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In the modern era of digital growth, Data centres serve as the important infrastructure of the interconnected global network. The Data centres perform as central hubs where immense volumes of data are processed, stored, and distributed. Reliable performance of data centres and Computer Room Air-Conditioning (CRAC) system is of critical importance, through which optimal environmental conditions are achieved. This paper proposes an interesting approach to evaluate the CRAC system’s ability to function properly under various uncertainties. Heat transfer model is developed using various environmental parameters, data server rack parameters, and evolving capacity of data servers. The uncertainties are modelled as random variables. One of the challenging issues in estimating the reliability of a system under uncertainties is to reduce the computational requirements while maintaining the accuracy. To overcome the issue, Kriging model is developed using adaptive sampling. The proposed approach is compared with the available approaches. The method shows better computational efficiency and accuracy.

Objective:Various metals play role in the survival and pathogenesis of the invasive fungal disease. The objectives of this study were to compare the levels of heavy metals in patients with chronic invasive fungal rhinosinusitis (CIFR) and healthy controls, and to analyze their role in disease outcome.Methods:Twenty-three patients (15 with invasive mucormycosis and 8 with invasive aspergillosis, Group 1), and 14 healthy controls (Group 2) were recruited. Blood samples were collected from each group into ion-free tubes and analyzed for serum levels of Nickel (Ni), Copper (Cu), Zinc (Zn), Gallium (Ga), Arsenic (As), Selenium (Se), Rubidium (Rb), Strontium (Sr), Cadmium (Cd), and Lead (Pb). The final outcome of the patients during their hospital stay was categorized clinico-radiologically as improved or worsened, or death.Results:The levels of all metals were higher in Group 1 except for As and Pb. However, the differences in Cu (p=0.0026), Ga (p=0.002), Cd (p=0.0027), and Pb (p=0.0075) levels were significant. Higher levels of Zn (p=0.009), Se (p=0.020), and Rb (p=0.016) were seen in the invasive aspergillosis subgroup. Although Zn (p=0.035), As (p=0.022), and Sr (p=0.002) levels were higher in patients with improved outcome, subgroup analysis showed no differences.Conclusion:The levels of some heavy metals in CIFR significantly differ from those of the general population and also vary with the type of the disease and its outcome. These levels may not have a direct effect on the outcome of the patient, but they do play a role in the pathogenesis of the invading fungus.

Purpose: To develop an inline automatic quality control to achieve consistent diagnostic image quality with subject‐specific scan time, and to demonstrate this method for 2D phase‐contrast flow MRI to reach a predetermined SNR. Methods: We designed a closed‐loop feedback framework between image reconstruction and data acquisition to intermittently check SNR (every 20 s) and automatically stop the acquisition when a target SNR is achieved. A free‐breathing 2D pseudo‐golden‐angle spiral phase‐contrast sequence was modified to listen for image‐quality messages from the reconstructions. Ten healthy volunteers and 1 patient were imaged at 0.55 T. Target SNR was selected based on retrospective analysis of cardiac output error, and performance of the automatic SNR‐driven "stop" was assessed inline. Results: SNR calculation and automated segmentation was feasible within 20 s with inline deployment. The SNR‐driven acquisition time was 2 min 39 s ± 67 s (aorta) and 3 min ± 80 s (main pulmonary artery) with a min/max acquisition time of 1 min 43 s/4 min 52 s (aorta) and 1 min 43 s/5 min 50 s (main pulmonary artery) across 6 healthy volunteers, while ensuring a diagnostic measurement with relative absolute error in quantitative flow measurement lower than 2.1% (aorta) and 6.3% (main pulmonary artery). Conclusion: The inline quality control enables subject‐specific optimized scan times while ensuring consistent diagnostic image quality. The distribution of automated stopping times across the population revealed the value of a subject‐specific scan time. [ABSTRACT FROM AUTHOR]

BackgroundAcute kidney injury (AKI) considerably increases the risk of short-term mortality in acute-on-chronic liver failure (ACLF) but predicting AKI is not possible with existing tools. Our study aimed at de novo discovery of AKI biomarkers in ACLF.MethodsThis observational study had two phases- (A) Discovery phase in which quantitative proteomics was carried-out with day-of-admission plasma from ACLF patients who initially had no-AKI but either progressed to AKI (n=10) or did not (n=9) within 7 days of admission and, (B) Validation phase in which selected biomarkers from the discovery phase were validated by ELISA in a larger set of ACLF plasma samples (n=93) followed by sub-group analyses.ResultsPlasma proteomics revealed 56 differentially expressed proteins in ACLF patients who progressed to AKI vs those who did not. The metallothionein protein-family was upregulated in patients who progressed to AKI and was validated by ELISA as significantly elevated in both- (i) ACLF-AKI vs no-AKI (p-value ≤ 0.0001) and (ii) progression to AKI vs no-progression to AKI (p-value ≤ 0.001). AUROC for AKI vs no-AKI was 0.786 (p-value ≤0.001) and for progression to AKI vs no-progression to AKI was 0.7888 (p-value ≤0.001). Kaplan-Meier analysis revealed that ACLF patients with plasma MT concentration >5.83 ng/mL had a high probability of developing AKI by day 7 (p-value ≤0.0001). High expression of metallothionein genes was found in post-mortem liver biopsies of ACLF patients.ConclusionDay-of-admission measurements of plasma metallothionein can act as predictive biomarkers of AKI in ACLF.

Aim: A treatment strategy for patients with a significant polyp or early colon cancer (SPECC) of the rectum presents a challenge due to the significant rate of covert malignancy and lack of standardized assessment. For this reason, NICE recommends multidisciplinary meetings to improve outcomes. The primary aim of the present study was to report the performance of our specialist early rectal cancer (SERC) multidisciplinary team (MDT) in correctly substratifying the risk of cancer and to discuss the limitations of staging investigations in those patients with "poor outcomes". Method: This was a retrospective review of patients referred to our SERC MDT from 2014 to 2019. Lesions were assigned by the MDT to three pre‐resection categories (low, intermediate, high) according to the risk of covert malignancy. Resection method and final histology were compared to the pre‐resection categories. Results: Of 350 SPECC lesions, 174 were assessed as low‐risk, 108 intermediate‐risk and 68 high‐risk. The cancer incidence was 4.8%, 8.3% and 53%, respectively (15.5% overall). Eight lesions were categorized as low‐risk but following piecemeal resection were found to be malignant. Five lesions, three of which were categorized as high‐risk, were ultimately benign following conventional surgery. One pT1sm1 cancer, removed by anterior resection, may have been treated by local excision. Conclusion: A total of 83% of malignant polyps were triaged to an en bloc resection technique and surgical resection avoided for nearly all benign lesions. However, 12 patients from this cohort were deemed to have a poor outcome because of miscategorization. Further comparative research is needed to establish the optimum strategy for rectal SPECC lesion assessment. Originality statement: There is currently no consensus for staging significant polyps of the rectum. This paper reports the effectiveness of a specialist early rectal cancer MDT to correctly risk‐stratify significant rectal polyps. It underscores the importance of accurate categorization for treatment decision‐making, while acknowledging the limitations of current staging modalities. [ABSTRACT FROM AUTHOR]