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Abstract Background and aim Contamination from increased anthropogenic activities poses a threat to human health as well as the ecosystem. To develop a nanotechnological approach to improve aqua fisheries, we synthesized magnetic hematite nanoparticle-based gel and evaluated its efficacy in a cadmium-polluted closed system to decontaminate water and improve tilapia fish health. Methods Green iron oxide nanoparticles were biosynthesized by the metabolite of bacillus subtilis and incorporated into polyvinyl alcohol to construct a hydrogel by cryogelation. Key findings The cryogel had interconnected macropores with diameters widely ranging between 20 and 200 μm and could be free-floating in water. When applied in cadmium-polluted tilapia culture, this nanogel reduced turbidity and ammonia in the aquarium, adsorbed cadmium from the water with a larger quantity on the gel’s outer surface than in its center., and reduced cadmium concentration in tilapia’s liver, gills, and muscles. Application of this nano-based cryogel reduced the toxic effects of cadmium on tilapia fish. It maintained hepatic and renal cell nuclear integrity as determined by comet assay. This nano-treatment also reversed the cadmium-induced elevations of plasma lipids, glucose, stress marker cortisol, the hepatic enzymes AST and ALT, and the kidney function marker urea, and improved the lymphocytopenia and other hematological functions in tilapia fish intoxicated by cadmium.

Aims: To examine the features of foreign body ingestion and evaluate the effectiveness of endoscopic therapy for foreign body ingestion in Bangladeshi children. Methods: I retrospectively reviewed the medical records of 97 children diagnosed with foreign body ingestion that required endoscopic removal from 2016 to 2023. Results: The children were aged between 3 months and 15 years, with a mean age of 2.9 ​± ​4.9 years, with more than 80 ​% of the patients being under 5 years of age. Foreign body ingestion was observed at a high frequency (71.1 ​%) in children aged one to five years. Coins (67 ​%) and button batteries (5.2 ​%) were the most common foreign bodies swallowed by kids, and the majority of them were accidental (97.9 ​%). The majority of the foreign bodies were blunt (74.3 ​%), but some were sharp (18.6 ​%). Fifty-six percent of esophageal foreign bodies and 94 ​% of gastric foreign bodies were asymptomatic. Around 80 ​% of button batteries and 77.8 ​% of pointed objects were effectively removed from the body within 24 ​h of ingestion. Similarly, food impaction and blunt objects (98.6 ​% and 100 ​%, respectively) were successfully removed after the 24-h period. Endoscopic removal was successful in 99 ​% of cases, with minimal complications. When button batteries and sharp objects were consumed, the severity of erythema, erosion, bleeding, and ulceration increased along with the length of impaction. Conclusions: Foreign body ingestion is a frequent occurrence in children under the age of five. Coin was the most common foreign body, with the majority of asymptomatic presentations. Prompt identification and timely extraction of swallowed foreign bodies may improve clinical outcomes.

Abstract Previous research on autism spectrum disorders (ASD) have showed important volumetric alterations in the cerebellum and brainstem. Most of these studies are however limited to case-control studies with small clinical samples and including mainly children or adolescents. Herein, we aimed to explore the association between the cumulative genetic load (polygenic risk score, PRS) for ASD and volumetric alterations in the cerebellum and brainstem, as well as global brain tissue volumes of the brain among adults at the population level. We utilized the latest genome-wide association study of ASD by the Psychiatric Genetics Consortium (18,381 cases, 27,969 controls) and constructed the ASD PRS in an independent cohort, the UK Biobank. Regression analyses controlled for multiple comparisons with the false-discovery rate (FDR) at 5% were performed to investigate the association between ASD PRS and forty-four brain magnetic resonance imaging (MRI) phenotypes among ~ 31,000 participants. Primary analyses included sixteen MRI phenotypes: total volumes of the brain, cerebrospinal fluid (CSF), grey matter (GM), white matter (WM), GM of whole cerebellum, brainstem, and ten regions of the cerebellum (I_IV, V, VI, VIIb, VIIIa, VIIIb, IX, X, CrusI and CrusII). Secondary analyses included twenty-eight MRI phenotypes: the sub-regional volumes of cerebellum including the GM of the vermis and both left and right lobules of each cerebellar region. ASD PRS were significantly associated with the volumes of seven brain areas, whereby higher PRS were associated to reduced volumes of the whole brain, WM, brainstem, and cerebellar regions I-IV, IX, and X, and an increased volume of the CSF. Three sub-regional volumes including the left cerebellar lobule I-IV, cerebellar vermes VIIIb, and X were significantly and negatively associated with ASD PRS. The study highlights a substantial connection between susceptibility to ASD, its underlying genetic etiology, and neuroanatomical alterations of the adult brain.

Abstract Background Hypertensive disorders of pregnancy (HDP) are a significant cause of maternal mortality worldwide. The classification and treatment of hypertension in pregnancy remain debated. We aim to compare the effectiveness of the revised 2017 ACC/AHA blood pressure threshold in predicting adverse pregnancy outcomes. Methods We conducted a secondary data analysis of the Alliance for Maternal and Newborn Health Improvement (AMANHI) biorepository study, including 10,001 pregnant women from Bangladesh, Pakistan, and Tanzania. Blood pressure was measured using validated devices at different antenatal care visits. The blood pressure readings were categorized as: normal blood pressure (systolic blood pressure (sBP)

Abstract Background Small-for-gestational-age (SGA), commonly caused by poor placentation, is a major contributor to global perinatal mortality and morbidity. Maternal serum levels of placental protein and angiogenic factors are changed in SGA. Using data from a population-based pregnancy cohort, we estimated the relationships between levels of second-trimester pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PlGF), and serum soluble fms-like tyrosine kinase-1 (sFlt-1) with SGA. Methods Three thousand pregnant women were enrolled. Trained health workers prospectively collected data at home visits. Maternal blood samples were collected, serum aliquots were prepared and stored at -80℃. Included in the analysis were 1,718 women who delivered a singleton live birth baby and provided a blood sample at 24–28 weeks of gestation. We used Mann-Whitney U test to examine differences of the median biomarker concentrations between SGA (

Abstract The escalating demand for data in wireless communication systems has posed significant challenges in recent years. This trend is predicted to continue, with explosive data usage and evolving quality of service demands from mobile users. The rapid increase in traffic demand, combined with the intricate nature of heterogeneous network (HetNet) scenarios, has significantly heightened the challenges confronting mobile network operators. These challenges encompass service quality, load distribution, coverage, and the overall user experience. Conventional approaches that prioritize maximum received power in the cell association mechanism tend to sustain network imbalances within the HetNets, making it difficult to cater for the diverse traffic requirements of mobile users. In this study, instead of focusing solely on enhancing individual user downlink rates, we maximize the number of users whose downlink needs are satisfied by integrating a cell range extension (CRE) technique with an ant colony optimization algorithm. Our proposed method considers both the workload of base stations and the signal to interference-plus-noise ratio of user devices to formulate an objective function aimed at calculating specific CRE bias values for individual small base stations. A comparative analysis of the proposed approach with existing techniques demonstrates its effectiveness. Simulation results underscore the success of our proposed strategy in meeting users’ throughput needs while reducing network imbalances and call drop rates.

Accelerated technological development has a significant role in highly increasing energy demand, which enhances the interest of companies and governments in adopting renewable energy sources and finding new technologies that enable the effective use of these sources, such as techniques for predicting the amounts of generated and consumed energy, technologies of energy storage, and others. The high complexity of energy networks also necessitates intelligent systems to manage energy production and distribution with high efficiency, which is based on intelligent data analysis techniques. This paper conducts a comprehensive analysis of the critical impact of intelligent data analysis techniques (Deep Learning and Machine Learning) in the management of renewable energy systems. Machine learning uses previous data to forecast and optimize energy production and consumption. While deep learning excels at dealing with complex connections and non-linear patterns, The analysis showed that using and developing these technologies in renewable energy applications improves decision-making processes by providing more accurate predictions, highly efficient resource usage, minimizing complexity in the computations and time of system implementation, and creating robust renewable energy systems with minimum cost. As the renewable energy sector grows, combining Deep Learning (DL) and Machine Learning (ML) will be critical to encouraging efficient investment and intelligent management practices in renewable energy and sustainability applications.

Cupola slag is a waste material of the steel and iron industries. Its composition is determined by the cupola furnace and other elements used in steel and iron manufacturing. This paper investigates the characterization behavior of various cupola slag materials. As a result, x-ray fluorescence (XRF), x-ray diffraction (XRD), thermogravimetry differential thermal analysis, and scanning electron microscopy (SEM) methods were used to characterize three cupola slag samples from distinct origins. In addition, various physical properties were used to compare different cupola slags. The specific gravity values of CS-1 (cupola slag-1 sample), CS-2 (cupola slag-2 sample), and CS-3 (cupola slag-3 sample) are 1.36, 2.5, and 2.917, respectively. The density and water absorption for CS-1, CS-2, and CS-3 are 1414.86, 1477.71, and 1796 kg/m3, and 0.37%, 0.32%, and 0.26%, respectively. Cupola slag also includes a larger percentage of lime, according to XRF data, which contributes to its improved binding characteristics. A higher calcium oxide content in CS-3 could facilitate the pozzolanic process. The presence of angular particles that aid in material binding is seen in the SEM image. Compounds with a nanostructure are then flawlessly blended into the mixture and grouped with calcium alumina silicates formed by cement hydration. The XRD pattern of cupola slag exhibits high peaks, indicating that the material is crystalline in character and can be utilized as sand. It also shows the presence of other chemical compounds, such as silica, which ranges from 30% to 45%. CS-1 and CS-2 have comparable XRD patterns. However, CS-3 has a somewhat different pattern because of the greater CaO content. Weight loss begins at higher temperatures, which shows that the material is stable at higher temperatures, according to a thermo-gravimetric study. The differential thermal analysis curve of CS-3 indicates that the material remains stable up to a temperature of 600 °C. The physical characteristics of all cupola slag samples show that cupola slag may be utilized to make sustainable building materials because of its lower specific gravity, density, and water absorption.

Waspaloy, a nickel-based super alloy, has much potential in gas turbine component production. Machining this type of material using the traditional manufacturing method is very hard. Hence, electrical discharge machining (EDM) was selected for the investigation of the machining characteristics of Waspaloy by choosing the control parameters, namely, current, voltage, pulse on time, pulse off time, and spark gap. Gray relational analysis is carried out using 18 experiments according to an orthogonal array (L18) to determine the gray relation grade for this machining process with multiple machining characteristics such as material removal rate (MR), tool wear rate (TW), and surface roughness (SR). The significant objective of the multi objective optimization to attain high MR, low TW, and low SR is found out. From gray relation optimization, the optimum machining conditions for EDM, namely, current: 26 A, voltage: 200 V, pulse on time: 120 μs, pulse on time: 10 μs, and spark gap: 0.15 m, have been identified. The foremost parameter affecting the responses was found to be peak current.

The significance of land surface temperature (LST) and near-surface air temperature (TAIR) extends to various applications, including the exploration of urban heat islands. Understanding urban heat islands is crucial for comprehending the intricate interactions among urbanization, climate dynamics, and human well-being. However, many aspects of these topics remain understudied. In this study, we conducted a comprehensive analysis of LST and TAIR, covering day and night and spanning all four seasons of a full year. We used global datasets and applied non-spatial and spatial analysis techniques in the Amman-Zarqa urban region, a typical arid to semiarid environment. The study had three primary objectives: (1) Assess how different human settlement types influence the variations in LST and TAIR across space and time. (2) Examine the spatial and temporal attributes of the relationships between TAIR and LST. (3) Synthesize insights regarding the spatial and temporal characteristics of urban heat islands in arid to semiarid environments. The findings unveiled that urban centers consistently exhibit the lowest daytime LST and maximum and minimum TAIR, across all seasons when compared to other human settlement types. Nighttime LST displayed more variable patterns. Urban centers act as surface urban cool islands during the day and canopy layer urban cool islands both day and night throughout the seasons. The presence of surface urban heat or cool islands at night is barely noticeable. Daytime and nighttime LST play a significant role in explaining the variability in maximum and minimum TAIR across all seasons, with the relationships exhibiting variations ranging from positive to non-significant to negative, influenced by location and seasonal changes. During the daytime, LST consistently exceeds TAIR across all seasons, whereas this relationship displays greater variability at night. The findings of this study hold significant implications for sustainable urban planning and efforts to combat the effects of urban heat islands.

This study highlights the potential of employing terahertz metamaterial structures as dual-band biosensors for the early detection of cancerous biological tissue. The fundamental principle leveraged here is the alteration of the effective dielectric constant of biological tissue by cancerous cells. The change in the dielectric constant, in turn, induces a shift in the resonance frequency of the metamaterial sensor. One notable advantage of the terahertz metamaterial sensor is its relatively compact size compared to other sensor types, as its dimensions are independent of the wavelength. This property translates into a requirement for a much smaller biopsy sample, facilitating less invasive testing procedures. Beyond the size advantage, the proposed biosensor demonstrates efficacy in detecting abnormalities within biological tissue.

The swift progress of 6G cellular networks responds to the urgent demand for seamlessly integrating Internet of Things (IoT) devices on a large scale. Among various emerging technologies, grant-free non-orthogonal multiple access (GF-NOMA) emerges as a standout, offering distinct advantages over traditional networks in accommodating extensive connectivity needs. GF-NOMA optimizes resource usage by reallocating each time-frequency slot to multiple devices with different power levels. Furthermore, it reduces the coordination burden typically associated with uplink communication by broadcasting random access channels. Nonetheless, GF-NOMA faces a significant challenge: the risk of multiple devices inadvertently selecting the same resource and power, resulting in data loss, particularly problematic during emergencies marked by uncoordinated communications. Additionally, the expanding deployment of IoT devices demands a proportional increase in resources, despite advancements in network technology. To address these challenges, this paper introduces an innovative architecture aimed at significantly boosting spatial capacity through the establishment of autonomous social interactions among IoT devices. The proposed SAFE-GF-NOMA aggregation scheme facilitates resource sharing in an independent and ad-hoc trust management environment by ensuring trustworthy sharing. The proposed Social IoT (SIoT) framework reduces uplink access by grouping devices based on trust metrics, resulting in a notable 50% reduction in collision probability, and over a 50% increase in success probability, and a threefold capacity increase compared to conventional systems. Additionally, our system achieves a substantial reduction in energy consumption, cutting it from 17 J to just 5 J per device within the cluster.

In this paper, a reconfigurable Multiple-Input Multiple-Output (MIMO) antenna array is presented for 5G portable devices. The proposed array consists of four radiating elements and an Electromagnetic Band Gap (EBG) structure. Planar monopole radiating elements are employed in the array with Coplanar Waveguide Ports (CWPs). Each CWP is grounded on one side to a reflecting L-shaped structure that has an effect of improving the antenna’s directivity. It is shown that by inductively connecting Minkowski fractal structure of $1^{st}$ order to the radiating element, the impedance matching is improved that results in enhancement in the array’s bandwidth performance. The EBG structure is used to provide the isolation between antenna elements in the MIMO array. The fractal structure is connected to the L-shaped reflector through four photosensitive light dependent resistor (LDR) switches. The effect of various LDR switching configurations on the performance of the antenna is investigated. The proposed array provides a novel performance in terms of S-parameters with enhancements in the radiation properties. Such enhancements

Aims: To assess the specifics of juvenile polyps and the value of polypectomy with complete colonoscopy in pediatric patients. Methods: I retrospectively reviewed the medical records of 81 children diagnosed with juvenile polyps from 2017 to 2021. Results: The patients' ages ranged from 1.5 to 18 years. Hematochezia was present in 100% of cases, in which 97.5% of the bleeding was painless. The most frequent was red or dark red hematochezia in 71.6% of cases, followed by red stool with blood dripping in 9 (11.1%) cases. The time interval between the first episode of hematochezia and the colonoscopy ranged from 1 to 47 months. Only 24.7% of polyps were diagnosed by digital rectal examination. Most of the Juvenile polyps were solitary (82.8%) and located in the rectosigmoid part of the colon. The size of the polyps varied from 0.3 to 4 ​cm. Early post-polypectomy bleeding occurred in two cases, while late post-polypectomy bleeding occurred in only one case. Conclusions: Although solitary juvenile polyps in the rectosigmoid colon are more common, some patients had multiple and some had proximal polyps. Therefore, a colonoscopy of the entire colon with therapeutic polypectomy is important for improved outcomes when evaluating painless, intermittent hematochezia in children.

In this paper, a compact endfire antenna array with low-profile, small clearance, and wideband operation is proposed for millimeter-wave (mmWave) fifth-generation (5G) mobile terminals. The wideband operation is achieved by exciting two identical bow-tie dipoles inserted on both sides of a multilayer substrate fed by an asymmetric open-end stripline to slotline transition. The antenna performance is significantly improved by introducing a set of vertical metallic vias. The proposed antenna element can achieve 29 % from 24.2 GHz to 32.4 GHz with a peak realized gain that varies from 3.5 dBi to 4.5 dBi. A linear 4-element antenna array is arranged and fabricated to verify the proposed antenna beamforming capabilities. The simulated and measured bandwidth achieves a wide range of 34.4 % (24-34 GHz) to support 26, 28, and 30 GHz 5G mmWave bands with an isolation level better than 20 dB and a peak realized gain over the interested bands ranging from 7.56 to 8.14 dBi. The simulated array scanning angle is ± 68° at 28 GHz within 3-dB gain deterioration. Furthermore, the simulated spherical coverage has met the requirements of 3GPP standards which make the proposed antenna array a promising candidate to be integrated within mmWave 5G mobile devices.

Rain attenuation poses a significant challenge for high-throughput communication systems. In response, this paper introduces an artificial intelligence (AI) model designed for predicting and mitigating rain-induced impairments in high-throughput satellite (HTS) to land channels. The model is based on three AI algorithms developed using 3D antenna design to characterize, analyze, and mitigate rain-induced attenuation, optimizing channel quality specifically in the United Arab Emirates (UAE). The study evaluates various parameters, including rain-specific attenuation, effective slant path through rain, rain-induced attenuation, signal carrier-to-noise ratio, and symbol error rate, for five conventional modulation schemes: Quadrature Phase-Shift Keying (QPSK), 8-Phase Shift Keying (8-PSK), 16-Quadrature Amplitude Modulation (16-QAM), 32-QAM, and 64-QAM. Additionally, the paper introduces a new database detailing rain-induced attenuation in HTS channels in the UAE at different frequencies using measured rainfall intensities. The paper concludes by proposing a smart antenna design with a frequency diversity technique for fade mitigation. Results indicate that rain-induced attenuation varies significantly based on rainfall rate and frequency. Specifically, at 25 GHz and a rainfall rate of 100 mm/h, the rain-induced attenuation can reach as high as 15 dB, resulting in a significant decline in signal quality and link performance. The

Abstract Background Hyperglycemia during pregnancy leads to adverse maternal and fetal outcomes. Thus, strict monitoring of blood glucose levels is warranted. This study aims to determine the association of early to mid-pregnancy HbA1c levels with the development of pregnancy complications in women from three countries in South Asia and Sub-Saharan Africa. Methods We performed a secondary analysis of the AMANHI (Alliance for Maternal and Newborn Health Improvement) cohort, which enrolled 10,001 pregnant women between May 2014 and June 2018 across Sylhet-Bangladesh, Karachi-Pakistan, and Pemba Island-Tanzania. HbA1c assays were performed at enrollment (8 to

Designing and developing small organic molecules for use as urease inhibitors is challenging due to the need for ecosystem sustainability and the requirement to prevent health risks related to the human stomach and urinary tract. Moreover, imaging analysis is widely utilized for tracking infections in intracellular and in vivo systems, which requires drug molecules with emissive potential, specifically in the low-energy region. This study comprises the synthesis of a Schiff base ligand and its selected transition metals to evaluate their UV/fluorescence properties, inhibitory activity against urease, and molecular docking. Screening of the symmetrical cage-like ligand and its metal complexes with various eco-friendly transition metals revealed significant urease inhibition potential. The IC50 value of the ligand for urease inhibition was 21.80 ± 1.88 µM, comparable to that of thiourea. Notably, upon coordination with transition metals, the ligand–nickel and ligand–copper complexes exhibited even greater potency than the reference compound, with IC50 values of 11.8 ± 1.14 and 9.31 ± 1.31 µM, respectively. The ligand–cobalt complex exhibited an enzyme inhibitory potential comparable with thiourea, while the zinc and iron complexes demonstrated the least activity, which might be due to weaker interactions with the investigated protein. Meanwhile, all the metal complexes demonstrated a pronounced optical response, which could be utilized for fluorescence-guided targeted drug delivery applications in the future. Molecular docking analysis and IC50 values from in vitro urease inhibition screening showed a trend of increasing activity from compounds 7d to 7c to 7b. Enzyme kinetics studies using the Lineweaver–Burk plot indicated mixed-type inhibition against 7c and non-competitive inhibition against 7d.

The design and development of fluorescent materials for detecting cancer-related enzymes are crucial for cancer diagnosis and treatment. Herein, we present a substituted rhodamine derivative for the chromogenic and fluorogenic detection of the cancer-relevant enzyme γ-glutamyltranspeptidase (GGT). Initially, the probe is non-chromic and non-emissive due to its spirolactam form, which hinders extensive electronic delocalization over broader pathway. However, selective enzymatic cleavage of the side-coupled group triggers spirolactam ring opening, resulting in electronic flow across the rhodamine skeleton, and reduces the band gap for low-energy electronic transitions. This transformation turns the reaction mixture from colorless to intense pink, with prominent UV and fluorescence bands. The sensor’s selectivity was tested against various human enzymes, including urease, alkaline phosphatase, acetylcholinesterase, tyrosinase, and cyclooxygenase, and showed no response. Absorption and fluorescence titration analyses of the probe upon incremental addition of GGT into the probe solution revealed a consistent increase in both absorption and emission spectra, along with intensified pink coloration. The cellular toxicity of the receptor was evaluated using the MTT assay, and bioimaging analysis was performed on BHK-21 cells, which produced bright red fluorescence, demonstrating the probe’s excellent cell penetration and digestion capabilities for intracellular analytical detection. Molecular docking results supported the fact that probe-4 made stable interactions with the GGT active site residues.

Offering intended products at an affordable price is a highly challenging task in a business environment. To meet such challenges, industrial experts and researchers have different approaches, such as shifting the purchase of materials from import mode to local vendors and optimizing machining cost by optimizing process parameters, waste reduction, rework reduction, and technological improvements. The novelty of this study lies in reducing material cost by accurate materials forecasting to minimize storage cost, ablation cost, average annual consumption cost, etc. This study aims to compare the efficacy of the Seasonal Decomposition Method (SDM) against Multi-Echelon Inventory Optimization (MEIO) for minimizing inventory through accurate materials forecasting. Through rigorous evaluation and analysis, this research seeks to clarify the strengths and weaknesses of each approach, thereby providing insights into their applicability and effectiveness in addressing inventory management challenges across diverse seasonal demand patterns. The sample size was taken as 50 per group. The G-power applied is about 80%. The significance value obtained is 0.001 (p < 0.05), indicating a statistically significant difference between the two algorithms used for inventory reduction and materials forecasting. SDM (63.43) outperforms MEIO (48.57) in terms of accuracy. SDM yielded a better accuracy when compared to MEIO for inventory minimization and materials forecasting.

Poor planning and scheduling increase buying, storage, and obsolescence expenses. Material shortages increase labor, machine optimum time, etc. Industrial raw materials, semi-finished items, spares, and consumables have distinct consumption patterns, reorder points, purchase lead times, quantity limits, discounts, etc. To save money, machine learning predicts demand and prepares materials. This study employs ARIMA or Support Vector Machine (SVM) machine learning-based forecasting approaches to forecast materials for less inventory. Feature engineering eliminates seasonality, time series, and external demand and ignores data irregularities, missing figures, and disparities. This approach needs to adapt traits to factors, separate test and training data, and consider many future models to represent the best forecasts. Forecast reliability and consistency were examined for each model. Inventory management systems were evaluated for computational complexity and installation ease and found implementation issues. Both models’ input data and resilience were examined using sensitivity analysis. Accurate prediction SVM and ARIMA predict material demand differently. Meaningful statistics show the optimal model. Performance differences between SVM and ARIMA enhance model selection. Thinking about the execution of high inventory system integration and computational complexity, response surface methodology chooses factorial variables with the highest or lowest responses. Analysis of variance, factor analysis, and effect modeling expansions demonstrated for the response.

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Climate change-induced saline intrusion into both surface and groundwater, extreme weather events, and unregulated water usage are serious threats to the drinking water supply in coastal areas worldwide, especially in least-developed countries. This research developed a data-driven decision-making methodology to evaluate the performance of rainwater harvesting (RWH) systems in the saline-prone southwestern coastal region of Bangladesh. Twenty-five community managed RWH systems, recently piloted in two major coastal districts, were considered the case study to develop and validate this evaluation tool. The evaluation methodology integrates daily water models, lifetime cost analysis, Geographic Information System (GIS)-based parameters supported by the Analytical Hierarchy Process (AHP), and field observation. While the meteorological parameters as well as the hydrological and economic performance were found to be highly suitable, 36 % of the systems showed moderate performance, as challenges remain in ensuring proper operation and maintenance practices at the community level. However, 40 % of the systems showed high performance, with two systems showing very high suitability, which suggests community managed RWH systems as a sustainable adaptation for coastal water supply.

Abstract The goal of deploying LTE‐Advanced heterogeneous networks is to meet the growing need for Quality of Service (QoS), high data rates, and more coverage. Load balancing is one of the biggest problems, especially when User Equipment (UE) uses received signal strength to connect to different transmission power network tiers. Spectrum for small cells has not been used to its full potential. While all the cells are using the same frequency spectrum and the small cells overlap the Macro Cells, preventing interference is another big problem. The proposed Cell Range Extension (CRE) and Almost Blank Sub‐frame (ABS) provides a solution to overcome these challenges. The proposed ABS in this paper is novel because it is a partial muting one rather than the full muting ABS in recent research studies. In addition, the cell association method is by distance rather than conventional Reference Signal Received Power (RSRP). CRE‐ABS has been applied simultaneously to solve both load balancing and interference. Simulation results show that the proposed scheme achieves substantial throughput and Jain's Fairness Index (JFI).

The nannoplankton research was conducted in the MH-2 well, Banggai-Sula Basin, Central Sulawesi. Thirty-four ditch-cutting samples were utilized to observe the Minahaki, Kintom, and Biak Formations. Age determination was carried out using biostratigraphy method and standard procedure for first and last occurrence of nannoplankton biodatum and had an absolute age, widely known as a zone indicator. This study aims to determine the age and nannoplankton biozonation of each geological formation in Banggai-Sula Basin. Based on the biostratigraphic analysis, 39 species from 14 genera with abundance frequencies ranging from rare to abundant were found in the MH-2 well. In this study, new results of the age of Banggai-Sula Basin areMiddle Miocene – Early Middle Pliocene (13,706 – 3,727 Ma), and can identify into six calcareous nannoplankton zones that are more detailed than previous researchers, Discoaster signus zone (NN5), Discoaster exilis zone (NN6-NN7), Discoaster berggrenii zone (NN11), Ceratolithus acustus zone (NN12), Helicosphaera sellii zone (NN13-NN15), and the Discoaster tamalis zone (NN16). Biostratigraphic data also shows new information for the first time, the absence of three zones from zone NN8 to zone NN10. This result indicates an unconformity in the Late Miocene age (10.606–8.20 Ma).

Seifu M Abera,1,2 Colin O’Donnell,3 Taufiq Salahuddin,1,2 Krishna Prabhu,4 Carol E Simons,1 P Michael Ho,5,6 Stephen W Waldo,3,5,6 Jacob A Doll1– 3 1Section of Cardiology, VA Puget Sound Health Care System, Seattle, WA, USA; 2Department of Medicine, University of Washington, Seattle, WA, USA; 3Department of Veterans Affairs Clinical Assessment, Reporting, and Tracking Program, VHA Office of Quality and Patient Safety, Washington, DC, USA; 4Hennepin County Medical Center, Minneapolis, MN, USA; 5Rocky Mountain Regional VA Medical Center, Aurora, CO, USA; 6Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USACorrespondence: Jacob A Doll, VA Puget Sound Health Care System, 1660 S. Columbian Way, S111-CARDIO, Seattle, WA, 98108, USA, Tel +1 206-277-6199, Fax +1 206-764-2257, Email jdoll@uw.eduObjective: Adherence to anti-platelet medications is critical following coronary stenting, but prior studies indicate that clinician assessment and patient self-assessment of adherence are poorly correlated with future medication-taking behavior. We therefore sought to determine if integrated pharmacy data can be used to identify patients at high risk of non-adherence after percutaneous coronary interventions (PCI).Methods: Using Veteran Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) data linked with pharmacy records, we assessed adherence to cardiovascular medications from 2012 to 2018. Adherence was defined as the proportion of days covered (PDC) ≥ 0.80. We assessed the association of pre-PCI adherence with post-PCI adherence to P2Y12 inhibitors and clinical outcomes using logistic regression and Cox proportional hazard models, respectively.Results: Among 56,357 patients, 66.0% filled at least 1 cardiovascular medication within VA for the year prior to PCI and were evaluable for adherence. Pre-PCI non-adherence was 20.7%, and non-adherent patients were more likely to be younger and present non-electively. Non-adherent patients were less likely to adhere to P2Y12 inhibitor therapy after PCI (Adjusted OR 0.45 C.I. 0.41– 0.46), compared with adherent patients, and had a higher adjusted risk of mortality (HR 1.17 C.I. 1.03– 1.33).Conclusion: Adherence to cardiovascular medications prior to PCI can be assessed for most patients using pharmacy data, and past adherence is associated with future adherence and mortality after PCI. Use of integrated pharmacy data to identify high-risk patients could improve outcomes and cost-effectiveness of adherence interventions.Plain Language Summary: Why was the study done?: Non-adherence to anti-platelet medications is common following coronary stenting procedures and is associated with worse outcomes, but predicting non-adherence is challenging.What did the researchers do and find?: The researchers examined pharmacy fill-based adherence assessments before and after stenting procedures. Pharmacy data can provide adherence estimates for most patients receiving percutaneous coronary intervention, and these estimates are associated with downstream medication-taking behavior and clinical outcomes.What do the results mean?: Health systems should seek to integrate pharmacy-based adherence estimates into routine care for patients with cardiovascular disease. Identification and targeting of patients at high-risk for non-adherence may improve the impact and cost-effectiveness of future research and health policy interventions aimed at improving adherence.Keywords: percutaneous coronary intervention, medication adherence

During the COVID-19 pandemic, the education sector of Bangladesh suffered a lot. To adapt to this uncertain situation, the online teaching–learning method was introduced for the first time in the dental colleges to continue regular classes. This qualitative study explored the in-depth perception among students of this new, affordable, flexible online learning method and to find out the scope of improvement of the delivery method. Two focus group discussions (FGD) were conducted, each including 6–8 participants (N = 16, the male/female ratio was 7:9) for gaining an in-depth understanding of the perception of online teaching among dental students. With the help of the trigger questions, the facilitator and moderators conducted both FGDs. By analyzing the focus group discussion, four distinct themes were identified. The main themes extracted from the data refer to the difficulties which students faced during participation in online classes (e.g., low attention span, unusual timing of classes, internet accessibility, power cut, boring content, etc.), advantages of online learning (e.g., saves time, able to continue studying during the lockdown, saves money, avoids commuting, being safe during a pandemic situation, one can participate in classes if sick, etc.), disadvantages of online classes (e.g., not feasible for clinical classes and lab works, lack of social interactions, lack of group study, long screen time, lack of after-class peer discussion, lack of engagement, etc.), and also scopes of improvements (e.g., technological training for staff, recorded classes, technological orientation for students, more engaging contents, online support, more interactive lessons, short duration of the class, break after 30–45 min, and also teachers training for online facilitation, etc.). In Bangladesh, the online teaching–learning method is not a regular practice. Most of the institutions were forced to adopt this method on very short notice because of the COVID-19 pandemic lockdown. Online education in a clinical subject such as dentistry requires a special training program, online content preparation, and interactive lesson delivery setup, which are big challenges for a resource-constrained medical education setup. The focus group discussion unveiled some key issues which indicated that there are many scopes for improvement in online teaching methods. With the help of the medical education department and through faculty development, the online learning sessions can be made attractive as well as beneficiary for the key stakeholders.

Abstract A comprehensive assessment of the spatial and temporal patterns of the most common indicators of climate change and variability in the Arab world in the past four decades was carried out. Monthly maximum and minimum air temperature and precipitation amount data for the period 1980–2018 were obtained from the CHELSA project with a resolution of 1 km2, which is suitable for detecting local geographic variations in climatic patterns. This data was analyzed using a seasonal-Kendall metric, followed by Sen’s slope analysis. The findings indicate that almost all areas of the Arab world are getting hotter. Maximum air temperatures increased by magnitudes varying from 0.027 to 0.714 °C/decade with a mean of 0.318 °C/decade while minimum air temperatures increased by magnitudes varying from 0.030 to 0.800 °C/decade with a mean of 0.356 °C/decade. Most of the Arab world did not exhibit clear increasing or decreasing precipitation trends. The remaining areas showed either decreasing or increasing precipitation trends. Decreasing trends varied from −0.001 to −1.825 kg m−2/decade with a mean of −0.163 kg m−2/decade, while increasing trends varied from 0.001 to 4.286 kg m−2/decade with a mean of 0.366 kg m−2/decade. We also analyzed country-wise data and identified areas of most vulnerability in the Arab world.

Our paper proposes a system of nonlinear mixed variational inequality problems (SNMVIPs) on Banach spaces. Under suitable assumptions, using the K-Fan fixed point theorem and Minty techniques, we demonstrate that the solution set to the SNMVIP is nonempty, weakly compact, and unique. Additionally, we suggest a stability result for the SNMVIPs by perturbing the duality mappings. Furthermore, we present an optimal control problem that is governed by the SNMVIPs and show that it can be solved.

Climate change-induced heat stress combines two challenges: high day- and nighttime temperatures, and physiological water deficit due to demand-side drought caused by increase in vapor-pressure deficit. It is one of the major factors in low productivity of maize in rainfed stress-prone environments in South Asia, affecting a large population of smallholder farmers who depend on maize for their sustenance and livelihoods. The International Maize and Wheat Improvement Center (CIMMYT) maize program in Asia, in partnership with public-sector maize research institutes and private-sector seed companies in South Asian countries, is implementing an intensive initiative for developing and deploying heat-tolerant maize that combines high yield potential with resilience to heat and drought stresses. With the integration of novel breeding tools and methods, including genomics-assisted breeding, doubled haploidy, field-based precision phenotyping, and trait-based selection, new maize germplasm with increased tolerance to heat stress is being developed for the South Asian tropics. Over a decade of concerted effort has resulted in the successful development and release of 20 high-yielding heat-tolerant maize hybrids in CIMMYT genetic backgrounds. Via public–private partnerships, eight hybrids are presently being deployed on over 50,000 ha in South Asian countries, including Bangladesh, Bhutan, India, Nepal, and Pakistan.

Abstract Background Considering the high frequency of respiratory infections among children in low- and middle-income countries (LMICs), the World Health Organization (WHO) developed a pragmatic guideline for managing pneumonia in low-resource settings. The guideline’s low specificity leads to many false-positive pneumonia cases receiving antibiotic treatment. Integrating diagnostic technology to incorporate lung sounds into WHO guidelines could improve childhood pneumonia diagnosis and management. This qualitative study aimed to explore the acceptability of a prototype digital stethoscope device among potential end-users in Bangladesh. Methods We conducted four focus group discussions (FGDs) with beneficiaries and service providers who used a 2018 digital stethoscope prototype. The data collection was conducted in November 2020. The study was carried out at Zakiganj Upazila (sub-district) of Sylhet district of Bangladesh. A total of 34 respondents, including parents of under-5 children, Community Health Care Providers (CHCPs), and community leaders were enrolled. Two researchers (TJ and a research assistant (not a co-author of this manuscript) conducted the FGDs. Verbatim transcripts were prepared, and translations were completed. Coding was executed in Microsoft Excel, and relevant quotes were extracted to ascertain the emerging themes. To ensure validity, two researchers coded the dataset independently and inconsistencies were resolved through discussion. Findings Mothers were more aware of the digital stethoscope than fathers. Except for the female community leaders, male leaders were unaware of the stethoscopes. Most CHCPs had positive perceptions of the digital stethoscope. They appreciated stethoscope training as they learned about new technology and diagnostic approaches. The users mentioned several technical shortcomings of the prototype device. A few stakeholders expressed dissatisfaction with the level of community involvement and information sharing from the study. The use of the device plummeted during the COVID-19 pandemic for fear of infection, to counteract which the CHCPs cleaned the device with chlorhexidine after every application as a precaution. Conclusion Overall, device use was supported by stakeholders despite perceptions that the prototype had some technological limitations, community engagement was suboptimal, and the COVID-19 pandemic caused disruptions. Stronger community engagement, addressing technological issues, and further research on its health systems application would improve the acceptability and effective use of the digital stethoscope.

This study aims to discuss how the European Union and Turkey deal with the Syrian refugee crisis. The research method used in this study was a systematic literature review using 504 scientific articles sourced from the Scopus database. In reviewing the articles, the authors used the Vosviewer application. The results revealed that Syrian refugees were accommodated correctly and facilitated properly and contributed to the problem by providing insight into digital literacy, information needs, and strategies among Syrian and Iraqi refugees entering Europe and changing perspectives on migrants and refugees as passive victims of this event made to make Syrian refugee decisions to stay in Germany, in an econometric strategy based on estimating models of equality in social unity, economic integration and the decision to stay. The results contribute to developing a research roadmap on the Syrian internecine crisis in Turkey and the European Union and contribute to international relations science. Turkey and the European Union. Subsequent research must use scientific articles from other reputable international databases, such as Web of Science and Dimensions Scholars.

The purpose of this study is to indicate the applicability of laminated plate theory to reinforced concrete (RC) slabs in the elastic stage. For static bending analysis of reinforced concrete (RC) slabs, analytical methods are applied, such as the first order shear deformation theory (FSDT) and the classical laminated plate theory (CLPT). This research takes into account that an RC slab is made up of several layers of concrete and steel bars that are bonded together. Two cases of simply supported square slabs, in which the slab thickness varies, have been considered. The deflection and stresses on the center of the RC slab have been calculated by using Navier approaches of the classical laminated plate theory of plates and the first order shear theory. The results were compared to the experimental and FEM findings of the previous study. The present research concluded that the results of the deflection predicted by laminated plate theory coincide with the experimental results with sufficient accuracy, and CLPT fails to take into account shear strains at the interfaces that making it less applicable compared to the FSDT. However, the application of the laminated plate theory formulas to determine the stresses for RC slab gave a bit different in the results compared with experimental results from a previous study. Also, the results of laminated plate theories are heavily influenced by a variety of assumptions.

MicroRNAs (miRNAs) are small non-coding RNAs that alter the expression of target genes at the post-transcriptional level, influencing diverse outcomes in metabolism, cell differentiation, proliferation, cell survival, and cell death. Dysregulated miRNA expression is implicated in various rheumatic conditions, including ankylosing spondylitis (AS), gout, juvenile idiopathic arthritis (JIA), osteoarthritis (OA), psoriatic arthritis, rheumatoid arthritis (RA), Sjogren’s syndrome, systemic lupus erythematosus (SLE) and systemic sclerosis. For this review, we used an open-source programming language- PowerShell, to scan the massive number of existing primary research publications on PubMed on miRNAs in these nine diseases to identify and count unique co-occurrences of individual miRNAs and the disease name. These counts were used to rank the top seven most relevant immuno-miRs based on their research volume in each rheumatic disease. Individual miRNAs were also screened for publication with the names of immune cells, cytokines, and pathological processes involved in rheumatic diseases. These occurrences were tabulated into matrices to identify hotspots for research relevance. Based on this information, we summarize the basic and clinical findings for the top three miRNAs — miR-146, miR-155, and miR-21 — whose relevance spans across multiple rheumatic diseases. Furthermore, we highlight some unique miRNAs for each disease and why some rheumatic conditions lack research in this emerging epigenetics field. With the overwhelming number of publications on miRNAs in rheumatic diseases, this review serves as a ‘relevance finder’ to guide researchers in selecting miRNAs based on the compiled existing knowledge of their involvement in disease pathogenesis. This approach applies to other disease contexts with the end goal of developing miRNA-based therapeutics.

Terpenes and their derivatives in essential oil have been raising an upstream interest due to their unwavering health-promoting effects and safety profiles, although the individual essential oil components are inadequately assessed for their biological potential. Terpinen-4-ol, a bioactive natural terpene-derivative unambiguously distributed in most essential oil sources, is displaying a very remarkable role as a phytometabolite. This review, therefore, deciphered the health-promoting effects of Terpinen-4-ol in oxidative stress-linked diseases including neurodegenerative disorders, cancers, cardiovascular diseases, diabetes, and inflammatory disorders. Using Google as a search engine, this systematic review unraveled 217 relevant articles out of 857 search results from Web of Science, PubMed, and ScienceDirect. Terpinen-4-ol is reported to increase superoxide dismutase, decrease glutathione-S-transferase and acetylcholine esterase, inhibit NF-κB and NLRP3 inflammasome activation pathway, downregulate the α-amylase activity and increase insulin sensitivity, and substantially inhibit the generation of inflammatory mediators such as IL-1β, IL-6, IL-10. Despite several beneficial actions of Terpinen-4-ol, it has hardly been expedited to use as pharmaceutical therapeutic target for unveiled biological activities. In that context, this review has focused on the role of Terpinen-4-ol in attenuating oxidative stress and stress-linked pathophysiological conditions unraveling a research gap on it to manifest its best pharmaceutical and therapeutic uses.

This study explores the phonological system in the Kempo subdialect (MSdK) and S>H Kolang subdialect (MSdS>H) in West Manggarai Regency. The study was conducted at nine survey sites by interviewing 200 vocabularies compiled by Swadesh. I analyzed the data by comparing the phonological systems between the two subdialects and formulating the possibilities of their occurrence in the word. The results show that the two subdialects have slightly different phonological systems. They have a different inventory of vowel phonemes: 15 consonant sounds in MSdK and 17 consonant sounds in MSdS>H. This study also found three non-pulmonic consonant phonemes in the two subdialects: bilabial /?/, Alveolar /?/, and Velar /?/. In the case of the two subdialects, the non-pulmonic consonant phonemes have unique characteristics: (1) appearing in the initial and middle positions of words, making it impossible for three pulmonic consonants (i.e., consonants /b/, /d/, and /g /) to appear in the initial position. The existence of the three consonant phonemes only appears when at the beginning of the word, it is preceded by another consonant forming a cluster and located on the first syllable (i.e., /mb/, /nd/, and /?g/). The two subdialects also have a relatively similar inventory of vocal phonemes: 6 vowel phonemes. Diphthongs are almost identical between the two subdialects, 7 diphthongs which only appear in mono-syllable words and are located at the end of words. In contrast, two additional diphthongs in MSdS>H appear in two-syllable words and the middle position of the word.

Abstract Background Each year, an estimated 15 million babies are born preterm. Micronutrient deficiencies, including vitamin D deficiency (VDD), are common in many low- and middle-income countries (LMICs), and these conditions are often associated with adverse pregnancy outcomes. Bangladesh experiences a high prevalence of VDD. The country also has a high preterm birth (PTB) rate. Using data from a population-based pregnancy cohort, we estimated the burden of VDD during pregnancy and its association with PTB. Methods Pregnant women (N = 3,000) were enrolled after ultrasound confirmation of gestational age at 8–19 weeks of gestation. Trained health workers prospectively collected phenotypic and epidemiological data at scheduled home visits. Trained phlebotomists collected maternal blood samples at enrollment and 24 -28 weeks of gestation. Aliquots of serum were stored at -800 C. We conducted a nested case–control study with all PTB (n = 262) and a random sample of term births (n = 668). The outcome, PTB, was defined as live births 30.25 nmol/L). We used logistic regression to determine the association of VDD with PTB, adjusting for potential confounders. Results The median and interquartile range of serum 25(OH)D was 38.0 nmol/L; 30.18 to 48.52 (nmol/L). After adjusting for co-variates, VDD was significantly associated with PTB [adjusted odds ratio (aOR) = 1.53, 95% confidence interval (CI) = 1.10 – 2.12]. The risk of PTB was also higher among women who were shorter (aOR = 1.81, 95% CI: 1.27–2.57), primiparous (aOR = 1.55, 95% CI = 1.12 – 2.12), passive smokers (aOR = 1.60, 95% CI = 1.09 – 2.34), and those who received iron supplementation during pregnancy (aOR = 1.66, 95% CI: 1.17, 2.37). Conclusion VDD is common in Bangladeshi pregnant women and is associated with an increased risk of PTB.

The study objective is to investigate the combustion characteristics of Callophyllum inophyllum fuel in presence of a magnetic fields. To conduct the experiment, a bunsen burner was utilized, with fuel and air being dispensed via a syringe pump and compressor, both regulated by a flowmeter. The fuel and air pipes were heated to 532.15 (K) to facilitate fuel evaporation. The equivalent ratio of 0.5, 1, and 1.5 was adjusted to control air discharge and fuel. An 11,000 gausses artificial magnet was used, with N-S, N-S, N-N, and S-S being the various magnetic pole configurations. The study found that the magnetic field can enhance combustion quality by affecting the molecules involved in the combustion process. The magnetic field's force also intensifies the movement of O2, making it more energetic. As O2 travels from the North Pole to the South Pole through the combustion reaction zone, it quickens the oxidation-reduction process and curtails diffusion combustion. The red color's intensity diminishes with the magnetic field's effect, indicating this phenomenon. When a magnetic field is applied, the polarity of C.inophyllum biodiesel fuel becomes highly favorable. The triglyceride carbon chain bonds become unstable, and the van der Walls dispersion forces are weakened, which facilitates easier O2 binding to the fuel, resulting in more efficient combustion. An increase in the laminar burning velocity value can be noticed when exposed to a magnetic field.

Abstract Millimeter wave (mm-Wave) wireless communication systems require high gain antennas to overcome path loss effects and thereby enhance system coverage. This paper presents the design and analysis of an antenna array for high gain performance of future mm-wave 5G communication systems. The proposed antenna is based on planar microstrip technology and fabricated on 0.254 mm thick dielectric substrate (Rogers-5880) having a relative permittivity of 2.2 and loss tangent of 0.0009. The single radiating element used to construct the antenna array is a microstrip patch that has a configuration resembling a two-pronged fork. The single radiator has a realized gain of 7.6 dBi. To achieve the gain required by 5G base stations, a 64-element array antenna design is proposed which has a bore side gain of 21.2 dBi at 37.2 GHz. The 8 × 8, 8 × 16, and 8 × 32 antenna array designs described here were simulated and optimized using CST Microwave Studio, which is a 3D full-wave electromagnetic solver. The overall characteristics of the array in terms of reflection-coefficient and radiation patterns makes the proposed design suitable for mm-Wave 5G and other communication systems.

BackgroundPulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.MethodsThis was a retrospective pooled analysis of two outpatient datasets of 3–35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi. We constructed, internally validated, and compared fit & discrimination of four models predicting SpO2

Summary: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).

The role of cytoreductive nephrectomy has become unclear since the introduction of immunotherapy which is now the backbone of the treatment for metastatic renal cell carcinoma. Different combinations are used based on the prognosis. Achieving a complete response would be ideal and includes radiographic disappearance of lesions. However, there have been a few reported cases of pathological complete response with persistent radiographic evidence of cancer. The authors report a case of pathological complete response despite persistent radiographic evidence of residual disease in a patient with metastatic renal cell carcinoma treated with pembrolizumab and axitinib. The patient subsequently underwent cytoreductive nephrectomy after the 13th dose of pembrolizumab. The resected mass consisted of scar tissue with no viable tumor cells seen on pathology but only scar tissue. This case reveals that persistent radiographic evidence of the tumor may be explained by scar tissue, challenging the role of cytoreductive nephrectomy in the era of immunotherapy.

With the advent of 5G communication networks, many novel areas of research have emerged and the spectrum of communicating objects has been diversified. Network Function Virtualization (NFV), and Software Defined Networking (SDN), are the two broader areas that are tremendously being explored to optimize the network performance parameters. Cellular Vehicle-to-Everything (C-V2X) is one such example of where end-to-end communication is developed with the aid of intervening network slices. Adoption of these technologies enables a shift towards Ultra-Reliable Low-Latency Communication (URLLC) across various domains including autonomous vehicles that demand a hundred percent Quality of Service (QoS) and extremely low latency rates. Due to the limitation of resources to ensure such communication requirements, telecom operators are profoundly researching software solutions for network resource allocation optimally. The concept of Network Slicing (NS) emerged from such end-to-end network resource allocation where connecting devices are routed toward the suitable resources to meet their requirements. Nevertheless, the bias, in terms of finding the best slice, observed in the network slices renders a non-optimal distribution of resources. To cater to such issues, a Deep Learning approach has been developed in this paper. The incoming traffic has been allocated network slices based on data-driven decisions as well as predictive network analysis for the future. A Long Short Term Memory (LSTM) time series prediction approach has been adopted that renders optimal resource utilization, lower latency rates, and high reliability across the network. The model will further ensure packet prioritization and will retain resource margin for crucial ones.

A compact quad-port Multiple-Input-Multiple-Output (MIMO) antenna with an electrical dimension of $0.28\lambda _{0}\times 0.28\lambda _{0}$ and impedance bandwidth of 5.03GHz (2.42-7.45GHz) is proposed. By combining a tapered feed line and stubs in the ground plane, which serve as open circuit stubs and whose dimensions are properly tuned to compensate for the antenna’s input impedance, as the inductance and capacitance values are dependent on it, the bandwidth and isolation are improved. The MIMO antenna has a 15dB average isolation and a group delay < 1nsec. In terms of the envelop correlation coefficient (ECC), diversity gain (DG), mean effective gain (MEG), and total active reflection coefficient (TARC), the proposed antenna’s diversity performance characteristics are investigated, and the obtained values are 0.004, 9.99dB, ±3dB, -10dB respectively. Further the channel capacity of the MIMO antenna is also calculated. The maximum channel capacity of the four elements is 21.34bits/sec./Hz. Equivalent circuit of the proposed MIMO is discussed in this article and S-parameter has been compared with simulated results and found good agreement between simulated and circuit results. A prototype was created to compare the calculated parameters with the measured ones to validate the suggested design. In addition, the scattering matrix, which includes the reflection coefficient (S11) and transmission coefficient (S21) between two elements, and other antenna parameters are all advantageous for applications in the Bluetooth (2.400-2.483GHz), ISM band (2.40-2.483GHz, 5.725-5.850GHz), WLAN/Wi-Fi, and 5G (sub-6GHz) bands.

Abstract Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.

This study aims to examine the philosophical life values of the Manggarai people in Western Flores, which are reflected in the proverbs of the Manggarai language (Go'et). Go'et is an oral literature that contains the values that govern the life of the Manggarai people. This study uses a qualitative descriptive approach design involving semantics theory to interpret the meaning of Go'et. The data in this study were obtained by conducting in-depth interviews with one of the Manggarai community leaders with the initials AW (52) and secondary data available on the Manggarai Nuca Lale website. The data obtained were then validated using the Indonesian-Mangarai dictionary to find samples that fit this study. Nine data are relevant to the scope of this study based on the results of data collection that have been done. From the data found, the researcher concluded that there are three central values in go'et which contain advice and instructions for living a life under the norms that apply to the Manggarai community, such as unity, Manners and Wisdom, and passion and hard work. These findings are consistent with the fact that the Manggarai people uphold the values of unity, cooperation, and harmony among community members.

PT. PLN (Persero) ULP Langsa city is one part of UP 3 langsa, the LS-05 feeder in section two is the location for placing several office buildings. Continuity stable distribution of electrical energy is one of the most important aspects in the distribution system. Based on these problems, the writer was inspired to consuct research with the aim of testing the reliability of the feeders LS-05 and LL-4 which was installed with LBS manuver motorized at both ends of feeders. The LS-05 feeder with section method SAIFI value is 2.2739 times/ customers/ year and SAIDI Value is 8.41995 hours/ customers/ year. For LL-4 feeder witsh the same method SAIFI value is 2.28905 times/ customers/ year, then using RIA-Section technique combined method, LS-05 feeder have SAIFI value is 2,0219 times/ customers/ year, SAIDI value is 8,3082 hours/ customers/ year, LL-4 feeder have SAIFI value is 2.6574 times/ customers/ year and SAIDI 9.3008 hours/ customers/ year. This value indicates thet these two methods have succeeded in showing a reliability index is in accordance with SPLN due to the addition of LBS motorized.

Abstract Fostering a culture of continuous improvement through regular monitoring of genetic trends in breeding pipelines is essential to improve efficiency and increase accountability. This is the first global study to estimate genetic trends across the International Maize and Wheat Improvement Center (CIMMYT) tropical maize breeding pipelines in eastern and southern Africa (ESA), South Asia, and Latin America over the past decade. Data from a total of 4152 advanced breeding trials and 34,813 entries, conducted at 1331 locations in 28 countries globally, were used for this study. Genetic trends for grain yield reached up to 138 kg ha−1 yr−1 in ESA, 118 kg ha−1 yr−1 South Asia and 143 kg ha−1 yr−1 in Latin America. Genetic trend was, in part, related to the extent of deployment of new breeding tools in each pipeline, strength of an extensive phenotyping network, and funding stability. Over the past decade, CIMMYT’s breeding pipelines have significantly evolved, incorporating new tools/technologies to increase selection accuracy and intensity, while reducing cycle time. The first pipeline, Eastern Africa Product Profile 1a (EA-PP1a), to implement marker-assisted forward-breeding for resistance to key diseases, coupled with rapid-cycle genomic selection for drought, recorded a genetic trend of 2.46% per year highlighting the potential for deploying new tools/technologies to increase genetic gain.