Search

This paper examines the downlink scenario of an unmanned aerial vehicle (UAV)-assisted non-orthogonal-multiple-access (NOMA), where the UAV acts as a decode-and-forward half-duplex (HD) or full-duplex (FD) relay to assist the transmission from a terrestrial base station (TBS) to ground devices. The main objective is to maximize the achievable sum rate for each relaying mode by jointly optimizing the beamforming at TBS and UAV, and the location of the UAV, subject to the power budget constraints at both the TBS and the UAV, the successive interference cancellation (SIC) constraint and the required quality-of-service at all ground devices. In order to tackle the highly-coupled decision variables, an efficient algorithm is designed by considering the alternating optimization approach which divides the original problem into a beamforming design optimization sub-problem and a UAV positioning optimization sub-problem, which are alternatively solved. The two sub-problems were tackled with the aid of the successive convex approximation (SCA). The simulation results demonstrate the accuracy of our solution approach and show the potential gains in the achievable sum rate brought by integrating the FD/HD aerial relay in NOMA networks.

Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure.

IMPORTANCE: Hearing loss may contribute to poor functional status via cognitive impairment and social isolation. Hearing aids may play a protective role by attenuating these downstream outcomes. However, population-based evidence is lacking. OBJECTIVE: To examine the association of hearing loss and hearing aids with functional status. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional (2016-2017) and longitudinal (2016-2022) analysis of data from the Atherosclerosis Risk in Communities cohort study included older, community-dwelling adults with complete data. Data were analyzed from June to December 2023. EXPOSURES: The better-hearing ear’s pure tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled categorically (no [BPTA ≤25 dB], mild [26-40 dB], and moderate or greater hearing loss [>40 dB]). Hearing aid use was self-reported. MAIN OUTCOMES AND MEASURES: Difficulties in activities of daily living (ADLs; eg, dressing and eating), instrumental activities of daily living (IADLS; eg, household chores and meal preparation), and heavier tasks (eg, walking a quarter of a mile) were self-reported at visit 6. The ability to perform usual activities, walk a half mile, walk up and down stairs, and do heavy housework without help were collected in follow-up surveys. Linear and logistic regression models were used that were adjusted for sociodemographic and health covariates. RESULTS: Among 3142 participants (mean [SD] age, 79.3 [4.6] years; 1828 women [58.2%]), 1013 (32.2%) had no hearing loss, 1220 (38.8%) had mild hearing loss, and 909 (29.0%) had moderate or greater hearing loss. Moderate or greater hearing loss was cross-sectionally associated with difficulty in 1 or more ADLs (odds ratio [OR], 1.27; 95% CI, 1.02-1.58), IADLs (OR, 1.34; 95% CI, 1.05-1.71), and heavier tasks (OR, 1.29; 95% CI, 1.04-1.62) compared with no hearing loss. Over time (mean [SD] follow-up, 1.9 [1.8] years), moderate or greater hearing loss was associated with a faster decline in the number of activities participants were able to do (β = −0.07 per year; 95% CI, −0.09 to −0.06) and greater odds of reporting inability to do 1 or more of the 4 activities (OR, 1.14; 95% CI, 1.05-1.24). Hearing aid users and nonusers did not differ. CONCLUSIONS AND RELEVANCE: The results of this study suggest that moderate or greater hearing loss was associated with functional difficulties and may contribute to a faster decline in function longitudinally independent of sociodemographic and health covariates. Hearing aids did not change the association among those with hearing loss.

IMPORTANCE: Patient education materials (PEMs) can promote patient engagement, satisfaction, and treatment adherence. The American Medical Association recommends that PEMs be developed for a sixth-grade or lower reading level. Health literacy (HL) refers to an individual’s ability to seek, understand, and use health information to make appropriate decisions regarding their health. Patients with suboptimal HL may not be able to understand or act on health information and are at risk for adverse health outcomes. OBJECTIVE: To assess the readability of PEMs on head and neck cancer (HNC) and to evaluate HL among patients with HNC. EVIDENCE REVIEW: A systematic review of the literature was performed by searching Cochrane, PubMed, and Scopus for peer-reviewed studies published from 1995 to 2024 using the keywords head and neck cancer, readability, health literacy, and related synonyms. Full-text studies in English that evaluated readability and/or HL measures were included. Readability assessments included the Flesch-Kincaid Grade Level (FKGL grade, 0-20, with higher grades indicating greater reading difficulty) and Flesch Reading Ease (FRE score, 1-100, with higher scores indicating easier readability), among others. Reviews, conference materials, opinion letters, and guidelines were excluded. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies. FINDINGS: Of the 3235 studies identified, 17 studies assessing the readability of 1124 HNC PEMs produced by professional societies, hospitals, and others were included. The mean FKGL grade ranged from 8.8 to 14.8; none of the studies reported a mean FKGL of grade 6 or lower. Eight studies assessed HL and found inadequate HL prevalence ranging from 11.9% to 47.0%. CONCLUSIONS AND RELEVANCE: These findings indicate that more than one-third of patients with HNC demonstrate inadequate HL, yet none of the PEMs assessed were developed for a sixth grade or lower reading level, as recommended by the American Medical Association. This incongruence highlights the need to address the readability of HNC PEMs to improve patient understanding of the disease and to mitigate potential barriers to shared decision-making for patients with HNC. It is crucial to acknowledge the responsibility of health care professionals to produce and promote more effective PEMs to dismantle the potentially preventable literacy barriers.

Severely infected diabetic ulcers of the big toe often necessitate surgical treatment. Depending on the wound stage and presence of osteomyelitis, conservative surgery and amputation are the main surgical treatments. Few articles reported the outcomes and complications of such procedures. This study is a preliminary comparative report on the early outcomes and complications of hallucal diabetic foot infection (DFI) treated with either conservative surgery or amputation.

To investigate the association between sensory loss and the timing and type of self-reported departures from the labor force, via retirement or disability, we used data from the Health and Retirement Study, cycles 2004–2018. Based on self-reported sensory loss, we classified individuals into four groups: no sensory loss, hearing loss only, vision loss only, and dual sensory loss (vision and hearing loss). We assumed that older adults could leave the labor force either by retirement or due to disability. Because once one type of exit is observed the other type cannot be observed, we implemented a competing risk approach to estimate the instantaneous rate of departure (sub-distribution hazard rate) for leaving the labor force due to disability, treating retirement as a competing risk, and for departures via retirement, with disability as the competing risk. We found that compared to older adults with no sensory loss, adults with vision loss are at a higher risk for leaving the labor force via disability (when treating retirement as a competing risk). Compared to no sensory loss, hearing loss was associated with a higher risk for retirement in models treating disability as a competing risk. Given the differences between disability and retirement benefits (before and after retirement age), policies intended to keep people with sensory loss from early labor force departures, such as accommodations in the workplace and/or hearing and vision care coverage, might contribute to better retiring conditions and healthy aging among older adults with sensory loss.

With the demand to reduce the release of CO2$_2$‐rich gases into the atmosphere, the offshore industry is turning to systems for gas capture and storage. The construction of a cave for that purpose is planned in the salt layer of the Santos Basin, Brazil; however, numerous factors bring uncertainties to the project. We propose combining systems engineering methods and digital twin technology to enable system concept and execution aiming at value robustness. The system is modeled in mission, subsystems, components, and design attributes. System utilities and costs are estimated for a range of viable solutions based on the relevance of each attribute to the stakeholders. The alternatives are evaluated using the Epoch‐Era Analysis framework for analyzing the system's performance over time in changing future scenarios. The system model also outlines a digital twin concept and identifies how it might support salt cave design and operations. Finally, the potential of tuning and improving system evaluation based on gathered data is examined, and measures toward further digital twin development are recommended.

In this research, a main matrix has been derived from the stress components in the inclined plane with an angle θ that calculates the normal stresses and shear stress in the inclined plane to be used in calculating the main stresses and the maximum shear stress in one step, this is done using the principal stress angle which is calculated from known stress compounds. As well as calculating the maximum shear stress after using the correction factor. The inverse of this derived matrix can be used to calculate the stress compounds through the known principal stresses and this applies to the components of the principal strain and strain, and the maximum shear strain. All this is done through MATLAB simulation Keywords: Normal Stresses and Strains, Shear, Principal Stresses, max. Shear Stress

The Crohn's disease exclusion diet (CDED) + partial enteral nutrition (PEN) is an emerging diet used to induce clinical remission in children with active Crohn's disease (CD). This study aims to determine the effectiveness of using the CDED+PEN to induce clinical remission in an Australian group of children with active CD using different PEN formulas and incorporating patient dietary requirements. We retrospectively collected data from children (both newly diagnosed and with existing CD while on therapy) with active CD (Paediatric Crohn's Disease Activity Index [PCDAI] ≥10) and biochemical evidence of active disease (elevated C‐reactive protein [CRP], erythrocyte sedimentation rate [ESR] or faecal calprotectin [FC]) who completed at least phase 1 (6 weeks) of the CDED+PEN to induce clinical remission. Data were collected at baseline, Week 6 and Week 12. The primary endpoint was clinical remission at Week 6 defined as PCDAI < 10. Twenty‐four children were included in phase 1 analysis (mean age 13.8 ± 3.2 years). Clinical remission at Week 6 was achieved in 17/24 (70.8%) patients. Mean PCDAI, CRP, ESR and FC decreased significantly after 6 weeks (p< 0.05). Formula type (cow's milk based, rice based, soy based) did not affect treatment efficacy. A greater than 50% decrease in FC was achieved in 14/21 (66.7%) patients who completed phase 1 and 12/14 (85.7%) patients who completed phase 2 of the CDED+PEN. Formula modifications to the CDED+PEN do not impact the expected treatment efficacy in Australian children with active luminal CD. The Crohn's Disease exclusion diet (CDED) effectively induces clinical remission in Canadian and European children with Crohn's disease (CD) when following a strict published protocol involving dairy and animal products.Patients prefer solid food‐based diet therapies over exclusive enteral nutrition. The Crohn's Disease exclusion diet (CDED) effectively induces clinical remission in Canadian and European children with Crohn's disease (CD) when following a strict published protocol involving dairy and animal products. Patients prefer solid food‐based diet therapies over exclusive enteral nutrition. Modified CDED versions, omitting dairy and animal products while incorporating soy milk and rice milk, can effectively induce clinical remission in children with active luminal CD.Despite utilizing different food and formula products from the original protocol, the CDED successfully induces clinical remission in Australian children with active luminal CD. Modified CDED versions, omitting dairy and animal products while incorporating soy milk and rice milk, can effectively induce clinical remission in children with active luminal CD. Despite utilizing different food and formula products from the original protocol, the CDED successfully induces clinical remission in Australian children with active luminal CD.

Extracellular senile plaques and intraneuronal neurofibrillary tangles are two devastating brain proteinopathies that are indicative of Alzheimerʼs disease, the most prevalent type of dementia. Currently, no effective medications are available to stop or reverse Alzheimerʼs disease. Ginkgo biloba extract, commonly referred to as EGb 761, is a natural product made from the leaves of the G. biloba tree. It has long been demonstrated to have therapeutic benefits in Alzheimerʼs disease. The current study assessed the beneficial effects of EGb 761 against Alzheimerʼs disease in comparison with memantine, a standard treatment for Alzheimerʼs disease. The scopolamine-heavy metals mixture rat Alzheimerʼs disease model is a newly created model to study the effects of EGb 761 oral therapy on cognitive performance and other Alzheimerʼs disease-like changes over a 28-day experimental period. This new Alzheimerʼs disease model provides better criteria for Alzheimerʼs disease hallmarks than the conventional scopolamine model. The EGb 761 reversed memory and learning deficits induced by the scopolamine-heavy metals mixture. These outcomes were linked to a more pronounced inhibitory effect on acetylcholinesterase, caspase-3, hippocampal amyloid-beta protein (A β 1 – 42), phosphorylated tau protein counts, and proinflammatory cytokines (tumor necrosis factor- α and interleukin-1 β) compared to the memantine-treated group. Furthermore, EGb 761 treatment considerably reduced lipid peroxidation (malondialdehyde) and improved reduced glutathione levels compared to memantine. Our results suggest EGb 761′s potential in treating central nervous system disorders. Itʼs a promising candidate for future Alzheimerʼs disease therapeutic exploration. This study also highlights the need for future research to focus on the positive benefits of herbal medicines. [ABSTRACT FROM AUTHOR]

ABSTRACT:Background:Guidelines on epilepsy monitoring unit (EMU) standards have been recently published. We aimed to survey Canadian EMUs to describe the landscape of safety practices and compare these to the recommendations from the new guidelines.Methods:A 34-item survey was created by compiling questions on EMU structure, patient monitoring, equipment, personnel, standardized protocol use, and use of injury prevention tools. The questionnaire was distributed online to 24 Canadian hospital centers performing video-EEG monitoring (VEM) in EMUs. Responses were tabulated and descriptively summarized.Results:In total, 26 EMUs responded (100% response rate), 50% of which were adult EMUs. EMUs were on average active for 23.4 years and had on average 3.6 beds. About 81% of respondents reported having a dedicated area for VEM, and 65% reported having designated EMU beds. Although a video monitoring station was available in 96% of EMUs, only 48% of EMUs provided continuous observation of patients (video and/or physical). A total of 65% of EMUs employed continuous heart monitoring. The technologist-to-patient ratio was 1:1–2 in 52% of EMUs during the day. No technologist supervision was most often reported in the evening and at night. Nurse-to-EMU-patient ratio was mostly 1:1–4 independent of the time of day. Consent forms were required before admission in 27% of EMUs.Conclusion:Canadian EMUs performed decently in terms of there being dedicated space for VEM, continuous heart monitoring, and adequate nurse-to-patient ratios. Other practices were quite variable, and adjustments should be made on a case-by-case basis to adhere to the latest guidelines.

Purpose: To investigate kinematic adaptations from self-selected to fast speed walking in ASD patients. Methods: 115 primary ASD and 66 controls underwent biplanar radiographic X-rays and 3D gait analysis to calculate trunk, segmental spine and lower limb kinematics during self-selected and fast speed walking. Kinematic adaptation was calculated as the difference (Δ) between fast and self-selected speed walking. ASD with 7 or more limited kinematic adaptation parameters were classified as ASD-limited-KA, while those with less than 7 limited kinematic adaptation parameters were classified as ASD-mild-KA. Results: 25 patients were classified as ASD-limited-KA and 90 as ASD-mild-KA. ASD-limited-KA patients walked with a lesser increase of pelvic rotation (Δ = 1.7 vs 5.5°), sagittal hip movement (Δ = 3.1 vs 7.4°) and shoulder–pelvis axial rotation (Δ = 3.4 vs 6.4°) compared to controls (all p&lt; 0.05). ASD-limited-KA had an increased SVA (60.6 vs − 5.7 mm), PT (23.7 vs 11.9°), PI–LL (9.7 vs − 11.7°), knee flexion (9.2 vs − 0.4°) and a decreased LL (44.0 vs 61.4°) compared to controls (all p&lt; 0.05). Kinematic and radiographic alterations were less pronounced in ASD-mild-KA. The limited increase of walking speed was correlated to the deteriorated physical component summary score of SF-36 (r= 0.37). Discussion: Kinematic limitations during adaptation from self-selected to fast speed walking highlight an alteration of a daily life activity in ASD patients. ASD with limited kinematic adaptations showed more severe sagittal malalignment with an increased SVA, PT, PI–LL, and knee flexion, a decreased LL and the most deteriorated quality of life. This highlights the importance of 3D movement analysis in the evaluation of ASD.

For high-risk patients with aortic arch pathology, hybrid aortic arch repair with simultaneous or staged thoracic endovascular repair of the descending aorta may be a viable alternative to open repair. However, data on postintervention aortic remodeling remain limited. We report the short-term outcomes of remodeling of the thoracoabdominal aorta after hybrid arch repair + thoracic endovascular repair.

ABSTRACTThis study investigates the initial and final setting times of fly ash-based geopolymer concrete using an activating solution that was a mixture of silica fume, sodium hydroxide, and water. The [...]

Purpose: The relationship between rod curvature and postoperative radiographic results is a debated topic. One of the reasons of the heterogeneity of the observed results might reside in the lack of a validated and widely employed method to measure the curvature of the rods. Aim of this study was to present and validate a novel method for rod measurement, which is based on routine X-rays and utilizes a regression algorithm that limits manual measurements and the related errors. Methods: Data from 20 adolescent idiopathic scoliosis/Scheuermann kyphosis (AIS/SK) patients and 35 adult spine deformity (ASD) patients for analysis, with 112 rods in total. An orthogonal reference grid was overlaid on the lateral X-ray; seven points were then marked along each rod and their coordinates recorded in a table. Using these coordinates, a third-order polynomial regression was applied to obtain the rod curvature equation (correlation coefficients > 0.97). Three observers (one surgeon, one experienced and one inexperienced observer) independently applied the developed method to measure the rod angulation of the included patients and performed the measurements twice. The reliability of the method was evaluated in terms of intraclass correlation coefficient (ICC), Bland–Altmann plot and 2SR. Results: The intra-observer ICCs for all measurements exceed 0.85, indicating an excellent correlation. For the AIS/SK group, the surgeon showed a slightly lower reliability compared to the other two evaluators (0.93 vs 0.98 and 0.98). However, the surgeon showed a higher reliability in measurements of the rods at the lumbar level, both for L1-S1 and L4-S1 (0.98 vs 0.96 and 0.89; 0.97 vs. 0.85 and 0.91, respectively). The variability also showed excellent results, with a mean variability ranging from 1.09° to 3.76°. The inter-observer ICCs for the three measurement groups showed an excellent reliability for the AIS/SK group (0.98). The reliability was slightly lower but still excellent for the lumbar measurements in ASD patients at L1-S1 (0.89) and L4-S1 (0.83). The results of the 2SRfor each measured segment were 4.4° for T5-T11, 5.4° for L1-S1 and 5.5° for L4-S1. Conclusion: The described method represents a reliable and reproducible way to measure rod curvature. This method is based on routine X-rays and utilizes a regression algorithm that limits manual measurements and the related errors.

This work presents an investigation and assessment framework, which, supported by realistic data, aims at provisioning operators with in-depth insights into the consumer-perceived Quality-of-Experience (QoE) at public Electric Vehicle (EV) charging infrastructures. Motivated by the unprecedented EV market growth, it is suspected that the existing charging infrastructure will soon be no longer capable of sustaining the rapidly growing charging demands; let alone that the currently adopted ad hoc infrastructure expansion strategies seem to be far from contributing any quality service sustainability solutions that tangibly reduce (ultimately mitigate) the severity of this problem. Without suitable QoE metrics, operators, today, face remarkable difficulty in assessing the performance of EV Charging Stations (EVCSs) in this regard. This paper aims at filling this gap through the formulation of novel and original critical QoE performance metrics that provide operators with visibility into the per-EVCS operational dynamics and allow for the optimization of these stations’ respective utilization. Such metrics shall then be used as inputs to a Machine Learning model finely tailored and trained using recent real-world data sets for the purpose of forecasting future long-term EVCS loads. This will, in turn, allow for making informed optimal EV charging infrastructure expansions that will be capable of reliably coping with the rising EV charging demands and maintaining acceptable QoE levels. The model’s accuracy has been tested and extensive simulations are conducted to evaluate the achieved performance in terms of the above-listed metrics and show the suitability of the recommended infrastructure expansions.

Millimeter wave (mmWave) full-duplex (FD) is a promising technique for improving capacity by maximizing the utilization of both time and the rich mmWave frequency resources. Still, it has restrictions due to FD self-interference (SI) and mmWave’s limited coverage. Therefore, this study dives into FD mmWave MIMO with the assistance of reconfigurable intelligent surfaces (RIS) for capacity improvement. First, we demonstrate the angular-domain reciprocity of FD antenna arrays under the far-field planar wavefront assumption. Accordingly, a strategy for joint downlink-uplink (DL-UL) channel estimation is presented. For estimating the SI channel, the direct channel, and the cascaded channel, the Khatri-Rao product-based compressive sensing (KR-CS), distributed CS (D-CS), and two-stage multiple measurement vector-based D-CS (M-D-CS) frameworks are proposed, respectively. Additionally, we propose a passive beamforming optimization solution based on the angular-domain cascaded channel. With hybrid beamforming architectures, a novel hybrid weighted minimum mean squared error method for SI cancellation (H-WMMSE-SIC) is proposed. Simulations have revealed that joint DL-UL processing significantly improves estimation performance in comparison to separate DL/UL channel estimation. Particularly, when the interference-to-noise ratio is less than 35 dB, our proposed H-WMMSE-SIC offers spectral efficiency performance comparable to fully-digital WMMSE-SIC. Finally, the computational complexity is analyzed for our proposed methods.

We consider a two-user uplink cooperative rate-splitting multiple access (C-RSMA) and seek to maximize the minimum signal-to-interference-plus-noise ratio (SINR) by jointly optimizing the beamforming at the base station (BS) and device transmit power. Due to the high coupling among the variables, the problem is non-convex and difficult to solve directly. To handle this challenge, we utilize successive convex approximation (SCA) and difference of convex (DC) based approach to approximate the non-convex problem to a convex one. The simulation results demonstrate that our proposed scheme can outperform cooperative non-orthogonal multiple access (C-NOMA) and other baseline schemes.

La fibrilación auricular (FA) está interconectada con la insuficiencia cardiaca (IC). Sin embargo, los factores que pueden precipitar la aparición de IC en los pacientes con FA están escasamente descritos. Con este estudio, se pretende determinar la incidencia, los predictores y el pronóstico de la IC de nueva aparición en una población de pacientes ancianos con FA sin antecedentes de IC.

This paper investigates the potential use of the International Roughness Index (IRI) in generating optimal rehabilitation plans at the network-level. The IRI data used in the study was obtained using the portable vehicle-mounted IRIMETER-2 profilometer, which is a product of Englo LLC, Tallinn, Estonia. An optimum rehabilitation model is proposed to minimize the average IRI value at the network-level subject to variable and budget constraints. The model mainly focuses on using major rehabilitation strategies that can produce a major improvement in pavement condition. An alternate maximization model that can use other pavement condition indicators, such as the present serviceability index (PSI) and pavement condition index (PCI), is also presented. The PSI and PCI can be estimated from the IRI using correlation models. The proposed optimum models are linear in form and can easily be solved using the proposed cost-effectiveness ratio. The sample results presented for a 27.1-km suburban highway indicate the reliability of using the IRI data to generate optimal rehabilitation plans. A statistical uncertainty analysis of IRI measurements produced a mild impact on optimal solutions derived using ten independent IRI tests and 99% confidence level. The uncertainty analysis has also indicated that the use of a single IRI test provides results that are statistically indifferent from those obtained using ten IRI tests.

This paper investigates the channel aging problem of mobile light-fidelity (LiFi) systems. In the LiFi physical layer, the majority of the optimization problems for mobile users are non-convex and require the use of dual decomposition or heuristics techniques. Such techniques are based on iterative algorithms, and often cause a high processing delay at the physical layer. Hence, the obtained solutions are rendered sub-optimal since the LiFi channels are evolving. In this paper, a proactive-optimization (PO) approach that can alleviate the LiFi channel aging problem is proposed. The core idea is to design a long-short-term-memory (LSTM) network that is capable of predicting posterior positions and orientations of mobile users, which can be then used to predict their channel coefficients. Consequently, the obtained channel coefficients can be exploited to derive near-optimal transmission-schemes prior to the intended service-time, which enables real-time service. Through various simulations, the performance of the designed LSTM model is evaluated in terms of prediction error and inference complexity, as well as its application in a practical LiFi optimization problem.

Due to the low inertia of inverter-based islanded microgrids (IMGs), these systems require a delicate and accurate load frequency control (LFC) scheme. The deployment of such a control scheme, which preserves the balance between the load and generation, needs a cyber layer on top of the physical system that makes IMGs an appealing target for a variety of cyber-physical attacks (CPAs). Among these CPAs, there is a family of malicious CPAs whose aim is to compromise the LFC scheme by changing the topology of IMG and its parameters. On this basis, an online system identification method is developed to estimate the parameters of IMG using the recursive least square forgetting factor (RLS-FF) approach. Then, based on the estimated parameters, an anomaly-based intrusion detection system (IDS) is developed to identify CPAs and distinguish them from the uncertainties in the normal operation of IMG. Following anomaly detection, a mitigation scheme is proposed to regulate the IMG’s frequency using an adaptive interval type-2 fuzzy logic controller (IT2FLC). The proposed IT2FLC uses different types of distributed energy resources (DERs)—i.e., tidal power plants and solar panels which are, respectively, equipped with inertia emulation and droop-based controllers—to improve the frequency excursion resulting from CPAs. The simulation results verify the performance of the developed detection and mitigation schemes, particularly when the RLS-FF parameters, i.e., forgetting factor, covariance matrix, and reset parameter, are obtained through the grey wolf optimization (GWO) algorithm. Furthermore, the designed mitigation scheme is corroborated by comparing its performance with several well-known attack-resilient control frameworks in LFC studies, e.g., linear quadratic regulator (LQR) and $H_{\infty }$ , using real-time simulations.

Introduction: The anterior ethmoidal artery (AEA) flap has been demonstrated to be a reliable option for endoscopic repair of symptomatic nasal septal perforations. The purpose of this study is to study the outcome of this technique.Methods: A retrospective case series of all consecutive patients who underwent repair of nasal septal perforation utilizing the AEA flap among 2 institutions from August 2020 to July of 2022 was conducted. Demographics and comorbidities were collected preoperatively and postoperatively. The main outcome of this study was to identify the risk factors for surgical failure.Results: Forty-one patients were included. Mean perforation size was 2.2 cm (range 0.5-4.5 cm). Mean age was 42.5 years (range 14-65 years), 53.6% were female, 39% were active smokers, mean body-mass-index (BMI) was 31.9 (range 19.1-45.5), 20% with history of CRS and 31.7% had diabetes mellitus (DM). Etiologies of the perforation included idiopathic (n = 12), iatrogenic (n = 13), intranasal drug use (n = 7), trauma (n = 6), and secondary to tumor resection (n = 3). Overall success rate for complete closure was 73.2%. Active smoking, history of intranasal drug use, and DM were significantly associated with surgical failure (72.7%vs 26.7%, P= .007; 36.4%vs 10%, P= .047; and 63.6%vs 20%, P= .008 respectively).Conclusion: The endoscopic AEA flap is a reliable technique for closure of nasal septal perforation. It may not work when the etiology is intranasal drug use. Close attention to diabetes and smoking status is also needed.

High-frequency magnetic field sensing is a vital feature of several biomedical and industrial applications. Typically, highly sensitive magnetic materials are used for such applications, yet such materials are expensive and their development is bespoke. Recently, there has been an increased interest in reshaping magnetic fields to enhance the high performance of sensing devices. In this article, we present and evaluate the design of a Lenz lens (LL)-based miniaturized magnetic field sensor onto a single substrate. We envision that our device can be used for magnetic field-based sensing applications. Through simulations, we show that the introduction of LL confines and enhances the magnetic field in the region of the sensor. Our design is validated using laboratory measurements that show a 40-fold improvement in the detected signal at 28.6 MHz when an LL is placed around the sensor. We also note that the enhancement leads to a 15-dB increase in the signal-to-noise ratio (SNR) of the detected signal. We fabricated the design using etching techniques that are both well-known and low-cost, therefore, showing potential for mass-scale production. We demonstrate that it is not only possible to create a device that enhances magnetic field sensitivity but also to do so in a manner that makes it easy to integrate with existing technologies. The latter feature allows it to become immediately useful for a variety of nuclear magnetic resonance (NMR) applications.

ABSTRACT Geopolymer concrete has demonstrated promising mechanical and microstructural properties in comparison with conventional concrete; however, the variability found in fly ash sources and properties may be an obstacle to [...]

ABSTRACT Acoustic emission (AE) monitoring during compressive loading was employed to investigate micro-crack formation and coalescence in cement paste specimens. To establish a correlation between damage and AE activity, the [...]

ABSTRACTObjectivesThis study described the epidemiological, clinical, and survival profiles of patients with gastrointestinal stromal tumor (GIST) in North Africa and the Middle East (AfME).MethodsThis regional, multicenter, observational, retrospective study collected 11-year data on demographics, medical history, disease characteristics, current treatment approaches of GIST, the safety of the most common tyrosine kinase inhibitors (TKIs), second cancers, and survival status.ResultsData of 201 eligible patients were analyzed: mean age was 56.9 ± 12.6 years; 111 (55.2%) patients were men, 21 (10.4%) patients had previous personal malignancy. The most common clinical presentation of GIST was dysphagia [92 (45.8%) patients]. The stomach was the most common primary site in 120 (60.7%) patients, 171 (85.1%) patients had localized disease at diagnosis. 198 (98.5%) GIST cases were CD117/CD34-positive. Imatinib was used in the neoadjuvant (18/21 patients), adjuvant (85/89 patients), and first-line metastatic treatment (28/33 patients) settings. The most common non-hematological toxicity associated with TKIs was vomiting in 32/85 (37.6%) patients. Overall, 100 (49.8%) patients (95%CI: 42.8–56.7%) were alive and disease-free while 30 (14.9%) patients were alive with active disease.ConclusionPresentation of GIST in our AfME population is consistent with global reports, being more frequent in patients >50 years old and having the stomach as the most common primary site. Unlike what is usually reported, though, we did have more patients with lymphatic spread of the disease. Despite the global trend and advances in the treatment of GIST according to molecular profile, this is still far to happen in our population given the lack of access to molecular profiles and the high associated cost.

In this work, the preparation and processing of aluminum-copper alloys, which added amounts of copper to aluminum in different parentages (2, 4, 5%) so that it does not exceed the saturation limit for aluminum (6% Copper). After adding these specific amounts of copper to aluminum, have been melting each alloy to thaw copper in aluminum fully and diffusion copper atoms in it, and after that the specimens were prepared and quenched at 8-30 hours and rapid cooling in the water, and then were studied parameters of heat treatment and different percentages of copper. It is clear from the schemes and experimental results that each weight ratio of copper in aluminum has a different approach to reach the best mechanical properties. After performing mechanical tests and tests, it was found that the highest hardness of the (aluminum-copper) alloy in the case of (2% Cu) amounted to (120 HB) and in the case of (4% Cu) the amount (211 HB) and in the case of (5% Cu) the amount (188 HB).

Copper-Nickel-Tin alloys have been recently developed by Hardening due to spinodal decomposition. The (Cu - 9Ni - 6Sn) system has shown promise in this direction and has been used to develop several high strength compositions. It is well known the fact that small element additions significantly modify phase transformation characteristics, the effect of adding Silicon or Silver on the Spinodal hardening in (Cu - 9Ni - 6Sn) alloy was studies close to the Spinodal cusp temperature. The presence of Silver also increased the ductility of alloy at the expense of some hardness. The effects of trace elements additions have been observed in this work with a view to improve high strength alloys as substitutes to the Copper – Beryllium alloys. The results obtained from the current research proved that adding a small amount of alloying elements with a percentage (1%) of silicon or silver to the base alloy (Cu - 9% Ni - 6% Sn), led to the stability of the mechanical properties resulting from the stability of the microstructure due to Heat treatment for hardening (Spinodal decomposition).

Background/AimsEmotional intelligence may help nurse managers to deal with conflicts. However, the relationship between emotional intelligence and conflict resolution is still not clearly understood. This study aimed to explore nurse managers' emotional intelligence levels and conflict resolution styles, and to identify any associations between these factors.MethodsA cross-sectional study design was used, with a convenience sample of 197 nurse managers recruited from five public and two university hospitals. Data were collected on emotional intelligence and conflict resolution using two specialised self-reported scale-based questionnaires. The Statistical Package for Social Sciences (version 25) was used to analyse data, with P<0.05 indicating statistical significance.ResultsThe nurse mangers' average emotional intelligence scores ranged from 80–139 and 40% had low levels of work-related emotional intelligence. The integrating style was the most commonly used approach to conflict resolution, while the avoiding style was the least used. Higher levels of emotional intelligence were significantly associated with integrating, obliging and compromising styles, and were able to predict the use of integrating and compromising styles of conflict resolution.ConclusionsNurse managers with higher levels of emotional intelligence are more likely to use the integrating and compromising styles of conflict resolution. Training programmes aiming to improve managers' conflict resolution skills should focus on assessing and increasing emotional intelligence.

El impacto del cáncer en los eventos de los pacientes con fibrilación auricular (FA) no está claro. El objetivo de este estudio es evaluar cómo el cáncer influye en el riesgo de eventos embólicos y hemorrágicos de los pacientes con FA.

Background:Migraine surgery at 1 of 6 identified “trigger sites” of a target cranial sensory nerve has rapidly grown in popularity since 2000. This study summarizes the effect of migraine surgery on headache severity, headache frequency, and the migraine headache index score which is derived by multiplying migraine severity, frequency, and duration. Materials and Methods:This is a PRISMA-compliant systematic review of 5 databases searched from inception through May 2020 and is registered under the PROSPERO ID: CRD42020197085. Clinical trials treating headaches with surgery were included. Risk of bias was assessed in randomized controlled trials. Meta-analyses were performed on outcomes using a random effects model to determine the pooled mean change from baseline and when possible, to compare treatment to control. Results:18 studies met criteria including 6 randomized controlled trials, 1 controlled clinical trial, and 11 uncontrolled clinical trials treated 1143 patients with pathologies including migraine, occipital migraine, frontal migraine, occipital nerve triggered headache, frontal headache, occipital neuralgia, and cervicogenic headache. Migraine surgery reduced headache frequency at 1 year postoperative by 13.0 days per month as compared to baseline (I2= 0%), reduced headache severity at 8 weeks to 5 years postoperative by 4.16 points on a 0 to 10 scale as compared to baseline (I2= 53%), and reduced migraine headache index at 1 to 5 years postoperative by 83.1 points as compared to baseline (I2= 2%). These meta-analyses are limited by a small number of studies that could be analyzed, including studies with high risk of bias. Conclusion:Migraine surgery provided a clinically and statistically significant reduction in headache frequency, severity, and migraine headache index scores. Additional studies, including randomized controlled trials with low risk-of-bias should be performed to improve the precision of the outcome improvements.

Providing adequate skid resistance is essential for road safety. Many transportation agencies measure the skid number using a locked-wheel skid trailer at a reference speed (e.g., 40 mph). The skid number is often measured at lower speeds due to restrictions such as speed limit and road geometry. In addition, some interstate highways have a speed limit up to 80 mph and the skid measurements are collected at lower speeds (e.g., 40 mph) which could impose hazard to motorists. This study developed a statistical model to predict the skid number at a reference speed based on measurements of skid number at any operation speed between 20 and 60 mph. The predicted skid number is a function of the mean profile depth of pavement surface and skid number measured at any operation speed. The results demonstrated a strong correlation between predicted and measured skid numbers. This model can utilize the skid number measured at safe speeds, when field operations do not allow data collection at a reference speed to predict the skid number at a reference speed. In addition, skid resistance can be measured at higher speeds (e.g., 60 mph) and converted to a skid number at a reference speed which could improve the safety of operators and motorists.

Le rachitisme hypoposphatémique lié à l’X (XLH) se traduit principalement par des déformations des membres inférieurs pouvant évoluer au cours de la croissance. Notre hypothèse est que la quantification de paramètres osseux permet la mise en évidence et le suivi des déformations chez l’enfant avec XLH.

ABSTRACT Sustainable concrete has reduced C[O.sub.2] emissions, is durable, and is expected to have less detrimental effect on future generations, due to the fact that it utilizes waste materials. However, [...]