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Previous research has consistently demonstrated that university students who identify as Black, Indigenous, and People of Color (BIPOC) are less likely to seek help for mental health issues than their White peers. This chapter examines the complex factors that influence the perceptions of mental health care in BIPOC student populations, including self- and perceived stigma, structural racism, racial microaggressions, model-minority stereotypes, and the role that familial and spiritual influences play in seeking help for mental health issues. Education and training in cultural competence, explicit and implicit biases, and racial microaggressions is vital for psychiatrists and other mental health clinicians to understand their roles in the treatment of BIPOC students. Lastly, culturally sensitive outreach to BIPOC student populations is crucial to improving mental health awareness and to address underutilization of collegiate mental health-care services.

One dimensional YVO4:Eu nanofibers were prepared by dispersion of ultrasonicated sol-gel derived nanoparticles of YVO4:Eu in solution of PVA. The fibers were derived by using electrospining process. The nanofibers sheet was characterized through XRD and SEM for their structural conformation. Moreover the paper reveals the comparative PL analysis of nanopowder (sol-gel derived) and nanofibers.

INTRODUCTION: Guillain-Barre is an immune-mediated neurologic disorder in which myopathy, paralysis and even respiratory failure can occur Typically, the antecedent is a bacterial or viral illness In this case, the patient was suffering from SARS -COV 2, which was complicated by this rare and severe disease METHODS: We have a case of a 53-year-old Hispanic male who presented to the hospital with four days of fevers and progressive shortness of breath Given high suspicion of severe acute respiratory syndrome coronavirus 2 (SARSCOV 2), he underwent computed tomography scan which was consistent with atypical bilateral pneumonia He would later be found positive for SARS-CoV 2 by reverse transcription polymerase chain reaction test Other than hypoxia and coarse breath sounds throughout lung fields, physical exam was unremarkable He was admitted to internal medicine and infectious disease was consulted He was started on a five-day course of Remdesivir and a ten dose course dexamethasone On day three, he began experiencing mild bilateral upper extremity weakness Shortly thereafter his symptoms progressed to bilateral upper extremity paresis, descending paralysis, absent deep tendon reflexes, and respiratory failure requiring mechanical ventilation Given patient history and physical exam findings there was a concern for Guillain-Barre which prompted neurology consultation Nerve conduction study were performed which confirmed the diagnosis and the patient was treated with a five-day course of intravenous immunoglobulin (IVIG) His case was further complicated by Klebsiella aerogenes pneumonia which was treated with ceftriaxone By day three of IVIG treatment, the patient was exhibiting 2/5 strength in upper extremities Patient had significant improvement in motor strength of bilateral upper and lower extremities by day six with only reported numbness and tingling in his hands and was successfully extubated He was transferred out of the critical care unit and was discharged from the hospital after three weeks with persistent paresthesia in upper extremities and mild dysphagia for which he was to receive outpatient speech therapy RESULTS: Early recognition and treatment of Guillain-Barre as a sequela of SARS-CoV 2 is vital as delays could lead to severe disability or even death

Background: This study is intended to evaluate the transversus abdominis plane (TAP) block for analgesia over the first 24 postoperative hours after lower segment cesarean section. Materials and methods: Fifty female parturients of American society of Anesthesiologists (ASA) physical status II undergoing lower segment cesarean section were randomized to undergo a bilateral TAP block with ropivacaine (group 1 = 25) or to undergo a bilateral TAP block with 0.9% saline (group 2 = 25). In addition, all patients received standard analgesic injection tramadol 100 mg and im injection diclofenac 75 mg as required in the postoperative period. All patients received standard spinal anesthesia, and TAP block was performed at end of the surgery. Each patient was assessed after operation at each half an hours up to 24 hours after surgery in postoperative period. Results: The mean visual analog scale (VAS) score of group 1 was statistically less than mean VAS score of group 2 (p < 0.001). The mean of total number analgesic requirement for first 24 hours postoperatively was significantly less in group 1 (1.68 ± 0.9) than group 2 (2.8 ± 0.33) respectively. Conclusion: Transversus abdominis plane block holds considerable promise as part of a multimodal analgesic regimen for post cesarean delivery analgesia. Transversus abdominis plane block is easy to perform and provided reliable and effective analgesia.

Objective.To determine whether increases in contact isolation precautions are associated with decreased adherence to isolation practices among healthcare workers (HCWs).Design.Prospective cohort study from February 2009 to October 2009.Setting.Eleven teaching hospitals.Participants.HCWs.Methods.One thousand thirteen observations conducted on HCWs. Additional data included the number of persons in isolation, types of HCWs, and hospital-specific contact precaution practices. Main outcome measures included compliance with individual components of contact isolation precautions (hand hygiene before and after patient encounter, donning of gown and glove upon entering a patient room, and doffing upon exiting) and overall compliance (all 5 measures together) during varying burdens of isolation.Results.Compliance with hand hygiene was as follows: prior to donning gowns/gloves, 37.2%; gowning, 74.3%; gloving, 80.1%; doffing of gowns/gloves, 80.1%; after gown/glove removal, 61%. Compliance with all components was 28.9%. As the burden of isolation increased (20% or less to greater than 60%), a decrease in compliance with hand hygiene (43.6%—4.9%) and with all 5 components (31.5%—6.5%) was observed. In multivariable analysis, there was an increase in noncompliance with all 5 components of the contact isolation precautions bundle (odds ratio [OR], 6.6 [95% confidence interval (CI), 1.15-37.44];P= .03) and in noncompliance with hand hygiene prior to donning gowns and gloves (OR, 10.1 [95% CI, 1.84—55.54];P= .008) associated with increasing burden of isolation.Conclusions.As the proportion of patients in contact isolation increases, compliance with contact isolation precautions decreases. Placing 40% of patients under contact precautions represents a tipping point for noncompliance with contact isolation precautions measures.

Eu2+ doped alkaline earth metals such as strontium aluminate, calcium aluminate and barium aluminate prepared by using modified combustion synthesis method at 600°c with Urea as fuel. Crystal structure is determined by using XRD and the sample confirmation by using the FTIR. The effect of the host material on the photoluminescence (PL) and phosphorescence properties were studied by using the Hitachi F-7000 spectrofluorimeter equipped with a 450W Xenon lamp, in the range 200-650 nm. The emission spectra of Eu2+ range from 450 to 500nm in the Blue to aqua region and the transition 4f7-4f6 5d1. The observed emission in CaAl2O4 is 440nm.

We investigated the clinical and microbiologic features of 300 cases of cephalosporin-resistant Escherichia coli producing extended-spectrum β-lactamase (ESBL) or plasmid-mediated AmpC β-lactamase (pAmpC) at three medical centers in the United States. Solid-organ malignancy, connective tissue disease, and a recent history of surgery were more common among pAmpC-producing cases ( n = 49), whereas urinary catheter at enrollment, diabetes, and hospitalization in the past year were more common among ESBL-producing cases ( n = 233). The factors independently associated with clinical outcome were the following: the presence of cardiovascular disease (odds ratio [OR], 2.88; 95% confidence interval [CI], 1.29 to 6.43), intra-abdominal infection (OR, 6.35; 95% CI, 1.51 to 26.7), other or multiples sources of infection (OR, 8.12; 95% CI, 2.3 to 28.6), age of 65 years or greater (OR, 0.43; 95% CI, 0.2 to 0.95), favorable baseline health status (OR, 0.39; 95% CI, 0.16 to 0.95), and appropriate empirical antimicrobial therapy given in the first 72 h (OR, 0.42; 95% CI, 0.20 to 0.88). β-Lactamase genes responsible for cephalosporin resistance were identified in 291 cases. CTX-M-type ESBLs accounted for 72.0%. Of those, 88.0% were CTX-M-15. The next most common type was CMY-type pAmpC (16.7%), followed by SHV- and TEM-type ESBLs (6.3 and 1.3%, respectively). Seven cases (2.3%) had KPC-type β-lactamase. Ertapenem, imipenem, meropenem, doripenem, piperacillin-tazobactam, amikacin, nitrofurantoin, and tigecycline were highly active, with greater than 90% of the isolates being susceptible. Cefepime was less active, with only 74.2% being susceptible due to the predominance of CTX-M-15. These findings have implications in the selection of appropriate empirical therapy when infection due to cephalosporin-resistant E. coli is suspected.

Methicillin-resistant Staphylococcus aureus (MRSA) USA300 clone is commonly found in the community and is being increasingly reported in the healthcare setting. A retrospective analysis was conducted to compare the epidemiology and outcomes between community-associated (CA) and healthcare-associated (HA) USA300 MRSA infections. The study enrolled 160 subjects with USA300 MRSA infections (47.5% CA-MRSA and 52.5% HA-MRSA). Failure in the HA group was higher (38.1%) compared with the CA group (23.7%) (P = 0.05). Predictors of failure included male gender, age, presence of any co-morbidity, coronary artery disease, chronic kidney disease, history of MRSA, previous admission, fluoroquinolone exposure, HA infection and osteomyelitis (P ≤ 0.05). Independent predictors of failure were osteomyelitis, history of MRSA, male gender and pneumonia. Recurrent disease was found in 32.6% of cases. Overall, USA300 MRSA most commonly causes infection of the skin and skin structure, however, 20% of subjects can experience more invasive disease with infection of the bloodstream, lung or bone. Failure rates are higher in subjects with healthcare risk factors or if the infection was acquired in the hospital, with these subjects experiencing more invasive infections such as bacteraemia, pneumonia or osteomyelitis.

In this paper, an optimal servo control strategy is presented to achieve high seek/settle performance without compromising the targeted seek time in hard disk drives. The cost function to be optimized is given by a weighted quadratic function with respect to time and the jerk of control command. Thanks to the fact that the cost function is directly penalized with time-varying weightings, the proposed method is more effective to minimize the settling vibration induced by the actuator seek profile compared with the previous optimization approaches in literature. The proposed approach is applicable to any given initial and terminal conditions.

DBaaS (Database as a Service) is a service provided and managed by the cloud provider and supports traditional database functionalities. The DBaaS use multi-tenant architecture to support multiple customers. The biggest problem concerned with DBaaS is the privacy and security of the data contained in the database stored in the cloud environment. The database is stored in a third party data center and it is assumed to be as untrusted. The database is therefore encrypted in order to prevent any data leaks on the third party data center. The result of any query to the database is decrypted at the service provider site before it is sent to the user. The above mentioned solution have two disadvantages. Firstly, the encryption and decryption are done at the server side and hence the cloud owner can extract information from the database. Secondly, the encryption of database does not support range queries on the database. The proposed framework focuses on securing database by supporting range queries and storing sensitive information with protection of memory leak. It performs database encryption, query encryption and also supports range query over encrypted databases. A double layered encryption mechanism is used for sensitive data and a single layer encryption is used for non-sensitive data. Order Preserving Encryption (OPE) is used for single layer encryption. OPE maintains the order in an encrypted database and so range query can be performed over encrypted database using an encrypted query. The drawback associated with OPE is the attacker can guess the value based on the ordering of data and so for sensitive attributes in the database, a double layered encryption using Format Preserving Encryption (FPE) followed by OPE symmetric key encryption algorithm is proposed.

This work presents modeling, analysis, and controller design of the steering subsystem of heavy vehicles as a subsystem of vehicle lateral control system for the automated highway systems. A physical model of the steering subsystem is derived where the hydraulic power assist unit is modeled as a family of static nonlinear boost curves. Based on open-loop frequency tests and analysis of the physical model structure and its dynamical characteristics, a nominal second order linear model of the steering subsystem is obtained. Then, a linear robust loop-shaping controller is designed to provide a good tracking performance of the closed-loop dynamics of the steering subsystem for varying gain cross over frequencies which is a result of the nonlinear characteristics of the hydraulic power assist. The controller has been successfully incorporated as an inner-loop controller into the nested lateral control architecture for autonomous driving and its efficacy has been demonstrated experimentally.

An identical linear lane-keeping controller designed for a passenger car was successfully implemented on a tractor semi-trailer. With the same control parameters, similar error dynamics were observed under two very different truck configurations: tractor with and without trailer. The results demonstrate that “rail-like” performance can be achieved through a relatively simple “look-ahead” controller. This paper describes the process of transfering the engineering intuition of “it is generally easier to steer a tractor semi-trailer than a passenger car,” to the design concept of “a well-designed look-ahead steering controller for passenger car is a good candidate for controlling tractor semi-trailer.”