Average Length Research Articles

Special interlayer pause strategy for controlling grain morphology and tensile property anisotropy of TC11 alloys fabricated by directed energy deposition technology

Directed energy deposition (DED)-built titanium alloys have long suffered from the anisotropic mechanical properties induced by the long columnar prior β grains growing along the building direction, which restricts their applications. In this work, a special interlayer pause (SIP) strategy is designed to reduce the tensile property anisotropy by adjusting the grain morphology. The grain morphologies, microstructure, crystallographic texture, tensile properties and their anisotropy of DEDed TC11 titanium alloys were systematically investigated. The results show that the SIP strategy promotes the columnar-to-equiaxed transition of grain morphology, reduces grain sizes, and weakens the crystallographic textures. The microstructure of SIP samples consists of superfine basketweave and lamellar α laths and residual β phases. The average length of α laths increases with the SIP layer number. In addition, the maintained superfine α phases contribute to an ultrahigh yield strength of ∼1200 MPa of the SIP samples. The yield strength of the horizontal direction gradually decreases and that of the vertical direction increases with increasing the SIP layer number, resulting in a lowered strength anisotropy of less than 2%. When adopting an optimal SIP strategy, the as-deposited TC11 alloy exhibits a relatively small ductility anisotropy.

Evaluation of intensive community care services for young people with psychiatric emergencies: study protocol for a multi-centre parallel-group, single-blinded randomized controlled trial with an internal pilot phase

BackgroundOver 3000 young people under the age of 18 are admitted to Tier 4 Child and Adolescent Mental Health Services (CAMHS) inpatient units across the UK each year. The average length of hospital stay for young people across all psychiatric units in the UK is 120 days. Research is needed to identify the most effective and efficient ways to care for young people (YP) with psychiatric emergencies. This study aims to evaluate the clinical effectiveness and cost-effectiveness of intensive community care service (ICCS) compared to treatment as usual (TAU) for young people with psychiatric emergencies.MethodsThis is a multicentre two-arm randomized controlled trial (RCT) with an internal pilot phase. Young people aged 12 to < 18 considered for admission at participating NHS organizations across the UK will be randomized 1:1 to either TAU or ICCS. The primary outcome is the time to return to or start education, employment, or training (EET) at 6 months post-randomization. Secondary outcomes will include evaluations of mental health and overall well-being and patient satisfaction. Service use and costs and cost-effectiveness will also be explored. Intention-to-treat analysis will be adopted. The trial is expected to be completed within 42 months, with an internal pilot phase in the first 12 months to assess the recruitment feasibility. A process evaluation using visual semi-structured interviews will be conducted with 42 young people and 42 healthcare workers.DiscussionThis trial is the first well-powered randomized controlled trial evaluating the clinical and cost-effectiveness of ICCS compared to TAU for young people with psychiatric emergencies in Great Britain.Trial registrationISRCTN ISRCTN42999542, Registration on April 29, 2020

Predictive value of serum albumin and calcium levels in burn patients with Pseudomonas aeruginosa infection: A comprehensive analysis of clinical outcomes.

In the ongoing challenge to reduce burn-associated mortality rates, this study explores the predictive capacity of clinical factors in burn patients, focusing on vitamin D, calcium, and serum albumin levels during hospitalisation in cases with Pseudomonas aeruginosa infection. Our research involves a comprehensive analysis of 100 burn patients, encompassing crucial clinical parameters such as the burn severity index, serum albumin, vitamin D, and calcium levels at admission. Data were meticulously entered into IBM Statistics SPSS software version 28 and subjected to statistical analysis. The study reveals an average patient age of 39.75 years and a notable 34% mortality rate. Additionally, the average lengths of hospital and intensive care unit (ICU) stays are determined to be 11.33 and 7.79 days, respectively. Significantly, a correlation between calcium and albumin variables and treatment outcomes is established, showcasing their potential to predict variable changes in patient mortality rates. Furthermore, a noteworthy association is observed between serum calcium levels and the duration of ICU hospitalisation. In conclusion, albumin and calcium variables emerge as sensitive and specific indicators for predicting outcomes in burn patients. Importantly, the independence of these factors from the physician's experience and diagnosis reduces human error and thus increases the accuracy of mortality prediction in this patient population.

Performance Evaluation of Coffee Coffea canephora (syn. Coffea robusta) Germplasm in the Hilly Region

The study was conducted at the Hill Agricultural Research Station, BARI, Khagrachari during the year 2017 to 2019. Thirty (30) genotype of Coffea canephora (syn. Coffea robusta) commonly known as robusta coffee from the existing coffee orchard of HARS, Khagrachari was selected for the study. The average height of evaluated line (CC Kha 001) was medium (4.31 m) and regular bearing shrub of small tree. The average width and length of leaf was 9.2 cm &amp; 20.86 cm respectively with 1.6 cm of leaf petiole length. The average width and length of individual fruit was 1.28 cm &amp; 1.16 cm respectively with 1.06 cm of thickness. Harvesting duration of fruit berry was mid-January to mid-February. The seed colour of evaluated coffee plant (CC Kha 001) was greenish brown with roundish shape. The average length and width of individual seed was 1.09 cm &amp; 0.99 cm respectively with 0.75 cm of thickness. Average weight of 100 been was 100.33 gm. Average berry weight (kg) per trunk was 8.08 (kg/tree).

Network Complexity and Stability of Microbes Enhanced by Microplastic Diversity.

Microplastic mixtures are ubiquitously distributed in global ecosystems and include varying types. However, it remains unknown how microplastic diversity affects the biotic interactions of microbes. Here, we developed novel experiments of 600 microcosms with microplastic diversity ranging from 1 to 6 types and examined ecological networks for microbial communities in lake sediments after 2 months of incubation at 15 and 20 °C. We found that microplastic diversity generally enhanced the complexity of microbial networks at both temperatures, such as increasing network connectance and reducing average path length. This phenomenon was further confirmed by strengthened species interactions toward high microplastic diversity except for the negative interactions at 15 °C. Interestingly, increasing temperatures further exaggerated the effects of microplastic diversity on network structures, resulting in higher network connectivity and species interactions. Consistently, using species extinction simulations, we found that higher microplastic diversity and temperature led to more robust networks, and their effects were additionally and positively mediated by the presence of biodegradable microplastics. Our findings provide the first evidence that increasing microplastic diversity could unexpectedly promote the complexity and stability of microbial networks and that future warming could amplify this effect.

A Quality Improvement Project to Reduce Rapid Response System Inequities for Patients with Limited English Proficiency at a Quaternary Academic Medical Center.

Recognition of clinically deteriorating hospitalized patients with activation of rapid response (RR) systems can prevent patient harm. Patients with limited English proficiency (LEP), however, experience less benefit from RR systems than do their English-speaking counterparts. To improve outcomes among hospitalized LEP patients experiencing clinical deteriorations. Quasi-experimental pre-post design using quality improvement (QI) statistics. All adult hospitalized non-intensive care patients with LEP who were admitted to a large academic medical center from May 2021 through March 2023 and experienced RR system activation were included in the evaluation. All patients included after May 2022 were exposed to the intervention. Implementation of a modified RR system for LEP patients in May 2022 that included electronic dashboard monitoring of early warning scores (EWSs) based on electronic medical record data; RR nurse initiation of consults or full RR system activation; and systematic engagement of interpreters. Process of care measures included monthly rates of RR system activation, critical response nurse consultations, and disease severity scores prior to activation. Main outcomes included average post-RR system activation length of stay, escalation of care, and in-hospital mortality. Analyses used QI statistics to identify special cause variation in pre-post control charts based on monthly data aggregates. In total, 222 patients experienced at least one RR system activation during the study period. We saw no special cause variation for process measures, or for length of hospitalization or escalation of care. There was, however, special cause variation in mortality rates with an overall pre-post decrease in average monthly mortality from 7.42% (n = 8/107) to 6.09% (n = 7/115). In this pilot study, prioritized tracking, utilization of EWS-triggered evaluations, and interpreter integration into the RR system for LEP patients were feasible to implement and showed promise for reducing post-RR system activation mortality.

Survival and behavior of Mojave desert tortoises head‐started with and without outdoor rearing

AbstractMojave desert tortoise (Gopherus agassizii) populations in some regions have declined by &gt;50% since 2004, prompting the need for more research on ways to recover populations. One possible recovery tool is head‐starting (i.e., the act of protecting and raising juvenile tortoises to sizes that increase survival upon release); however, head‐starting can have high start‐up and maintenance costs that can limit its feasibility. Strategies that reduce cost and rearing duration may foster broader and more effective use. We released and radio‐tracked 60 juvenile tortoises in the Mojave National Preserve in California, USA, that had been reared under 2 treatments: those reared 1 year indoors after hatching, then 1 year outdoors (combo) and those reared just 1 year indoors (indoor‐only). We tested whether indoor‐only rearing alone could be a more efficient means of producing robust head‐started tortoises. We examined the behavior, movement, and survival of tortoises after release into the wild from 2020 to 2021 to determine whether these outcomes differed between husbandry treatments. Combo tortoises tended to perform settling behaviors (mean ± 1 SE days to building first burrow = 6.7 ± 0.8, entering dormancy = 23.3 ± 2.1, and emerging from dormancy = 189.6 ± 4.4) earlier than indoor‐only tortoises (7.4 ± 0.9, 31.5 ± 2.6, and 193.9 ± 5.9, respectively), but this difference was not significant, suggesting the rearing method did not greatly alter settling behavior. Indoor‐only tortoises dispersed at least twice as far from their release site (156.2 ± 26.3 m compared with 77.3 ± 20.6 m for combo tortoises), had larger mean use areas (3.7 ± 0.1 ha compared with 2.8 ± 0.3 ha for combo tortoises for 95% Brownian bridge movement model estimates), and greater variability in their movements than combo tortoises (daily average step length post‐emergence: 4.3 ± 0.2 m compared with 2.8 ± 0.1 m for combo tortoises). Despite differences in their movements, indoor‐only and combo tortoises had similar survival rates over the study, 51% versus 42%, respectively, during a period of extreme drought in 2021. The similarity in survival between groups gives head‐starting practitioners freedom in their rearing methods. The indoor‐only group had lower site fidelity, which should be considered when this is an undesirable trait for released tortoises.

A comparison of objective priors for Cronbach’s coefficient alpha using a balanced random effects model

. In this article, the reference and probability matching priors for Cronbach’s alpha will be derived. The performance of these two priors will be compared to that of the well-known Jeffreys prior and a divergence prior. Cronbach’s alpha is a measure used to assess the reliability of a set of test items. A simulation study will be considered to compare the performance of the priors, where the coverage rates, average interval lengths, and standard deviations of the interval lengths will be computed. A second simulation study will be considered where the mean relative error will be compared for the various priors using three different loss functions. The following loss functions will be considered, Squared error loss, Absolute error loss, and Linex loss. An illustrative example will also be considered. Throughout the article, the random effects approach will be used.

Digitally Recording Comfort Observations in the Last Days of Life.

Background: 37.5% of deaths in our area occur in hospital. There are known high unmet needs of adult patients dying in hospital, this unmet need can be reduced by using an individualised care plan and specialist palliative care review. Intervention: In 2022 UHSussex developed an electronic comfort observation chart and individualised care plan, with a centralised dashboard allowing Palliative Care Teams (SPCT) to view trends, target interventions, and a rolling prospective audit. Results: 3000 patients have had their care supported with electronic comfort observations (e-comfort obs). Over 72% of all deaths in the Trust in the last 3months have been on e-comfort obs, with 2/3 of all deaths in the first 12months on e-comfort obs. The average length of time on e-comfort obs is 4days resulting in 70,000 sets of e-comfort obs recorded since launch. Seven percent of e-comfort obs record moderate or severe symptoms. We have identified benefits to people who are dying, those important to them, ward staff, SPCT and on a systems level. Conclusion: E-comfort obs can be successfully embedded in a large acute Trust. This development should improve quality of end of life care in our hospitals both for individuals and for future patients, through on-going targeted education and intervention. Further work is needed to develop the system further including integrating data from electronic prescribing.

Alterations in leukocyte telomere length and mitochondrial DNA copy number in benzene poisoning patients.

The aim of this study is to examine and evaluate the impact of benzene poisoning on the relative content of the mitochondrial MT-ND1 gene and telomere length in individuals with occupational chronic benzene poisoning (CBP) compared to a control group. The study will analyze and gather data on the mitochondrial gene content and telomere length in cases of benzene poisoning, and investigate the relationship with blood routine parameters in order to contribute scientific experimental data for the prevention and treatment of CBP. The case group comprised 30 individuals diagnosed with occupational chronic benzene poisoning, whereas the control group consisted of 60 healthy individuals who underwent physical examinations at our hospital concurrently. Blood routine indicators were detected and analyzed, and the PCR method was employed to measure changes in mitochondrial MT-ND1 content and telomere length. Subsequently, a comparison and analysis of the aforementioned indicators was conducted. The case group exhibited a higher mitochondrial gene content (median 366.2, IQR 90.0 rate) compared to the control group (median 101.5, IQR 12.0 rate), with a statistically significant difference between the two groups (P < 0.05). Additionally, the case group demonstrated lower white blood cell levels (3.78 ± 1.387 × 109/L) compared to the control group (5.74 ± 1.41 × 109/L), with a significant difference between the two groups (P < 0.05). Furthermore, the case group displayed lower red blood cell levels (3.86 ± 0.65 × 1012/L) compared to the control group (4.89 ± 0.65 × 1012/L), with a significant difference between the two groups (P < 0.05). The hemoglobin level in the case group (113.33 ± 16.34g/L) was lower than that in the control group (138.22 ± 13.22g/L). There was a significant difference between the two groups (P < 0.05). Platelet levels in the case group (153.80 ± 58.31 × 109/L) is smaller than the control group (244.92 ± 51.99 × 109/L), there was a significant difference between the two groups (P < 0.05). The average telomere length of the normal control group was 1.451 ± 0.475 (rate); The mean telomere length of individuals in the case group diagnosed with benzene poisoning was determined to be 1.237 ± 0.457 (rate). No significant correlation was observed between telomere length and three blood routine parameters, namely white blood cells (WBC), hemoglobin (HB), and platelets (PLT). However, a significant correlation was found between telomere length and red blood cell count (RBC). Additionally, a negative correlation was observed between mitochondrial gene content and white blood cell count (r = - 0.314, P = 0.026), as well as between mitochondrial gene content and red blood cell count (r = - 0.226, P = 0.032). Furthermore, a negative correlation was identified between mitochondrial gene content and hemoglobin (r = - 0.314, P = 0.028), and platelets (r = - 0.445, P = 0.001). Individuals diagnosed with occupational chronic benzene poisoning exhibit a reduction in telomere length and an elevation in the relative content of the mitochondrial MT-ND1 gene. Moreover, a negative correlation is observed between the content of the mitochondrial MT-ND1 gene and four blood routine parameters, namely white blood cells (WBC), red blood cells (RBC), hemoglobin (HB), and platelets (PLT). Consequently, benzene exposure may potentially contribute to the onset of premature aging.

In Situ Study and Improvement of the Temperature Increase and Isothermal Retention Stages in the Polyacrylonitrile (PAN) Fiber Pre-Oxidation Process.

The pre-oxidation process of Polyacrylonitrile (PAN) fibers is a complex procedure involving multiple stages of temperature increase and isothermal temperature retention. However, the impact of the temperature increase stage on PAN fiber has often been overlooked. To address this, samples were collected before and after the temperature increase and isothermal retention stages, treating them as separate influencing factors. Therefore, the pre-oxidation process can be divided into four distinct stages: (1) A temperature increase stage before the cyclization reactions: the PAN fiber's small-size crystals melt, and the crystal orientation changes under fixed tension, leading to shrinkage and increased orientation of the micropore. (2) An isothermal retention stage before the cyclization reactions: The crystal structure maintains well, resulting in minimal micropore evolution. The PAN fiber's crystal orientation and micropore orientation increased under fixed tension. (3) A temperature increase stage after the cyclization reactions: The PAN fiber's crystal melts again, reducing the average chord length and relative volume of the micropore. However, the PAN fiber can recrystallize under fixed tension. (4) An isothermal retention stage after the cyclization reactions: Significant crystal melting of the PAN fiber occurs, but the highly oriented crystals are maintained well. The average chord length and relative volume of the micropore increase. Recommendations for improving the pre-oxidation process are made according to these stages.

Unveiling the microbial communities and metabolic pathways of Keem, a traditional starter culture, through whole-genome sequencing

Traditional alcoholic beverages have played a significant role in the cultural, social, and culinary fabric of societies worldwide for centuries. Studying the microbial community structure and their metabolic potential in such beverages is necessary to define product quality, safety, and consistency, as well as to explore associated biotechnological applications. In the present investigation, Illumina-based (MiSeq system) whole-genome shotgun sequencing was utilized to characterize the microbial diversity and conduct predictive gene function analysis of keem, a starter culture employed by the Jaunsari tribal community in India for producing various traditional alcoholic beverages. A total of 8,665,213 sequences, with an average base length of 151 bps, were analyzed using MG-RAST. The analysis revealed the dominance of bacteria (95.81%), followed by eukaryotes (4.11%), archaea (0.05%), and viruses (0.03%). At the phylum level, Actinobacteria (81.18%) was the most abundant, followed by Firmicutes (10.56%), Proteobacteria (4.00%), and Ascomycota (3.02%). The most predominant genera were Saccharopolyspora (36.31%), followed by Brevibacterium (15.49%), Streptomyces (9.52%), Staphylococcus (8.75%), Bacillus (4.59%), and Brachybacterium (3.42%). At the species level, the bacterial, fungal, and viral populations of the keem sample could be categorized into 3347, 57, and 106 species, respectively. Various functional attributes to the sequenced data were assigned using Cluster of Orthologous Groups (COG), Non-supervised Orthologous Groups (NOG), subsystem, and KEGG Orthology (KO) annotations. The most prevalent metabolic pathways included carbohydrate, lipid, and amino acid metabolism, as well as the biosynthesis of glycans, secondary metabolites, and xenobiotic biodegradation. Given the rich microbial diversity and its associated metabolic potential, investigating the transition of keem from a traditional starter culture to an industrial one presents a compelling avenue for future research.

Construction of Six Sigma-based control chart for interval-valued data

Construction of control charts is straightforward if the data are real-valued. However, there are situations where data are essentially interval-valued in which each observation is represented by minimum and maximum values. While there are only few attempts to develop control charts for interval-valued data, there have been no simple-to-use approaches developed to deal with such type of data. In this article, we propose to make use of the popular Taguchi orthogonal array experiment to first redefine the data for experimental setup and then use Six Sigma control limits to determine overall control limits for interval-valued data. The resulting multiple control limits have inner and outer control limits for simultaneously monitoring minimum and maximum values of the averages of interval-valued data. The proposed control chart is then illustrated using a data set, and conclusions are drawn based on the results. It is observed that the proposed Six Sigma-based control chart for interval-valued data is, in fact, easy-to-use, and it performs better in detecting the out-of-control situations. We have established this using average run length comparisons as well with the traditional charts.

Performance of Progressive Generations of GPT on an Exam Designed for Certifying Physicians as Certified Clinical Densitometrists

Background: Artificial intelligence (AI) large language models (LLMs) such as ChatGPT have demonstrated the ability to pass standardized exams. These models are not trained for a specific task, but instead trained to predict sequences of text from large corpora of documents sourced from the internet. It has been shown that even models trained on this general task can pass exams in a variety of domain-specific fields, including the United States Medical Licensing Examination. We asked if large language models would perform as well on a much narrower subdomain tests designed for medical specialists. Furthermore, we wanted to better understand how progressive generations of GPT (generative pre-trained transformer) models may be evolving in the completeness and sophistication of their responses even while generational training remains general. In this study, we evaluated the performance of two versions of GPT (GPT 3 and 4) on their ability to pass the certification exam given to physicians to work as osteoporosis specialists and become a certified clinical densitometrists. The CCD exam has a possible score range of 150 to 400. To pass, you need a score of 300.Methods: A 100-question multiple-choice practice exam was obtained from a 3rd party exam preparation website that mimics the accredited certification tests given by the ISCD (International Society for Clinical Densitometry). The exam was administered to two versions of GPT, the free version (GPT Playground) and ChatGPT+, which are based on GPT-3 and GPT-4, respectively (OpenAI, San Francisco, CA). The systems were prompted with the exam questions verbatim. If the response was purely textual and did not specify which of the multiple-choice answers to select, the authors matched the text to the closest answer. Each exam was graded and an estimated ISCD score was provided from the exam website. In addition, each response was evaluated by a rheumatologist CCD and ranked for accuracy using a 5-level scale. The two GPT versions were compared in terms of response accuracy and length.Results: The average response length was 11.6 ±19 words for GPT-3 and 50.0±43.6 words for GPT-4. GPT-3 answered 62 questions correctly resulting in a failing ISCD score of 289. However, GPT-4 answered 82 questions correctly with a passing score of 342. GPT-3 scored highest on the “Overview of Low Bone Mass and Osteoporosis” category (72 % correct) while GPT-4 scored well above 80 % accuracy on all categories except “Imaging Technology in Bone Health” (65 % correct). Regarding subjective accuracy, GPT-3 answered 23 questions with nonsensical or totally wrong responses while GPT-4 had no responses in that category.Conclusion: If this had been an actual certification exam, GPT-4 would now have a CCD suffix to its name even after being trained using general internet knowledge. Clearly, more goes into physician training than can be captured in this exam. However, GPT algorithms may prove to be valuable physician aids in the diagnoses and monitoring of osteoporosis and other diseases.

Reaction of Partially Methylated Polygalacturonic Acid with Iron(III) Chloride and Characterization of a New Mixed Chloride-Polygalacturonate Complex.

We have described a new route for the preparation of partially methylated polygalacturonic acid containing hydrolyzed (acidic) and unhydrolyzed (methyl esterified) carboxylate groups in a ratio of 1:1 (PGA, compound 1), and one of its basic FeIII-salts (compound 2) with a ~1:2 FeIII:GA stoichiometry (GA means galacturonic acid and methylated galacturonic acid units). The partially hydrolyzed pectin was transformed into compound 1 with the use of double ion exchange with a strongly acidic macroreticular sulfonated styrene-divinylbenzene copolymer as a hydrogen ion source. The reaction of compound 1 with FeCl3 resulted in compound 2. Compound 2 has a polymeric nature and contains binuclear FeIII(µ-O)(µ-OH)FeIII core units with two kinds of distorted octahedral iron geometries. The salt-forming acidic and methylated GA units of compound 1 are coordinated to FeIII centers in asymmetric bidentate-chelating and -bridging (via C=O group and glycosidic oxygen) modes, respectively. Two kinds of outer-sphere chloride anions were also detected by XPS in various chemical environments fixed by different sets of hydrogen bonds. We also observed a partial reduction of FeIII into FeII due to the ring-opening of the chain-end GA units of compound 1. This reaction provides a new route to determine the number of chain-ends in compound 2, and with the use of the number of GA units calculated from charge neutrality, the average length of these chains and the average molecular weight were also determined. The average molecular weight of the partially methylated polygalacturonic acid used in the industrial-scale production of commercial anti-anemic iron-polygalacturonate agents was ~50,000 g/mol. Compound 2 was also characterized by IR, Mössbauer, and X-ray photoelectron spectroscopy, and magnetic susceptibility measurements. These results on the structure and average molecular weight of basic iron(III) polygalacturonate provide a tool to design Fe-PGA complexes with tuned iron-releasing properties.

Response of carbon sources and their various concentrations on in vitro rooting of banana cv. Chinichampa (AAB) through shoot tip ​

In vitro propagated banana plants are steadily becoming the planting material of choice because of disease free, uniformity and the possibility of rapid multiplication. The present investigation was carried out at the tissue culture laboratory, Department of Horticulture, School of Agricultural Sciences, Nagaland University, Medziphema campus during the year 2019-2022. Data recorded for different parameters viz. days to greening, days required for multiple buds’ initiation, number of multiple buds produced per explant and length of multiple buds after 30 days were subjected to completely randomized design (CRD). The present study revealed the importance of various carbon sources and their role in micropropagation of banana through shoot tip culture. The minimum days required for root initiation were observed in root induction media (RIM) supplemented with 30g glucose. Rooting percentage (%), number of roots per shoot and length of longest roots (cm) after 30 days was seen in RIM supplemented with table sugar at 40g, 30g and 20g respectively. Meanwhile maximum average length of shoot (cm) after 30 days was observed in RIM supplemented with 40g glucose and highest number of leaves per plantlets was recorded in RIM supplemented with 30g sucrose. The results indicate the significance of carbon sources in micropropagation of banana. They improved plant regeneration and facilitated rapid multiplication of disease and virus free banana plantlets.

Treatable mortality and health care related factors across European countries.

Despite the improvements in European health systems, a large number of premature deaths are attributable to treatable mortality. Men make up the majority of these deaths, with a significant gap existing between women and men's treatable mortality rate in the EU. This study aims to identify the healthcare-related factors, including health expenditures, human and physical resources, and hospital services use associated with treatable mortality in women and men across European countries during the period 2011-2019. We use Eurostat data for 28 EU countries in the period 2011-2019. We estimate a panel data linear regression with country fixed effects and quantile linear regression for men and women. The results found (i) differences in drivers for male and female treatable mortality, but common drivers hold the same direction for both sexes; (ii) favorable drivers are GDP per capita, health expenditures, number of physicians per capita, and (only for men) the average length of a hospital stay, (iii) unfavorable drivers are nurses and beds per capita, although nurses are not significant for explaining female mortality. Policy recommendations may arise that involve an improvement in hospital bed management and the design of more specific policies aimed at healthcare professionals.

Functional outcome of direct anterior versus posterior approach in total hip arthroplasty: a propensity-matched Asian study.

The direct anterior approach (DAA) to total hip arthroplasty (THA) is a surgical approach that minimises soft tissue trauma, resulting in faster rehabilitation when compared to a posterior approach (PA). This study aimed to evaluate the difference between the two groups in an Asian cohort using propensity score matching. A retrospective review of prospectively collected registry data of 794 primary THAs was performed. The effects on patients with DAA THA versus patients with PA THA were investigated. Propensity scores were generated using logistic regression to adjust for confounding variables of age, gender, body mass index and diagnosis. Data analysis was performed, and statistical significance was defined as a P value < 0.05. The average length of stay (LOS) for the PA group and DAA group was 5.4 days and 2.9 days, respectively (P < 0.001). One (1.9%) patient from the PA group suffered a posterior dislocation 6 months after surgery and subsequently underwent revision surgery 2 years later. No dislocations were detected in the DAA group. The DAA group had better functional outcome, satisfaction and expectation scores at 6 months and 2 years. In this study, patients who underwent DAA THA had better functional outcome at 2 years and almost 2 days shorter overall LOS than those who underwent PA THA. Therefore, the DAA to THA is a novel technique that has shown improved functional outcomes, with fewer complications compared to PA THA.

Fluid Slip and Drag Reduction on Liquid-Infused Surfaces under High Static Pressure.

Liquid-infused surfaces (LIS) have been shown to reduce the huge frictional drag affecting microfluidic flow and are expected to be more robust than superhydrophobic surfaces when exposed to external pressure as the lubricant in LIS is incompressible. Here, we investigate the effect of applying static pressure on the effective slip length measured on Teflon wrinkled surfaces infused with silicone oil through pressure measurements in microfluidic devices. The effect of static pressure on LIS was found to depend on air content in the flowing water: for degassed water, the average effective slip length was beff = 2.16 ± 0.90 μm, irrespective of applied pressure. In gassed water, the average effective slip length was beff = 4.32 ± 1.06 μm at zero applied pressure, decreased by 55% to 2.37 ± 0.90 μm when the pressure was increased to 50 kPa, and then remained constant up to 200 kPa. The result is due to nanobubbles present on LIS, which are compressed or partially dissolved under pressure, and the effect is more evident when the size and portion of surface nanobubbles are higher. In contrast, on superhydrophobic wrinkles, the decline in beff was more sensitive to applied pressure, with beff = 6.8 ± 1.4 μm at 0 kPa and, on average, beff = -1 ± 3 μm for pressures higher than 50 kPa for both gassed and degassed water. Large fluctuations in the experimental measurements were observed on superhydrophobic wrinkles, suggesting the nucleation of large bubbles on the surface. The same pressure increase did not affect the flow on smooth substrates, on which gas nanobubbles were not observed. Contrary to expectations, we observed that drag reduction in LIS is affected by applied pressure, which we conclude is because, in a similar manner to superhydrophobic surfaces, they lose the interfacial gas, which lubricates the flow.

Generalized multivariate EWMA control chart supplemented with bivariate ranked set techniques

ABSTRACT Existing univariate exponential weighted moving average (EWMA) control charts with ranked set schemes are used for monitoring related characteristics independently. Also, existing multivariate EWMA control charts are generally applicable for simple random sampling (SRS) based processes. In this work, a generalized multivariate EWMA control chart is proposed with bivariate ranked set techniques (BVRST) for simultaneously monitoring. Furthermore, an extensive comparative analysis between proposed generalized multivariate EWMA and classical control chart is conducted. In this regard, we have used various performance measures, which cover average run length, median of run length, relative average run length, performance comparison index, and extra quadratic loss. The performance measures are obtained using the Monte Carlo simulation (MCS) approach. Results revealed that the proposed generalized multivariate EWMA control chart has an outstanding detection ability relative to the existing multivariate control charts. Additionally, existing multivariate control charts are found special cases of the proposed control chart. A real-life example from the agriculture field is included in which chemical properties (residual sodium and calcium-magnesium contents) of irrigation water are monitored through the control charts. The results revealed that the proposed control chart is proficient in diagnosing small variations in the chemical characteristics relative to the existing control charts.