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The emergency department plays an important role in the diagnosis of cancer for many patients. Several large studies have identified several routes to cancer diagnosis, with the emergency department representing [...], Background: Although suspicions of cancer may be raised in patients who visit the emergency department, little is known about emergency department use before a cancer diagnosis. We sought to describe emergency department use among patients in Ontario within the 90 days before confirmed cancer diagnosis and to evaluate factors associated with this emergency department use. Methods: We conducted a retrospective, population-based study of patients aged 18 years or older who had a confirmed cancer diagnosis in Ontario from 2014 to 2021 using linked administrative databases. The primary outcome was any emergency department visit within 90 days before the cancer diagnosis date. We used multivariable logistic regression to evaluate factors associated with emergency department use, such as demographics (e.g., age, sex, rurality, Ontario Health region, indicators of marginalization), comorbidities, previous emergency department visits and hospital admissions, continuity of primary care, type of cancer, and year of cancer diagnosis. Results: We included 651 071 patients with cancer. Of these, 229 683 (35.3%) had an emergency department visit within 90 days before diagnosis, 51.4% of whom were admitted to hospital from the emergency department. Factors associated with increased odds of emergency department use before cancer diagnosis included rurality (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.13-1.17), residence in northern Ontario (North East region OR 1.14, 95% CI 1.10-1.17 and North West region OR 1.27, 95% CI 1.21-1.32, v. Toronto region), and living in the most marginalized areas (material resources OR 1.37, 95% CI 1.35-1.40 and housing OR 1.09, 95% CI 1.06-1.11, v. least marginalized quintile). We observed significant variation in emergency department use by cancer type, with high odds of emergency department use among patients with intracranial, pancreatic, liver or gallbladder, or thoracic cancer. Interpretation: Emergency department use is common before cancer diagnosis, with about one-third of patients with cancer in Ontario using the emergency department before diagnosis. Understanding why patients visit the emergency department before cancer diagnosis is important, particularly for patients who live in rural or marginalized areas, or those who have specific cancer types.

Adult survivors of childhood cancer are at elevated risk of late morbidity and premature mortality ('late effects'), resulting from their treatment. (1) As many as 80% of childhood cancer survivors [...], Background: Adult survivors of childhood cancer are at elevated risk of morbidity and mortality compared to the general population, but their adherence to lifelong periodic surveillance is suboptimal. We aimed to examine adherence to surveillance guidelines for high-yield tests and identify risk factors for nonadherence in adult survivors of childhood cancer. Methods: In this retrospective, population-based cohort study, we used health care administrative data from Ontario, Canada, to identify adult survivors of childhood cancer diagnosed between 1986 and 2014 who were at elevated risk of therapy-related colorectal cancer, breast cancer, or cardiomyopathy. Using a Poisson regression framework, we assessed longitudinal adherence and predictors of adherence to the Children's Oncology Group surveillance guideline. Results: Among 3241 survivors, 327 (10%), 234 (7%), and 3205 (99%) were at elevated risk for colorectal cancer, breast cancer, and cardiomyopathy, respectively. Within these cohorts, only 13%, 6%, and 53% were adherent to recommended surveillance as of February 2020. During a median follow-up of 7.8 years, the proportion of time spent adherent was 14% among survivors at elevated risk for colorectal cancer, 10% for breast cancer, and 43% for cardiomyopathy. Significant predictors of adherence varied across the risk groups, but higher comorbidity was associated with adherence to recommended surveillance. Interpretation: Survivors of childhood cancer in Ontario are rarely up to date for recommended surveillance tests. Tailored interventions beyond specialized clinics are needed to improve surveillance adherence.

Virtual reality (VR) can potentially enhance student engagement and memory retention in the classroom. However, distraction among participants in a VR-based classroom is a significant concern. Several factors, including mind wandering, external noise, stress, etc., can cause students to become internally and/or externally distracted while learning. To detect distractions, single or multi-modal features can be used. A single modality is found to be insufficient to detect both internal and external distractions, mainly because of individual variability. In this work, we investigated multi-modal features: eye tracking and EEG data, to classify the internal and external distractions in an educational VR environment. We set up our educational VR environment and equipped it for multi-modal data collection. We implemented different machine learning (ML) methods, including k-nearest-neighbors (kNN), Random Forest (RF), one-dimensional convolutional neural network - long short-term memory (1 D-CNN-LSTM), and two-dimensional convolutional neural networks (2D-CNN) to classify participants' internal and external distraction states using the multi-modal features. We performed cross-subject, cross-session, and gender-based grouping tests to evaluate our models. We found that the RF classifier achieves the highest accuracy over 83% in the cross-subject test, around 68% to 78% in the cross-session test, and around 90% in the gender-based grouping test compared to other models. SHAP analysis of the extracted features illustrated greater contributions from the occipital and prefrontal regions of the brain, as well as gaze angle, gaze origin, and head rotation features from the eye tracking data.

Oral anticoagulants (OACs) are used to prevent and treat arterial and venous thrombosis. Bleeding associated with OACs is the most common adverse drug event that leads to visits to the [...], BACKGROUND: Data on resuming oral anticoagulants (OACs) after bleeding are primarily from studies involving patients given warfarin, with few data on direct OACs (DOACs). We aimed to characterize prescribing patterns for OACs after OAC-related bleeding and compare the rates of bleeding, thrombosis and mortality in patients who resumed either type of OAC with those who did not. METHODS: We conducted a population-based cohort study of adults aged 66 years or older who were admitted to hospital for bleeding while receiving OACs from Apr. 1, 2012, to Mar. 31, 2017, using linked administrative health databases from Ontario. We used competing risk methods to calculate cause-specific adjusted hazard ratios (HRs) for thrombosis, bleeding and mortality with resumption of OACs adjusted as a time-varying covariate. We determined time to OAC resumption using the Kaplan-Meier method. RESULTS: We included 6793 patients with gastrointestinal (n = 4297, 63.3%), intracranial (n = 805, 11.9%) or other bleeding (n = 1691, 25.0%). At cohort entry, 3874 patients (57.0%) were prescribed warfarin and 2919 patients (43.0%) were prescribed a DOAC. The most common indication for OAC was atrial fibrillation (n = 5557, 81.8%), followed by venous thromboembolism (n = 1367, 20.1%). Oral anticoagulants were resumed in 4792 patients (70.5%) within 365 days of the index bleed. The median time to resumption was 46 (interquartile range 6-550) days. We found that resuming OAC was associated with reduced rates of thrombosis (adjusted HR 0.60, 95% confidence interval [CI] 0.50-0.72) and mortality (adjusted HR 0.54, 95% CI 0.48-0.60), and an increased rate of rebleeding (adjusted HR 1.88, 95% CI 1.64-2.17). INTERPRETATION: We found that resuming OAC is associated with a reduction in thrombosis and mortality but an increase in bleeding. Randomized controlled trials that evaluate the net benefit of strategies for resumption of OAC after a bleeding event are warranted.

In a clusters based infinite/super population (SP) setup, the inference complexity for regression parameters depend on the cluster correlations structure oriented marginal fixed or mixed effects based mean models, where as opposed to the fixed effects based models the mixed models exhibit both regression and cluster variance/correlation parameters in the mean structure especially for discrete such as clustered counts and binary data. On the other hand, as recently discussed by Sutradhar (2022, Sankhya B,84, 259-302), in the fixed models setup the modelling of cluster correlations can be complex. In the finite population (FP) setup where FP data follow a SP model but the regression effects estimation is done using a two-stage cluster sample, the inferences become much more complex. As opposed to the recent mixed models based FP inferences (Sutradhar 2023b, Annals of the Institute of Statistical Mathematics,75, 425-462), there does not appear any studies for fixed models based analysis for exponential family data where true correlation structures play important role in defining FP regression parameters. To resolve this inference issue, in this paper we make following specific contributions. First, the cluster correlations for linear, counts and binary data are developed in a SP setup such that the marginal mean models depend only on the fixed regression effects. Second the FP data which are hypothetical or unobserved until a sample is taken to observe a part, are utilized to develop hypothetical estimating equations for the SP regression parameters, which subsequently define the FP regression and correlation parameters. Third, the design weighted unbiased estimators are obtained for the FP regression and correlation parameters, where the specific formulas for correlation estimators depend on the nature of the response data whether linear, counts or binary. Also, as an additional application of the regression effects estimation, the FP total prediction is discussed. Next, the design consistency of the regression estimators is developed in details.

Convolutional neural networks (CNNs) have achieved significant success in various applications. Numerous hardware accelerators are introduced to accelerate CNN execution with improved energy efficiency compared to traditional software implementations. Despite the achieved success, deploying traditional hardware accelerators for bulky CNNs on current and emerging smart devices is impeded by limited resources, including memory, power, area, and computational capabilities. Recent works introduced processing-in-memory (PIM), a non-Von-Neumann architecture, which is a promising approach to tackle the problem of data movement between logic and memory blocks. However, as observed from the literature, the existing PIM architectures cannot congregate all the computational operations due to limited programmability and flexibility. Furthermore, the capabilities of the PIM are challenged by the limited available on-chip memory. To enable faster computations and address the limited on-chip memory constraints, this work introduces a novel reconfigurable approximate computing (AC)-based PIM, termed reconfigurable approximate PIM (ReApprox-PIM). The proposed ReApprox-PIM is capable of addressing the two challenges mentioned above in the following manner: 1) it utilizes a programmable lookup-table (LUT)-based processing architecture that can support different AC techniques via programmability and 2) followed by resource-efficient, fast CNN computing via the implementation of highly optimized AC techniques. This results in improved computing footprint, operational parallelism, and reduced computational latency and power consumption compared to prior PIMs relying on exact computations for CNN inference acceleration at a minimal sacrifice of accuracy. We have evaluated the proposed ReApprox-PIM on various CNN architectures, for inference applications, including standard LeNet, AlexNet, ResNet-18, −34, and −50. Our experimental results show that the ReApprox-PIM achieves a speedup of $1.63\times $ with $1.66\times $ lower area for the processing components compared to the existing PIM architectures. Furthermore, the proposed ReApprox-PIM achieves $2.5\times $ higher energy efficiency and $1.3\times $ higher throughput compared to the state-of-the-art LUT-based PIM architectures.

Cancer is one of the leading causes of mortality worldwide, and patients with cancer frequently use the emergency department. (1-5) Previous studies have shown the importance of continuity of medical [...], BACKGROUND: Patients with cancer have complex care requirements and frequently use the emergency department. The purpose of this study was to determine whether continuity of care, cancer expertise of an institution or both affect outcomes in patients with cancer in the emergency setting. METHODS: We conducted a retrospective cohort study using administrative databases from Ontario, Canada, involving records of patients aged 20 years and older who received chemotherapy or radiation in the 30 days before a cancer-related visit to the emergency department between 2006 and 2011. Patients seen in an emergency department at an alternative hospital (not the site where cancer treatment was given) were matched based on propensity score to patients who visited their original hospital (site where cancer treatment was given). Next, patients seen at an alternative emergency department that was in a general hospital (i.e., not a cancer centre) were matched to patients who visited their original hospital or a cancer centre. Outcomes were admission to hospital at the index visit to the emergency department, 30-day mortality, having imaging with computed tomography and return visits to the emergency department. RESULTS: We found 42820 patients who were eligible for our study. Patients seen in the emergency departments at alternative hospitals were less likely to be admitted to hospital (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.74-0.83) and had higher hazards of return visits to the emergency department than matched patients at original hospitals (hazard ratio [HR] 1.06, 95% CI 1.03-1.11). In comparison, patients at alternative general hospitals also had lower odds of admission to hospital (OR 0.83, 95% CI 0.79-0.88) and higher hazards of return visits to the emergency department (HR 1.07, 95% CI 1.03-1.11) compared with matched counterparts; however, these patients had higher 30-day mortality (OR 1.13, 95% CI 1.05-1.22) and lower odds of having CT imaging (OR 0.74, 95% CI 0.69-0.80). INTERPRETATION: Cancer expertise of an institution rather than continuity of care may be an important predictor of outcomes following emergency treatment of patients with cancer.

In the modern era, water pollution, especially from industries, agricultural farms, and residential areas, is caused by the release of a large scale of heavy metals, organic pollutants, chemicals, etc., into the environment, posing a serious threat to aquatic ecosystems and nature. Moreover, untreated sewage waste discharged directly into nearby water bodies can cause various diseases to mankind due to the high load of fecal coliform bacteria. This work demonstrates the development of a biocompatible, cost-effective, highly robust, efficient, flexible, freestanding, and reusable membrane using naturally formed biocompatible kaolinite clay-doped poly(vinylidene fluoride-hexafluoropropylene) (PVDF-HFP) for effective piezodynamic destruction of coliform bacteria. In this study, Escherichia coli(E. coli) and Enterococcus faecalis(E. faecalis) have been used to evaluate the mechanical stimulus-responsive antibacterial efficacy of the nanocomposite membrane. The membrane can effectively eradicate nearly 99% viable E. coliand 97% E. faecaliswithin a span of 40 min under mechanical stimulation (soft ultrasound ∼15 kHz). To further understand the mechanism, an evaluation of reactive oxygen species and bacterial FESEM was performed. These studies revealed that bacterial cells suffered severe visible cell damage after 40 min of piezocatalysis, elucidating the fact that the synthesized membrane is capable of producing a superior piezodynamic antibacterial effect.

When spatial data are repeatedly collected over a short period of time, they exhibit two-way correlations. More specifically at a given point of time the neighboring responses from a spatial family become pair-wise spatially correlated, and over time each of these familial responses become longitudinally correlated, leading to a two-way multivariate spatial longitudinal correlation model. Recently, this type of two-way multivariate correlation model was studied by Sutradhar (2021, Sankhya A, 83, 206-244) for linear longitudinal spatial data. However, as the binary correlations can not be obtained directly from linear correlations, the construction of spatial longitudinal model for binary data requires special efforts mainly for combining the two structures, spatial and longitudinal, those are themselves complex for binary data. In this paper we resolve this challenge by using first a conditional (on spatial family-based random effects) binary dynamic logits (CBDL) model for longitudinal binary data, and then integrating out the family-based random effects over their distributional properties those used originally to generate spatial correlations. For inferences for the proposed model, we develop the so-called generalized quasi-likelihood (GQL) and method of moments approaches. Asymptotic properties such as consistency of the estimators of all parameters and asymptotic normality for the GQL estimators of main regression parameters are discussed in details.

Agrobacteriumtumefaciens-mediated rice transformation efficiency depends on several factors such as genotype, type of explant, media composition and growth regulators, co-cultivation conditions, antibiotics, temperature, A.tumefaciensstrain and their cell density, gene construct, explant competence after wounding, and control of A.tumefaciensovergrowth. Most of these issues have been addressed earlier, but only for a few elite indicarice cultivars like IR64, IR72, Pusa Basmati 1, Samba Mahsuri, etc. Besides these, there are some local cultivars having considerable consumers' preference and farmers' choice. Considering these aspects, the objective of the study was to standardize the callus transformation technique. In our earlier study, a popular rice variety, Khitish (IET 4094) from West Bengal, was found to be the most amenable genotype for indirect regeneration. Hence, this variety was selected for transformation experiments with A.tumefaciensstrain LBA4404 harbouring the binary vector pCAMBIA2301. Here, the co-cultivation-based transformation protocol was optimized by introducing several steps such as pre-culture in co-cultivation media before callus infection, washing with antibiotics dissolved in MS instead of water after co-cultivation, and pre-selection with only Agrobacteriumelimination antibiotics after washing–drying step. To control the Agrobacterium, a combination of cefotaxime and timentin was used during these steps. This resulted in lowest Agrobacteriumovergrowth and highest transformation frequency (28.2% in Khitish). The transient expression and stable integration of foreign gene were confirmed by GUS assay and PCR amplification of nptII selection marker gene in T0plant genomic DNA, respectively.

In foggy highways, the secure vehicular communication system can be very important in preventing traffic chaos, congestion, and accident; however, potential attackers may hack this system that can create many problems in controlling or managing the traffic. In this paper, we propose a quantum cryptographic protocol for secure vehicular communication for foggy highways, which is unconditionally secure against outside and participant attacks. The outside attacks include intercept, intercept-resend, entangle-measure, man-in-the-middle, collective, Trojan horse, and coherent attacks; whereas, the participant attacks include the collusion, forgery, and collision attacks. In this protocol, the traffic control system broadcasts the information regularly so that the vehicles can take appropriate action and avoid traffic chaos, congestion, and accidents. This protocol can be used on busy and foggy highways such as the interstate-75 highway in the United States, M4 motorway in England, Tohoku Expressway in Japan, and Yamuna Expressway in India to prevent vehicle collisions. Quantum cryptographic protocol for secure vehicular communication is important because they provide a highly secure method of communication that is immune to eavesdropping and interception. The motivation for developing the quantum cryptographic protocol for secure vehicular communication comes from the growing need for secure communication in the digital age.

When spatial data are repeatedly collected from the same spatial locations over a short period of time, a spatial panel/longitudinal data set is generated. Thus, this type of spatial longitudinal data must exhibit both spatial and longitudinal correlations, which are not easy to model. This work is motivated by existing studies in statistics and econometrics literature but the proposed model and inference procedures should be applicable to the spatial panel data encountered in other fields as well such as environmental and/or ecological setups. Specifically, unlike the existing studies, we propose a new dynamic mixed model to accommodate both spatial and panel correlations. A complete theoretical analysis is given for the estimation of regression effects, and spatial and panel correlations by exploiting second and higher order moments based quasi-likelihood methods. Asymptotic properties are also studied in details. The step by step estimation results developed in the paper should be useful to the practitioners dealing with spatial panel data.

Sutradhar (2008, Sankhya B,18-33) has studied a GLMM (generalized linear mixed model) for count data in a finite population setup where a sample of families/clusters were chosen from a finite population using PPS (probability proportional to size) sampling scheme. The properties of the estimators were studied through a simulation study. In this paper we consider (1) an auto-regressive type dynamic (ARTD) model for longitudinal count data, and (2) a MDL (multinomial dynamic logits) model for longitudinal categorical/multinomial data; and develop a practically important two-stage cluster sampling (TSCS) design weights based estimating equations for the regression and dynamic dependence parameters involved in both ARTD and MDL models in a finite population setup. Specifically, the survey weighted generalized quasi-likelihood (WGQL) and the survey weighted maximum likelihood (WML) estimation approaches are used for the count and multinomial models, respectively. We also demonstrate in the paper that the proposed TSCS based WGQL and WML estimators specially for the regression parameters (of main interest) are consistent, whereas the existing ‘working’ longitudinal correlations based GEE (generalized estimating equations) fails to produce consistent estimates and/or consistent variance estimates. The variances of the regression estimates along with their unbiased estimates are derived for both count and multinomial models. Furthermore, the asymptotic normality of the regression estimators are developed based on a large number of independent but non-identical clusters under non-overlapping stratums.

In this work, kraft lignin (KL) was depolymerized in an oxalic acid-mediated aqueous solution to vanillin and vanillic acid. The phenolic compounds were assessed by high-performance liquid chromatography (HPLC). The 13C nuclear magnetic resonance (13C-NMR) and heteronuclear single quantum coherence-nuclear magnetic resonance (HSQC-NMR) of the extracted products showed the presence of aromatic moieties, confirming the abundance of phenolic compounds and the absence of the lignin inter-unit linkages. The proton nuclear magnetic resonance (1H-NMR) and HSQC-NMR of the partially depolymerized lignin confirmed the cleavage of β-O-4 linkages. The findings showed that the depolymerization of KL (5 wt.%) in the presence of 1.25 M oxalic acid and 50 psi oxygen pressure at 125 °C for 60 min generated the maximum vanillin and vanillic acid yields of 15.7 wt.% and 11.7 wt.%, respectively. It was also revealed that increasing the oxalic acid concentration increased the yields of vanillin and vanillic acid. The current study demonstrated that the niobium pentoxide catalyst increased the vanillin and vanillic acid yields by 49.5% and 53% in KL depolymerization, respectively, while significantly decreasing the yields in lignosulfonate depolymerization reaction. The one-step aqueous reaction, relatively high production yield, recovery (up to 78.6 wt%), and recyclability (45 wt%) of the oxalic acid could make this process industrially attractive for the vanillin production from KL.

In the last decade, the popularity of deep reinforcement learning (DRL)-based controller design for complex and uncertain nonlinear dynamic systems has grown exponentially due to its model-free approach. Most of these studies focus on algorithmic developments to improve the learning process. However, the performance of the final learned control policy in a closed-loop deployment needs to be explored. They are greatly dependent on carefully selecting the input feature set or state and the design of the reward structure. The present investigation is a novel simulation study to demonstrate the impact of these two critical factors on a benchmark nonlinear control problem: the swing-up and stabilisation of an inverted pendulum on the cart with restricted cart movement. This study compares the raw sensor signal-based, physics-inspired, hand-crafted, system-knowledge-driven, meaningful features along with deep autoencoder-based self-synthesised abstract features when using the deep deterministic policy gradient-type DRL algorithm for controller design in continuous action space. In addition, the impact of different reward structures designed with sparse, situation-based, intuitive incentive-penalty enhancements on the standard quadratic reward function formulation is also studied. Finally, the superiority of specific blends of feature set/state and reward structures over the rest is established in a closed-loop study by comparing and analysing standard performance metrics and energy-efficient control action.

This paper considers a semi-parametric model for longitudinal negative binomial counts under the assumption that the repeated count responses follow an ARMA type non-stationary correlation structure. A step-by-step estimation approach is developed which provides consistent estimators for the non-parametric function, the auto-correlation structure and overdispersion parameter involved in the marginal negative binomial model, subsequently yielding a consistent estimator for the main regression parameter. Proofs for the consistency properties of the estimators are given. Also the convergence rates for the estimators of the non-parametric function as well as main parameters of the model are derived.

AbstractAlzheimer’s disease (AD) is a brain disease characterized by gradual memory loss and cognitive impairments. Acetylcholinesterase (AChE) inhibitors—such as donepezil, memantine, and tacrine—are FDA-approved medications for AD treatment. Due to the lack of their efficacy and higher side effects, many researchers have been searching for effective and safer alternatives. In this study, experimentally proved phytochemicals against brain diseases were screened based on their binding energies to the target site of AChE, pharmacokinetic properties, and drug-likeness. Although some phytochemicals showed higher binding affinities than the control drug (donepezil), they did not show permeability across the blood-brain barrier (BBB). However, berberine, anthocyanin, and diterpene alkaloid can cross the BBB and showed good binding affinities of −10.3, −10.1, and −10.2 kcal/mol, respectively. MD simulation and PCA of the simulation data of the protein and protein-ligand complexes proved that the complexes are stable in the biological environment. A total of 16 derivatives of berberine and 3 derivatives of anthocyanin also showed higher binding energies compared to the binding affinity (−11.5 kcal/mol) of the donepezil. The derivatives were designed by substituting –F, –CF3, –CN, and –NH2, and provided higher docking scores due to increasing of nonbonding interactions. MM/GBSA calculations show that the binding free energies of the best predicted derivatives of diterpene alkaloid, anthocyanin, and berberine (DA22, AC11, and BB40) are −100.4 ± 8.4, −79.3 ± 8.7, and −78.3 ± 10.7 kcal/mol, respectively, with the protein. Overall, this study was successful in finding new, highly effective, and possibly safer inhibitors of AChE.Communicated by Ramaswamy H. Sarma

Efficient hydrogenation of N-heterocycles employing low-cost and easy-to-access catalysts is highly desirable as the corresponding hydrogenated N-heterocycles have significant importance. Herein, we disclosed the well-defined phosphine-free Mn-catalyzed effective transfer hydrogenation (TH) of various N-heterocycles using ammonia borane as the hydrogen source. In this work, a series of phosphine-free Mn(I) complexes were synthesized to investigate the importance of the ligand backbone containing benzimidazole N–H, amine N–H, and a soft sulfur atom. Reactivity studies of these Mn complexes revealed that the proton-responsive Mn1complex bearing the N–H proton of benzimidazole, amine, and hemilabile sulfur arm was found to be most effective. The capability of this procedure was verified by the synthesis of several hydrogenated N-heterocycles and biologically active compounds. Mechanistic pathways were established by performing several control reactions and kinetic experiments.

Fabrication of Aluminium-based metal matrix composites has proved to be one of the most promising alternatives to the conventional alloying methodologies in recent times for manufacturing lightweight materials with high strength bearing capacities. Apart from possessing appreciable mechanical properties, these fabricated composites are also expected to withstand significant wear resistance for various applications in extreme conditions. Braking pads can be considered as one of such applications which demand the material to be extremely resistant to high abrasion even at elevated temperatures. Hence the use of composites on such occasions is not uncommon. Owing to the significant increment in strength and toughness from the addition of SiC and the elevation of wear resistance by virtue of self-lubricating nature of graphite, they have proved to be the top choice for reinforcements. The present study deals with the fabrication and characterization of SiC and graphite-reinforced Aluminium LM6 alloys for their implementation as the primary constituent material in braking systems. Hence, the tribological analysis, comprising of estimation of the coefficient of friction, specific wear rate and wear track analysis of the fabricated composite, can be considered as the primary findings of the present study. The results indicated the ability of graphite to impart significant wear resistance at elevated temperatures. Employing the well-known stir casting methodology for fabrication purposes can also be considered as one of the highlights of the current investigation. The accurate assessment of mechanical properties was obtained through hardness, tensile and compression tests. Further, optical microscopy, electron diffraction spectroscopy and XRD analysis are presented with an aim to bridge the gap between theoretical expectations and experimental results. All the results were observed to be in good agreement with each other indicating the influence of SiC and Graphite reinforcements in elevating the mechanical properties of the fabricated composite.

Low and declining female labour force participation in India over the past two decades has turned attention to the high unpaid work time spent by women. The question, however, remains whether women spend more time on unpaid work because there are not enough jobs or whether it is time spent on unpaid work that is holding them back from participation in the labour force. Against this backdrop, the present article explores India’s nationally representative time-use survey conducted by National Sample Survey Office (NSSO) to estimate factors that explain variations in time spent by women in unpaid work at the state level. The results show that structural transformation, entailing a reduction in employment in agriculture and an increase in the share of industries in state GDP, does not necessarily entail any reduction in unpaid time spent by women if the technology embodied in industrialisation is not gender-friendly. Worryingly, progress in female literacy recorded by states is no guarantee of a reduction in unpaid work by women. However, a gender-friendly atmosphere does make a difference in the reduction in unpaid work reported by women. Similarly, targeted public policy intervention does relax the constraints that women face at home, with a positive effect on unpaid work time.

Smooth and efficient braking has always been a crucial factor to influence the efficiency of an automobile. This factor has prompted several researchers to indulge in the never-ending chase for a constant development and innovation in the domain of braking systems. Recent progress in this field is evident from the implementation of the new disc brake systems replacing the conventionally used drum type brakes. However, the conventionally existing disc braking systems are continuously exposed to the significant thermal and mechanical stresses that causes structural deformation, overheating, thermal cracking, and squeals of the rotor, which pose a threat to the lifetime and future performance of the rotor pads. Generally, in industrial automobiles, grey cast iron is used as rotor material since it exhibits positive results to thermal and mechanical loads, however investigations demonstrated that superior results can be obtained using other materials as well. Hence in the present study, an attempt to use SiC/Graphite reinforced Aluminium alloy (LM6) as an efficient alternative has been made. Consequently, the performance of the fabricated material was initially estimated through several thermal and mechanical investigations of tensile tests, compression tests, thermal conductivity, thermo-mechanical analysis and differential scanning calorimetry. Moreover, with an intention to validate the experimental observations, and to predict the real-life performance, finite element analysis on disc brake rotor of Maruti Alto 800 was conducted. The 3D model of the rotor was designed on Catia V5R20 using actual measurements of the disc brake prototype. This 3D model and measured parameters were used as an input feed for the accurate simulation of modal, structural and thermal behaviour in ANSYS 18.1 FEA software. The results of the experimentations were observed to be in good agreement with the simulation results, indicating the accuracy of the experimental predictions.

Soil erosion is one of the major environmental issues influencing productivity and soil deterioration. Various erosion agents have contributed to soil erosion in recent years, but flowing water continues to be the primary cause. This study used ten key factors, including the Analytic Hierarchy Process (AHP) and Revised Universal Soil Loss Equation (RUSLE) methodologies, to assess erosion risk in the Siddheswari River basin. The final erosion map is produced by integrating ten factors within the ArcGIS environment. Results indicate that the extreme soil erosion zone covers 168.70 km2area (19.30%) and scattered over the upper and middle catchment; the high soil erosion region covers 172.58 km2(19.75%) area of the upper, middle, and lower catchment; low and very low erosion vulnerable zones covering 201.07 km2(23.01%) and 100.47 km2(11.50%) areas respectively of the basin’s total area and mainly located near the western boundaries of a watershed and some neglected portions of the upper and middle catchment of the basin. Moderate soil erosion region covering 231.06 km2areas (26.44%) characterized by moderate slope steepness and low-to-moderate vegetation. Spatial predicted soil erosion rate using the RUSLE method also shows a higher erosion rate. The high annual soil loss is observed in the high altitude and sloping regions, precisely in the side slope plateau fringe and denudational slope. The predicted results using AHP and RUSLE methods show that higher altitude areas near upper and upper–middle catchments are more vulnerable to erosion. The conclusion demonstrates that the Siddheswari basin's upper and upper–middle catchment areas have the highest soil erosion concerns.

In this paper, a scheme is proposed for selecting the bounds of controller parameters required for tuning proportional integral and derivative controllers for linear time-invariant multi input multi output (MIMO) systems. In an evolutionary optimization algorithm, the judicious selection of the tuning range of proportional integral and derivative controller parameters is of primary consideration for the algorithm to work efficiently. The proposed scheme is used with the Effective Transfer Functions model of the MIMO plant under consideration. It unifies the decoupling technique applicable to both unstable and stable MIMO systems. The procedure for selecting an optimum range of the controller parameters has been tested using Particle Swarm Optimization and Harmony Search techniques. Simulation results exhibit the effectiveness of the proposed method for the selection of parameter ranges for the controller. The results show significant reductions in peak overshoot and settling time. The drop in Integral square error values computed in the present scheme is 6–19% compared to those reported in published literature, which establishes the potent of the proposed method. The efficacy of the technique has been tested on a MIMO plant in LabVIEW® based hardware platform.

Tillage and water erosion induce spatially dependent changes in soil properties that influence productivity. Soil–landscape rehabilitation (returning translocated topsoil to landscape positions of soil loss by erosion) is one method to improve the productivity of severely eroded land. The objective of this study was to investigate relationships among key soil chemical, biological, and physical factors and crop growth and grain yield in eroded and rehabilitated landform positions. Soil–landscape rehabilitation was performed by moving 15–20 cm of topsoil from the lower slope to the upper slope positions of replicate plots; adjacent plots were left in their eroded condition. Crop response was monitored for 6 years. Rehabilitation resulted in large changes in the upper slope, especially in the most eroded landscape positions, where rehabilitated plots had lower inorganic carbon (IC) and higher organic carbon, available macronutrients, water infiltration rates, fungal and bacterial populations, and other measures of soil quality compared with control plots. Differences in surface soil IC that result from extensive erosion exposing calcareous subsoils, explained 70% of the yield variability in the upper slope. In the lower slope, the soil removal treatment was the main predictor of crop yield. Areas of soil removal had relatively high early‐season water content and low fungal and bacterial populations. Improving soil properties in areas of high soil loss by erosion increased both grain yield and yield stability across climatic conditions. Soil properties were highly variable in eroded landscapes.Soil properties were drastically changed by replacing translocated topsoil.Soil properties were highly correlated with each other.Differences in surface soil IC explained 70% of the upper slope yield variability.Toeslopes with soil removed had low yields, high water content, and low microbial populations.

IMPORTANCE: Excess adiposity confers higher risk of breast cancer for women. For women who have lost substantial weight, it is unclear whether previous obesity confers residual increased baseline risk of breast cancer compared with peers without obesity. OBJECTIVES: To determine whether there is a residual risk of breast cancer due to prior obesity among patients who undergo bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS: Retrospective matched cohort study of 69 260 women with index date between January 1, 2010, and December 31, 2016. Patients were followed up for 5 years after bariatric surgery or index date. Population-based clinical and administrative data from multiple databases in Ontario, Canada, were used to match a cohort of women who underwent bariatric surgery for obesity (baseline body mass index [BMI] ≥35 with comorbid conditions or BMI ≥40) to women without a history of bariatric surgery according to age and breast cancer screening history. Nonsurgical controls were divided into 4 BMI categories (<25, 25-29, 30-34, and ≥35). Data were analyzed on October 21, 2021. EXPOSURES: Weight loss via bariatric surgery. MAIN OUTCOMES AND MEASURES: Residual hazard of breast cancer after washout periods of 1, 2, and 5 years. Comparisons were made between the surgical and nonsurgical cohorts overall and within each of the BMI subgroups. RESULTS: In total, 69 260 women were included in the analysis, with 13 852 women in each of the 5 study cohorts. The mean (SD) age was 45.1 (10.9) years. In the postsurgical cohort vs the overall nonsurgical cohort (n = 55 408), there was an increased hazard for incident breast cancer in the nonsurgical group after washout periods of 1 year (hazard ratio [HR], 1.40 [95% CI, 1.18-1.67]), 2 years (HR, 1.31 [95% CI, 1.12-1.53]), and 5 years (HR, 1.38 [95% CI, 1.21-1.58]). When the postsurgical cohort was compared with the nonsurgical cohort with BMI less than 25, the hazard of incident breast cancer was not significantly different regardless of the washout period, whereas there was a reduced hazard for incident breast cancer among postsurgical patients compared with nonsurgical patients in all high BMI categories (BMI ≥25). CONCLUSIONS AND RELEVANCE: Findings suggest that bariatric surgery was associated with a reduced risk of developing breast cancer for women with prior obesity equivalent to that of a woman with a BMI less than 25 and a lower risk when compared with all groups with BMI greater than or equal to 25.

Purpose: The target of this paper is to design a simple and an efficient controller for artificial pancreas (AP) system for blood glucose (BG) regulation in type-1 diabetic mellitus (T1DM) patient. Bergman’s intravenous model is chosen for the controller design as the model is minimum ordered model of T1DM patient. Method: A multi-objective output feedback controller has been designed for AP system considering robustness, disturbance rejection, and transient criterion. Considering H∞, pole-placement, and H2constraints, a control algorithm has been developed and has been solved using linear matrix inequality (LMI) technique. Result: As a testing platform of the intravenous model-based designed controller, UVa/Padova T1DM metabolic simulator has been chosen which uses subcutaneous insulin delivery method. The controller has been tested in the presence of unannounced meal disturbances. Experimental results show that the controller regulates BG level very efficiently with lesser amount of insulin and avoids hypoglycemia effect. In the presence of external noises like glucose sensor noise and insulin pump error, the robustness of the controller has been checked. The performance of the controller has been compared with compound internal model control (IMC) strategy reported earlier for same meal scenario. Conclusion: The designed multi-objective controller gives better performance metrices than compound IMC controller.

IMPORTANCE: The surgeon-anesthesiologist teamwork and relationship is crucial to good patient outcomes. Familiarity among work team members is associated with enhanced success in multiple fields but rarely studied in the operating room. OBJECTIVE: To examine the association between surgeon-anesthesiologist dyad familiarity—as the number of times working together—with short-term postoperative outcomes for complex gastrointestinal cancer surgery. DESIGN, SETTING, AND PARTICIPANTS: This population-based retrospective cohort study based in Ontario, Canada, included adults undergoing esophagectomy, pancreatectomy, and hepatectomy for cancer from 2007 through 2018. The data were analyzed January 1, 2007, through December 21, 2018. EXPOSURES: Dyad familiarity captured as the annual volume of procedures of interest done by the surgeon-anesthesiologist dyad in the 4 years before the index surgery. MAIN OUTCOMES AND MEASURES: Ninety-day major morbidity (any Clavien-Dindo grade 3 to 5). The association between exposure and outcome was examined using multivariable logistic regression. RESULTS: Seven thousand eight hundred ninety-three patients with a median age of 65 years (66.3% men) were included. They were cared for by 737 anesthesiologists and 163 surgeons who were also included. The median surgeon-anesthesiologist dyad volume was 1 (range, 0-12.2) procedures per year. Ninety-day major morbidity occurred in 43.0% of patients. There was a linear association between dyad volume and 90-day major morbidity. After adjustment, the annual dyad volume was independently associated with lower odds of 90-day major morbidity, with an odds ratio of 0.95 (95% CI, 0.92-0.98; P = .01) for each incremental procedure per year, per dyad. The results did not change when examining 30-day major morbidity. CONCLUSIONS AND RELEVANCE: Among adults undergoing complex gastrointestinal cancer surgery, increasing familiarity of the surgeon-anesthesiologist dyad was associated with improved short-term patient outcomes. For each additional time that a unique surgeon-anesthesiologist dyad worked together, the odds of 90-day major morbidity decreased by 5%. These findings support organizing perioperative care to increase the familiarity of surgeon-anesthesiologist dyads.

There are limited data regarding the association between cancer and ischemic stroke, particularly among individuals with previous stroke. Our objective was to measure and compare the risk of ischemic stroke in individuals with and without cancer.

Aluminium-copper alloys are known for their very good strength at high temperature .Addition of copper improves the strength at high temperatures due to precipitation strengthening. Fluidity in casting is the major factor which affects the cast quality of the final components. Addition of Silicon with copper in Aluminium improves fluidity and finally quality of the cast components. But presence of Silicon adversely affects the strength at high temperature. In the present work cooling curve analysis of Al-Cu alloy (without Silicon) is done for different wt% of copper addition. The current study for Al-Cu alloy is based on sand casting method as it is one of the cost effective manufacturing method. Cooling curve obtained from the simulation results used to predict the fluidity, microstructure of the alloy when copper wt% is varied. Predicted microstructure and grain structure from the cooling curve goes well with the microstructure studied from shop floor casting .In the present work “Z-cast” casting simulation software is used for casting simulation. Among three different alloy composition studied aluminium with 8% copper gives the best results when compared on the basis of grain size .But fluidity analysis reveal poor fluidity for the alloy having 8 wt% of copper. The current analysis helps to study the optimum aluminium –copper alloy composition that can be used in high temperature applications.

IMPORTANCE: Patients with cancer are known to have increased risk of COVID-19 complications, including death. OBJECTIVE: To determine the association of COVID-19 vaccination with breakthrough infections and complications in patients with cancer compared to noncancer controls. DESIGN, SETTING, AND PARTICIPANTS: Retrospective population-based cohort study using linked administrative databases in Ontario, Canada, in residents 18 years and older who received COVID-19 vaccination. Three matched groups were identified (based on age, sex, type of vaccine, date of vaccine): 1:4 match for patients with hematologic and solid cancer to noncancer controls (hematologic and solid cancers separately analyzed), 1:1 match between patients with hematologic and patients with solid cancer. EXPOSURES: Cancer diagnosis. MAIN OUTCOMES AND MEASURES: Outcomes occurring 14 days after receipt of second COVID-19 vaccination dose: primary outcome was SARS-CoV-2 breakthrough infection; secondary outcomes were emergency department visit, hospitalization, and death within 4 weeks of SARS-CoV-2 infection (end of follow-up March 31, 2022). Multivariable cumulative incidence function models were used to obtain adjusted hazard ratio (aHR) and 95% CIs. RESULTS: A total of 289 400 vaccinated patients with cancer (39 880 hematologic; 249 520 solid) with 1 157 600 matched noncancer controls were identified; the cohort was 65.4% female, and mean (SD) age was 66 (14.0) years. SARS-CoV-2 breakthrough infection was higher in patients with hematologic cancer (aHR, 1.33; 95% CI, 1.20-1.46; P < .001) but not in patients with solid cancer (aHR, 1.00; 95% CI, 0.96-1.05; P = .87). COVID-19 severe outcomes (composite of hospitalization and death) were significantly higher in patients with cancer compared to patients without cancer (aHR, 1.52; 95% CI, 1.42-1.63; P < .001). Risk of severe outcomes was higher among patients with hematologic cancer (aHR, 2.51; 95% CI, 2.21-2.85; P < .001) than patients with solid cancer (aHR, 1.43; 95% CI, 1.24-1.64; P < .001). Patients receiving active treatment had a further heightened risk for COVID-19 severe outcomes, particularly those who received anti-CD20 therapy. Third vaccination dose was associated with lower infection and COVID-19 complications, except for patients receiving anti-CD20 therapy. CONCLUSIONS AND RELEVANCE: In this large population-based cohort study, patients with cancer had greater risk of SARS-CoV-2 infection and worse outcomes than patients without cancer, and the risk was highest for patients with hematologic cancer and any patients with cancer receiving active treatment. Triple vaccination was associated with lower risk of poor outcomes.

Warriyar and Sutradhar (Brazilian J. Probab. Stat., 28, 561–586, 2014) studied a semi-parametric linear model in a longitudinal setup with Gaussian errors, where the main regression parameters were estimated using an efficient GQL (generalized quasi-likelihood) estimation approach, and the efficiency properties of the estimators were examined through a simulation study. In this paper we provide a generalization of their linear semi-parametric regression model to a wider setup where the error distributions are relaxed and errors are assumed to follow a four-moments based semi-parametric structure leading to a doubly semi-parametric model. On top of regression parameters and nonparametric function estimation, this doubly semi-parametric nature of the model makes the four-moments based variance and correlation parameters estimation quite challenging. We resolve this computational issue analytically by developing exact formulas for all necessary higher order moments. As the longitudinal studies involve large number of independent individuals providing repeated responses, we study the asymptotic properties of the estimators and make sure that the estimators including the estimator of nonparametric function are consistent.

AbstractVeterinary clinical skills training is evolving rapidly around the world and there is increasing interest in Bangladesh in opening clinical skills laboratories and using models in teaching. The first clinical skills laboratory was opened at Chattogram Veterinary and Animal Sciences University in 2019. The current study aimed to identify the most important clinical skills for veterinarians in Bangladesh to inform the further development of clinical skills laboratories and ensure resources are deployed effectively and efficiently. Lists of clinical skills were collated from the literature, national and international accreditation standards, and regional syllabi. The list was refined through local consultation, focused on farm and pet animals, and was disseminated via an online survey to veterinarians and final-year students who were asked to rate the level of importance of each skill for a new graduate. The survey was completed by 215 veterinarians and 115 students. A ranked list was generated with injection techniques, animal handling, clinical examination, and basic surgical skills among the most important. Some techniques requiring specific equipment and some advanced surgical procedures were considered less important. As a result of the study, the most important clinical skills for a new graduate in Bangladesh have been identified for the first time. The results will inform the development of models, the use of clinical skills laboratories, and the design of clinical skills courses for veterinary training. Our approach of drawing upon existing lists followed by local stakeholders consultation is recommended to others to ensure clinical skills teaching is regionally relevant.

BackgroundNo research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of subsequent healthcare service use.ObjectiveWe aimed to compare the rate of outpatient visits, emergency department (ED) visits and hospitalisations during a 5-year follow-up period among smokers who had and had not accessed a smoking cessation treatment programme.MethodsThe study was a retrospective matched cohort study using linked demographic and administrative healthcare databases in Ontario, Canada. 9951 patients who accessed smoking cessation services between July 2011 and December 2012 were matched to a smoker who did not access services, obtained from the Canadian Community Health Survey, using a combination of hard matching and propensity score matching. Outcomes were rates of healthcare service use from index date (programme enrolment or survey response) to March 2017.ResultsAfter controlling for potential confounders, patients in the overall treatment cohort had modestly greater rates of the outcomes: outpatient visits (rate ratio (RR) 1.10, 95% CI: 1.06 to 1.14), ED visits (RR 1.08, 95% CI: 1.03 to 1.13) and hospitalisations (RR 1.09, 95% CI: 1.02 to 1.18). Effect modification of the association between smoking cessation treatment and healthcare service use by prevalent comorbidity was found for outpatient visits (p=0.006), and hospitalisations (p=0.050), but not ED visits.ConclusionsPatients who enrolled in smoking cessation treatment offered through primary care clinics in Ontario displayed a modest but significantly greater rate of outpatient visits, ED visits and hospitalisations over a 5-year follow-up period.

BackgroundIn 2007, Cancer Care Ontario began standardised symptom assessment as part of routine care using the Edmonton Symptom Assessment System (ESAS).AimThe purpose of this study was to evaluate the impact of ESAS on receipt of palliative care when compared with a matched group of unexposed patients.DesignA retrospective-matched cohort study examined the impact of ESAS screening on initiation of palliative care services provided by physicians or homecare nurses. The study included adult patients diagnosed with cancer between 2007 and 2015. Exposure was defined as completing ≥1 ESAS during the study period. Using 4 hard and 14 propensity score-matched variables, patients with cancer exposed to ESAS were matched 1:1 to those who were not. Matched patients were followed from first ESAS until initiation of palliative care, death or end of study.ResultsThe final cohort consisted of 204 688 matched patients with no prior palliative care consult. The pairs were well matched. The cumulative incidence of receiving palliative care within the first 5 years was higher among those exposed to ESAS compared with those who were not (27.9% (95% CI: 27.5% to 28.2%) versus 27.9% (95% CI: 27.5% to 28.2%)), when death is considered as a competing event. In the adjusted cause-specific Cox proportional hazards model, ESAS assessment was associated with a 6% increase in palliative care services (HR: 1.06, 95% CI: 1.04 to 1.08).ConclusionWe have demonstrated that patients exposed to ESAS were more likely to receive palliative care services compared with patients who were not exposed. This observation provides real-world data of the impact of routine assessment with a patient-reported outcome.

Graphical abstract:

Groundwater potential zonation is crucial for sustainable groundwater resource management, especially in regions with high groundwater demand. This study presents a novel approach using GIS-based sensitivity analyses to optimize the causative factors of groundwater potential zones (GPZ) in the Alipurduar district, West Bengal, India. Twelve groundwater conditioning factors, including lithology, geomorphology, land use and land cover, lineament density, drainage density, slope, rainfall, topographic wetness index, normalized difference vegetation index, topographic position index, roughness, and curvature, were considered to prepare the GPZ. The analytical hierarchical process method was employed to calculate the corresponding normalized rates and weights for thematic layers. Thematic maps were accumulated using a weighted sum technique to produce the GPZ map, which was verified through overlay analysis with observed dug well data. The study also demonstrates the effectiveness of GIS-based single parameter and map removal sensitivity analysis in optimizing the conditioning factors used in groundwater potential zonation. Lithology was identified as the most influential parameter, with a mean effective weight of 45% and a mean variation of 1.6% in GPZ. The receiver operating characteristic curve exhibited a good prognostic accuracy of 81%. This research provides valuable recommendations for selecting appropriate conditioning factors for groundwater resource assessment and management. Moreover, it offers practical insights into groundwater resource assessment and management in data-scarce regions, showcasing the application of GIS technology in groundwater potential zonation.

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The multiparty comparison allows to compare two integers $x$x and $y$y blindly, where a set of players hold the shares of the elements $x and y, x, y \in \mathbb {F}_{p}$xandy,x,y∈Fp, a prime field. The existing multiparty comparison protocols execute in constant rounds, but the number of multiplications depends on the size of the prime $p$p, i.e., the communication complexity will be high for large prime $p$p. In this paper, we present a multiparty comparison protocol with constant rounds in which the number of multiplications depends on the number of players rather than the prime $p$p itself. This multiparty comparison protocol is further extended to design a multiparty equality-test protocol. An equality-test protocol computes the equality of shares in constant rounds and its number of multiplications depends on the number of players. Our proposed protocols multiparty comparison and equality-test are unconditionally secure against the active and passive attacks and have $O(n)$O(n) communication complexity, where $n$n is the number of players. We also present an efficient technique for fault detection that can verify the correctness of various protocols.

This paper analyses the impact of Ukraine–Russia conflict on stock markets in Europe. We consider the stock markets of nine EU countries and Russia. The analysis consists of day-firm which includes the time between 24 November 2021 and 23 May 2022. We consider ordinary least squared (OLS) and fixed effects as baseline models. Additionally, we consider the impact of this conflict on stock return for several months, the elasticity test, the instrumental variable—two-stage least squared (2SLS) approach for the robustness test and endogeneity concerns. We find evidence of the negative impact of the Ukraine–Russia conflict on stock return of that stock markets. In addition, our finding indicates that the impact of this war on the mining construction and manufacturing sectors is greater than on other sectors because Russia and Ukraine are the key suppliers or exporters of mining and manufacturing sector. Our finding also indicates that Ukraine–Russia conflict largely affects stock return of Russian stocks because Russia is directly involved in the conflict.