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This article introduces extended (s,m)-prequasiinvex functions on coordinates, a new form of generalized convex function. Using a previously established identity, we derive new fractional Hermite-Hadamard type integral inequalities for functions whose mixed partial derivatives belong to this new class of functions. The obtained results generalize existing Hermite-Hadamard type inequalities and have numerous applications in mathematics and physics. To demonstrate the utility of our findings, we provide examples of applications to special means, such as arithmetic, harmonic and p-logarithmic means.

Control of residual chlorine concentration within a desirable range throughout water distribution systems can cause the destruction of potentially harmful pathogens without chlorine adverse health effects & its toxic by-products. Hence, optimal scheduling of booster chlorination stations in the WDSs to ensure healthy water supply with the lowest dose of chlorine consumption is vital. The aim of the present study is to develop a multi-objective optimization model in order to minimize the mass injection rate as well as the probability of chlorine violation in the WDSs, which has been implemented in the MATLAB-EPANET platform. Multi-objective krill herd and multi-objective particle swarm optimization algorithms have been utilized as optimizers to obtain the desired Pareto front in the real-scale Brushy Plains network. The resulted Pareto fronts showed that in most of their solutions, as long as the mass injection rate increased, the probability of chlorine violation decreased. In this study, the solution with the less PCV in each Pareto was selected as the optimal solution to assure the healthy water supply. Though the MOPSO resulted Pareto showed more solution diversity, MKH optimal solution has a better MIR function than MOPSO optimal solution with the same amount of PCV. Analyzing the residual chlorine concentration profiles of the monitoring period corresponding to the MKH optimal solution showed that the chlorine concentration of the most nodes of Brushy Plains network exist in the desirable range of 0.2 to 0.8 mg/L and the residual chlorine of 100% of nodes exist in the range of 0.2 to 1.6 mg/L. Also, the MKH results are superior to those of the previous studies in terms of the total mass injection rate. Generally, in addition to economic advantages, minimizing chlorine injection rate and the probability of chlorine violation simultaneously in the water distribution systems reduces the adverse health effects of the disinfectant by-products.

Aims: Revision total knee arthroplasty (rTKA) is a technically challenging and costly procedure. It is well-documented that primary TKA (pTKA) have better survivorship than rTKA; however, we were unable to identify any studies explicitly investigating previous rTKA as a risk factor for failure following rTKA. The purpose of this study is to compare the outcomes following rTKA between patients undergoing index rTKA and those who had been previously revised. Methods: This retrospective, observational study reviewed patients who underwent unilateral, aseptic rTKA at an academic orthopaedic speciality hospital between June 2011 and April 2020 with > one-year of follow-up. Patients were dichotomized based on whether this was their first revision procedure or not. Patient demographics, surgical factors, postoperative outcomes, and re-revision rates were compared between the groups. Results: A total of 663 cases were identified (486 index rTKAs and 177 multiply revised TKAs). There were no differences in demographics, rTKA type, or indication for revision. Multiply revised patients had significantly longer rTKA operative times (p < 0.001), and were more likely to be discharged to an acute rehabilitation centre (6.2% vs 4.5%) or skilled nursing facility (29.9% vs 17.5%; p = 0.003). Patients who had been multiply revised were also significantly more likely to have subsequent reoperation (18.1% vs 9.5%; p = 0.004) and re-revision (27.1% vs 18.1%; p = 0.013). The number of previous revisions did not correlate with the number of subsequent reoperations (r = 0.038; p = 0.670) or re-revisions (r = −0.102; p = 0.251). Conclusion: Multiply revised TKA had worse outcomes, with higher rates of facility discharge, longer operative times, and greater reoperation and re-revision rates compared to index rTKA. Cite this article: Bone Jt Open 2023;4(5):393–398.

Abstract Introduction Prior studies have demonstrated an association between time to revision total knee arthroplasty (rTKA) and indication; however, the impact of early versus late revision on post-operative outcomes has not been reported. Materials and methods A retrospective, observational study examined patients who underwent unilateral, aseptic rTKA at an academic orthopedic hospital between 6/2011 and 4/2020 with > 1-year of follow-up. Patients were early revisions if they were revised within 2 years of primary TKA (pTKA) or late revisions if revised after greater than 2 years. Patient demographics, surgical factors, and post-operative outcomes were compared. Results 470 rTKA were included (199 early, 271 late). Early rTKA patients were younger by 2.5 years (p = 0.002). The predominant indications for early rTKA were instability (28.6%) and arthrofibrosis/stiffness (26.6%), and the predominant indications for late rTKA were aseptic loosening (45.8%) and instability (26.2%; p

Riffle-pool sequences are fundamental, ubiquitous morphological features of alluvial rivers that are thoroughly studied in general and commonly incorporated into river restoration projects. Most previous investigations on the effect of riffle-pool sequences on hyporheic exchanges focused on solely bed undulation, because that is widely thought to be the defining feature of riffle-pool sequences. However, riffle- pool sequences also have significant width undulations that are vital to riffle-pool sequences morphodynamics, yet relatively few studies exist on the effect of such undulations on hyporheic exchanges. Thus, in this study based on laboratory experiments and numerical simulations, we investigate the effect of bed and width undulations on hyporheic zone characteristics for various ratio of width amplitude to bed amplitude. The variation of hyporheic exchange characteristics (i.e. hyporheic exchange flux and residence time) for different riffle-pool designs were also assessed by creating prescribed topography of synthetic river valleys. The results showed that due to pressure variation along width undulations, the upwelling and downwelling patterns can also be observed for only width undulations in rivers, in the absence of bed undulations, and as width undulation amplitude decreases, the normalized hyporheic exchanges (Q*HZ) increase and normalized median residence time (RT*) decreases. Also, simultaneous channel bed and width undulations result in higher Q*HZ especially when a pool is located in an expansion (aka “oversized” cross-section) and a riffle in a constriction (“nozzle”). Our results suggest that river restoration project that artificially construct wide pools and constricted riffles will achieve maximum Q*HZ and RT*, though they will not be geomorphically self-sustainable.

Detecting road cracks is essential for inspecting and assessing the integrity of concrete pavement structures. Traditional image-based methods often require complex preprocessing to extract crack features, making them challenging when dealing with noisy concrete surfaces in diverse real-world scenarios, such as autonomous vehicle road detection. This study introduces an image-based crack detection approach that combines a Random Forest machine learning classifier with a deep convolutional neural network (CNN) to address these challenges. Three state-of-the-art models, namely MobileNet, InceptionV3, and Xception, were employed and trained using a dataset of 30,000 images to build an effective CNN. A systematic comparison of validation accuracy across various base learning rates identified a base learning rate of 0.001 as optimal, achieving a maximum validation accuracy of 99.97%. This optimal learning rate was then applied in the subsequent testing phase. The robustness and flexibility of the trained models were evaluated using 6,000 test photos, each with a resolution of 224 × 224 pixels, which were not part of the training or validation sets. The outstanding results, boasting a remarkable 99.95% accuracy, 99.95% precision, 99.94% recall, and a matching 99.94% F1 Score, unequivocally affirm the efficacy of the proposed technique in precisely identifying road fractures in photographs taken on real concrete surfaces.

This paper introduces new versions of Hermite–Hadamard, midpoint- and trapezoid-type inequalities involving fractional integral operators with exponential kernels. We explore these inequalities for differentiable convex functions and demonstrate their connections with classical integrals. This paper validates the derived inequalities through a numerical example with graphical representations and provides some practical applications, highlighting their relevance to special means. This study presents novel results, offering new insights into classical integrals as the fractional order β approaches 1, in addition to the fractional integrals we examined.

Due to low susceptibility of coronavirus disease of 2019 (COVID-19) in children, limited studies are available regarding COVID-19 in the pediatric population in Tunisia. The current study evaluated the incidence, clinical characteristics, and outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection among children hospitalized at Béchir Hamza Children’s Hospital. A retrospective cohort analysis was conducted using the hospital database between March 2020 and February 2022 with children aged ≤15 years with SARS-CoV-2 infection (confirmed by RT-PCR). A total of 327 COVID-19 hospitalized patients with a mean age of 3.3 years were included; the majority were male. Neurological disease (20%) was the most common comorbidity, while fever (95.3%) followed by cough (43.7%) and dyspnea (39.6%) were the most frequent symptoms reported. Severe disease with oxygen requirement occurred in 30% of the patients; 13% were admitted in the Intensive Care Unit. The overall incidence rate of COVID-19 hospitalization (in Tunis governorates) was 77.02 per 100,000 while the inpatient case fatality rate was 5% in the study population. The most prevalent circulating variant during our study period was Delta (48.8%), followed by Omicron (26%). More than 45% of the study population were n = 25, 26.5%) had at least one comorbidity. Thus, the study findings highlight the high disease burden of COVID-19 in infants.

Low-cost mullite-kaolinite material has recently received more attention as an alternative to conventional ceramic materials such as alumina and silica to prepare ceramic hollow fibre membranes (CHFMs) due to its high alumina contents and silica and thermal/chemical stability. However, weak bending strength is still one of the key bottlenecks that delay their commercial applications. In this work, we successfully fabricate a novel mullite-SS HFM with enhanced bending strength using mullite-kaolinite power with different stainless steel alloy (SS) 316 L contents of 0.0, 2.5, 5.0, 7.5, 10 and 12 % (w/w) as a reinforcement material by phase inversion/sintering techniques. The SS alloy was a potential material to enhance the mechanical strength of mullite HFMs due to its excellent mechanical properties. The effects of the major fabrication parameters of SS contents, mullite contents, and fabrication parameters such as air gap distance and bore fluid flow rates were well studied and evaluated through the fabrication process. Fabricated mullite-SS HFMs were characterized by morphology, porosity, pore size/pore size distribution, and bending strength. Afterwards, they were evaluated in an oil/water separation system regarding water flux and oil rejection rate. Based on the findings, there was a gradual increase in the bending strength from 32.1 to 79.8 MPa with increased SS contents from 0 to 12 % (w/w). At 10 % (w/w) SS, the satisfactory morphology with the balance between the bending strength of 66.7 MPa and porosity of 29 % was obtained. This bending strength was significantly higher than reported for mullite-kaolinite HFMs in previous works. Moreover, At 10 % (w/w) SS, the oil–water rejection performance of 96.9% and the water permeation of 290 L/m2. h was satisfactory at the sintering temperature of 1300 °C. These findings suggest the advantage of this membrane for various water treatment applications, such as oil/water separation, due to its outstanding physical properties.

Key Clinical Message In this case report we describe a patient with Grave's disease (GD) who was first diagnosed with pancytopenia and did not have any typical symptoms of GD. His hematologic abnormalities were alleviated after treatment with an anti‐thyroid drug. Hence, in patients with pancytopenia, GD should also be considered. Abstract A variety of hematologic abnormalities can be seen in Graves' disease (GD), however; here, we describe a patient with GD and a very rare complication; pancytopenia. His hematologic abnormalities and clinical status were alleviated after treatment with an anti‐thyroid drug. Hence, in patients with pancytopenia and normal bone marrow examination, GD should also be considered.

Recently, the need to develop statistical distributions has become the most important spot. In this context, we employ the α-power transformation (APT) method to convert the generalized Pareto distribution (GPD) into a new distribution. Some statistical properties of the proposed distribution are being studied, such as moments, arithmetic mean, moment-generating function, random variables, entropy, reliability, and hazard function (HF). In addition, the proposed distribution is compared with the Pareto distribution and some other forms of alpha power distributions, such as the alpha power Pareto (APP) distribution, alpha power Rayleigh (APR) distribution, and the alpha power Lomax (APL) distribution. Finally, we demonstrate the benefits of the proposed distribution through a simulation study and two real data sets. It was found that the results showed the MLE method is reliable, the APTGP distribution is a competitive distribution for the aforementioned data set, and it is a mirror image of the Pareto distribution.

In this paper, we present a new approach to construct fractional 2-point right Radau type integral inequalities using a novel identity, for functions with s-convex first derivatives in the second sense via Riemann–Liouville fractional integral operators. We then demonstrate the accuracy of our results through a 2D example, as well as practical applications of the integral inequalities to quadrature formulas and special means such as arithmetic and p-logarithmic means.

Background. Patients with β-thalassemia major depend on lifelong transfusion, resulting in tissue iron overload. This longitudinal retrospective observational study aims to assess myocardial and liver iron overload using magnetic resonance imaging (MRI) and investigate the lag between myocardial and liver iron unloading in β-thalassemia patients undergoing chelation therapy. Methods. Beta-thalassemia major patients with at least two MRI studies between 2016 and 2020 were enrolled. Myocardial and liver iron overload were defined as T2∗ less than 20 and 2.1, respectively. Outcomes included mortality, myocardial and liver T2∗ changes, and systolic dysfunction assessed by cardiac MRI. Results. Fifty-five patients with a mean age of 24.62 ± 7.94 years, a mean follow-up duration of 24.3 ± 12.9 months, and a mean ferritin level of 1475.75 ± 771.12 ng/mL were enrolled. All of the abovementioned patients only took deferoxamine as the iron-chelating medication. Mortality occurred in three patients (5.5%) during follow-up. Liver T2∗ significantly increased (p value

This work aims to study the influence of shock/ gradual annealing temperature on the properties of ZnO thin film with different film thickness. ZnO thin films have been prepared on glass substrates using a sol-gel method deposing by dip-coating technique. Zinc acetate dihydrate, monoethanolamine, and 2-methoxyethanol were used as starting materials, stabilizer, and solvent respectively. The X-ray diffraction patterns show that all films have the wurtzite structure and the (002) diffraction peak dominated in all of them. The ZnO films with a higher thickness and annealed under thermal shock, show higher peaks intensity and lower grain size compared to the films annealed by gradually increasing temperature. Scanning electron microscopy images confirmed the results of DRX. The best electrical and optical properties have been obtained for the samples with higher thicknesses and annealed by heat shock. ZnO thin films show a resistance value of 1,296 Ω.cm and a band gap value of 3.245 eV with high transmittance (>90%).

In this paper, we introduce the class of strongly $m$--$MT$-convex functions based on the identity given in [P. Cerone et al., 1999]. We establish new inequalities of the Ostrowski-type for functions whose $n^{th}$ derivatives are strongly $m$--$MT$-convex functions.

Background and Objective: Diabetic macular edema (DME) is one of the common complications of diabetes which significantly accounts for preventable visual impairment and blindness. Central macular thickness (CMT) is a feature found in DME patients. This study aims to determine the relationship between optical coherence tomography (OCT)-measured CMT and visual acuity (VA) in patients with DME before and after intravitreal injection of bevacizumab. Methods: This cross-sectional study was conducted on 100 patients with diabetic macular edema with involvement of both eyes referred to the Ophthalmology Department of Rouhani Hospital in Babol who underwent intravitreal injection of Bevacizumab. VA (measured by Snellen chart), CMT (measured by OCT), clinical and paraclinical factors (including the duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), hypertension, and smoking history data) were evaluated and compared among all patients just before and 45 days after Bevacizumab injection. Findings: Before the injection of Bevacizumab in 200 eyes, the mean value of VA (letter score) and mean value of CMT (µm) were 36.83±12.73 and 425.48±85.18 µm, respectively (p

Objective Neck imbalance negatively affects body aesthetics of adolescent idiopathic scoliosis (AIS) patients. The evaluation of neck imbalance is currently limited to radiographic parameters, but lacks visual indicators. Therefore, the purpose of this study was to establish indexes of neck imbalance based on body image and to investigate whether these indexes can truly reflect neck imbalance in AIS patients. Methods We performed a cross‐sectional study at a single institution between June 2017 and September 2020 and there were 115 subjects involved in this research. All patients were diagnosed with adolescent idiopathic scoliosis, Lenke type I/II. Radiographic parameters measured included cervical axis tilt (CAT), T1 tilt, first rib angle (FRA), clavicle angle (CA), radiographic shoulder height (RSH), proximal thoracic curve (PTC), apical vertebra translation of proximal thoracic (AVT of PT), main thoracic curve (MTC), apical vertebra translation of main thoracic (AVT of MT) and coronal balance (CB/C7PL‐CSVL). Neck imbalance indexes were obtained and measured following a standardized manner. Intra‐class correlation coefficient (ICC) analysis was performed for neck imbalance indexes to determine their intra‐observer and inter‐observer reliability, and correlation tests were performed for neck imbalance indexes with the radiographic parameters mentioned above. Results Strong intraobserver and interobserver reliability were observed in neck imbalance index (NII) 1 (0.91 and 0.88), neck imbalance index 2 (0.85 and 0.81) and NII 3 (0.82 and 0.80), P