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In this project, the creation and application of computer-based fault detection methods for transmission lines with multiple terminals are discussed.These methods are part of a fault-finding system that precisely locates the fault site by using voltage and current signal measurements from smart electronic devices installed on transmission-line terminals. The transformer loading, connection type, and electrical characteristics are all data that the algorithms have access to. The power system components used by the fault-location techniques are likewise presented in this project’s phase component models.

Sumana Reddy,1 Beyla Patel,2 Luke Baldelli,3 Rajiv T Majithia,4 Michael K Dougherty3,4 1Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; 2School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; 3Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; 4Rex Digestive Healthcare, UNC REX Healthcare, Raleigh, NC, USACorrespondence: Michael K Dougherty, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, 4182 Bioinformatics, 130 Mason Farm Road, Chapel Hill, NC, 27599-6134, USA, Tel +1 984-215-4672, Fax +1 919-590-6724, Email Michael.Dougherty@unchealth.unc.eduPurpose: In spring 2020, Coronavirus Disease 2019 (COVID-19) “stay-at-home” orders may have led to later, more acute disease presentations of emergent conditions such as gastrointestinal bleeding (GIB). In this retrospective cohort study, we compared incidence and severity of GIB during the strictest COVID shutdown to pre-COVID periods.Patients and methods: We compared weekly counts of emergency department (ED) visits for GIB between March 27 and May 7, 2020 (COVID period) and pre-COVID periods in 2019 and 2020 in a US statewide network of hospitals. We compared the severity of GIB presentations using incident rate ratios (IRR) of “severe” GIB (requiring ≥ 4 units of blood, endoscopic therapy, interventional radiology or surgical procedure), intensive care (ICU) admission and shock. We also looked for effect modification of demographic covariates on associations between year and GIB outcomes.Results: Fewer patients presented to ED for GIB during COVID than during the same dates in 2019 (534 versus 904; IRR 0.59, 95% CI 0.53– 0.66). A greater proportion of COVID-period ED visits required inpatient admission (73.6% vs 67.8%, p = 0.02) and had severe GIB (19.3% vs 14.9%, p = 0.03). Proportion of patients requiring transfusion (p < 0.001), with shock (p < 0.01), or with critical hemoglobin (p = 0.003) or lactate (p = 0.02) were worse during COVID. Non-white patients experienced disproportionately worse outcomes during COVID than in 2019, with greater absolute counts of shock (65 vs 62, p = 0.01 for interaction) or ICU admission (40 vs 35, p = 0.01 for interaction).Conclusion: Fewer acute GIB presented during the pandemic period compared to the year prior. The severity of pandemic presentations was greater, driven by disproportionately worse outcomes in minorities.Keywords: SARS-CoV-2 lockdown, collateral damage, health disparities, GI bleed

Shanshan Hou,1,2 Xiaokang Wang,3 Fang Wang,4 Zhongliang Li,5 Hui Wang,6 Jiahui Li,7 Jing Wang,8 Haiying He,9 Liping Deng,10 Yushu Feng,11 Xiufang Fan,12 Wen Li,13 Qinghua Lu,14 Yanying Ma,15 Guoying Zhao,16 Simmy Reddy,17 Yanqiu Wu,2,&ast; Yonghui Yu1,3,&ast; 1Department of Neonatology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, People’s Republic of China; 2Department of Pediatric, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China; 3Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250021, People’s Republic of China; 4Department of Neonatology, Liaocheng People’s Hospital, Liaocheng, 252000, People’s Republic of China; 5Department of Neonatology, W.F. Maternal and Child Health Hospital, Weifang, 261011, People’s Republic of China; 6Department of Neonatology, Hebei PetroChina Central Hospital, Langfang, 065000, People’s Republic of China; 7Department of Neonatology, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, People’s Republic of China; 8Department of Neonatology, Women and Children’s Healthcare Hospital of Linyi, Linyi, 276000, People’s Republic of China; 9Department of Neonatology, Baogang Third Hospital of Hongci Group, Baotou, 014010, People’s Republic of China; 10Department of Neonatology, Heze Municipal Hospital, Heze, 274031, People’s Republic of China; 11Department of Neonatology, Linyi People’s Hospital, Linyi, 276000, People’s Republic of China; 12Department of Neonatology, Jinan Maternity and Child Health Care Hospital, Jinan, 250001, People’s Republic of China; 13Department of Neonatology, Qilu Hospital of Shandong University, Jinan, 250012, People’s Republic of China; 14Department of Neonatology, Shandong Maternal and Child Health Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250014, People’s Republic of China; 15Department of Neonatology, Jinan Second Maternal and Child Health Care Hospital, Jinan, 271100, People’s Republic of China; 16Department of Neonatology, Binzhou Medical University Hospital, Binzhou, 256603, People’s Republic of China; 17Cheeloo College of Medicine, Shandong University, Jinan, 250021, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yonghui Yu, Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 234, Jingwu, Road, Huai Yin District, Jinan, Shandong, 250021, People’s Republic of China, Tel +86-0531-66953201, Email alice20402@126.com; yuyonghui6888@126.com Yanqiu Wu, Department of Pediatric, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20, Yuhuangding East Road, Zhi fu District, Yantai, 264000, People’s Republic of China, Tel +86-0535-6691999, Email yqwu76@126.comPurpose: Significant antibiotic overuse due to prolonged antibiotic duration has not draw enough attention in developing countries with high antibiotic consumption. We aimed to describe the current status of prolonged early antibiotic duration in very-low-birth-weight (VLBW) infants in a large regional multicenter cohort in China.Patients and Methods: Institution-based prospective cohort study was conducted in all VLBW infants admitted to 16 Grade A tertiary hospitals between January 1, 2019 and December 31, 2020. Early antibiotic use was defined as antibiotic initiation within the first 3 days of life. Prolonged early antibiotic course was defined as early antibiotic initiation for more than 7 days in infants with early-onset sepsis (EOS) or more than 3 days in infants with unlikely EOS. Antibiotic use was described as days of therapy (DOT) per 1000 patient days (PD).Results: Among 1684 eligible VLBW infants, 1544 (91.7%) infants were prescribed with prolonged early antibiotic course, including 618 infants with EOS and 926 infants with unlikely EOS. The median duration of early antibiotic course was 13 (IQR 8;20) days, with 78.0% of courses > 7 days and 43.6% of courses > 14 days. Total early antibiotic use was 408.3DOT/1000Pd, of which prolonged antibiotic courses accounted for 98.2% of all antibiotic use days. More than three antibiotics used, escalation antibiotic therapy, antibiotics for special use and the use of third generation cephalosporins and carbapenems were significantly common in prolonged courses compared to short courses in both infants with EOS and unlikely EOS group (P< 0.05).Conclusion: A large proportion of VLBW infants had excessively prolonged early antibiotic durations in the regional multicenter in China. Timely discontinuation of antibiotics in VLBW infants according to standardized guidelines and limit on the use of third-generation cephalosporins and carbapenems may be key drivers in reducing the antibiotic overuse in developing countries like ours.Keywords: very-low-birth-weight infants, early antibiotic use, prolonged antibiotic course, days of therapy

Kasra Amirdelfan,1 Mindy Hong,2 Bobby Tay,3 Surekha Reddy,4 Vinay Reddy,4 Michael Yang,5 Krishn Khanna,3 Prasad Shirvalkar,6 Christopher Abrecht,7 Amitabh Gulati8 1IPM Medical Group, Walnut Creek, CA, USA; 2Hinge Health, San Francisco, CA, USA; 3Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA; 4Spine and Nerve Diagnostic Center, Roseville, CA, USA; 5Summit Pain Alliance, Santa Rosa, CA, USA; 6UCSF Weill Institute of Neurosciences University of California San Francisco, San Francisco, CA, USA; 7Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA; 8Memorial Sloan Kettering Cancer Center, New York, NY, USACorrespondence: Amitabh GulatiMemorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USATel +1 212 639-2000Email amitabhgulati@gmail.comPurpose: This study aims to examine high-frequency impulse therapy (HFIT) impact on pain and function among patients undergoing care for chronic low back pain (CLBP).Methods: A pilot randomized-controlled trial of HFIT system versus sham was conducted across 5 orthopedic and pain center sites in California, USA. Thirty-six patients seeking clinical care for CLBP were randomized. Primary outcome was function measured by the Six Minute Walk Test (6MWT). Secondary outcomes were function (Timed Up and Go [TUG] and Oswestry Disability Index [ODI]), pain (Numerical Rating Scale [NRS]), quality of life (Patient Global Impression of Change [PGIC]), and device use. Patients were assessed at baseline and every week for 4 weeks of follow-up. Mann–Whitney U-test was used to analyze changes in each outcome. Repeated measures ANOVA was used to assess the effect of treatment over time.Results: The average age of subjects was 53.9 ± 15.7 (mean ± SD) years, with 12.1 ± 8.8 years of chronic low back pain. Patients who received an HFIT device had a significantly higher 6MWT score at weeks 2 [Cohen’s d (95% CI): 0.33 (0.02, 0.61)], 3 [0.32 (0.01, 0.59)] and 4 [0.31 (0.01, 0.60)], respectively, as compared to their baseline scores (p < 0.05). Patients in the treatment group had significantly lower TUG scores at week 3 [0.30 (0.04, 0.57)] and significantly lower NRS scores at weeks 2 [0.34 (0.02, 0.58)] and 4 [0.41 (0.10, 0.67)] (p < 0.05).Conclusion: A larger-scale RCT can build on the findings of this study to test whether HFIT is effective in reducing pain and improving function in CLBP patients. This study shows encouraging evidence of functional improvement and reduction in pain in subjects who used HFIT. The efficacy and minimally invasive nature of HFIT is anticipated to substantially improve the management of CLBP patients.Keywords: HFIT, pain, chronic pain, neuromodulation, noninvasive treatment

Niroj Kumar Sahoo,1 Richa Ranjan,2 Mudit Tyagi,3 Hitesh Agrawal,3 Subhakar Reddy3 1Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada, India; 2Bharti Eye Foundation and Hospital, New Delhi, India; 3Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, IndiaCorrespondence: Mudit TyagiSmt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Banjara Hills, Hyderabad, 34, IndiaTel +91-9553339042Email drmudittyagi@gmail.comAbstract: A gradual shift in trend from primary enucleation to globe salvaging radiation therapy for the management of ocular tumors has resulted in the rise of several post-treatment ocular complications including radiation retinopathy. Radiation retinopathy is a chronic, progressive, and occlusive vasculopathy that can manifest anytime between 1 month to 15 years after starting radiation therapy. The aim of treatment in most of these cases is to prevent further vision loss. Treatment options such as laser photocoagulation, anti-vascular endothelial growth factor and intraviral steroids have been described. However, despite several advances in diagnostic and therapeutic modalities, a significant proportion of eyes with radiation retinopathy eventually go blind. This review summarises some of the clinical features, investigative modalities, and recent therapeutic strategies used in the management of radiation retinopathy.Keywords: radiation retinopathy, radiation maculopathy, anti-VEGFs, laser photocoagulation, ocular tumors

Stainless steel, an alloy comprising chromium, iron and occasionally nickel and other metals, demonstrates exceptional corrosion resistance. The transformation of metal into thin, flat components is achieved through the industrial process known as sheet metal fabrication. The utilization of metal sheets is widespread, contributing to the creation of numerous everyday items. This study aims to investigate the formability of 310 austenitic stainless steel under varying temperatures (623K, 723K, and 823K). The evaluation was executed utilizing the Nakazima test method within the context of the stretch forming procedure. Prior to delving into the assessment of formability, an exhaustive examination of the mechanical properties of the high-strength stainless steel AISI 310 was conducted. This involved subjecting the material to tensile tests at varying temperatures - specifically, 623K, 723K, and 823K - each performed at a consistent strain rate of 0.1/s. The resultant data encompassed an array of failure modes and stress-strain curves for the individual test specimens, all of which were meticulously obtained and subjected to thorough analysis.Forming limit diagrams were subsequently constructed based on the gleaned results, affording a visual representation of the material’s formability under the specific conditions studied. Moreover, these experiments were replicated through simulations employing the LS-DYNA software, with a subsequent comparative examination conducted against the tangible outcomes derived from practical experimentation.

Cloud computing is a cost-effective approach to provide on demand computing and data storage solutions. Data storage is one of the key services provided by the cloud. Cloud offers improved efficiency, flexibility, and scalability, but all these advantages can be overturned if security is not taken into consideration. It is the cloud vender’s responsibility to keep the data safe with highly secure cloud services, which helps them earn the trust of the customers. Today, cloud security is critical since most organizations are already using cloud computing in alternate forms. There is always a concern that the highly sensitive business information and intellectual property may be exposed or misused due to increasingly sophisticated cyber threats. This research paper provides a distributed architecture for cloud data security which is independent of the underlying platforms. A cloud security architecture provides written and visual model to define how to configure and secure operations within the cloud. This paper compares the performance of RC4 against AES-256. The performance of the proposed encryption algorithms is evaluated on a widely used database MySQL. This paper provides a better solution to ensure the security of cloud databases by using two encryption algorithms.

The conventional optimization process in Injection Moulding includes actual shop floor trials in which melt temperature, mould temperature, injection time, injection pressure, pattern, feeder size, shape and location cores, mould layout, gating etc. are changed in each iteration which involves high machining cost, tooling cost, modification cost, melting cost, and transportation cost as well as, materials, energy, time are wasted in each trial until and unless the required results are obtained. Water meter component (DN20 Vent) is designed in CREO 5.0, and then components are 3D printed to cross check the dimensions and also to confirm whether all the other components can be accommodated or not. Then the mould flow analysis will be performed on a water meter components using different materials and changing the processing parameters. The input processing parameters considered are melt temperature, mould temperature and injection time, whereas the responses are warpage, volumetric shrinkage, cycle time and quality prediction. Grey relational analysis is carried out to determine the optimum injection moulding processing parameters.. The effort has been made to minimize the warpage, volumetric shrinkage, cycle time and maximize the quality prediction mould cavity and core for the components are designed in CREO 5.0 and manufactured using P20 tool steel. Then the water meter components are manufactured by inputting the optimal processing parameters in injection moulding machine to achieve high productivity and quality.

Douglas K Sigford,1 Shivani Reddy,1 Christine Mollineaux,2 Shlomit Schaal1 1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, 2Department of Ophthalmology and Visual Science, University of Kentucky, Lexington, KY, USA Purpose: To report on endophthalmitis occurrence and associated risk factors following the intravitreal injection of anti-VEGF agents based on a review of published literature.Materials and methods: A Medline search was performed using the terms “bevacizumab” and “ranibizumab”. A total of 534 English-language articles of varying design and published from 2006 to November 2013 were analyzed for endophthalmitis occurrence and contributing perioperative factors.Results: A total of 445,503 injections were counted. There were 103 cases of postinjection endophthalmitis in 176,124 injections (0.058%) with bevacizumab (Avastin) versus 79 cases in 269,379 injections (0.029%) with ranibizumab (Lucentis). This difference was due to a significantly higher occurrence of culture-negative endophthalmitis associated with bevacizumab injections. Culture-positive risk was not statistically different between the two drugs. The reported use of postinjection topical antibiotics increased the risk of culture-positive endophthalmitis. No association was found with the use of povidone iodine, a lid speculum, a mask, or an operating room. Streptococcus spp. were the most prevalent causative organism, accounting for nine of 54 (17%) of all culture-positive cases.Conclusion: Reported postinjection endophthalmitis occurred significantly more in patients treated with bevacizumab than those treated with ranibizumab. However, culture-positive occurrence was similar. Despite the potential for contamination at the time of drug compounding, bevacizumab does not appear to confer a higher risk of culture-positive endophthalmitis than ranibizumab. This study also suggests antibiotic use may increase endophthalmitis occurrence. Keywords: endophthalmitis, eye infections, intravitreal injections, panophthalmitis

Presented is a new method for making composition graded metal-ceramic composites using reactive interdiffusion between a metal and a complex ceramic. Composition variation in both metal and ceramic phases with distance along the direction of diffusion is achieved. The design criteria for developing such composites are discussed. The system should exhibit extensive solid solubility in both metallic and ceramic phases, a defined gradation in the stabilities of the oxides, and mobility of electrons or holes in the oxide solid solution. The complex ceramic used for making the composite should be polycrystalline with sufficient porosity to accommodate the volume expansion caused by alloy precipitation. An inert atmosphere to prevent oxidation and high processing temperature to facilitate diffusive transport are required. The process is illustrated using the reaction couples Fe-NiTiO3, Fe-(Mg,Co)TiO3 and Fe-(Ni,Co)TiO3.