Search

Increasing patient and therapeutic complexity have created both challenges and opportunities for heart failure care. Within this background, the coronavirus disease-2019 pandemic has disrupted care as usual, accelerating the need for transition from volume-based to value-based care, and demanding a rapid expansion of telehealth and remote care for heart failure. Patients, clinicians, health systems, and payors have by necessity become more invested in these issues. Herein we review recent changes in health care policy related to the movement from volume to value-based payment and from in-person to remote care delivery.

Crop water productivity is a key element of water and food security in the world and can be quantified by the water footprint (WF). Previous studies have looked at the spatially explicit distribution of crop WFs but little is known about the temporal dynamics. We develop a new global gridded crop model – AquaCrop-Earth@lternatives (ACEA) – that can simulate three consumptive WF components: green (WFg), blue from irrigation (WFbi), and blue from capillary rise (WFbc) at high temporal and spatial resolutions. The model is applied to analyse global maize production during 1986–2016 at 5 × 5 arc minute grid. Our results show that in 2012–2016, the global average unit WF of maize is 723.2 m3 t−1 y−1 (89.5 % WFg, 8.3 % WFbi, 2.2 % WFbc) with values varying greatly around the world. Regions characterised by high agricultural development generally show a small unit WF and its interannual variation, such as Western Europe and Northern America (WF 3 t−1 y−1, CV  2500 m3 t−1 y−1, CV > 40 %). Since 1986, the global unit WF of maize has reduced by 34.6 % mainly due to the historical decrease in yield gaps. However, due to the rapid expansion of rainfed and irrigated cropland, the global WF of maize production has increased by 48.8 % peaking at 762.9 × 109 m3 y−1 in 2016. As many regions still have a high potential in decreasing yield gaps, the unit WF of maize is likely to continue reducing, whereas the WF of maize production is likely to continue growing as humanity’s rising appetite can lead to further cropland expansion. The simulation of other crops with ACEA is necessary to assess the pressure of overall crop production on ecosystems and freshwater resources worldwide.

El COVID-19, conocido popularmente como coronavirus, ha sido uno de los fenómenos mediáticos más relevantes desde principios de 2020. Uno de los efectos más notorios de su rápida expansión en España fue la cancelación del Mobile World Congress (MWC). Se trata de un foro global que reúne anualmente a las principales empresas tecnológicas del mundo y se define, en materia de agenda empresarial, como uno de los principales eventos anuales del sector. Según las estimaciones realizadas por la empresa organizadora GSMA, la previsión de asistentes al evento, previo a los resultados conocidos, era de más de 100.000 personas, contando tanto los asistentes de las empresas participantes como el público en general. Pese a ello, el pasado 12 de febrero y refiriéndose a las sucesivas cancelaciones de las empresas patrocinadoras y participantes por motivos de salud pública, la organización del MWC decidió cancelar el evento. Se analizan en este trabajo 125 noticias de los dos principales periódicos económicos en España y a través de una metodología basada en el análisis del contenido se comprueba el impacto del Congreso objeto de este estudio. En el periodo estudiado se concluye que las noticias sobre el Congreso Mundial de Móviles no fueron tan relevantes para estos medios de comunicación como sí lo fueron los efectos del covid-19.

Understanding the relationship between a species and its habitats is important for both conservation of imperiled species and control of invasive species. For migratory species, we hypothesize that maintaining connectivity between segregated habitats is more important than improving the quality of each habitat. In the case of anadromous lampreys of conservation concern, we posit that restoring passage routes between spawning, rearing and feeding habitats will result in higher larval abundance upstream from barriers than efforts to improve quality of these freshwater habitats. To explore this hypothesis, we reviewed conservation actions for native anadromous lampreys in freshwater and found that: i) improving passage between habitats results in immediate and quantifiable increases in larval abundance, ii) anadromous lampreys are capable of existing in suboptimal habitats, and iii) small reservoirs of production drive rapid expansion when anadromous lampreys are released from passage constraints. Hence, maintaining habitat connectivity is clearly crucial for conservation of anadromous lampreys. There are fewer examples of improvements to freshwater habitat that increased larval lamprey abundance, perhaps because lampreys are rarely the focus of these efforts. However, habitat limitations such as stream de-watering, chemical pollution, and scour occur and will likely be exacerbated by climate change. Documenting habitat actions that reverse these problems may provide evidence for the merits of lamprey-specific habitat improvement. Our observations are relevant to sea lamprey control in the Great Lakes because barriers and chemical treatment are key instruments of population regulation, and can be strategically deployed to limit production.

With the rapid expansion of the scale of multiprocessor systems, the importance of fault tolerance and fault diagnosis is increasingly concerned. For an interconnection network G, the h-component connectivity is an important indicator for evaluating the fault tolerance of G, which is defined as the minimum number of vertices whose deletion will disconnect G such that the remaining has at least h components. The h-component diagnosability, a newly precise diagnosis strategy to analyze the reliability of G, is the diagnosability under the condition that the number of components is at least h in the resulting graph after removing the faulty processor set. The t / k -diagnosability is a classic imprecise diagnosis strategy, which can identify up to t faulty processors by sacrificing accuracy to a certain extent, namely misdiagnosing at most k fault-free processors. In this paper, we investigate some combinatorial properties and the fault tolerance ability of the n-dimensional Bicube network, denoted by B Q n . Then we first prove that the ( h + 1 ) -component connectivity of B Q n is h ( n − 1 ) − h ( h − 1 ) 2 + 1 ( n ≥ 6 , 1 ≤ h ≤ n − 1 ). Moreover, we derive that the ( h + 1 ) -component diagnosability of B Q n is ( h + 1 ) ( n − 1 ) − h ( h + 1 ) 2 + 1 under the PMC model and MM⁎ model ( n ≥ 7 , 1 ≤ h ≤ n − 3 ). Furthermore, under the PMC model, we propose the t / k -diagnosis algorithm of B Q n and then derive that B Q n is [ ( k + 1 ) n − k ( k + 3 ) 2 ] / k -diagnosable ( n ≥ 6 , 0 ≤ k ≤ n − 2 ).

The deployable bridge based on scissor structures is one of the effective methods to quickly restore traffic after natural and man-made disasters. Scissor structures have the advantages of high storage rate, lightweight, and convenient storage and transportation. However, when scissor structures are used as load-bearing structures, their stiffness and bearing capacity are low. In this study, a three-dimensional deployable bridge based on the cable-strengthened scissor structures was proposed. In addition to rapid expansion, steel cables were used to strengthen scissor structures to improve the stiffness and bearing capacity. Besides, the static loading comparative tests on cable-strengthened scissor structures and traditional scissor structures (cable-free scissor structures) were performed. The results show that the stiffness of the cable-free scissor structure is small, the bending moment of members is large, and the stress distribution is uneven. The stiffness of cable-strengthened scissor structure is significantly improved; the bending moment of members is significantly reduced; and the stress distribution in the member section is more uniform. It is proved that cables can be used to improve the stiffness and load-bearing capacity of scissor structures without affecting the deployability.

Due to the rapid expansion of the construction industries, cement production is ever-increasing worldwide and maintaining the qualities of the local cement became vital for safe and durable structures. In this regard, the radiometric assessment of cement plays a significant role. The specific activities of the naturally occurring radionuclides present in ten Portland cement samples that can cause possible health hazards were determined using a gamma-ray spectrometer equipped with (3 × 3) inch NaI (Tl) detector with 1024 channels. The measured activity concentrations of Ra-226, Th-232, and K-40 were found in the range of 12.38–55.75 (average of 31.29 Bq/kg), 6.29–57.54 (average of 15.97 Bq/kg), and 112.63–266.37 (average of 168.24 Bq/kg), respectively. The recorded average activity concentration of these radionuclides in the cement was below the stipulated world standard by UNSCEAR (Sources and Effects of Ionizing Radiation, United Nations Scientific Committee on the Effects of Atomic Radiation UNSCEAR 2000 Report to the General Assembly, with Scientific Annexes, vol. I, 2000). The obtained mean activity concentration of Raeq in the cement (67.101 Bq/kg) was much lower than the recommended guideline of 370 Bq/kg. In addition, the mean value of the calculated absorbed dose rate (59.947 nGy·h−1), annual effective dose (0.220 mSv·y−1), activity concentration index (0.240), alpha index (0.156), excess lifetime cancer risk (0.771 × 10−3) external (0.084) and internal (0.300) hazard index of the studied samples were much below the recommended safety limits. It is affirmed that the cement sold in the local market can safely be used for building constructions.

Tumours are surrounded by a host of noncancerous cells that fulfil both supportive and suppressive roles within the tumour microenvironment (TME). The drive to understand the biology behind each of these components has led to a rapid expansion in the number and use of 3D in vitro models, as researchers find ways to incorporate multiple cell types into physiomimetic configurations. The use and increasing complexity of these models does however demand many considerations. In this review we discuss approaches adopted to recapitulate complex tumour biology in tractable 3D models. We consider how these cell types can be sourced and combined and examine methods for the deconvolution of complex multicellular models into manageable and informative outputs.

Abstract. Background: China accounts for 15% of the global suicide death toll, yet suicide research efforts in the country are not well known by international colleagues. Aims: We aimed to outline the development of suicide research in China, appraise research findings, and identify key contributors. Method: English and Chinese research publication databases were systematically searched and relevant papers were reviewed. Chinese and English publications were compared. Results: There are almost 10 times more Chinese publications than English ones. The research focuses of and key contributors to the Chinese and English literature exhibit more differences than commonalities. The field experienced rapid expansion in the new millennium with more and higher quality publications and more funding support. Psychosocial-oriented perspectives guided most of the papers. Poisoning by pesticide as a suicide method and youth as a subpopulation group received the most research attention. Limitations: The scoping review does not provide in-depth syntheses on specific topics and does not include more recent publications. Conclusion: Research on suicide in China has been actively carried out during the 30-year period we reviewed, which might have contributed to suicide prevention in China. Research gaps identified by the review should be addressed to sustain the achievements.

Several severe acute respiratory syndrome coronavirus 2 variants of concern (VOCs) emerged in late 2020; lineage B.1.1.7 initially dominated globally. However, lineages B.1.351 and P.1 represent potentially greater risk for transmission and immune escape. In British Columbia, Canada, B.1.1.7 and B.1.351 were first identified in December 2020 and P.1 in February 2021. We combined quantitative PCR and whole-genome sequencing to assess relative contribution of VOCs in nearly 67,000 infections during the first 16 weeks of 2021 in British Columbia. B.1.1.7 accounted for 50% by week 8. P.1 accounted for

The fluidized bed reactor has been recognized for large-scale CaO/Ca(OH)2 heat storage system. In this work, the effects of critical factors such as particle size, fluidization number, steam concentration in hydration, initial temperature, cycle number and type of carrier gas on heat release performance of CaO in the fluidized bed reactor were experimentally investigated. CaO under fluidization state exhibits excellent cyclic stability on the heat release performance. The decay in heat release temperature of CaO under fluidization state is less 10% of that under static state. With increasing the cycle number, the heat release temperature of CaO using N2 as carrier gas decreases because of the rapid expansion of particles. After 20 cycles with N2 as carrier gas, the average particle size of CaO increases by 46.2% and the hydration conversion of CaO reaches above 95%. The hydration conversion of CaO experienced 20 cycles using air as carrier gas is 20% lower than that using N2 as carrier gas due to the presence of CO2 in air. The experimental investigation of CaO/Ca(OH)2 heat storage provides an important reference for the development of CaO/Ca(OH)2 system using the fluidized bed reactor.

Facing the rapid expansion of the sharing economy, it is essential to understand the trusting mechanism in the P2P sector and its consequence on the perceived risks. This study extends the elaborat...

The rapid expansion of coronavirus SARS-CoV-2 has impacted various ethnic groups all over the world. The burden of infectious diseases including COVID-19 are generally reported to be higher for the Indigenous people. The historical knowledge have also suggested that the indigenous populations suffer more than the general populations in the pandemic. Recently, it has been reported that the indigenous groups of Brazil have been massively affected by COVID-19. Series of studies have shown that many of the indigenous communities reached at the verge of extinction due to this pandemic. Importantly, South Asia also has several indigenous and smaller communities, that are living in isolation. Till date, despite the two consecutive waves in India, there is no report on the impact of COVID-19 for indigenous tribes. Since smaller populations experiencing drift may have greater risk of such pandemic, we have analysed Runs of Homozygosity (ROH) among South Asian populations and identified several populations with longer homozygous segments. The longer runs of homozygosity at certain genomic regions may increases the susceptibility for COVID-19. Thus, we suggest extreme careful management of this pandemic among isolated populations of South Asia.

Histidine phosphorylation is an important and ubiquitous post-translational modification. Histidine undergoes phosphorylation on either of the nitrogens in its imidazole side chain, giving rise to 1- and 3- phosphohistidine (pHis) isomers, each having a phosphoramidate linkage that is labile at high temperatures and low pH, in contrast with stable phosphomonoester protein modifications. While all organisms routinely use pHis as an enzyme intermediate, prokaryotes, lower eukaryotes and plants also use it for signal transduction. However, research to uncover additional roles for pHis in higher eukaryotes is still at a nascent stage. Since the discovery of pHis in 1962, progress in this field has been relatively slow, in part due to a lack of the tools and techniques necessary to study this labile modification. However, in the past ten years the development of phosphoproteomic techniques to detect phosphohistidine (pHis), and methods to synthesize stable pHis analogues, which enabled the development of anti-phosphohistidine (pHis) antibodies, have accelerated our understanding. Recent studies that employed anti-pHis antibodies and other advanced techniques have contributed to a rapid expansion in our knowledge of histidine phosphorylation. In this review, we examine the varied roles of pHis-containing proteins from a chemical and structural perspective, and present an overview of recent developments in pHis proteomics and antibody development.

IntroductionDollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers.MethodsData were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics.ResultsCensus tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as ‘other’.ConclusionsDollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores’ rapid expansion.

In the context of Netflix’s rapid expansion in European markets and its growing investments in original content, this article conducts a comparative case study analysis of Netflix offerings and investment strategies in four European Union countries: Belgium, Romania, Spain, and Sweden. A first aim of the article is to establish the extent to which offerings in these markets confirm or reshape the findings of transnational flow studies on the imbalance of content supply. A second aim is to analyze how these offerings reflect the platform’s investment strategies in the different markets. Although findings point to increased diversity in catalog composition, as well as growing investments in European works, Netflix also reconfirms and contributes to existing power imbalances between markets. US content dominates the four European catalogs, while investments in European original content considerably favor strong media markets over weaker ones.

Artificial intelligence (AI) is the usage of scientific techniques to simulate human intellectual skills and to tackle complex medical issues involving complicated genetic defects such as cancer. The rapid expansion of AI in the past era has paved the way to optimum judgment-making by superior intellect, where the human brain is constrained to manage large information in a limited period. Cancer is a complicated ailment along with several genomic variants. AI-centred systems carry enormous potential in detecting these genomic alterations and abnormal protein communications at a very initial phase. The contemporary biomedical study is also dedicated to bringing AI expertise to hospitals securely and ethically. AI-centred support to diagnosticians and doctors can be the big surge ahead for the forecast of illness threat, identification, diagnosis, and therapies. The applications related to AI and Machine Learning (ML) in the identification of cancer and its therapy possess the potential to provide therapeutic support for quicker planning of a novel therapy for each person. Through the utilization of AI- based methods, scientists can work together in real-time and distribute their expertise digitally to possibly cure billions. In this review, the focus was on the study of linking biology with AI and describe how AI-centred support could assist oncologists in accurate therapy. It is essential to identify new biomarkers that inject drug defiance and discover medicinal goals to improve medication methods. The advent of the “next-generation sequencing” (NGS) programs resolves these challenges and has transformed the prospect of “Precision Oncology” (PO). NGS delivers numerous medical functions which are vital for hazard prediction, initial diagnosis of infection, “Sequence” identification and “Medical Imaging” (MI), precise diagnosis, “biomarker” detection, and recognition of medicinal goals for innovation in medicine. NGS creates a huge repository that requires specific “bioinformatics” sources to examine the information that is pertinent and medically important. The malignancy diagnostics and analytical forecast are improved with NGS and MI that provide superior quality images via AI technology. Irrespective of the advancements in technology, AI faces a few problems and constraints, and the clinical application of NGS continues to be authenticated. Through the steady progress of invention and expertise, the prospects of AI and PO look promising. The purpose of this review was to assess, evaluate, classify, and tackle the present developments in cancer diagnosis utilizing AI methods for breast, lung, liver, skin cancer, and leukaemia. The research emphasizes in what way cancer identification, the treatment procedure is aided by utilizing AI with supervised, unsupervised, and deep learning (DL) methods. Numerous AI methods were assessed on benchmark datasets with respect to “accuracy”, “sensitivity”, “specificity”, and “false-positive” (FP) metrics. Lastly, challenges along with future work were discussed.

Amidst the rapid expansion of education reform aimed at promoting educational equity, noticeably absent has been a focus on school counseling—a profession uniquely positioned to support students’ postsecondary, social emotional, and academic development. Despite research continually affirming the positive influence of counselors on students, uneven access to counseling support across US public schools, especially in urban areas, remains a reality today. Notably, high student-to-counselor ratios in schools that educate a large proportion of students of color and those living in low-income communities suggest that those students most in need of access to counseling support are the least likely to receive it. In this essay, we outline school counselors’ unique roles in supporting minoritized youth and draw on Bronfenbrenner’s (The ecology of human development: experiments in nature and design, Harvard University Press, Cambridge, 1979) ecological systems theory to consider the nested systems in which counselors work—systems which, we argue, place constraints on school counseling equity. This systems-level framing moves away from casting the limitations of our current student support model as an individual-level, personnel issue and instead conceptualizes it as an organizational one that must be remedied to ensure all students have equal access to critical counseling support.

The lucrative and rapid expansion of the wellness tourism sector in Europe and Asia has led to intense competition among wellness tourism destinations. This study investigates the business in five ...

The rapid expansion of China’s shadow banking system in recent years has led to continuous accumulation of risks and posed threats to the security of China’s real economy. According to the specific...

Recent years have witnessed the rapid expansion of the home-sharing business. The home-sharing services provided by Airbnb not only allow the homeowner to earn extra income by renting out part of the property to the potential renters but also provides the renters an authentic travel experience by living with residents. The emerging business model of Airbnb may bring about some uncertainties to rental housing markets. This study aims to explore an important issue – whether the home-sharing services provided by Airbnb would exacerbate the problem of housing affordability in Hong Kong. By examining the data from multiple sources such as the website of Airbnb and Census statistics from the Hong Kong Government, and housing rental transactions from property agents’ website via several econometric methods, we found that (1) the arrival of Airbnb would drive up housing rent rate around 3.6–4%; (2) The Airbnb activities would increase the rent-to-income ratio by 4%–4.7% in Hong Kong; (3) short-term home-sharing provided by Airbnb under current circumstance would lead to housing unaffordability in Hong Kong. It is suggested that regulations/guidelines on home-sharing should set a quota or limit the number of offering from long-term rentals to short-term rentals.

The COVID-19 (coronavirus disease 2019) pandemic brought rapid expansion of pediatric telehealth to maintain patient access to care while decreasing COVID-19 community spread. We designed a retrospective, serial, cross-sectional study to investigate if telehealth implementation at an academic pediatric practice led to disparities in health care access. Significant differences were found in pre-COVID-19 versus during COVID-19 patient demographics. Patients seen during COVID-19 were more likely to be younger, White/Caucasian or Asian, English speaking, and have private insurance. They were less likely to be Black/African American or Latinx and request interpreters. Age was the only significant difference in patient demographics between in-person and telehealth visits during COVID-19. A multivariate regression showed older age as a significant positive predictor of having a video visit and public insurance as a significant negative predictor. Our study demonstrates telehealth disparities based on insurance existed at our clinic as did inequities in who was seen before versus during COVID-19.

This paper examines the effect of rapid expansion of the hedge fund industry on mutual fund managerial turnovers. Deuskar et al. (2011) find that mutual funds retain skilled managers by offering side-by-side arrangements. We find that talented fund managers tend to leave mutual funds and establish their own hedge funds when side-by-side arrangements are not feasible. Mutual fund returns and flows decrease if their managers leave mutual funds to establish hedge funds, especially when the hedge fund industry is growing rapidly and performing well. Both institutional and retail investors react to this managerial turnover by reducing net flows.

Subsidence and accelerated sea level rise impact nesting area availability and flood probabilities of breeding islands for colonial nesting waterbirds. In 2017 and 2018, we monitored 855 nests of four species of colonial nesting waterbirds on Rabbit Island, LA, to determine factors affecting nest and chick success. Based on logistic exposure models of nests, tricolored herons had the greatest likelihood of survival to hatch (mean (95% confidence interval)) (77% (65.9–83.1%)), followed by brown pelicans (70% (59.9–98.5%)), roseate spoonbills (70% (38.9–83.8%)), and Forster’s terns (12% (10.7–12.2%)). Likelihood of survival to fledge was highest for tricolored herons (32% (12.8–40.7%)), followed by brown pelicans (28% (19.5–28.6%)), roseate spoonbills (47% (43.7–53.3%)), and Forster’s terns (0% (0.005–0.01%)). Nesting strategy and nest timing impacted survival rate; however, the effect depended on timing of inundation events as the timing of inundation events varied across years. Flooding was the primary cause of nest failure for most species. In 2003–2012, rapid expansion in brown pelican colony numbers and significant chick production occurred at Rabbit Island, but hydrologic records indicate no island inundation occurred during the breeding season from the beginning of the hydrologic record (2006) through 2011. Thus, our results contrast with those of previous studies conducted under different hydrologic conditions and demonstrate the challenges of short-term studies informing coastal restoration in a system that is influenced by multi-year to multi-decadal climatic cycles.

Purpose: The potential benefits of ICT integration in learning in schools have been extensively discussed in the academic literature worldwide. In recent years globally, there has been rapid expansion in integration of ICT in primary school education. Countries has further put in place many initiatives to enhance the same. Integration of Information and Communication Technology (ICT) is a critical factor in ensuring improved quality education. Despite the many benefits that are known to be brought by integrating ICT in teaching and learning, studies have shown that integration remains low especially in primary schools. The general objective of the study was to establish the influence of information communication technology on child education Methodology: The paper used a desk study review methodology where relevant empirical literature was reviewed to identify main themes and to extract knowledge gaps. Findings: The study found out that the influence of ICTs in learning cannot be dealt with in isolation. For technology to be effective, it must be availed to learners at the right time and place. There is need to be effective, it must be availed to learner’s proximity; that is in classrooms or supposed learning environment Recommendations: The study recommends that school management should focus on increasing their ICTs infrastructure by provision of computers, building computer laboratories and encouraging public-private partnership so as to help in internet connectivity and provision of basic infrastructure. Capacity building is an important initiative that helps in ensuring that the benefits that accrue from use of technology in education are maximized. Additionally, students should be provided with technical assistance to use ICTs in teaching and learning

Purpose The rapid expansion of telemedicine has presented a challenge for the care of patients with genitourinary malignancies. We sought to assess patient and physician perspectives on the use of telemedicine for genitourinary cancer care. Methods We conducted a prospective cross-sectional study of patients who had telemedicine visits with urology, medical oncology, or radiation oncology for management of genitourinary malignancies from July-August 2020. Patients and physicians each received a questionnaire regarding the telemedicine experience. Responses were scored on a 5-point Likert scale. The primary outcomes of the study were patient and physician satisfaction. Results Of the 115 patients who enrolled, we received 96 patient responses and 46 physician responses. Overall, 77% of patients and 70% of physicians reported being “extremely satisfied” with the telemedicine encounter. Satisfaction was high among all components of the encounter including patient-physician communication, counseling, shared decision making, time spent, timeliness and efficiency, and convenience. Additionally, 78% of patients and 85% of physicians “strongly agreed” that they were able to discuss sensitive topics about cancer care as well as they could at an in-person visit. Nine telemedicine visits (9%) encountered technological barriers. Technological barriers were associated with lower overall satisfaction scores among both patients and physicians (p ≤ 0.01). Conclusion We observed high levels of patient and physician satisfaction for telemedicine visits for management of genitourinary malignancies. Technological barriers were encountered by 9% of patients and were associated with decreased satisfaction.

Owing to the rapid expansion of preparing a low-cost and pure carbon nanotubes (CNTs) from large available raw materials as cheap carbon precursors and catalyst depositions via chemical vapor depos...

Container on Barge (COB) facilitates intermodal transportation by transporting shipping containers on barge tows. COB has seen rapid expansion globally over the past 20 years, providing a cost-efficient, environmentally friendly, and congestion-reducing mode of container transportation. European countries have led COB transportation in both study and application over the past two decades. However, increasing interest is observed in both the USA and Asia. In this literature review and comparative analysis, 135 COB-focused peer-reviewed articles are reviewed and analyzed to systematically describe the development and current status of COB transportation research. The relevant literature is analyzed to reveal publication rates and titles, geographical regions of interest, research questions, applied methodologies, advantages of COB transportation, and key success factors. The aim of our effort is to provide information on various aspects of COB development among different regions in the world and to summarize the existing literature to support and guide future COB development.

COVID-19 spurred rapid expansion of pharmacy-based point-of-care testing (POCT). This growth was aided, in part, by federal guidance that removed state-level regulatory uncertainty surrounding the ability of pharmacists to administer, interpret, and act on the results of tests. Surveys suggest there is considerable confusion about the legality of these services by state regulators. To ensure the sustainability of POCT services over time, states should consider adopting a standard of care approach to regulation, allowing a flexible framework for practice innovation and expansion over time.

Light Detection and Ranging (LiDAR) technology is playing a major role in different applications. Indeed, the possibility of exploiting either 3D geometric features and radiometric information makes LiDAR suitable for a wide range of practical domains. LiDAR proved also being quite flexible in terms of platforms where it can be implemented for the acquisition, spanning from airborne sensors up to car-based and hand-held instruments. Due to the rapid expansion of research concerning LiDAR intensity, the ISPRS WG III/5 launched in 2017 an initiative aimed at providing free access to LiDAR data acquired by modern multispectral ALS sensors as well as MLS data. The two datasets, MLS Data Set 1 – (“Sun Prairie”), and Multispectral LiDAR Data Set 2 – (“Tobermory”), were provided by Teledyne Optech Company (Canada) and were made freely available to researchers upon request. This paper is presenting the first results of this initiative in terms of applications, application domains and topics tackled by applicants. The relevance of this data set is also evaluated through a bibliometric analysis considering both Scopus and Web of Science indexed databases to analyse the main directions where the scientific research, the technical development and the application interest is moving to.

The rapid expansion of cities has tremendously increased the storm water volume, which frequently causes local flooding. Conventional drainage systems are often unable to sustain these run-off volu...

Vascular Ehlers–Danlos syndrome (vEDS) causes fatal vascular complications due to vascular fragility. However, invasive therapeutic procedures are generally avoided except in emergencies. We report a case of vEDS presenting with rapid expansion of a hepatic arterial aneurysm successfully treated using prophylactic endovascular therapy. A 43-year-old woman with vEDS confirmed by genetic testing was hospitalized for a symptomatic hepatic arterial aneurysm that expanded rapidly within a week. Prophylactic coil embolization was then successfully performed. Although the general applicability of this approach cannot be determined, prophylactic endovascular therapy can clearly be an option for arterial aneurysms at high risk of rupture.

The development of pharmaceutical companies, which is an important part of the national economy and industry, is closely related to people’s livelihood issues. With the era of big data, this paper uses the two-stage DEA and Malmquist method to evaluate the efficiency of listed Chinese pharmaceutical companies. From a static and dynamic perspective, it analyses the total factor productivity index, pure efficiency change index, scale efficiency index, and so on. The results show that government subsidies have not had a positive impact on most Chinese pharmaceutical companies, and for films, diseconomies of scale caused by rapid expansion should be avoided.

Hasta finales del 2019, el Covid-19 era un virus desconocido. Su aparición y rápida expansión sorprendió a la comunidad médica internacional. Más allá de la facilidad de contagio y su potencial gravedad, actualmente está causando mayor conmoción el creciente número de pacientes que después de ser dados de alta, recaen y en ocasiones fallecen. A esta fecha se han registrado seis casos de reinfección comprobada a nivel mundial. Es una cantidad mínima en el universo de personas infectadas. No obstante, ¿la inmunidad contra la reinfección es temporal?, ¿debemos preocuparnos mientras los mecanismos inmunológicos sean desconocidos en profundidad? A fin de encontrar respuesta a estos interrogantes, se planteó como objetivo analizar la recurrencia de infecciones de Covid-19. Para eso, entre los días 20 al 27 de octubre de 2020, y del 1 al 3 de marzo de 2021, se realizó una revisión bibliográfica a través del buscador Google en las bases de datos Pubmed/Medline, Scielo, Scopus, ScienceDirect, Google Scholar, sitios oficiales y especializados. Como criterios de inclusión se aplicaron los descriptores: Covid-19, inmunidad, reincidencia, reinfección, Covid-19 en Argentina. En el marco de la revisión, los principales hallazgos son: 1) las pruebas médico-científicas son insuficientes para afirmar que un paciente dado de alta tiene muchas posibilidades para reinfectarse con Covid-19; 2) la inmunidad contra la reinfección es temporal; y 3) ante la posibilidad de recurrencia y la falta de evidencia concluyente sobre la estabilidad inmunológica, la recomendación más acertada para cualquier ciudadano es mantener las medidas de prevención y bioseguridad.

Giant ascending aortic aneurysm (AscAA >10 cm) is an uncommon entity with a variable presentation. The size of the aneurysm, rapid expansion, and calcification are associated with an increased risk of rupture. Atherosclerosis is the most common etiology of aortic aneurysm in the elderly population. Multimodality imaging can be wisely used for diagnosis, risk stratification, and follow-up. We herein report a case of successfully repaired giant calcified AscAA with a maximum diameter of 10 cm. We also provide a brief discussion on the role of multimodality imaging.

The rapid expansion of the gene therapy pipeline in recent years offers significant potential to treat diseases with great unmet medical need. However, the unique nature of these therapies poses challenges to regulating them within traditional frameworks, even when developing in a single country. Various factors exacerbate the issues in commercializing products across regions, including the lack of established regulatory frameworks for developing gene therapy products in many jurisdictions. While some countries have established separate regulatory frameworks for advanced therapies/regenerative medicine products, differences exist between them. Recommended solutions to overcome these hurdles include fostering convergence among countries with separate regulatory frameworks for these products and utilizing reliance and recognition for countries without such frameworks. Additionally, regulators who choose to establish new dedicated frameworks for regulating gene therapies should consider the inclusion of key elements such as expedited regulatory pathways that offer early engagement with regulators, innovative clinical trial design, and adequate post-market confirmatory studies. Increasing the alignment of regulatory pathways across countries will be crucial to facilitating the development of, and access to, gene therapies on a global scale.

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus. Its symptoms are similar to those of the common flu, including fever, cough, dyspnea, myalgia, and fatigue. Due to its rapid expansion globally, the World Health Organization (OMS) declared it a pandemic. The molecular test commonly used worldwide for direct detection of the virus is the RT-PCR test but it takes time to process and the materials used are scarce. In this work we propose: (a) The design and implementation of a deep neural network architecture for the detection of patients with COVID-19 using as input X-ray images of the chest; the architecture is made up of a feature extraction phase, that is, a pre-trained model VGG16 extracts the features of the image; then in the second phase, a multilayer neural network classifies into one of two particular classes (1: COVID, 0: NO COVID). (b) The implementation of a Web platform that allows interested people to use our architecture in a clear, simple and transparent way. The deep learning algorithm was implemented in Python with specific libraries for the design of neural networks, while the Web platform was implemented in PHP using the Laravel framework and MySQL database. We evaluate the performance of our proposal using the sensitivity, specificity and area under the curve (AUC) evaluation metrics, obtaining good results in very short computational times. Fil: Orozco, Carlos Ismael. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina Fil: Xamena, Eduardo. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Martinez, Cristian Alejandro. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina Fil: Rodriguez, Diego Alejandro. Universidad Nacional de Salta. Facultad de Ciencias Exactas. Departamento de Informática; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina