Within these biofilms, bacteria can appear to be many times more resistant to antibiotics or disinfectants. This systematic review explores the prevalence and microbial profile associated with biofilm production of bacteria isolated from endotracheal tubes and its associations with antimicrobial resistance. A comprehensive search was performed on databases PubMed, Embase, and Google Scholar for relevant articles published between 1st January 2000 and 31st December 2022. The relevant articles were exported to Mendeley Desktop 1.19.8 and screened by title and abstract, followed by full text screening based on the eligibility criteria of the study. Quality assessment of the studies was performed using the Newcastle–Ottawa Scale (NOS) customized for cross-sectional studies. Furthermore, the prevalence of antimicrobial resistance in biofilm-producers isolated from endotracheal tube specimens was investigated. Twenty studies encompassing 981 endotracheal tubes met the eligibility criteria. Pseudomonas spp. and Acinetobacter spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in Pseudomonas spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in Acinetobacter spp. with a very high resistance rate against fluoroquinolones, third-generation cephalosporins and carbapenems. In conclusion, endotracheal tubes were associated with colonization by biofilm forming bacteria with varying levels of antimicrobial resistance. Biofilms may promote the occurrence of recalcitrant infections in endotracheal tubes which need to be managed with appropriate protocols and antimicrobial stewardship. Research focus should shift towards meticulous exploration of biofilm-associated infections to improve detection and management. [ABSTRACT FROM AUTHOR]

The current study deals with experiments on hydro-suction removal of cohesionless bed material from reservoirs. The primary focus lies in scrutinizing the scour profile and the volume of bed material removed through hydro-suction. A comprehensive record of 252 datasets was collected from experiments done on various combinations of governing parameters. The resultant equilibrium scour profile exhibited a symmetrical configuration resembling a semi-ellipsoidal shape. Notably, for the densimetric Forude number equal to or less than 5.8, a small central hump within the scour hole was seen. The investigation found that the optimal sediment removal efficiency was obtained when the C / D ratio was zero (where C is the suction inlet height and D is the suction pipe diameter) and with the highest densimetric Froude number. The sediment to water volume removal was highest in the initial few seconds, and reduced swiftly, followed by a subsequent smaller peak and gradually decreased to zero at equilibrium. Empirical equations for computing maximum scour depth, scour radius, and scour profile at equilibrium also were developed, which predict values within a commendable ±10% error range. [ABSTRACT FROM AUTHOR]

We enumerate the various laparoscopic strategies to resolve upper urinary tract (UUT) obstruction in the context of variations in anatomy and report their outcomes. Retrospective review of primary laparoscopic UUT reconstructions performed between May 2012 and May 2021. Anomalies included: malrotated kidney (MRK), horseshoe kidney (HSK), duplex kidney (DK), pure intrarenal pelvis (IRP) and mid-ureteric stenosis (MUS). Success was defined by postoperative resolution of symptoms, improvement of anterior–posterior renal pelvic diameter (APD) on US and drainage on Mag3. Complications were categorised by Clavien–Dindo grading. Outcomes compared using the student's t-test with P < 0.05 considered statistically significant. Of the 214 laparoscopic primary UUT reconstructions, 37 (17.2 %) were: 13-MRK, 12-HSK, 4-DK, 4-IRP and 4-MUS. Median age at surgery was 5-years (range 0.3–15). Dismembered pyeloplasty: 8; pyeloplasty with renal sinus dissection: 8; neo-PUJ anastomosis: 8; primary ureterocalycostomy: 7; pyeloureterostomy: 2; and uretero-ureterostomy: 4. Median follow-up was 43-months (range 8–108) with a success rate of 94.5 % (35/37). Complete resolution of symptoms in 20/21 patients; improvement of hydronephrosis on US in 35/37 patients (median pre-operative APD 27 mm vs. median postoperative APD 8 mm) [ P < 0.001]; improvement of drainage on diuretic renogram in 32/34 kidneys and stable/improved DRF in 34/35 kidneys (median preoperative DRF - 45 % vs. median postoperative DRF - 47 %) [ P > 0.05]. Postoperative complications managed medically (II Clavien) included urinary tract infections – 2 patients (5 %), stent-related symptoms in 2 (5 %) and umbilical port site collection in 1 patient (3 %). Recurrent pelvi–ureteric junction obstruction PUJO occurred in one patient (3 %) requiring redo surgery (IIIb Clavien), renal stones in 1 (3 %) which resolved with ESWL (IIIb Clavien); in 1 (3 %) patient with a HSK there was complete loss of ipsilateral kidney function but this was managed conservatively up to date (I Clavien). Laparoscopic transperitoneal approach allows the prompt recognition of in-situ anatomical variants. UUT obstruction in such settings calls for a variety of strategies with excellent outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Internet of Medical Things (IoMT) has transformed the healthcare sector by allowing for the continuous gathering, transfer, and analysis of medical data via networked devices.However, as IoMT has become more integrated into healthcare systems, it has been vulnerable to cybersecurity attacks, posing dangers to patient safety and data privacy. This study tackles the essential challenge of safeguarding the IoMT ecosystem by implementing cutting-edge deep learning approaches for threat identification and avoidance.Our study begins by looking at a variety of cyber risks that the IoMT faces, including as backdoors, DDoS assaults, MITM assaults, ransomware and SQL injections.These hostile operations may impair medical services and jeopardize critical med- ical data.To combat these risks, we offer a strong intrusion detection system, that constantly monitors the IoMT architecture for any unusual activity.The findings of this research contribute significantly to the development of a secure and resilient medical IoT ecosystem.The performance metrics of the proposed intrusion detection system, including accuracy, precision, recall, and F1 Score, were evaluated for four different models: CNN, Autoencoder, Transformer Network, and LSTM Network.The LSTM Network ex- hibited exceptional performance, achieving an accuracy of 97%, precision of 93%, recall of 96%, and an F1 Score of 94%.The compiled model, named Adam-LSTM, leverages the strengths of the Adam optimizer and LSTM architecture. Comparative anal- ysis with alternative algorithms demonstrated the superiority of the proposed approach in accurately and efficiently identifying intrusions.The IoMT can supply dependable healthcare services to patients while preserving their sensitive medical information by proactively securing digital health through deep learning-based threat detection.This study provides the groundwork for future breakthroughs in medical IoT cybersecurity solutions and promotes the idea of a smarter and safer healthcare landscape. [ABSTRACT FROM AUTHOR]

One of the buzz words in current research depends for a weather forecast is the atmospheric temperature, and this value may change at any time. Predicting air temperature exactly is necessary since it is particularly important for various communities and events. In today's world of massive amounts of data and unforeseen data fluctuations, long-short term memory (LSTM), a sort of neural network method, is becoming more and more popular. The present work employed a sequence to sequence LSTM autoencoder to forecast Indian weather patterns. The prediction model was trained using historical data obtained from the Khordha district administration. The proposed method primarily emphasizes two phases of the procedure. The present study involves an examination of a proposed model, wherein a comparison is made between four distinct variants of LSTM techniques: vanilla LSTM, stacked LSTM, bidirectional LSTM, and convLSTM. The objective of this analysis is to predict temperature patterns. Additionally, this paper utilizes an LSTM autoencoder model to forecast the temperature for the subsequent two-year period in the Khordha district of Odisha, India. The experimental investigation demonstrates that the utilization of Stacking encoder-decoders with bidirectional LSTM cells leads to a notable enhancement in the accuracy of the model, resulting in maximum efficacy. A notably lower Mean Absolute Error (MAE) result suggests that the 9-layer stacked autoencoder model has superior performance in predicting both the minimum and maximum temperature. [ABSTRACT FROM AUTHOR]

In modern surveillance, automatic target recognition (ATR) is a critical challenge, necessitating rapid and precise object identification, especially in military and disaster response scenarios. This research presents a comprehensive framework for ground target classification, focusing on Synthetic Aperture Radar (SAR) imagery. Harnessing the Moving and Stationary Target Acquisition and Recognition (MSTAR) Mixed Targets dataset, this study integrates Convolutional Neural Networks (CNNs) into SAR image analysis. Transfer learning emerges as a key strategy, adapting insights from pre-trained CNNs to the intricacies of target recognition in SAR imagery. This approach outperforms traditional methods, enhancing efficiency amid dataset annotation challenges. Noteworthy CNN architectures including DarkNet-19, DenseNet-121, InceptionV4, ResNet-152, and VGG19 are explored. The ResNet-152 model demonstrates exceptional performance, emerging as a leading contender with a remarkable testing accuracy of 98.56% when trained from scratch. Furthermore, by employing transfer learning, the model's accuracy may be further enhanced to reach 98.81% on the testing dataset. This research signifies a transformative SAR imagery path guided by pre-trained CNNs and transfer learning. It reshapes ATR's accuracy and efficiency, pointing to a future where innovation surmounts challenges previously deemed insurmountable. [ABSTRACT FROM AUTHOR]

The outbreak of conflict between Russia and Ukraine on February 23, 2022, was a huge shock, and it quickly became the dominant topic of conversation on social media. Our research is based on Twitter conversations about the conflict between Russia and Ukraine. This paper intends to monitor and analyze the Twitter conversation on the continuing war in Ukraine using natural language processing techniques such as word cloud analysis, sentiment analysis, and visualization. The major goal is to acquire insight into Twitter users' shifting thoughts and opinions on various parts of the conflict over time. The study's findings have important implications for politicians, journalists, and social media users who want to follow and understand how online communities' attitudes on global issues change. We hope that this study will help to gain a deeper knowledge of how social media works in affecting public debate and how it might be used to gain insights into public opinion on crucial global issues. In this work logistic regression, K-nearest neighbours and decision tree algorithm are used to analyse the sentiments and got classification accuracy of 94.58%, 88.89% and 90.45% respectively. [ABSTRACT FROM AUTHOR]

Combined heart–liver transplantation (CHLT) is becoming increasingly frequent as a maturing population of patients with Fontan-palliated congenital heart disease develop advanced liver fibrosis or cirrhosis. The authors present their experience with CHLT for congenital and noncongenital indications, and identify characteristics associated with poor outcomes that may guide intervention in high-risk patients. This was a single-center retrospective cohort study. This study was conducted at Vanderbilt University Medical Center in Nashville, Tennessee. The study included 16 consecutive adult recipients of CHLT at the authors' institution between April 2017 and February 2022. Eleven patients underwent transplantation for Fontan indications, and 5 were transplanted for non-Fontan indications. Compared with non-Fontan patients, Fontan recipients had longer cardiopulmonary bypass duration (199 v 119 minutes, p =m0.002), operative times (786 v 599 minutes, p = 0.01), and larger blood product transfusions (15.4 v 6.3 L, p = 0.18). Six of 16 patients required extracorporeal membrane oxygenation (ECMO), of whom 4 were Fontan patients who subsequently died. Patients who required ECMO had lower 5-hour lactate clearance (0.0 v 3.5 mmol/L, p = 0.001), higher number of vasoactive infusions, lower pulmonary artery pulsatility indices (0.58 v 1.77, p = 0.03), and higher peak inspiratory pressures (28.0 v 18.5 mmHg, p = 0.01) after liver reperfusion. Combined heart–liver transplantation in patients with Fontan-associated end-organ disease is particularly challenging and associated with higher recipient morbidity compared with non-Fontan–related CHLT. Early hemodynamic intervention for signs of ventricular dysfunction may improve outcomes in this growing high-risk population. [ABSTRACT FROM AUTHOR]

• To the best of our knowledge, this is the first study from India that compared the swallowing function in older adults with and without comorbid conditions, such as diabetes mellitus, hypertension, asthma, and others. • The swallowing issues increase with the aging, although the geriatric population may not strongly report those changes clinically. • Older adults generally do not show up any concern with respect to swallowing functions in their daily living, their nutritional & health status get compromised thereby leading to a poor quality of life. The present study aimed to investigate older adults' perspective on their swallowing physiology using a PROM tool. The study further explored the swallowing issues among older adults with and without comorbid conditions. One hundred twenty-two (122) participants participated in the e-survey. A questionnaire was developed to assess the swallowing deficits among older adults, and Eating Assessment Tool-10 (EAT-10) was administered to assess the PROM. The results revealed that 40% of older adults with comorbid conditions had EAT-10 scores greater than 3, suggesting swallowing deficits. A significant difference was observed between the two groups with respect to swallowing deficits, as reported on EAT-10. Based on the results, it can be delineated that swallowing deficits emerge with aging. More of older adults with comorbid conditions reported swallowing deficits in comparison to those without comorbid conditions. Hence, their nutritional and health status gets compromised, leading to poor quality of life. [ABSTRACT FROM AUTHOR]

• As of August 18th, 2022, the COVID-19 pandemic has claimed over 6,400,000 lives worldwide and over 1,000,000 lives in the United States. • Prior retrospective studies exist in the literature, documenting that statins have a mortality benefit in patients hospitalized with COVID-19. These studies have focused on populations with a high proportion of Caucasians. • This retrospective study examines a population that is majority African American and found no benefit of statins in patients hospitalized with COVID-19 in mortality, survival time, need for ICU care, length of ICU stay, need for ventilator, duration of intubation, or need for dialysis. • Further research should be done examining the interplay between COVID-19, statins, and race/ethnicity to better elucidate whether statins have any beneficial effect in decreasing mortality caused by COVID-19. The COVID-19 pandemic has claimed over 6.4 million lives globally. Finding effective medications to reduce mortality in hospitalized COVID-19 patients remains critical. No previous study has been published on the effects of statin use in a majority African American COVID-19 patient population. This study aims to assess the relationship between in-hospital statin use and mortality in this population. A retrospective chart review of patients diagnosed with COVID-19 from March 2020 to June 2020 admitted to the Phoebe Putney Health System in Albany, Georgia, an early epicenter of the COVID-19 pandemic, was conducted. The outcomes of 735 hospitalized COVID-19 positive patients from over 40 counties in Georgia were analyzed. The primary outcome of interest was all-cause mortality, with secondary outcomes of interest of ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis. Multivariate logistic regression and Cox proportional hazards analysis were conducted to examine the effect of in-hospital statin use and mortality. 186 of 735 total patients were prescribed statins in-hospital. 83.8% were African American. Multivariate logistic regression found in-hospital statin use was not significantly associated with the primary outcome – all-cause mortality (p=0.23). Similar findings were seen in need for ICU care, length of ICU stay, need for mechanical ventilator, duration of intubation, and need for dialysis (p>0.05). Additionally, results from a Cox proportional hazards model found in-hospital statin use was not associated with survival time. Sensitivity analysis conducted on only African American patients validated that in-hospital statin use was not associated with all-cause mortality in these patients. Of note, immunosuppression and severe disease presentation were associated with a six-fold increase in risk of mortality and the largest decreases in survival time. It is possible statins have no mortality benefit for this patient population, but further research beyond this association study would need to be conducted to determine this conclusively. From this study, the best clinical recommendation would be to continue statins for COVID-19 patients with pre-hospital statin use and to launch a randomized clinical trial to definitively determine the efficacy of statins in the treatment of hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

Smallholders in developing and emerging economies face significant challenges when marketing fruits and vegetables. Over the past decades, governments have increased efforts to provide smallholders with marketing outlets, including contracting firms and government-supported outlets like "mandis" in India. This study examines the marketing outlet choices of fruit and vegetable producers in this region and assesses how marketing channel choices influence the prices they receive for their products. Utilizing farm-level data, the study reveals that local crop producers receive higher prices (13 to 73 percent more) when selling through mandis compared to private traders. In comparison, farmers of high-value export crops receive lower prices (19 percent less) when selling through mandis compared to private traders. This disparity emphasizes the need for tailored marketing policies rather than one-size-fits-all approaches for smallholders in development contexts. [ABSTRACT FROM AUTHOR]

The wind turbine generators (WTG's) incapability of primary frequency support during system contingencies due to its decoupled nature from the system frequency causes profound integration and stability issues. The present study focuses on resolving such issues by enabling the WTGs to participate in long-term frequency support under the derated operation of WTGs. The deloading operation of WTGs can provide a specific reserve power margin by reducing its rotor speed, which can be utilized during system contingencies. In literature, linear and quadratic deloading techniques have been proposed but these fail to replicate the nonlinear characteristics of the WTG accurately, thereby making deloading ineffective. To effectively implement the deloading, this work uses a more-accurate higher-order Newton's interpolation polynomial (HNIP), to cope with the highly nonlinear characteristics of WTG. The proposed deloading approach is also augmented with a fuzzy-based intelligent supplementary control structure to handle the inherent and incorporated nonlinearities in WTG. The microgrid system, consisting of a conventional energy source with WTG, has been considered as system under investigation. The integral time absolute error for step wind profile and variable speed wind profile was found to be improved by 97.65% and 97.29%, respectively, with the proposed novel deloading technique with fuzzy-PID compared to PID. Further, to ensure the implementation viability of the proposed control scheme, real-time validation of the same is carried out on OPAL-RT 4510, having a Xilinx Kintex-7 FPGA board. It was found that for all the scenarios considered for real-time digital simulation purposes, the results unerringly matched with MATLAB/Simulink. [Display omitted] • Design and implementation of novel nonlinear deloading strategy for WTG. • Implementation of nonlinear fuzzy control structure as supplementary controller. • Real-time validation of proposed novel scheme on OPAL-RT 4510 for investigated MGS. [ABSTRACT FROM AUTHOR]

• In the early hours (12 h) can lead to significant changes in the transcranial ultrasonographic measurements. • Following ventriculoperitoneal shunt, the reductions in the optic nerve sheath diameter and the third ventricular diameter are substantial. • The improvements in intracranial hemodynamics are statistically significant following ventriculoperitoneal shunt. • The reductions in optic nerve sheath diameter is associated with the clinical improvement in headache following ventriculoperitoneal shunt as compared to other modalities. Transcranial sonographic (TCS) evaluation of optic nerve sheath diameter (ONSD), third ventricular diameter (TVD) and mean flow velocities (Vm) and pulsatility index (PI) of middle cerebral artery (MCA) can provide important insights to the change in intracranial dynamics following ventriculo-peritoneal (VP) shunt surgery. The primary objective of this study was to observe changes in ONSD values following VP shunt at 12 h, compared to pre-VP shunt values. After obtaining ethical approval, patients admitted with a diagnosis of hydrocephalus posted for a VP shunt surgery were prospectively enrolled. TCS evaluation was done before induction of anesthesia and 12-hour post-VP shunt surgery. We recorded the values of ONSD, TVD and Vm and PI MCA at both time points. Thirty-four patients (19 male) were evaluated for ONSD and for the improvement of symptoms. Transtemporal window could not be obtained in six patients. At 12 h following VP shunt, bilateral median ONSD values reduced significantly from their pre-VP shunt values [right ONSD- 0.62 (0.59–0.64) to 0.53 (0.5–0.54) mm (p < 0.001); left ONSD- 0.62 (0.59–0.63) to 0.53 (0.5–0.54) mm (p < 0.001)]. Similarly, the median TVD at 12 h post-VP shunt reduced significantly from its pre-VP shunt measurements [0.97 (0.85–1.09) to 0.74 (0.7–0.84) cm]. PI MCA values reduced significantly, while Vm MCA values increased significantly from the pre-VP shunt values. VP shunt reduced the ONSD, TVD, PI MCA and increased the Vm MCA after shunt surgery as early as 12hrs. [ABSTRACT FROM AUTHOR]

Diabetic Retinopathy (DR) is an eye ailment in diabetics, often causing vision loss. Timely retinal screenings can help prevent blindness. While DR cannot be cured, early detection can curb vision decline. Ophthalmologists diagnose DR using Optical Coherence Tomography (OCT) or Fundus Images. Evaluating via fundus images can be complex and potentially imprecise. The study offers a computer-supported diagnosis to aid ophthalmologists. It uses Multi-level Otsu thresholding to segment Fundus Images, with segmented outputs processed further. Advanced feature extraction techniques like the Gray-Level Co-occurrence Matrix (GLCM) and dynamic Flemingo optimization enhance DR feature identification. Additionally, a novel cascaded voting ensemble deep neural network model is introduced, merging multiple algorithmic insights to improve classification. The paper concludes by aligning classifications with a standard grading system, giving clinicians a clear DR severity gauge for better treatment planning. [ABSTRACT FROM AUTHOR]

Advanced 5 G and 6 G technologies have accelerated the adoption of the Internet of Things (IoT) and are a priority in providing support for high-speed communication and fast data analysis. One of IoT networks benefits is automated networking, which unfortunately increases the risk of security, integrity, and privacy breaches. Therefore, in this paper, we propose a weighted stacked ensemble model combining deep convolutional generative adversarial and bidirectional long short-term memory networks. The proposed model has been regularized, and hyperparameter tuning has been performed. The tuned model is then evaluated on four publicly available current IoT datasets. The proposed model exhibits significant improvement in standard performance measures for both binary and multiclass classification. Generalization error has been reduced by a rate of 0.005% and to overcome the issue of overfitting, a L2 regularization technique has been deployed. The overall Accuracy of the model on various datasets is 99.99% for BOT-IoT, 99.08% for IoT23, 99.82% for UNSWNB15, and 99.96% for ToN_IoT, respectively, alongside improvements in Precision, Recall, and F1-score. • Identification of research gaps and performed data preprocessing by gradient descent. • The proposed method is an infusion of advanced neural networks. • This ensemble of neural networks has reduced the generalization error and variance. • Hyperparameter tuning and regularization are used for achieving refined results. • The model is compared with the existing literature to establish the novelty. [ABSTRACT FROM AUTHOR]

Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in 235 ICUs in 8 Asian countries: India, Malaysia, Mongolia, Nepal, Pakistan, the Philippines, Thailand, and Vietnam. From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression. 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower-middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P <.0001); female sex (aOR = 1.39; 95% CI = 1.21-1.59; P <.0001); using suprapubic-catheter (aOR = 4.72; 95% CI = 1.69-13.21; P <.0001); length of stay before CAUTI acquisition (aOR = 1.04; 95% CI = 1.04-1.05; P <.0001); UC and device utilization-ratio (aOR = 1.07; 95% CI = 1.01-1.13; P =.02); hospitalized at trauma-ICU (aOR = 14.12; 95% CI = 4.68-42.67; P <.0001), neurologic-ICU (aOR = 14.13; 95% CI = 6.63-30.11; P <.0001), neurosurgical-ICU (aOR = 13.79; 95% CI = 6.88-27.64; P <.0001); public-facilities (aOR = 3.23; 95% CI = 2.34-4.46; P <.0001). CAUTI rate and risk are higher for older patients, women, hospitalized at trauma-ICU, neurologic-ICU, neurosurgical-ICU, and public facilities. All of them are unlikely to change. It is suggested to focus on reducing the length of stay and the Urinary catheter device utilization ratio, avoiding suprapubic catheters, and implementing evidence-based CAUTI prevention recommendations. • Identify rates and risk factors for CAUTI in ICUs of 8 Asian Countries. • A cohort study over 8 years with data on 84,920 patients from 8 Countries. • Length of stay increase the risk of CAUTI by 4% per day. • The urinary catheter and device utilization ratio increases the risk of CAUTI. • Age, female sex, suprapubic catheter, and public facilities increase CAUTI risk. [ABSTRACT FROM AUTHOR]

The evolving challenge of persistent symptoms post-Coronavirus disease-2019 (COVID-19), particularly debilitating cardio-pulmonary manifestations, necessitates further exploration. Our study aimed to assess the cardio-pulmonary complications in patients a year after hospital discharge from severe COVID-19, contrasting these with findings from a non-COVID group. The OneCoV2 study, a prospective, case-control study, was conducted at a tertiary care teaching hospital in northern India. We enrolled 43 subjects, with a mean age of 25.57 ± 7.94 years (COVID group) and 27.30 ± 8.17 years (non-COVID group). Comprehensive tests included pulmonary function tests, cardiac function tests, 6-min walk tests, and laboratory investigations. Significant differences were found in the pulmonary function [forced vital capacity (FVC) (p = 0.037), forced expiratory flow (FEF) 25–75 % (p = 0.013)], and cardiac function [left ventricular ejection fraction (LVEF) (p = 0.032), heart rate (HR) (p = 0.047)], along with the six-minute walk test results between the two groups. In the COVID group, Pearson's correlation showed a negative correlation between FVC and C-reactive protein (CRP) [r = −0.488, p = 0.007] and a positive correlation between the six-minute walk test [r = 0.431, p = 0.003] and HR [r = 0.503, p = 0.013]. Our data suggest that pulmonary abnormalities are prevalent in COVID patients even after 1-year of hospital discharge. Cardiac biomarkers also show an inclination towards the COVID group. While we found significant correlations involving some parameters like FVC, CRP, HR, and results from the six-minute walk test, we did not find any significant correlations with the other tested parameters in our study. [ABSTRACT FROM AUTHOR]

The use of thoracic epidural analgesia in infants and children could attenuate the stress response and thereby improve the outcomes associated with cardiac surgery. This study is a prospective observational study conducted on 118 patients admitted for cardiac surgery. All patients received thoracic epidural analgesia. Laboratory investigations including inflammatory markers, markers for different organ functions, and intensive care unit parameters were collected at different time points (preoperative, immediate postoperative, on day 1, and day 2). Inflammatory markers such as IL6, IL8, and metabolic response as measured by serum cortisol and blood sugar were significantly high in the immediate postoperative period, which later stabilized in the next 48 h. There was also a sharp increase in the anti-inflammatory marker IL-10 in an immediate postoperative period, which settled later on but continued to be higher than baseline in the next 48 h. All these markers showed lower values when compared to published literature. The baseline renal oxygen saturation using near infrared spectroscopy (NIRS) value in our study was 59.3 + 19, which increased to 76.4 + 12.7 on day 2. Serum neutrophil gelatinase associated lipocalin (NGAL) remained well below normal levels in the perioperative period. PF (pO2/FiO2) ratio and pO2 consistently improved postoperatively with the maximum on day 2. The median mechanical ventilation (MV) duration was 18 h, and the mean length of stay that included intensive care unit stay was 12 days. No epidural-related adverse events were noted. Apart from good analgesia, patients receiving thoracic epidural analgesia displayed a reduction in perioperative stress, superior postoperative glycemic control, reduction in inflammatory markers, postoperative acute kidney injury, and pulmonary complications. [ABSTRACT FROM AUTHOR]

Phlebitis is one of the most common complications of the peripheral venous catheter (PVC) and adversely impacts future venous access, and bacterial phlebitis may lead to bloodstream infection. The objective of the study was to reduce the to reduce the incidence of infusion-related phlebitis in children admitted to the pediatric critical care unit. This Quality Initiative was implemented in the pediatric critical care unit of a tertiary care hospital between November 2019 and April 2020. Five interventions were identified (hand hygiene, use of transparent dressing, use of extension lines with PVCs, use of hard cardboard splints for joint immobilization, use of heparinized flush after medication administration) and were introduced sequentially. Over the next five weeks, a new intervention was introduced weekly while continuing the previous ones, if found to be working well as per improvement parameter, the phlebitis rate. From the sixth week onwards, all five interventions were applied together as a bundle. Total seven hundred eighteen PVCs were sited in 284 (Male: female 1.58:1) patients during study period and a total of 56 incidences of phlebitis were observed. Mean baseline phlebitis rate was 48.5%. In the next 5 weeks when interventions were implemented as planned, phlebitis rate was 35.7% (n = 10), 16.6% (n = 03), 21.6% (n = 8), 10% (n = 05), and 13.3% (n = 2) respectively. Implementation of all five interventions together as a bundle led to reduction in phlebitis rate below 5 % consistently over the next 18 weeks (n = 8). A consistent reduction in PVC-related phlebitis can be achieved by the implementation of evidence-based interventions for the prevention of phlebitis, as a bundle. [ABSTRACT FROM AUTHOR]

This study investigated torque expression in maxillary incisors using two passive self-ligating bracket types (Damon Q and Pitts 21) placed at different heights using the Finite element method. Two passive self-ligating brackets, Damon Q (Ormco, USA) and Pitts 21 (OC Orthodontics, USA) were 3D modeled using micro-computed tomography. Damon Q (0.022ˮ x 0.028″ slot size) and Pitts 21 (0.021ˮ x 0.021″ slot size) brackets were placed on a maxillary central incisor at predetermined vertical heights. Arch wires of size 0.019ˮ x 0.025″ stainless steel (Damon Q) and 0.020ˮ x 0.020" Titanium Molybdenum (Pitts 21) were placed in the bracket slots. Pitts 21 brackets showed higher torquing moments at all bonding heights as compared to Damon Q brackets. The minimum torquing moment was 9.03Nmm at 5 mm for Damon Q and the maximum torquing moment was 14.92Nmm for Pitts 21 at a bracket bonding height of 8 mm. Total deformation for Pitts 21 at a height of 5 mm from the incisal edge was 0.61 × 10−6mm as compared to that of Damon Q which was 0.41 × 10−6mm. Lowest Von Mises stress values were at 27.07 MPa in Damon Q brackets at a bracket height of 5 mm from the incisal edge. Highest Von Mises stress values were 36.80 MPa for Pitts 21 brackets at a bracket height of 8 mm from the incisal edge. Pitts 21 brackets exhibited superior torquing characteristics compared to Damon Q. Total deformation in Pitts 21 was higher than Damon Q at all tested bracket bonding heights. [Display omitted] [ABSTRACT FROM AUTHOR]