Sum Of Indices Research Articles

Performance of an MRI scoring system for inflammation of joints and entheses in peripheral SpA: post-hoc analysis of the CRESPA trial.

The aim of this study was to investigate the reliability, validity, and sensitivity to change of a novel MRI scoring system in early peripheral SpA (pSpA). MRI of the pelvis and lower extremities was performed before initiation of the TNF inhibitor golimumab in 56 patients and repeated in 46 patients who achieved sustained clinical remission after 24, 36 or 48 weeks. Three readers applied a semi-quantitative MRI scoring system for lower-extremity joint and entheseal inflammation. Four lesion types were assessed: entheseal osteitis, entheseal soft-tissue inflammation, joint osteitis, and joint synovitis/effusion. MRI response was defined as a decrease in MRI lower-extremity inflammation index (sum of scores from 75 sites, each scored 0-3) above the smallest detectable change (SDC). At follow-up, the MRI index decreased in 34 of 46 patients (74%), and 15 (33%) patients achieved MRI response, i.e. a decrease above SDC of 2.8. When restricting the analysis to patients with clinical involvement of lower-extremity sites that were assessed by MRI, 13 of 28 (46%) achieved MRI response. Interreader reliability was very good, with an average-measure intraclass correlation coefficient of 0.92 (95% CI: 0.85-0.95) for status scores and 0.89 (0.80-0.94) for change in scores. The MRI index correlated with other measures of disease activity, including CRP [Spearman's rho 0.41 (0.23-0.56)], swollen joint count of 6 joints [0.47 (0.27-0.63)], tender enthesis count of 14 entheses [0.32 (0.12-0.50)] and pain score [0.28 (0.08-0.46)], all P < 0.05. The proposed MRI lower-extremity inflammation index demonstrated reliability, validity, and sensitivity to change in patients with early pSpA. Clinicaltrials.gov, http://clinicaltrials.gov, NCT01426815.

Node Importance Identification for Temporal Networks Based on Optimized Supra-Adjacency Matrix.

The research on node importance identification for temporal networks has attracted much attention. In this work, combined with the multi-layer coupled network analysis method, an optimized supra-adjacency matrix (OSAM) modeling method was proposed. In the process of constructing an optimized super adjacency matrix, the intra-layer relationship matrixes were improved by introducing the edge weight. The inter-layer relationship matrixes were formed by improved similarly and the inter-layer relationship is directional by using the characteristics of directed graphs. The model established by the OSAM method accurately expresses the structure of the temporal network and considers the influence of intra- and inter-layer relationships on the importance of nodes. In addition, an index was calculated by the average of the sum of the eigenvector centrality indices for a node in each layer and the node importance sorted list was obtained from this index to express the global importance of nodes in temporal networks. The experimental results on three real temporal network datasets Enron, Emaildept3, and Workspace showed that compared with the SAM and the SSAM methods, the OSAM method has a faster message propagation rate and larger message coverage and better SIR and NDCG@10 indicators.

Association of organophosphate ester exposure with cardiovascular disease among US adults: Cross-sectional findings from the 2011–2018 National Health and Nutrition Examination Survey

Organophosphate esters (OPEs) are widely used as flame retardants and plasticizers worldwide. Therefore, the potentially deleterious effect of OPE on human beings deserves extensive attention. The primary objective of this present study was to untangle the relationship between OPE exposure and cardiovascular disease (CVD) among general population. Detailed information about participants’ baseline characteristics, involving socioeconomic data, demographic data and key covariates was obtained from National Health and Nutrition Examination Survey (NHANES) 2011–2018. Multivariate logistic regression models with adjustment for prior-determined covariates were utilized to examine the relationship between various OPEs and CVD among US adults and calculate odd ratios (ORs) and corresponding confidence intervals (CIs). Two multi-pollutant statistical strategies (weighted quantile sum regression and Bayesian kernel machine regression) were employed to investigate the joint effect of OPE mixture on CVD. A total of 5067 participants were included in this study. In completely-adjusted logistic model, the highest tertiles of OPE metabolites were positively associated with CVD risk, while the relationships did not reach statistical significance. The weighted quantile sum (WQS) index was significantly correlated with increased prevalence of CVD (adjusted OR: 1.25; CI: 1.02, 1.53, p value = 0.032) and Diphenyl phosphate (DPHP) was the greatest contributor (31.38%). The BKMR also indicated that mixed OPE exposure associated with an increased risk of CVD. Taken together, the present study demonstrated that there were possible links between OPE exposures and increased risk of CVD, while the relationships did not reach statistical significance. Our study provided the suggestive evidence that cumulative effect of OPE mixtures on CVD. DPHP may be a major driver of this positive association. Given the limitation of cross-sectional design and relatively limited kinds of OPE metabolites, further studies are warranted to longitudinally evaluate the potential effect of a wider range of OPEs on CVD or cardiac metabolism.

Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study

ObjectivesThis study explored the effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder (ASD), a proxy for symptom aggravation, among Korean children aged 5–14 years.DesignTime-series...

In Vitro Selective Combinatory Effect of Ciprofloxacin with Nitroxoline, Sanguinarine, and Zinc Pyrithione against Diarrhea-Causing and Gut Beneficial Bacteria.

ABSTRACTAntibiotic resistance in diarrhea-causing bacteria and its disruption of gut microbiota composition are health problems worldwide. The development of combinatory agents that increase the selective inhibitory effect (synergism) against diarrheagenic pathogens and, simultaneously, have a lowered impact (antagonism) or no negative action on the gut microbiota is therefore proposed as a new strategy efficient for chemotherapy against diarrheal conditions. In this study, the in vitro selective combinatory effect of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione, representing various classes of alkaloid-related compounds (nitroquinolines, benzylisoquinolines and metal-pyridine derivative complexes) against selected standard diarrhea-causing (Bacillus cereus, Enterococcus faecalis, Listeria monocytogenes, Shigella flexneri, and Vibrio parahaemolyticus) and gut-beneficial (Bifidobacterium adolescentis, Bifidobacterium animalis subsp. lactis, Bifidobacterium breve, Lactobacillus casei, and Lactobacillus rhamnosus) bacteria, was evaluated according to the sum of fractional inhibitory concentration indices (FICIs) obtained by the checkerboard method. The results showed that the individual combination of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione produced a synergistic effect against the pathogenic bacteria, with FICI values ranging from 0.071 to 0.5, whereas their antagonistic interaction toward the Bifidobacterium strains (with FICI values ranging from 4.012 to 8.023) was observed. Ciprofloxacin-zinc pyrithione produced significant synergistic action against S. flexneri, whereas a strong antagonistic interaction was observed toward B. breve for the ciprofloxacin-nitroxoline combination. These findings suggest that certain combinations of agents tested in this study can be used for the development of antidiarrheal therapeutic agents with reduced harmful action on the gastrointestinal microbiome. However, further studies focused on their pharmacological efficacy and safety are needed before they are considered for clinical trials.IMPORTANCE Diarrheal infections, which are commonly treated by antibiotics, are still responsible for over 4 to 5 million cases of human deaths annually. Moreover, the rising incidence of antibiotic resistance and its negative effect on beneficial bacteria (e.g., Bifidobacteria) of the gut microbial community are another problem. Thus, the development of selective agents able to inhibit diarrheal bacteria and, simultaneously, that have no negative impact on the gut microbiota, is important. Our results showed that individual combinations of ciprofloxacin with nitroxoline, sanguinarine, and zinc pyrithione produced synergism against the pathogenic bacteria, whereas their antagonistic interaction toward the beneficial strains was observed. The antagonism can be considered a positive effect contributing to the safety of the therapeutic agents, whereas their synergism against diarrheal bacteria significantly potentiates total antimicrobial efficacy. The certain combinations tested in this study can be used for the development of antidiarrheal agents with reduced harmful action on the gastrointestinal microbiome.

Differences in the closeness of spatial relationship between Ricanidae in their prime and natural enemies in five kinds of tea gardens

AbstractTo identify the natural enemy species which are close to Ricanidae in spatial relationship and to provide scientific basis for biological control and reasonable protection of natural enemies, geostatistics and the angular cosine coefficient method were used to analyze the population of Ricanidae in their prime and their natural enemies in the Anji white tea garden, the Longjing43 tea garden, the Nongkangzao tea garden, the Pingyangtezao tea garden and the Wuniuzao tea garden. The spatial relationship between six natural enemies and Ricanidae was also studied. The angular cosine coefficients were normalized to obtain the intimacy index. According to the sum of the intimacy index and the serial number of the intimacy index of each natural enemy in five tea gardens, the following conclusions could be drawn: the top three natural enemies closely related to Ricanidae in spatial relationship were Clubiona reichlini, Clubiona japonicola and Misumenops tricuspidatus; at least two species of the top three natural enemies in each tea garden were the same as the top three natural enemies in the comprehensive analysis of the five tea gardens; one of the factors that determined the spatial relationship between natural enemies and Ricanidae was the ratio of the number of Ricanidae and natural enemies. The results of this study identified the spider species of natural enemies which should be rationally used and protected in the five tea gardens.

Influence of Mobile Robots on Human Safety Perception and System Productivity in Wholesale and Retail Trade Environments: A Pilot Study

Ensuring human safety has been one of the most critical considerations within the field of human–robot interaction. To explore the effects of working with autonomous robots on human coworkers’ perceived workload and job performance, two experiments were conducted in this study. Eight participants were recruited in the first experiment. Results revealed an increase in both subjective and objective workload measurements: compared to the baseline “no robot” to “empty payload” condition, the sum of NASA Task Load Index (NASA-TLX) scores increased from 129.3 (58.8) to 147.6 (53.7) ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$p$</tex-math></inline-formula> -value = 0.041) and the pupil diameter increased from 4.07 (0.64) mm to 4.11 (0.67) mm; while working with a full payload robot, the sum of NASA-TLX scores increased to 151.7 (55.9) ( <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$p$</tex-math></inline-formula> -value = 0.010) and the pupil diameter increased to 4.12 (0.66) mm. Increased task completion time (3.1% for empty payload condition and 6.6% for full payload condition) showed a decrease in human productivity. However, this slight human output reduction was compensated by the substantial gain from the robot. Similar effects of autonomous mobile robots on participants’ NASA-TLX scores and task completion time were observed in the second experiment, where eight participants performed the order picking and sorting tasks in a high-fidelity grocery store setting. Results from the study suggested the feasibility of applying fully autonomous mobile robots in Wholesale and Retail Trade settings to improve human–robot team productivity while prioritizing physical safety and reasonable increases in mental workload.

Clinical Model for the Prediction of Severe Liver Fibrosis in Adult Patients with Type II Diabetes Mellitus.

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD)-related severe liver fibrosis is associated with a higher risk of progressing to decompensated cirrhosis and hepatic failure and developing NAFLD-related hepatocellular carcinoma (HCC), particularly in populations with diabetes. Our pilot study aims to evaluate the performances of various noninvasive methods in predicting liver fibrosis in a population of patients with diabetes and to establish a new scoring system for the prediction of severe fibrosis (>F3). Materials and Methods: A total of 175 patients with diabetes were enrolled for liver fibrosis evaluation. Using the degree of agreement (concordance) between a noninvasive score based on serum biomarkers (NAFLD fibrosis score) and point shear-wave elastography (pSWE) as the reference method, we generated receiver operating characteristic (ROC) curves and performed a multivariate analysis to predict severe liver fibrosis. Results: In our population of patients with diabetes, gamma-glutamyltransferase (GGT), age, body mass index (BMI), the homeostatic model assessment of insulin resistance (HOMA-IR), and glycosylated hemoglobin (HbA1C) were significant predictors for the diagnosis of the F3/F4 group (area under the ROC: 0.767, 0.743, 0.757, 0.772, and 0.7, respectively; p < 0.005 for all). Moreover, the combined composite score (the sum of GGT, age, BMI, HOMA index, and HbA1C) had the highest diagnostic performance at a cut-off value of 3 (AUROC—0.899; p < 0001). The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were 91.20%, 79%, 79%, and 89%, respectively, and 89% of patients were correctly classified as having severe liver fibrosis. In contrast with the Fibrosis 4 (FIB-4) score and the AST-to-platelet ratio index (APRI), the composite score had the best accuracy in discriminating advanced fibrosis. Conclusions: The proposed composite score had a reliable and acceptable diagnostic accuracy in identifying patients with diabetes at risk of having severe fibrosis using readily available laboratory and clinical data.

Deep autoencoder-powered pattern identification of sleep disturbance using multi-site cross-sectional survey data.

Pattern identification (PI) is a diagnostic method used in Traditional East Asian medicine (TEAM) to select appropriate and personalized acupuncture points and herbal medicines for individual patients. Developing a reproducible PI model using clinical information is important as it would reflect the actual clinical setting and improve the effectiveness of TEAM treatment. In this paper, we suggest a novel deep learning-based PI model with feature extraction using a deep autoencoder and k-means clustering through a cross-sectional study of sleep disturbance patient data. The data were obtained from an anonymous electronic survey in the Republic of Korea Army (ROKA) members from August 16, 2021, to September 20, 2021. The survey instrument consisted of six sections: demographics, medical history, military duty, sleep-related assessments (Pittsburgh sleep quality index (PSQI), Berlin questionnaire, and sleeping environment), diet/nutrition-related assessments [dietary habit survey questionnaire and nutrition quotient (NQ)], and gastrointestinal-related assessments [gastrointestinal symptom rating scale (GSRS) and Bristol stool scale]. Principal component analysis (PCA) and a deep autoencoder were used to extract features, which were then clustered using the k-means clustering method. The Calinski-Harabasz index, silhouette coefficient, and within-cluster sum of squares were used for internal cluster validation and the final PSQI, Berlin questionnaire, GSRS, and NQ scores were used for external cluster validation. One-way analysis of variance followed by the Tukey test and chi-squared test were used for between-cluster comparisons. Among 4,869 survey responders, 2,579 patients with sleep disturbances were obtained after filtering using a PSQI score of >5. When comparing clustering performance using raw data and extracted features by PCA and the deep autoencoder, the best feature extraction method for clustering was the deep autoencoder (16 nodes for the first and third hidden layers, and two nodes for the second hidden layer). Our model could cluster three different PI types because the optimal number of clusters was determined to be three via the elbow method. After external cluster validation, three PI types were differentiated by changes in sleep quality, dietary habits, and concomitant gastrointestinal symptoms. This model may be applied to the development of artificial intelligence-based clinical decision support systems through electronic medical records and clinical trial protocols for evaluating the effectiveness of TEAM treatment.

In Vitro Growth-Inhibitory Synergistic Effect of Zinc Pyrithione in Combination with Gentamicin against Bacterial Skin Pathogens of Livestock.

Bacterial skin diseases of livestock could be a serious global threat, especially in association with overcoming bacterial resistance. Combinatory action of antimicrobial agents proves to be an effective strategy to overcome the problem of increasing antibiotic resistance of microorganisms. In this study, the in vitro combined effect of zinc pyrithione with gentamicin against bacterial skin pathogens of livestock (Staphylococcus aureus, Streptococcus agalactiae, and Streptococcus dysgalactiae) was evaluated according to the sum of fractional inhibitory concentration indices (FICI) obtained by checkerboard method. The results showed that a combination of zinc pyrithione with gentamicin produced a strong synergistic effect (p < 0.001) against all tested streptococcal strains (with FICI values ranging from 0.20 to 0.42). Compared to that, only three out of eight S. aureus strains were highly susceptible to the combination of antimicrobial agents at single concentration (0.25 µg/mL) of zinc pyrithione with range of FICI 0.35–0.43. These findings suggest that interference between agents tested in this study can be used for the development of future veterinary pharmaceutical preparations for the treatment of bacterial skin infections of livestock.

Study of Neighborhood Degree-Based Topological Indices via Direct and NM-Polynomial of Starphene Graph

Our objective is to compute the neighborhood degree-based topological indices via NM-polynomial for starphene. In the neighborhood degree-based topological indices, we compute the third version of the Zagreb index; neighborhood second Zagreb index; neighborhood forgotten topological index; neighborhood second modified Zagreb index; neighborhood general Randic index; neighborhood harmonic index; neighborhood inverse sum index; first, second, third, fourth, and fifth NDe indices; fourth atom bond connective index; fifth geometric arithmetic index; fifth arithmetic-geometric index; fifth hyper-first and second Zagreb index; general first neighborhood index; and Sanskruti index. These neighborhood topological indices are computed both direct and via the NM-polynomial approach.

DRIS Norms and Sufficiency Ranges for Persimmon ‘Rojo Brillante’ Grown under Mediterranean Conditions in Spain

The aim of this study was to establish DRIS (Diagnosis and Recommendation Integrated System) norms and Nutritional Optimal Ranges (NOR) for ‘Rojo Brillante’ Protected Designation of Origin (PDO) ‘Ribera del Xúquer’. The database contained 800 leaf samples collected in different crop phenological stages [after flowering (AF), fruit enlargement (FE), fruit colouring (FC), and harvesting HV)]. DRIS norms (78) were established for macronutrients: N, P, K, Ca, Mg and S; micronutrients B, Cu, Fe, Mn, and Zn and salinity elements: Na and Cl. The Nutrient Balance Index (NBI; the absolute value of the sum of the DRIS indices) was used to determine the optimal sampling period. Fruit enlargement was the period during which persimmon trees were more nutritionally balanced regardless of sprout origin (vegetative or floral) and irrigation type (drip or flood) in orchards

Measuring patient well-being: an exploratory study of the Haptotherapeutic Well-Being Scale (HWS)

Background The HWS is developed for measuring patient well-being and may be useful in linking the specific Haptotherapy (HT) interventions – insight-providing conversations, skills exercises, and therapeutic touch – to the various dimensions of well-being. The aim is to obtain insight into the reliability and validity of the newly developed HWS and its potential usefulness in the clinical setting. Method: HT patients aged 18 or older (N = 640) completed a one-time digital questionnaire at home before treatment. A control group of 18 years or older who were not treated by a haptotherapist (N = 151) completed the same questionnaire at home. Results We demonstrated significant medium and strong correlations of four of the five HWS subscales, each with two or more Four-Dimensional Symptom Questionnaire (4DSQ) subscales and the HWS sum score with all 4DSQ subscales. The factor analysis of the HWS yielded one factor, Cronbach's Alpha: .860. The HWS sum score of the No-HT group was significantly higher than the HT group, and the same goes for all HWS subscales. Furthermore, we demonstrated significant strong correlations of all five HWS subscales with the 5-item World Health Organization Well-Being Index (WHO-5) sum score and a significant and strong correlation of the HWS sum score with the WHO-5 sum score. Conclusion The Haptotherapeutic Well-being Scale (HWS) appears to be reliable and can be used for measuring well-being from a haptotherapeutic perspective. Further research is needed to confirm the reliability and validity of the HWS, and its sensitivity to detect changes. Appendices HWS in English, Dutch, German and French.

Computation of M-Polynomial and Topological Indices of Phenol Formaldehyde

Phenol formaldehyde (phenolic resin) has a wide range of moldings. However, it has immense consumption in manufacturing electrical equipment due to its insulating property. Phenolic resin retains properties at the freezing point, and also its age cannot be determined. Due to its insulator property, it has wide use in electrical equipment. In this article, degree-based topological indices of phenol formaldehyde are determined with the help of M-polynomial. We calculate the Zagreb index, Randić index, K-Banhatti indices, modified K-Banhatti indices, atom-bond connectivity index, geometric arithmetic index, symmetric index, inverse sum index, and harmonic index.

Environmental pollution, ecological and human health risk assessment of heavy metals in rice farming system near the Buriganga River in Dhaka, Bangladesh

ABSTRACT The current study focused on quantifying hazardous heavy metals (As, Cd, Cr, Pb, Ni, and Zn) in soil-rice systems near the Buriganga River in Bangladesh to assess their impact on human health and the environment. The mean concentrations of As, Cd, Cr, Ni, and Zn in soil exceeded FAO/WHO acceptable limits, and the metal pollution index (MPI) indicated that all soil samples collected from the rice fields were severely polluted (MPI˃30) than water and rice grain samples. According to the sum of pollution index (SPI) by studied metals, rice grains collected from Kamrangirchor (29.36), Dhakauddan (28.75), and Bosila (18.08) were severely polluted. Mean Bio-concentration factors (BCFs) and Transfer factors (TFgrain/soil) in rice grains were in the following order: Cd (6.034) > Zn (1.752) > Pb (0.697) ˃ Ni (0.666) > Cr (0.135) > As (0.037), and Cd (1.150) > Zn (0.421) > Ni (0.112) ˃ Pb (0.072) > Cr (0.015) > As (0.034) respectively indicating higher accumulation of Cd in rice grain than others toxic heavy metal. The potential ecological risk index (RI) showed that except for water in Kamrangirchar and Keraniganj rice fields, all other rice fields soil and water samples did not pose severe ecological pollution (RI˂110) by different toxic heavy metals. Health risk assessment showed that rice grains are unsafe for human consumption as the carcinogenic health risk (CHR˃10-3) and non-carcinogenic health risk (HI ˃1) quotients seem more than the safe level in all samples collected from rice fields surrounding the Buriganga River. Findings show that heavy metal concentrations are high in rice fields near the Buriganga River, endangering the environment and consumer health.

Novel cyclohepta[b]thiophene derivative incorporating pyrimidine, pyridine, and chromene moiety as potential antimicrobial agents targeting DNA gyrase

The emergence of drug-resistant microbes is responsible for high morbidity and mortality worldwide. In our endeavors to cultivate novel and effectual antimicrobial agents, we present the triumphant synthesis of a novel class of cyclohepta-thieno-pyrimidins 4-8, cyclohepta[b]thiophene appended 2-imino-2H-chromene-3-carboxamide and 3-imino-3H-benzo[f]chromene-2-carboxamide derivatives 9-11 molecules, to enrich their biological behavior. The desired molecules had undergone in-vitro appraisal for their antimicrobial activity, demonstrating encouraging results. Besides, the time-kill kinetics, antibiofilm activity and the DNA gyrase inhibition of the active thiophene compounds were evaluated. The DNA gyrase inhibition by the active thiophenes was also determined with IC50 values to range between (5.3-18.7µM) compared with Levofloxacin and Ciprofloxacin. Also, the sum of the Fractional Inhibitory Concentration Index (ΣFICI) was used to assess synergy between thiophenes and Levofloxacin. Additionally, the antimicrobial activity of the most active thiophene derivative was analyzed after ɣ -irradiation. Moreover, the in-silico prediction methodology was contemplated for foretelling the physicochemical, pharmacokinetic and ADME traits of the most active synthesized compounds and the standard reference drugs: Levofloxacin and Ciprofloxacin. The docking examination was carried out for the most promising derivatives 1, 2, 3, 4, 9, Novobiocin, and Levofloxacin inside the active site of DNA gyrase, and their respective docking scores were contrasted with the scores of the above-mentioned standard drugs.

Proof of a conjecture on communicability distance sum index of graphs

Let G be a connected graph with adjacency matrix A, and let A=exp⁡(A). The communicability distance between two vertices u and v of G is defined as ξuv=(Auu+Avv−2Auv)1/2, and the communicability distance sum index (CDS index for short) of G is the sum of all communicability distances between vertices of G. In this paper, it is shown that the complete graph Kn is the unique graph attaining the minimum CDS index among all connected graphs of order n. This confirms a conjecture of Estrada (2012) [2]. Furthermore, some upper and lower bounds for the CDS index of graphs are provided.

The Burnout Epidemic Within A Viral Pandemic: Impact of a Wellness Initiative

BackgroundAnesthesiologists are at high risk of developing burnout, a condition which can lead to many deleterious effects for the physician, and far-reaching effects on their patients and hospital systems. The COVID-19 pandemic has presented new challenges that have further exacerbated the risk of burnout in anesthesiologists. It is critical to develop effective strategies to promote well-being and decrease burnout for physicians in this specialty. The purpose of this observational study was to evaluate the impact of a Physician Well-Being Initiative on distress and well-being in anesthesiologists. It was hypothesized that the wellness intervention would promote an improvement in well-being scores. MethodsThe Physician Well-Being Initiative was launched in August 2019 in the Department of Anesthesiology, Pain Management and Perioperative Medicine at Henry Ford Hospital in Detroit, Michigan. The Physician Well-Being Initiative was designed to address several of the key factors that improve physician wellness, including 1) a sense of autonomy; 2) positive view of leadership; and 3) flexible schedule opportunities. To assess the impact of the Physician Well-Being Initiative on the well-being and distress scores of participating anesthesiologists, the physicians were emailed the validated Well-Being Index survey at baseline and 3, 6 and 12 months. The Well-Being Index evaluates multiple items of distress in the healthcare setting. The sample size was limited to the 54 anesthesiologists at Henry Ford Hospital. ResultsForty-four of the 54 anesthesiologists completed the baseline questionnaire. A total of 44 physicians answered the questionnaire at baseline, with more male than female physicians (35 males and 7 females) and the majority (17/44) in practice for 5-10 years. Thirty-two physicians completed the survey at 3 and 6 months, and 31 physicians at 12 months after the launch of the Physician Well-Being Initiative. Twenty-one physicians completed the questionnaire at all 4 time points. Although the COVID-19 pandemic started shortly after the 6-month surveys were submitted, results indicated that there was a 0.05 decrease in the Well-Being Index sum score for every 1-month of time (coefficient -0.05, 95% CI -0.01, -0.08, P = 0.013). This study shows that, with the wellness initiative in place, the department was able to maintain and potentially even reduce physician distress despite the concurrent onset of the pandemic. ConclusionsFollowing the launch of a sustained wellness initiative, this study demonstrates that physician wellness improved with time. This suggests that it takes time for a wellness initiative to have an effect on well-being and distress in anesthesiologists.

Distribution of invasive exotic species Artocarpus heterophyllus Lam. in a forest fragment in the Amazon

Artocarpus heterophyllus is an invasive exotic species known for its negative impacts on Brazilian ecosystems. The aim of this study was to evaluate the distribution and population structure of A. heterophyllus in the plant community of a forest fragment in the Amazon. Individuals of this species were subject to active search at Sumaúma State Park, in Manaus, and two plots were delimited, where these individuals were counted. In each plot, the jackfruit tree individual with the largest Diameter at Breast Height (DBH) was centralized, and from it, native species were inventoried. The parameters of relative density, relative dominance and the importance value index were estimated. Jackfruit tree individuals in the plots had grouped distribution and their number in plots 1 and 2 was 308 and 872 individuals, respectively. In quadrant 1, 254 jackfruit trees and 118 native individuals were recorded, and in quadrant 2, 629 jackfruit and 130 native individuals. The jackfruit tree reached indices higher than the sum of the phytosociological indices of all native species. Jackfruit tree distribution was considered similar to that occurring in other already invaded areas of Brazil, which may indicate that the same impacts may occur in Amazonian ecosystems.

On the inverse sum indeg index (\(ISI\)), spectral radius of \(ISI\) matrix and \(ISI\) energy

The inverse sum indeg index \(ISI(G)\) of a graph is equal to the sum over all edges \(uv\in E(G)\) of weights \(\frac{d_{u}d_{v}}{d_{u}+d_{v}}\). This paper presents the relation between the inverse sum indeg index and the chromatic number. The bounds for the spectral radius of the inverse sum indeg matrix and the inverse sum indeg energy are obtained. Additionally, the Nordhaus-Gaddum-type results for the inverse sum indeg index, the inverse sum indeg energy and the spectral radius of the inverse sum index matrix are given.