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This paper presents a Computer‐aided design (CAD) model for a‐IGZO thin film transistors (TFTs) by adapting SPICE level‐61 RPI a‐Si: H (Hydrogenated Amorphous Silicon) TFT model and level‐62 RPI Poly‐Si (Poly Silicon) TFT model. This work provides a complete understanding of SPICE level‐61 and 62 model parameters, which must be tuned for a‐IGZO TFT simulation. The adapted SPICE models of level‐61 and level‐62 could model all regions of operation of the TFT, that is, above‐threshold and below‐threshold regions. Adapted RPI poly‐Si model also shows the kink effect in ZnO thin film transistors (TFTs) due to the recombination of electron–hole pairs in the channel via boundary trap states present in the poly‐Si TFTs thereby increasing the drain current in the transistors above pinch‐off region. The extracted performance parameters of the adapted models were found to be contiguous with experimental results. The maximum deviation in the subthreshold slope is approximately 5 mV/decade for level‐61 a‐Si TFT, and for level‐62 poly‐Si TFT, deviation in the subthreshold slope is even less, that is, 0.2 mV/decade. The experimental and simulated characteristics, extracted on‐to‐off ratio, negative bias reverse saturation current, and threshold voltage were almost similar. However, an average deviation of 2.4% and 2.27% was observed in the output characteristics of the adapted level‐61 and level‐62 models, respectively. [ABSTRACT FROM AUTHOR]

Due to its significant role in neurodegeneration, Cyclin‐dependent kinase 5 (CDK5) has emerged as a potential target for addressing neuropathological disorders, including Alzheimer's disease (AD). The application of CDK5 inhibitors has demonstrated promise in the treatment of AD. This prompted us to model this interesting target using a computational workflow named Docking‐based Comparative Intermolecular Contacts Analysis (dbCICA). Approaches including 3D‐QSAR, genetic algorithm, and pharmacophore modeling were employed to discover new CDK inhibitors. [ABSTRACT FROM AUTHOR]

Background: Environmentally sustainable diets are represented in the EAT‐Lancet recommendations developed by the Lancet Commission on Planetary Health in 2019. Very few studies have compared Indian diets with the EAT‐Lancet recommendations. The present study performed such a comparison using primary dietary consumption data from adults in north and south India. Methods: Data from 8762 adults (52.4 ± 11.7 years) residing in Sonipat and Vizag India were collected on sociodemographic characteristics, wealth index (household assets) and dietary intake (food frequency questionnaire: nine food groups). The quantity consumed and energy from each food group was compared with the EAT‐Lancet recommendations. We investigated the likelihood of deficit or excess in consumption compared to the EAT‐Lancet recommendations by different sociodemographic factors. Results: Half of the participants were women and half resided in rural areas. Vegetables and fruits were consumed in lower quantity, whereas dairy and added fats were consumed in higher quantity than recommended by the EAT‐Lancet recommendations. For whole grains, female gender and poorest wealth index were the factors associated with deficit or no consumption, whereas, for vegetables and fruits, it was poorest wealth index and residence in rural areas (p < 0.05, all). Rural residence and poorest wealth index were associated with excess consumption of dairy and added fats (p < 0.05, all). Conclusions: The diets of the study participants were mainly plant‐based, and high in dairy but lacking in nutrient‐rich foods such as vegetables and fruits. Appropriate policy actions for making healthy sustainable diets and micronutrient‐rich foods available and affordable to all with a particular focus on the poor and rural populations are warranted. Very few studies have compared Indian diets with the EAT‐Lancet dietary recommendations. The present study performed such a comparison using primary dietary consumption data, finding that Indian diets were mainly plant‐based, being high in dairy but lacking in nutrient‐rich foods such as vegetables and fruits. Highlights: Compared with the EAT‐Lancet recommendations, Indian diets were deficit in fruits and vegetables consumption but exceeded in dairy and added fats.Female gender, rural residence and poorest wealth index were associated with lower nutrient rich foods consumption.To ensure sustainable and healthy diets in India, the EAT‐Lancet recommendations should be adopted considering Indian Council of Medical Research guidelines.Urgent policy actions are needed to make healthy and sustainable diets locally available accessible and affordable to all. [ABSTRACT FROM AUTHOR]

Objective: The study investigated adherence with MMF treatment among patients attending rheumatology clinics at University Hospitals Coventry and Warwickshire NHS Trust (UHCW) with Autoimmune inflammatory rheumatic diseases (AIIRDs). Methods: This retrospective study collated hospital pharmacy data in patients who requested the prescription for MMF between January 2015 and December 2018. Clinical data were obtained from paper and electronic notes. Data were analysed using Microsoft Excel. Ethical approval was obtained through Coventry University. Results: We recruited 144 patients into this study with age range from 18 to 91 years, including 100 females and 44 males. There were 112 White patients, 22 of South Asian origin, 3 East Asian and 4 black patients. SLE (56), scleroderma (18), mixed connective tissue disease (15), myositis (13), vasculitis (13) were the commonest diagnoses. Overall adherence with Mycophenolate mofetil was 62%. The adherence rates were below 80% for all age groups with ∼60% of patients having adherence levels of >60%. Poor adherence with MMF correlated with 3‐fold increase in risk of flares compared to good adherence (p = 0.002). We also found a significant difference between Asian patients (mean adherence 47%) and White patients (mean adherence 65%, p < 0.001). Conclusion: Adherence with MMF has improved considerably compared to historical studies, although these remain suboptimal. Certain population groups such as young adults, elderly and Asian patients continue to have lower adherence and higher risk of flares. Strategies are needed to improve adherence levels overall and specifically in the high‐risk groups to reduce risk of flares and organ damage. [ABSTRACT FROM AUTHOR]

In this paper, we implement the semi‐analytical schemes, namely, local fractional homotopy perturbation Sumudu transform method (LFHPSTM) and local fractional homotopy analysis Sumudu transform method (LFHASTM), for finding the approximate analytical solutions of local fractional Laplace equations under different initial conditions on Cantor sets. The novelty of the work lies in the application of these suggested schemes which were never used to solve the local fractional Laplace equation. The Laplace equation mainly contributes to electrostatistics, mechanical engineering, and theoretical physics. This equation also helps in formulation of the electrostatic problem of a rod under a torsion load. Moreover, it helps in handling potential field problems also. These aspects enhance the significance of getting a solution of the local fractional Laplace equation in fractal media. The suggested methods are copulation of local fractional homotopy perturbation method and local fractional homotopy analysis method with the local fractional Sumudu transform, respectively. The computational process indicates that the schemes are very efficient to obtain nondifferentiable solutions for given equations in a smooth way. Moreover, the solution analysis depicts that both the local fractional hybrid homotopy schemes are in a good agreement with each other. These methods depict the accuracy and efficiency of the implemented methods in view of correspondence with solutions obtained with other methods in previous works. The numerical simulations for obtained results are discussed for various values of order of a local fractional derivative. The 3D graphs on the Cantor set are constructed with the help of Matlab software. [ABSTRACT FROM AUTHOR]

Background: Oncology patients and physicians value empathy because of its association with improved health outcomes. Common measures of empathy lack consistency and were developed without direct input from patients. Because of their intense engagement with health care systems, oncology patients may have unique perspectives on what behaviors signal empathy in a clinical setting.Methods: As part of a cross-sectional study of patient perspectives on clinician empathy at an academic cancer center in the northeastern United States, the authors solicited up to 10 free-text responses to an open-ended question about what clinician behaviors define empathy.Results: The authors categorized open-ended responses from 89 oncology patients into 5 categories representing 14 themes. These categories were relationship sensitivity, focus on the whole person, communication, clinician attributes, and institutional resources and care processes. Frequently represented themes, including listening, understanding, and attention to emotions and what matters most, aligned with existing measures of empathy; behaviors that were not well represented among existing measures included qualities of information sharing and other communication elements. Patients also associated clinician demeanor, accessibility, and competence with empathy.Conclusions: Oncology patients' perspectives on empathy highlight clinician behaviors and attributes that may help to refine patient experience measures and may be adopted by clinicians and cancer centers to enhance patient care and outcomes. High-quality communication skills training can promote active listening and paying attention to the whole person. A system-level focus on delivering empathic care may improve patients' experiences and outcomes.Lay Summary: Oncology patients' responses to an open-ended question about empathic clinician behavior have revealed insights into a variety of behaviors that are perceived as demonstrative of empathy. These include behaviors that imply sensitivity to the clinician-patient relationship, such as listening and understanding and attention to the whole person. Participants valued caring communication and demeanor and clinician accessibility. Perspective taking was not common among answers. Many existing measures of clinical care quality do not include the behaviors cited by patients as empathic. These results can inform efforts to refine quality measures of empathy-associated behaviors in clinical practice. Cancer centers can use skills training to improve elements of communication. [ABSTRACT FROM AUTHOR]

The clinical phenotype of leucine-rich glioma-inactivated protein 1 (LGI1) and contactin-associated proteinlike 2 (CASPR2) autoimmunity is well defined in adults. Data for children are limited (<10 cases). Among 13,319 pediatric patients serologically tested for autoimmune neurological disorders (2010-2017), 264 were seropositive for voltage-gated potassium channel-complex-IgG (radioimmunoprecipitation). Only 13 (4.9%) were positive by transfected cell-binding assay for LGI1-IgG (n = 7), CASPR2-IgG (n = 3), or both (n = 3). This is significantly less than in adults. Encephalopathy, seizures, and peripheral nerve hyperexcitability were common, as was coexisting autoimmunity. No faciobrachial dystonic seizures or cancers were identified. Functional neurologic disorders were frequently the initial diagnosis, and immunotherapy appeared beneficial. Ann Neurol 2018;84:473-480. [ABSTRACT FROM AUTHOR]

Objective: Loss of function of the astrocyte-specific protein MLC1 leads to the childhood-onset leukodystrophy "megalencephalic leukoencephalopathy with subcortical cysts" (MLC). Studies on isolated cells show a role for MLC1 in astrocyte volume regulation and suggest that disturbed brain ion and water homeostasis is central to the disease. Excitability of neuronal networks is particularly sensitive to ion and water homeostasis. In line with this, reports of seizures and epilepsy in MLC patients exist. However, systematic assessment and mechanistic understanding of seizures in MLC are lacking.Methods: We analyzed an MLC patient inventory to study occurrence of seizures in MLC. We used two distinct genetic mouse models of MLC to further study epileptiform activity and seizure threshold through wireless extracellular field potential recordings. Whole-cell patch-clamp recordings and K+ -sensitive electrode recordings in mouse brain slices were used to explore the underlying mechanisms of epilepsy in MLC.Results: An early onset of seizures is common in MLC. Similarly, in MLC mice, we uncovered spontaneous epileptiform brain activity and a lowered threshold for induced seizures. At the cellular level, we found that although passive and active properties of individual pyramidal neurons are unchanged, extracellular K+ dynamics and neuronal network activity are abnormal in MLC mice.Interpretation: Disturbed astrocyte regulation of ion and water homeostasis in MLC causes hyperexcitability of neuronal networks and seizures. These findings suggest a role for defective astrocyte volume regulation in epilepsy. Ann Neurol 2018;83:636-649. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the incidence and prevalence of autoimmune encephalitis and compare it to that of infectious encephalitis.Methods: We performed a population-based comparative study of the incidence and prevalence of autoimmune and infectious encephalitis in Olmsted County, Minnesota. Autoimmune encephalitis diagnosis and subgroups were defined by 2016 diagnostic criteria, and infectious encephalitis diagnosis required a confirmed infectious pathogen. Age- and sex-adjusted prevalence and incidence rates were calculated. Patients with encephalitis of uncertain etiology were excluded.Results: The prevalence of autoimmune encephalitis on January 1, 2014 of 13.7/100,000 was not significantly different from that of all infectious encephalitides (11.6/100,000; p = 0.63) or the viral subcategory (8.3/100,000; p = 0.17). The incidence rates (1995-2015) of autoimmune and infectious encephalitis were 0.8/100,000 and 1.0/100,000 person-years, respectively (p = 0.58). The number of relapses or recurrent hospitalizations was higher for autoimmune than infectious encephalitis (p = 0.03). The incidence of autoimmune encephalitis increased over time from 0.4/100,000 person-years (1995-2005) to 1.2/100,000 person-years (2006-2015; p = 0.02), attributable to increased detection of autoantibody-positive cases. The incidence (2.8 vs 0.7/100,000 person-years, p = 0.01) and prevalence (38.3 vs 13.7/100,000, p = 0.04) of autoimmune encephalitis was higher among African Americans than Caucasians. The prevalence of specific neural autoantibodies was as follows: myelin oligodendrocyte glycoprotein, 1.9/100,000; glutamic acid decarboxylase 65, 1.9/100,000; unclassified neural autoantibody, 1.4/100,000; leucine-rich glioma-inactivated protein 1, 0.7/100,000; collapsin response-mediator protein 5, 0.7/100,000; N-methyl-D-aspartate receptor, 0.6/100,000; antineuronal nuclear antibody type 2, 0.6/100,000; and glial fibrillary acidic protein α, 0.6/100,000.Interpretation: This study shows that the prevalence and incidence of autoimmune encephalitis are comparable to infectious encephalitis, and its detection is increasing over time. Ann Neurol 2018;83:166-177. [ABSTRACT FROM AUTHOR]

Introduction: Heterogeneity of presenting symptoms makes the initial clinical diagnosis of Guillain-Barré syndrome (GBS) challenging.Methods: Observational retrospective study from 2 teaching hospitals (Parkland Memorial Hospital and University of Texas Southwestern University Hospital) between 2008 and 2013.Results: Sixty-nine GBS patients were identified. GBS was suspected on initial emergency department visit in only 49%. During first hospital encounter, 58% were evaluated by a neurologist. Neuropathic pain and presence of intact deep tendon reflexes were associated with delayed GBS diagnosis (P < 0.05). There was significantly better clinical outcome among patients who were evaluated by a neurologist during the initial visit (P < 0.005). Among these patients there was also significant difference in discharge destination; 71.2% of patients evaluated by a neurologist were discharged home (P < 0.01). Patients in whom GBS was not suspected at the time of initial Neurology evaluation were more likely to require intubation and to have residual weakness at the time of discharge (P < 0.05).Conclusions: Atypical clinical signs and symptoms may lead to delayed diagnosis of GBS. Early neurological evaluation is associated with improved clinical diagnosis and discharge disposition. [ABSTRACT FROM AUTHOR]

Ball bearings are considered as a critical element in various mechanical systems. Vibration signal analysis is very effective method for finding bearing fault. Accelerometers are used to capture the multi-component vibration signal generated in the machine when it is in use. Various methods based on empirical mode decomposition (EMD) have been used for ball bearing fault diagnosis. EMD method usually suffered from the boundary distortion of intrinsic mode function. Classification of ball bearing fault is one of the challenging tasks in the field of mechanical systems. Various classification schemes such as support vector machine (SVM), K-means clustering, extreme learning machine (ELM) have been used for the classification of ball bearing fault. In this study, footprint analysis of Hilbert transform along with the neural network has been done for ball bearing fault analysis. A comparative analysis of the proposed research study has been done with available methods such as SVM and ELM. A high fault classification accuracy has been achieved using the proposed method for detection of ball bearing fault. [ABSTRACT FROM AUTHOR]