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Several uncertainties exist regarding how we will conduct our clinical, didactic, business, and social activities as the coronavirus disease 2019 (COVID-19) global pandemic abates and social distancing guidelines are relaxed. We anticipate changes in how we interact with our patients and other providers, how patient workflow is designed, the methods used to conduct our teaching sessions, and how we perform procedures in different clinical settings. The objective of the present report is to review some of the changes to consider in the clinical and academic oral and maxillofacial surgery workflow and, allow for a smoother transition, with less risk to our patients and healthcare personnel. New infection control policies should be strictly enforced and monitored in all clinical and nonclinical settings, with an overall goal to decrease the risk of exposure and transmission. Screening for COVID-19 symptoms, testing when indicated, and establishing the epidemiologic linkage will be crucial to containing and preventing new COVID-19 cases until a vaccine or an alternate solution is available. Additionally, the shortage of essential supplies such as drugs and personal protective equipment, the design and ventilation of workspaces and waiting areas, the increase in overhead costs, and the possible absence of staff, if quarantine is necessary, must be considered. This shift in our workflow and patient care paths will likely continue in the short-term at least through 2021 or the next 12 to 24 months. Thus, we must prioritize surgery, balancing patient preferences and healthcare personnel risks. We have an opportunity now to make changes and embrace telemedicine and other collaborative virtual platforms for teaching and clinical care. It is crucial that we maintain COVID-19 awareness, proper surveillance in our microenvironments, good clinical judgment, and ethical values to continue to deliver high-quality, economical, and accessible patient care.

Purpose Real-time implementation of sophisticated algorithms on robotic systems demands a rewarding interface between hardware and software components. Individual robot manufacturers have dedicated controllers and languages. However, robot operation would require either the knowledge of additional software or expensive add-on installations for effective communication between the robot controller and the computation software. This paper aims to present a novel method of interfacing the commercial robot controllers with most widely used simulation platform, e.g. MATLAB in real-time with a demonstration of visual predictive controller. Design/methodology/approach A remote personal computer (PC), running MATLAB, is connected with the IRC5 controller of an ABB robotic arm through the File Transfer Protocol (FTP). FTP server on the IRC5 responds to a request from an FTP client (MATLAB) on a remote computer. MATLAB provides the basic platform for programming and control algorithm development. The controlled output is transferred to the robot controller through Ethernet port as files and, thereby, the proposed scheme ensures connection and control of the robot using the control algorithms developed by the researchers without the additional cost of buying add-on packages or mastering vendor-specific programming languages. Findings New control strategies and contrivances can be developed with numerous conditions and constraints in simulation platforms. When the results are to be implemented in real-time systems, the proposed method helps to establish a simple, fast and cost-effective communication with commercial robot controllers for validating the real-time performance of the developed control algorithm. Practical implications The proposed method is used for real-time implementation of visual servo control with predictive controller, for accurate pick-and-place application with different initial conditions. The same strategy has been proven effective in supervisory control using two cameras and artificial neural network-based visual control of robotic manipulators. Originality/value This paper elaborates a real-time example using visual servoing for researchers working with industrial robots, enabling them to understand and explore the possibilities of robot communication.

Electrical charge storing electrodes and their surface modification are intensively investigated to improve the charge storability indicators in electrochemical energy storage devices. Here, the effects of a thin chemisorbed polyaniline (PANI) film on the charge storage behavior of rod-shaped spinal-type cobalt oxide (Co3O4) nanorods (PANI@Co3O4) are detailed for fabrication of battery–supercapacitor hybrid (BSH) devices. The PANI@Co3O4 showed larger surface area and optimum porosity properties, which contributed to ∼50 % enhanced specific charge than that in the Co3O4. The deconvoluted total charge storage gain showed more contribution to the bulk-diffusion controlled process (battery-type), lower ion transport resistance and Warburg impedance in the PANI@Co3O4 electrode than that in the Co3O4. Two-sets of BSH devices are fabricated using PANI@Co3O4 as a positive electrode and mesoporous carbon (MC) and activated carbon (AC) negative electrodes in an aqueous electrolyte and benchmarked with symmetric supercapacitors fabricated using the two carbons. The PANI@Co3O4//MC device showed nearly two-fold higher specific energy (ES) than that of PANI@Co3O4//AC. Interestingly, AC//AC symmetric supercapacitors showed two-fold higher ES than the MC//MC device. Origin of differences in the charge storage behavior of the two types of devices are systematically analyzed and reported.

Introduction: This case report describes the treatment of a 21-year-old man who presented in an orthodontic office for treatment but lived in a city 100 miles away and wanted the orthognathic surgery in another state in America. The patient presented with an anterior open bite and skeletal Class III relationship. Methods: The treatment plan included: (1) effective and careful communication of the treatment plan with the patient, orthodontist and oral and maxillofacial surgeon; (2) pre-surgical alignment and levelling of the teeth in both arches with Invisalign; (3) a long-distance communication between the orthodontist and the surgeon for surgical plan with virtual surgical planning (VSP Orthognathics; 3D Systems, www.3Dsystem.com ) online; (4) maxillary advancement (LeFort I osteotomy) with mandibular set-back (bilateral sagittal split osteotomy); (5) postsurgical correction of the malocclusion with clear brackets and aligners; and (6) retention and final small tooth movement adjustments with aligners/clear retainers. Results: The anterior open bite was treated, crowding was eliminated in the upper and lower anterior segment, correction of skeletal and dental Class III malocclusion was obtained, mandibular plane angle was reduced and facial profile improved. Conclusions: The results suggest that aesthetic and functional results can be achieved with long-distance communication of two specialties and with the combined use of clear aligners and clear fixed appliances.

Chinese steamed bread (CSB) accounts for 30% of the wheat end‐use in China. CSB was studied as a platform for fiber and protein enrichment, employing corn distillers dried grains. Food grade distiller's grain (FDDG) processed from co‐products from the corn ethanol industry was used as the enrichment ingredient. Since CSB uses a lean formula with little or no added sugar or fat, it relies entirely on fermentation and steaming for flavor and texture development. FDDG was used to replace 0%–25% all‐purpose flour (APF) in CSB formulations. Effects of FDDG on dough properties and quality of CSB were evaluated by instrumental (Farinograph, Mixolab, and Texture Analyzer), nutritional, and sensory methods. Protein and dietary fiber contents showed significant increases to 18.8% and 15.3%, respectively, for 100 g of steamed bread (25% FDDG db). Fiber in 100 g of fresh FDDG CSB ranged from 2.8 to 7.7 g. FDDG fortified doughs demonstrated higher water absorption, while dough development time, dough stability, and dough extensibility decreased significantly with partial APF replacement. FDDG contributed to increased hardness and adhesiveness in the CSB. Crumb analysis revealed reduced number of gas cells at higher FDDG substitution. FDDG enrichment reduced brightness (L*) of flour blends and CSB. Rheological and sensory analysis showed an upper level of FDDG substitution of 15% was acceptable without detriment to dough functionality, texture, and taste., This study provides compositional and food functional attributes of Chinese steam bread fortified with a high protein and high fiber ingredient. Distillers dried grains (38% protein and 40% dietary fiber) from corn was developed for food‐grade application and enrichment of steamed bread.

There is an increased demand for an ideal biodegradable biomaterial that eradicates infection, while concurrently promoting tissue regeneration in osteomyelitic bone, which eliminates the need for revision surgery. In this study, our objective was to evaluate the efficacy of a nanocomposite fibrous scaffold (silica coated nanohydroxyapatite-gelatin reinforced with poly-l-lactic acid yarns) containing vancomycin for treating methicillin-resistant Staphylococcus aureus (MRSA) induced osteomyelitis in rat models. The antibiotic was either incorporated during scaffold synthesis (SE-V) or loaded directly after the development of the scaffold (SA-V) at 5 wt% and 15 wt%. There was a sustained release of vancomycin from both the groups of scaffolds for 30 days and the released drug demonstrated antibacterial activity against MRSA. Furthermore, implantation of the composite scaffold into osteomyelitic rat femur resulted in significant bacterial reduction, mainly with 15 wt% drug and its efficacy was comparable to that of commercial graft Stimulan. Both drug entrapped and absorbed composite scaffolds promoted bone regeneration in 3 months, with no distinguishable difference between them. However, Stimulan resorbed fast and there were bone voids at the defect site after 3 months. Hence, the nanocomposite fibrous scaffold containing vancomycin can be proposed as a bi-functional graft that can reduce bacterial infection, while subsequently engineer new bone in osteomyelitis.

Purpose This paper aims to improve the performance of a two-camera robotic feedback system designed for automatic pick and place application by modifying its velocity profile during switching of control. Design/methodology/approach Cooperation of global and local vision sensors ensures visibility of the target for a two-camera robotic system. The master camera, monitoring the workspace, guides the robot such that image-based visual servoing (IBVS) by the eye-in-hand camera transcends its inherent shortcomings. A hybrid control law steers the robot until the system switches to IBVS in a region proven for its asymptotic stability and convergence through a qualitative overview of the scheme. Complementary gain factors can ensure a smooth transition in velocity during switching considering the versatility and range of the workspace. Findings The proposed strategy is verified through simulation studies and implemented on a 6-DOF industrial robot ABB IRB 1200 to validate the practicality of adaptive gain approach while switching in a hybrid visual feedback system. This approach can be extended to any control problem with uneven switching surfaces or coarse/fine controllers which are subjected to discrete time events. Practical implications In complex workspace where robots operate in parallel with other robots/humans and share workspaces, the supervisory control scheme ensures convergence. This study proves that hybrid control laws are more effective than conventional approaches in unstructured environments and visibility constraints can be overcome by the integration of multiple vision sensors. Originality/value The supervisory control is designed to combine the visual feedback data from eye-in-hand and eye-to-hand sensors. A gain adaptive approach smoothens the velocity characteristics of the end-effector while switching the control from master camera to the end-effector camera.

This article reports that extremely thin nanobelts (thickness ~ 10 nm) exhibit pseudocapacitive (PC) charge storage in the asymmetric supercapacitor (ASC) configuration, while show battery-type charge storage in their single electrodes. Two types of nanobelts, viz. NiO–Co3O4 hybrid and spinal-type NiCo2O4, developed by electrospinning technique are used in this work. The charge storage behaviour of the nanobelts is benchmarked against their binary metal oxide nanowires, i.e., NiO and Co3O4, as well as a hybrid of similar chemistry, CuO–Co3O4. The nanobelts have thickness of ~ 10 nm and width ~ 200 nm, whereas the nanowires have diameter of ~ 100 nm. Clear differences in charge storage behaviours are observed in NiO–Co3O4 hybrid nanobelts based ASCs compared to those fabricated using the other materials—the former showed capacitive behaviour whereas the others revealed battery-type discharge behaviour. Origin of pseudocapacitance in nanobelts based ASCs is shown to arise from their nanobelts morphology with thickness less than typical electron diffusion lengths (~ 20 nm). Among all the five type of devices fabricated, the NiO–Co3O4 hybrid ASCs exhibited the highest specific energy, specific power and cycling stability.

Protection systems are one of the most critical components in the transmission system and are becoming more digital with ongoing automation. These digital systems are prone to vulnerabilities/attacks, and exploitation of these vulnerabilities may cause major impacts on the electric grid performance. Multiple alarms reported in the control center could be a result of the faults (expected operations) or failures in the protection system (anomalies/ unexpected operation). Situational awareness gained through sensors such as a phasor measurement unit (PMU) and data acquired through the cyber system provide an opportunity to develop continuous cyber-physical monitoring of the system. Note that relay data are not reported in the control center continuously. This paper presents a cyber-physical data analytics based technique to monitor transmission protection system and detect malicious activity. Initially, continuous monitoring of PMU data is utilized for data anomaly detection, which includes bad or missing data using long short-term memory (LSTM). Then, PMU data of interest are utilized for failure diagnosis, using a semisupervised deep autoencoder model. In this research, cyber anomalies are modeled by manipulating the setting/logic design of protective devices, and a ridge regression based classifier with a feature engineering pipeline is used to detect cyber anomalies. The results from the deep autoencoder model and ridge regression based classifier are then utilized for detailed investigation to find the root causes of the observed events assisted by the cyber log data from the protection devices. The algorithm is validated using a real-time simulation of the IEEE test system with industrial hardware relays and PMUs in the loop. Data analytics algorithm running on server utilizes these real-time data continuously for anomaly detection and classification for the developed use cases.

Law brings structure and order in the society. Rightly so, it is imperative to have a strong competition law regime in place to guide the activities of the marketplace, the backbone of the economy. India has had a very eventful journey in finding out, formulating and fixing a proper competition legislation in place. The Competition Act regulates the domestic market activities of India by supporting activities that promote healthy competition. As India completes almost two decades after the enactment of the Competition Act of 2002, the author tries to elucidate on the journey of Indian Competition law by discussing its precursor, the MRTP Act, the present legislation, and also enumerates the challenges that are faced by the competition and anti-trust laws in the country.

The Latarjet surgical technique is one of the most effective and well-known techniques in the treatment of anterior shoulder instability(1). The modified Latarjet technique is a history book of surgical details demonstrated by renowned masters of shoulder surgery. The procedure includes soft-tissue repair and osseous reconstruction to stabilize the glenohumeral joint in recurrent anterior instability. The procedure has been shown to have reliable success in reducing recurrent instability and minimizing risk of dislocation arthropathy(2-4). DESCRIPTION: The Latarjet technique can be performed via a cosmetic axillary-based approach. The subscapularis is split horizontally without detachment as described by Neer(5). The capsule is released like in a medially based T-plasty as described by Altchek et al.(6). The coracoid osteotomy is performed with a 90° oscillating saw and prepared for en-face implantation as described by Edwards and Walch(7). The inferior surface of the coracoid is decorticated and prepared per Molé(8). Coracoid fixation is performed with two 3.5-mm cortical screws. The soft-tissue reconstruction is selectively tensioned per Warner et al.(9). The capsular shift is augmented with a pants-over-vest repair per Kim et al.(10). ALTERNATIVES: Nonoperative treatment in young patients with glenohumeral instability and bone loss can lead to recurrence rates as high as 87%(11). Arthroscopic management with anterior capsulolabral repair and a remplissage procedure can be beneficial for patients with instability. In the setting of bone loss, arthroscopic repair is associated with failure rates as high as 75%(12). RATIONALE: In the setting of glenoid and/or humeral bone loss, there is a loss of native osseous anatomy, leading to a higher risk of instability. Gerber and Nyffeler reported a >30% loss of compressive force when the vertical edge of the glenoid defect is greater than one-half of the glenoid diameter(13). The Latarjet procedure is a reliable procedure that reconstructs the anterior osseous anatomy as well as the capsular laxity, restoring glenohumeral stability. When compared with arthroscopic labral repair, the Latarjet procedure is superior with more consistent improvements in functional outcomes with low risk of recurrence, even in high-risk populations of young, active athletes in contact sports(2,3). EXPECTED OUTCOMES: At our institution, a total of 34 patients underwent Latarjet reconstruction as described in the present article and videos from 2013 to 2018, with a minimum follow-up of 1 year. Among these patients, the mean Single Assessment Numeric Evaluation score was 90.7 (range, 70 to 100). There were 4 cases of recurrent instability with graft fracture or resorption (11.8%). Zimmermann et al. presented a series of Latarjet reconstructions with similar functional outcomes and a recurrence rate of 11%(4). Meta-analysis of long-term Latarjet studies show high rates of return to sports and successful outcomes in 86% of cases, with an 8.5% recurrence rate(2). IMPORTANT TIPS: The Latarjet procedure can be consistently performed with a subscapularis-sparing approach, which minimizes adverse comorbidities. Splitting the subscapularis at the inferior one-third junction will position the surgical window directly over the bottom half of the glenoid, which optimizes coracoid implantation. A medially based T-plasty will maximize the glenoid exposure for direct coracoid implantation. Subsequently, the capsule may be shifted for capsular imbrication. Low-profile, non-bulky retractors will help to improve visualization. Adjusting the arm is a key technique in performing this surgical procedure. This adjustment will help to shift the surgical window, expose key anatomic structures, and allow a capsular shift without overtensioning. This cannot be overstated.

In current study a careful and dedicated observation was done to investigate the effect of the externally applied optical field on electrolysis of water to produce hydrogen. As optical field sources, the green and red diode pumped solid state lasers (DPSSL) were utilized. Due to its non-absorbance characteristics in water, the green laser has had the largest impact on the generation/production of hydrogen. In order to dissociate hydronium and hydroxide ions during orientation toward polarisation of water, the electrical field's intensity must be high enough. The mechanism of optical field to expose the hydrogen production in water electrolysis has the capability to break the autoprotolysis and generate the auto-ionization. However, the presence of a sacrificial agent and a laser source combined to produce a better effect, resulting in a five-fold increase in hydrogen output compared to ordinary water electrolysis. UV-Vis and the gas chromatography was performed for supporting the research claim. The gas chromatogram was indicating a clear peak at retention time 1.47 minutes with abundance 338878 a.u. which predicts the purity and abundance of produced hydrogen.

To evaluate the neurological and neurophysiological outcomes of retractor-endoscopic versus open release in carpal tunnel syndrome (rCTS and oCTS, respectively) and cubital tunnel syndrome (rCbTS and oCbTS, respectively) at 3- and 12-month follow-up.Between 2013 and 2017, 80 patients were prospectively blindly randomized. McGowan scores were used for preoperative grading and outcomes were assessed using a modified Bishop rating system (BRS). Furthermore, incapacity to work, duration of postoperative pain, hypoesthesia, atrophy, subjective weakness, and a subjective assessment of the operative result were analyzed. The differences in the cohorts were evaluated with t-tests and ANOVAs as parametric tests and Kruskal-Wallis and Mann-Whitney U tests as nonparametric tests.The 80 patients underwent retractor-endoscopic or open decompression of the median or ulnar nerve. The rCTS group exhibited significant improvements in neurophysiological data (P = 0.032), shorter periods of postoperative pain (P = 0.03), and less discomfort (P = 0.005), as well as significantly better BRS results after 3 months compared with the oCTS group (P = 0.005). Between the oCbS and rCbTS groups, no significant differences were observed (P 0.05). Regarding improvements in McGowan scores, no statistically significant differences were observed between the rCTS and oCTS groups after 3 months (P = 0.52) or 12 months (P = 0.86), nor were any observed between the rCbTS and oCbTS groups after 3 months (P = 0.88) or 12 months (P = 0.10).Significantly superior results were obtained at short-term follow-up for rCTS, whereas no superiority was found for rCbTS release. This study concluded that this endoscopic procedure is safe as well as and effective and has the potential to achieve better results in carpal tunnel syndrome compared with conventional methods.

Depending on severity of presentation, pituitary apoplexy can be managed with acute surgery or non-operatively. We aim to assess long-term tumour control, visual and endocrinological outcomes following pituitary apoplexy with special emphasis on patients treated non-operatively.Multicentre retrospective cohort study. All patients with symptomatic pituitary apoplexy were included. Patients were divided into 3 groups: group 1: surgery within 7 days; group 2: surgery 7 days-3 months; group 3: non-operative. Further intervention for oncological reasons during follow-up was the primary outcome. Secondary outcome measures included visual and endocrinological function at last follow-up.One hundred sixty patients were identified with mean follow-up of 48 months (n = 61 group 1; n = 34 group 2; n = 64 group 3). Factors influencing decision for surgical treatment included visual acuity loss (OR: 2.50; 95% CI: 1.02-6.10), oculomotor nerve palsy (OR: 2.80; 95% CI: 1.08-7.25) and compression of chiasm on imaging (OR: 9.50; 95% CI: 2.06-43.73). Treatment for tumour progression/recurrence was required in 17%, 37% and 24% in groups 1, 2 and 3, respectively (p = 0.07). Urgent surgery (OR: 0.16; 95% CI: 0.04-0.59) and tumour regression on follow-up (OR: 0.04; 95% CI: 0.04-0.36) were independently associated with long-term tumour control. Visual and endocrinological outcomes were comparable between groups.Urgent surgery is an independent predictor of long-term tumour control following pituitary apoplexy. However, 76% of patients who successfully complete 3 months of non-operative treatment may not require any intervention in the long term.

Visual servoing is the method of controlling a robot using image input from one or more image sensors to complete a predefined task. This paper examines the effectiveness of a Recurrent Neural Network (RNN) to predict the position and orientation (pose) of an industrial robot manipulator for automatic pick and place applications mainly in unstructured environment. The robot manipulator moves to the target object based on the pose commands obtained from the trained neural network. Various images obtained from the camera attached to the end-effector and corresponding pose of the end-effector are the input and the output data for training the neural network. The performance of the RNN in predicting the robot pose is compared with the feedforward neural (FFN) network and cascade forward neural (CFN) network. The proposed method is validated experimentally using ABB IRB 1200 6-DOF industrial robot manipulator.

Case A 21-year-old woman with a history of multiple failed surgical and conservative management for recurrent involuntary shoulder instability presented with 1-year history of shoulder pain. Physical examination demonstrated intractable static anterior glenohumeral instability, deficient capsular tissue, with reducible scapular winging secondary to long thoracic nerve palsy. Allograft capsular reconstruction and open split pectoralis major tendon transfer were performed to salvage shoulder motion and stabilize her shoulder girdle. Conclusion This report presents a novel repair option for intractable shoulder instability and scapular winging. Surgeons should recognize potential causes of shoulder instability and familiarize themselves with multiple stabilization techniques as potential salvage options before glenohumeral fusion.

PURPOSE The purpose of the study was to examine the impact of residency training institutions on the pursuit of a career in academic oral and maxillofacial surgery and assess variables associated with academic productivity. MATERIALS AND METHODS This was a cross-sectional study of full-time academic oral and maxillofacial surgeons (OMSs) in the United States. The primary predictor variable was program of residency training. Secondary predictors included gender, fellowship training, advanced degrees, and private practice affiliation. The primary outcome variable was the number of graduates in a ful-time academic position. Academic productivity (h-index, publication number) was a secondary outcome. Descriptive, logistic and linear regression analyses were computed. RESULTS The study sample consisted of 294 full-time academic OMSs in 82 training programs. The top 10 high-output residency programs were identified and graduates from these programs were more likely to have a medical degree (OR = 1.99, 9% CI: 1.17 - 3.36, p=0.0108), higher h-indices (11.03 vs 7.96, p = 0.0032) and higher number of publications (40.3 vs 25.6, p = 0.003). Faculty characteristics associated with higher h-indices included a medical degree (10.33 vs 7.66, p = 0.0067), PhD (15.23 vs 8.38, p = 0.0002), MPH (17.47 vs 8.66, p = 0.0040) and fellowship training (11.15 vs 7.76, p = 0.0012). There were no significant differences between genders in having a medical degree, completing a subspecialty fellowship, or academic productivity. Female surgeons represented 16.33% of academic OMSs and were more likely to have entered academia more recently based on duration in years of academic appointment (12.48 versus 21.08; p < 0.001). CONCLUSIONS Ten programs have trained 29.6% (n = 87) of all full-time academic OMSs. These programs' graduates were more likely to have a medical degree, higher h-indices, and greater number of publications.

Introduction: Colon cancer is the third most commonly diagnosed cancer in males and the second in females, with more than 1.4 million new cancer cases every year. Colon cancer can take many years to develop and early detection of colon cancer greatly improves the chances of a cure. Aim: This study was conducted to study the different modes of clinical presentation of colonic malignancy and its relation to the site of the lesion as seen at a tertiary care hospital in North Kerala, India. Materials and Methods: This was a prospective cohort study carried out on patients diagnosed with colonic cancer and admitted to the Department of Surgery of a tertiary care hospital in North Kerala, India, during the study period of one year from November 2014 to November 2015. Total of 45 patients were clinically evaluated, investigated, taken up for surgical management and followed-up. The collected data were entered into the study proforma and analysed using Statistical Package for Social Sciences. The Chi-square test for goodness of fit, Chi-square test for association and Student’s t-test were used. Results were considered statistically significant when p-value was less than 0.05. Results: Of the 42 cases of carcinoma of colon, 24 (57.1%) were males and 18 (42.9%) were females with a male to female ratio of 1.3:1. The maximum frequency of cases were in between the ages 51 and 60 years (6th decade) followed by the 7th and 8th decades. The mean age of presentation of carcinoma in the left colon (64.43 years) was significantly higher than the right side (55.95 years). The most common symptom/signs were abdominal pain (78.6%), anemia (54.8%), altered bowel habits (50%), abdominal mass (38.1%) loss of weight/appetite (33.3%), constipation (31%) and blood and mucus per rectum (28.6%). Conclusion: Cancer of the colon primarily affected older individuals especially those with left colonic cancers. Common complaints such as abdominal pain, altered bowel habits, constipation and blood and mucous per rectum were seen frequently in the patients having colonic cancer. Certain symptoms like constipation, altered bowel habits and blood and mucous per rectum were more in patients with cancer in the left colon.

The paper aims to investigate the impact of COVID-19 pandemic on the perception of travelers and identify new policies and intervention areas for improving urban bus service. This was carried out based on the perception data collected from travelers in the years 2018 (before pandemic) and 2020(in post lockdown scenario). Data was collected from the state of Kerala, India, and Importance-Satisfaction Analysis (ISA) with fuzzy c-means clustering was carried out to identify improvement areas for both scenarios. Results show a substantial increase in the number of priority areas as compared to the pre-pandemic scenario. Bus service attributes such as cleanliness, crowding level, and pedestrian environment emerged as new intervention areas of bus service during the pandemic. This is a clear reflection of the increased awareness of travelers about the prevailing pandemic scenario and the need for improvement in attributes related to social distancing and hygiene. The higher priority to information related attributes of bus service clearly shows the need for improvement in such attributes for the safe planning of trips during the pandemic. The work also estimated desired service levels of quantitative attributes to enhance the satisfaction levels of users. An evaluation of five bus routes in Kochi based on the desired levels shows the underperformance of attributes such as headway, punctuality, and crowding level. While the findings are city-specific, the methodology and experience may be adopted to enhance the service quality of buses and other public transport.

In the agriculture sector, livestock are considered extremely resilient to climate change and are tipped to play a significant role in ensuring food security to meet the increased demands of growing human population by 2050. Compared to other domestic species, goats are considered the ideal animal model for climate change due to its high thermal and drought resilience, ability to survive on limited pastures, and high disease resistance. This review is therefore a revisit to the advantages of rearing goats over other livestock species under current and future trends of changes in climate, particularly to cope with recurrent multiple stressors such as heat load, and lack of water and feed. In summary, goats, also called as poor man's cow, are preferred by the small-scale landless farmers due to their low input and assured higher output system, as they require low initial investment, with minimum specialized facilities and labors. Furthermore, they perceive goats as better resilient animal to cope with multiple stressors such as heat load, and water and feed scarcity, and possess better skills to cope with bush, when compared with sheep and cattle. The unique capacity for employing behavioral plasticity and morphological features of goats gives them clear advantage over sheep and cattle, when coping with seasonal biotopes, and experiences of water and feed shortage. When facing with low-quality feed, they also are superior to cattle and sheep to digest dry matter and to recycle nitrogen. Additionally, goats have superior ability to desiccate feces and concentrate urine, when compared with sheep and cattle. These advantages make goat the go-to species for efficiently countering the adversities associated with climate change and to optimize appropriate economic return through sustained production. Therefore, goats are tipped to be the future animals with extreme potential to counter the projected alarming climate change impacts and expected to play a significant role in ensuring food security to meet the demands of the growing human population by the end of this century.

Tuning of porosity and surface properties of nanoparticles especially on carbon-based nanomaterials, adopting a ‘greener’ or self-activation synthesis technique for electrical charge storage, is progressing. Herein, we report the self-activation of Teak wood sawdust in a nitrogen atmosphere at different activation temperatures to synthesize carbon nanoparticles. The activated carbon nanoparticles synthesized at 900 °C exhibits a maximum ~ 360 m2 g−1 surface area with ~ 2 nm average pore size diameter. Five electrolytes viz. KOH, KCl, Na2SO4, NaCl, and H3PO4 are used for studying the supercapacitance nature of the activated carbon nanoparticles in a 3-electrode configuration. A maximum specific capacitance of ~ 208 F g−1 @ 0.25 A g−1 is obtained in 1 M KOH as the electrolyte. Two symmetric supercapacitors, aqueous (1 M KOH) and solid-state (PVA/KOH), are fabricated, and their performance difference is compiled. The solid-state symmetric supercapacitor performs in a wider voltage window (1.7 V) with a superior energy density of 27.1 Wh kg−1 at a power density of 178 W kg−1.

PURPOSE A growing concern in the community of oral and maxillofacial surgeons (OMSs) is the progressive hearing loss that has become more evident in older surgeons. Very few studies have focused on the effects on a surgeon's hearing based on his or her environment. The purpose of this study was to investigate whether the noise produced by suction, compared with federal guidelines, could have a damaging effect on the hearing of OMSs. MATERIALS AND METHODS A CEM DT-8851 industrial high-accuracy digital sound noise level meter data logger (CEM Instruments, Bengal, India) was used to capture the sound intensities in various procedures. The sound meter was used to record the intensities of sound produced, in decibels, in clinics and operating rooms. The analysis was divided into different variables: non-drilling/suction (in which neither a drill nor suction was used but suction was on), suction, drilling, suction and drilling, suction and irrigation, and Yankauer suction. RESULTS A total of 50 clinic and 50 operating room procedures were recorded, focusing on suction. The noise intensities captured were analyzed based on federal workplace standards. Compared with non-drilling/suction, all other noise exposures on average were greater in intensity and statistically significant with P

Integration of distributed energy resources has been significantly increasing in the electric power grid. One of the predominant renewable energy sources, wind energy, possess a significant challenge for grid operations, due to its intermittency, uncertainity, and variability. In changing operating conditions with wind uncertainity, part of wind may need to be curtailed for the safe utilization of the transmission system. In order to minimize the wind power curtailment and to keep the power flow on a transmission line under limits, a cyber resilient distributed remedial action scheme (DRAS) is developed in this paper. The remedial action scheme (RAS) is formulated as an optimization problem, considering the real-power flow constraints of the transmission lines and given wind variability. In this paper, DRAS is developed to operate even with failures in the computing nodes to make it cyber-resilient. Distributed simplex algorithm is used for optimization in the distributed RAS. The DRAS is implemented in a decentralized platform called Resilient Information Architecture Platform for Smart Grid to enable cyber resiliency of DRAS. The effectiveness of the proposed approach is validated through offline simulations of the New England 39-bus system and online simulations of IEEE 14-bus test system. A cyber–physical testbed utilizing real time digital simulator, phasor measurement units, and BeagleBones has been used for the online simulation and validation of the developed cyber-resilient RAS.

Electrochemical sensor for the determination of Vitamin B 12 was fabricated using a disposable pencil graphite electrode. The main highlight of this work is that without any electrode modification and analyte pre-concentration, direct electrochemical detection of Vitamin B 12 was made possible. Morphological and structural studies were incorporated. Electrochemical studies were done using cyclic voltammetry and differential pulse voltammetry. Electrochemical reduction of Vitamin B 12 was observed at -0.82 V. Sensor exhibited a linear range of 2.5-30 nM with a sensitivity of 1.96 µA/nM/cm2. The viability of the sensor towards practical use was tested in commercial Vitamin B 12 tablet.

Full-mouth extractions (FMEs) are common procedures that are classically performed electively due to caries and periodontal disease. Up to 17% of adults over the age of 65 and 2% of adults aged 20-64 in the United States are edentulous. At the University of Cincinnati Medical Center, approximately 250 FMEs are performed annually with nearly half performed on adults over the age of 50. There is currently an absence of data on this patient population and their overall outcomes. The authors hypothesize that FMEs are often performed on socioeconomically and medically vulnerable populations, thereby further compromising their conditions and potentially contributing to their demise. The authors aim to describe patient-related characteristics and document post-FME time to death. The authors performed a single-center retrospective chart review from July 1, 2012, to January 1, 2020. Inclusion criteria included all patients who underwent FME at the institution due to caries, periodontal disease, and non-restorable dentition. Patients were excluded if there were insufficient data or identifiers. Recorded data included demographics, medical insurance, medical history, and social history. The primary outcome variable was post-FME time to death. Patient mortality was identified through chart review and inquiry of the National Death Index, a database of the National Center for Health Statistics. Statistical analysis was performed with SASv9.4 and included simple descriptive statistics and multivariate survival analysis. A total of 1829 patients were included in the study; 976 were female. Median age was 49 (IQR 38-58); 65% identified as Caucasian and the remaining African-American. Insurance coverage included Medicaid (59%), Medicare (30%), and private insurance (10%). In total, 1709 patients were diagnosed with more than 1 comorbidity at the time of FME. The most prevalent were psychiatric illness (50%), diabetes mellitus (20%), coronary artery disease or congestive heart failure (16%), and chronic obstructive pulmonary disease or emphysema (14%). Overall, 1072 patients (59%) were identified as current smokers, 690 (38%) as alcohol users, and 394 (22%) had a history of illicit drug use; 85 (5%) patients were nursing home residents. As of December 31, 2019, a total of 170 patients (9.3%) were identified as dead; 51% of deaths occurred within the first 2 years of the procedure, and 87% occurred within 5 years. Median time to death was 2.0 years (IQR 0.9-3.8) at a median age of 56 (IQR 46-63). Mortality rate was higher in nursing home residents at 29%. Post-FME predictors of mortality included male gender (P-value 3 (P-value FME patients are typically medically disadvantaged and likely to be on Medicaid or Medicare. Approximately 1 in 10 FME patients died within 5 years of the procedure at the center. This may suggest that FME exposure can lead to serious deterioration, comorbidities or death. Further studies are currently underway at the institution to assess FME-related complication rates and quality of life improvement. The authors recommend thoughtful consideration to the overall implications of such a procedure on the well-being of patients rather than strict adherence to traditional indications.

Mental illness is highly prevalent among adults in the United States, with almost 1 in 5 adults living with some degree of mental illness. Given most of oral and maxillofacial surgery (OMS) procedures are inherently anxiety-generating, the authors sought to determine the burden of psychiatric illness in the population seeking care at an outpatient OMS unit of the University of Cincinnati. The authors hypothesized that psychiatric diagnoses would be common in this population. This is an ongoing retrospective cohort study. Study subjects were identified by searching CPT codes through electronic health records to identify all patients older than 15 years of age who underwent any oral and maxillofacial surgery outpatient procedure in 2018 (January 1 to December 21). Data on demographics, ASA status, presence of psychiatric diagnosis according to DSM-5, type of procedure, and complications were collected by performing a retrospective chart review. A total of 4616 patients were identified for the chosen timeframe. All the duplicates (387 patients) were removed; 252 patients were further removed as they did not meet the inclusion criteria (no procedure performed, Descriptive analysis was conducted and prevalence rates were calculated. Out of total of 1300 patients who were reviewed, 60.9% (792) were females and 39.1% (508) were males. Age range was from 15 to 98 years with a mean age of 34.2 years; 45.2% (588) were Caucasian, 39% (507) were African-American, 0.7% (9) were Asian, 3.1% (40) were Hispanic, 3.3% (43) were other races, and 8.7% (113) were of unknown race; 32.1% (418) of patients were classified as ASA I, 55.6% (723) were ASA II, 11.2% (145) were ASA 3, and 1.1% (14) were ASA IV. Among the total reviewed population through OMS vision, 305 patients were found to have reported psychiatric diagnosis. Further review of medical history of the remaining patients was performed through Epic, and 26 more patients were found to have reported psychiatric diagnosis. A total of 25.5% (331) of patients were found to have a pre-existing psychiatric diagnosis. Out of these patients, 62 had neurogenic disorders, 29 had schizophrenia spectrum disorders, 56 had bipolar disorders, 218 had anxiety and depressive disorders, 82 had substance use and addictive disorders, 5 had personality disorders, and 7 had other disorders. A total of 102 patients had multiple psychiatric diagnosis. Among the 1300 procedures completed, 11.8% (153) of patients experienced postoperative complications and, among these, 24.9% (38) had psychiatric diagnoses. The review shows that psychiatric illnesses are common among the oral and maxillofacial surgery population. This population is also likely to have more complications. The ongoing record review would shed more light in this arena when complete. Prognostic implications of preoperative psychiatric disorders on surgical outcome should be demonstrated prospectively in intervention studies.

BACKGROUND: DJ-1 knockout (DJ-1 KO) rats exhibit a moderate parkinsonian phenotype, with gross motor deficits and ca. 50% loss of midbrain dopaminergic neurons appearing around 6–8 months of age. Fine motor impairments are often observed in Parkinson’s disease (PD), but skilled motor function in recently developed transgenic rat models of PD is not well characterized. OBJECTIVES: To assess the longitudinal performance of DJ-1 KO rats on a skilled forelimb reaching task. METHODS: DJ-1 KO and wild-type (WT) rats were trained from 2–10 months of age on an isometric pullbar task designed to test forelimb strength and coordination. After 36 consecutive weeks of training (ca. 10 months old), task difficulty was then increased to challenge the motor capabilities of the DJ-1 KO rats. Throughout the study, subjects also received weekly assessments of gross locomotor activity in an open field. RESULTS: Pull-task performance of the DJ-1 KO rats was impaired compared to WT, with deficits reaching significance around 7–9 months of age. When challenged, DJ-1 KO rats were able to exert increased force on the pullbar but continued to exhibit deficits compared to WT rats. Throughout the study, no differences in distance travelled or rearing frequency were observed in the open field, but DJ-1 KO rats were found to spend significantly more time in the center of the open field than WT rats. CONCLUSIONS: Using a sensitive, automated assay of forelimb strength and coordination, we find that skilled forelimb motor performance is impaired in DJ-1 KO rats.

CASE A 68-year-old male, status post revision right reverse total shoulder arthroplasty (RTSA) for periprosthetic fracture, suffered a periprosthetic joint infection necessitating 2-stage revision. Imaging revealed 8.6 cm of ipsilateral proximal humeral bone loss (PHBL) including loss of the greater and lesser tuberosities. A 2-stage revision was performed using an antibiotic spacer, followed by a custom long-stem RTSA for definitive reconstruction. Two years postoperatively, the patient had significantly improved pain and functional range of motion. CONCLUSION Custom long-stem RTSA could serve as a potentially viable reconstructive option in patients with severe PHBL.