Estimating reference evapotranspiration (ET o) at 24 h timesteps has been considered sufficiently accurate for a long time. However, recent advances in weather data acquisition have made it feasible to apply hourly procedures in ET o computation. Hourly timesteps can improve the accuracy of ET o estimates, as data averaged daily may misrepresent evaporative power during parts of the day. The objective of the present study is to assess the differences between daily ET o computations performed on 24 h (ET o,d) and hourly (ET o,h) timesteps for rice-wheat cropping systems in the Ganga Basin, India. The meteorological data for computing reference evapotranspiration were collected from an automatic weather station located in an experimental plot at IIT Kanpur, India. Daily and hourly ET o computations were performed according to the FAO-PM (Allen et al, 1998) equation for rice and wheat cropping seasons. Diurnal variations of meteorological parameters resulted in underestimation of ET o when the daily time step is considered. No significant difference was observed during wet periods. It is also observed that the hourly estimates of ET o were able to capture the abrupt changes in climate variables, while the daily ET o fails to get it as it considers the average values only. As a result, the sums of hourly values are more reliable for ET o estimates in the Ganga Plains.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, with diagnosis preceded by symptoms that may include fever, weight loss, fatigue, bleeding and bruising. Timely diagnosis and treatment of ALL may lead to improved outcomes and reduced morbidity from associated complications including tumor lysis syndrome, hyperviscosity, and stroke. PROCEDURE: We performed a retrospective cohort analysis of 274 pediatric pre-B cell ALL and lymphoma patients within Montefiore Health System to determine whether there were factors associated with time from symptom onset to diagnosis. RESULTS: Median time to diagnosis for all patients was 11.5 days (IQR7.8, 14.3) and was similar between Hispanic, Non-Hispanic Black, and Non-Hispanic White racial/ethnic groups (10.5 vs 14.0 vs 8.0 days; p=0.70), and by male and female patients (14 vs 10 days; p=0.08). Those with Medicaid insurance (n=189) were diagnosed sooner than those with private or self-pay insurance (n=85) (median of 10 vs 16 days; p=0.05). Similar findings were demonstrated when evaluating by Medicaid, Private, and Self-Pay insurance types. English and Other language speakers experienced fewer median days from symptom onset to diagnosis date compared to Spanish speakers (11 vs 7 vs 14; p=0.05). Exploratory analyses suggest that insurance status may impact the time to diagnosis to a greater degree in Non-Hispanics, while English language and female sex may represent a greater advantage to Hispanics. CONCLUSIONS: This study demonstrates that insurance status and language preference may impact the time to diagnosis of pediatric ALL. There is further need to confirm our findings and to study possible causes driving these disparities.

This study compared the efficacy of three-drug antiemetic regimens (olanzapine, fosaprepitant, and 5-HT3 receptor antagonist versus dexamethasone, fosaprepitant, and 5-HT3 receptor antagonist) on chemotherapy-induced nausea and vomiting (CINV) in children. Complete response (CR) was defined as no emesis or use of rescue antiemetics. In the acute phase, 52% of patients in the olanzapine group achieved a CR compared to 63% in the dexamethasone group (p=0.354). In the delayed phase, CR was 80% versus 73% (p= 0.702), respectively. Olanzapine is an acceptable agent to use in place of dexamethasone when a patient is not a candidate for corticosteroid as CINV prophylaxis.

Aim of the study. The goal of the study was to assess the frequency of malignancies hidden under the diagnosis of “Bell’s palsy”. We aimed to create diagnostic algorithm to avoid failures concerning patients whose only symptom of parotid gland cancer was irreversible FNP. Materials and methods. We analyzed 253 consecutive patients with FNP treated in our department in the last 5 years. All patients with irreversible FNP were reassessed in 6-12 months. We underlined all shortcomings in the diagnostics of those in whom malignancies were found out in MRI of the neck and presented the proposal of diagnostic algorithm to avoid missing such an entity. Results. Bell’s palsy was observed in 157 / 253 patients (62.06%), in 36 / 157 (22.92%) it remained permanent. In 4 / 36 patients (11.11%) with irreversible FNP, which constituted 2.54% of all “Bell’s palsy” cases, parotid gland deep lobe mass was found out in MRI. In one patient infiltration of the skull base was diagnosed. Adenoid cystic carcinoma was confirmed in final histopathology in all cases. Conclusions. Our experience has shown that irreversible FNP can be a revelator of the malignant tumor located in the deep lobe of the parotid gland. Contrast-enhanced MRI covering intra- and extracranial segments of facial nerve should be ordered in all cases of FNP without recovery after 4 months. The main point of our study is to underline that the assessment of the deep lobe of the parotid gland with MRI should be included in the standard diagnostic protocol in all irreversible “Bell’s palsy” cases. Key words: Bell’s palsy, facial nerve palsy, parotid gland cancer

Stimulating and harnessing circularly polarized luminescence (CPL) is not only a sine qua non for fundamentally unveiling chirogenesis in physical chemistry, and also a pivotal prerequisite for implementation of such phenomenon in area of chiral optoelectronics and theranostics. Herein, red-emissive carbonized polymer dots (CPDs)-based helical structures were synthesized in this work via biomolecule-tailored organic-inorganic co-assembly strategy. The surface states related chirality exhibited enhanced circular dichroism (CD) and CPL activities with anisotropic factors as high as gCD,max=5.4×10-3 and glum,max=1.5×10-2 respectively. The obtained CPL signals can be further manipulated with an excitation-dependent manner indicating a synergistic-competition phenomenon is existed between configurational chirality and intermolecular energy-transfer dynamics, which is further supported by simulations based on density function theory (DFT). Such tunable CPL behaviors triggers revolutionary designs and applications of these chiral CPDs into the realm of chirality-related biological issues and next generation chiral optoelectronics.

Intramyocardial dissection hematoma (IDH) is an extremely rare complication of myocardial infarction (MI). Echocardiography is the initial imaging modality for IDH in patients with MI. We reported the case of a 74-year-old patient admitted because of abdominal pain and remarkably increased white cell count. He had anterior-wall MI and underwent percutaneous device intervention 8-months ago, his B-cell acute lymphoblastic leukemia (ALL) was recently diagnosed. Two dimensional echocardiography demonstrated decreased lower-anterior interventricular septum akinesis with the formation of an apical left ventricular aneurysm, and a cavitation with echolucent center formed within the tissue of the apical area was detected. Three-dimensional echocardiography with the true-view effect displayed a clearer image of dissecting flap resembling a sheet of tissue and fibers and bundles in the cavitation suggested dissected myocardium. Compared to the echocardiography performed 3-days ago in his community hospital, the intimal flap with the cavitary lesion in the apical region was newly developed. Therefore, the diagnosis of newly developed IDH was made. Considering hematological malignancy and hemodynamic instability, the patient was managed with conservative pharmacological treatments.

The growing world population increases demand for agricultural production, which is becoming even more challenging as climate change increases global temperatures and causes more extreme weather events. Using high-throughput phenotyping, this study examines the phenotypic variation of 149 accessions of Brachypodium distachyon under drought, heat, and the combination of both stresses. Heat alone causes the largest amounts of tissue damage and the combination of heat and drought causes the largest decrease in plant biomass compared to other treatments, however, we identified heat alone as being the most detrimental stress condition. Notably, we identified Bd21-0, the reference line for B. distachyon, as not having robust growth under stress conditions, especially in the heat-drought combined treatment. We found climate of origin (climate data from the accessions' collection locations) to be significantly associated with height and percent of plant tissue damage under the conditions assessed, indicating a relationship between climate of origin and B. distachyon phenotype under drought and heat stresses. Additionally, genome wide association mapping found a number of genetic loci associated with changes in plant height, biomass, and the amount of damaged tissue under stress. Significant SNPs were closely located to genes known to be involved in plant responses to abiotic stresses. The anticipated increase in drought and heat stress as a result of climate change and the distinct impact of stresses in combination, as demonstrated in this study, underscores the importance of phenotyping plants under multiple stresses that frequently converge.

High-oil tobacco varieties have been recently engineered to produce increased leaf oil content for future food and fuel needs. An engineered variety of Nicotiana tabacum produces ~30 percent of leaf dry weight in lipids in the form of triacylglycerol (TAG), a significant increase relative to the less than 1 percent storage oil normally found in wild-type leaves. This high-oil tobacco also accumulates oil bodies in stomatal guard cells. In order to understand the impact of oil on guard cell shape, aperture, and dynamics, we have co-opted computer vision tools in PlantCV to create an accurate, flexible, and high-throughput method for microscopy image analysis of stomata. To this end, leaf impressions are made with silicone putty; clear nail polish peels of the putty impressions are imaged using light microscopy. Binary thresholding followed by point-and-click regions of interest and morphology calculations provide stomatal counts, aperture, and other shape characteristics. Applying this method to high-oil tobacco demonstrated reduced stomatal aperture but the same number of stomata per unit leaf area, providing a mechanistic explanation of high-oil tobacco responses to high temperature and water deficit stresses.

3D scans of real world objects are often represented by point clouds, creating XYZ-coordinates of individual scan points. However, unlike point clouds that are generated from CAD data, points generated from a real world scene lack information about their local context, making segmentation of the structural information contained in the data difficult. Using neural networks (e.g. PointNet) has shown promising results. However, this approach is not well suited for scans of large areas of similar objects, like e.g. a wheat field, because of limitations of the input vector size of the neural network. In addition, point clouds are often unordered, further complicating processing. Since point clouds of biological objects often contain recurring features, we propose to subdivide the point cloud into locally neighboring subsets with a fixed number of points. The collection of subsets can then be used to train neural networks. This approach preserves the original resolution of the point cloud while offering simple data augmentation concepts like creating a number of different subset collections from the same ground truth. There are several advantages to this approach, like significantly simplifying the training phase, because a single, large annotated scan can be sufficient for training, utilizing the similarity of the instances of a plant in the field.

The 3-dimensional structure of habitats is a critical component of species' niches driving coexistence in species-rich ecosystems. However, its influence on structuring and partitioning recruitment niches has not been widely addressed. We developed a new method to combine Species Distribution Modeling and Structure from Motion and characterized three-dimensional recruitment niches of two ecosystem engineers on Caribbean coral reefs, scleractinian corals and gorgonians. Fine-scale roughness was the most important predictor of suitable habitat for both taxa, and their niches largely overlapped, primarily due to scleractinians broader niche breadth. Crevices and holes at mm-scales on calcareous rock with low coral cover were more suitable for octocorals than for scleractinian recruits, suggesting the decline of scleractinian corals is facilitating the recruitment of octocorals on contemporary Caribbean reefs. However, the relative abundances of the taxa were independent of the amount of suitable habitat on the reef, emphasizing niche-processes solely do not predict recruitment rates.

The protein secondary structure (SS) prediction plays an important role in the characterization of general protein structure and function. In recent years, a new generation of algorithms for SS prediction based on embeddings from protein language models (pLMs) is emerging. These algorithms reach state-of-the-art accuracy without the need for time-consuming multiple sequence alignment (MSA) calculations. LSTM-based SPOT-1D-LM and NetSurfP-3.0 are the latest examples of such predictors. We present the ProteinUnetLM model using a convolutional Attention U-Net architecture that provides prediction quality and inference times at least as good as the best LSTM-based models for 8-class SS prediction (SS8). Additionally, we address the issue of the heavily imbalanced nature of the SS8 problem by extending the loss function with the Matthews correlation coefficient (MCC), and by proper assessment using previously introduced adjusted geometric mean metric (AGM). ProteinUnetLM achieved better AGM and sequence overlap score (SOV) than LSTM-based predictors, especially for the rare structures 310-helix (G), beta-bridge (B), and high curvature loop (S). It is also competitive on challenging datasets without homologs, free-modeling targets, and chameleon sequences. Moreover, ProteinUnetLM outperformed its previous MSA-based version ProteinUnet2, and provided better AGM than AlphaFold2 for 1/3 of proteins from the CASP14 dataset, proving its potential for making a significant step forward in the domain. To facilitate the usage of our solution by protein scientists, we provide an easy-to-use web interface under [https://biolib.com/SUT/ProteinUnetLM/](https://biolib.com/SUT/ProteinUnetLM/).

Artificial Intelligence (AI) is playing a dominant role in the 21 st century. Organizations have more data than ever, so it's crucial to ensure that the analytics team should differentiate between Interesting Data and Useful Data. Amongst the important aspects in Machine Learning are "Feature Selection" and "Feature Extraction". We are now witnessing the emerging fourth industrial revolution and a considerable number of evolutionary changes in machine learning methodologies to achieve operational excellence in operating and maintaining the industrial assets efficiently, reliably, safely and cost-effectively. AI techniques such as, knowledge based systems, expert systems, artificial neural networks, genetic algorithms, fuzzy logic, case-based reasoning and any combination of these techniques (hybrid systems), machine learning, biomimicry such as swarm intelligence and distributed intelligence. are widely used by multi-disciplinarians to solve a whole range of hitherto intractable problems associated with the proactive maintenance management of industrial assets. In this paper, an attempt is made to review the role of artificial intelligence in condition monitoring and diagnostic engineering management of modern engineering assets. The paper also highlights that unethical and immoral misuse of AI is dangerous.

We consider nonparametric estimation of some regression curves when the data are observed with additive distortion which depends on an observed confounding variable. The unobservable response variable and covariates are both distorted in a additive fashion by unknown distorting functions. We study the estimates of nonparametric mean function and its first derivative, the variance function, the Sharpe ratio function and correlation curve function. We obtain asymptotic normality results for the proposed nonparametric estimators. Monte Carlo simulation experiments are conducted to examine the performance of the proposed estimators. The proposed estimators are applied to analyze a QSAR fish toxicity dataset for an illustration.

The paper presents a nonlinear coupled isothermal model of the process of surface treatment by a particle beam. The model takes into account the interaction of impurity diffusion and mechanical disturbances, as well as the transfer of the introduced impurity by the vacancy mechanism and under the action of stresses. The problem is solved numerically using an implicit symmetric difference scheme of the second order approximation in time and spatial coordinates. The finite time of mass flux relaxation and the dependence of diffusion coefficient on the composition and on the concentration of vacancies lead to peculiarities in the propagation of both the concentration wave and the wave of mechanical disturbances. Vacancies lead to acceleration of impurity propagation and the increase in strain/stresses.

As a clinical pharmacist and clinical pharmacologist for about 25 years at the Food and Drugs Administration (FDA), I have always wondered about the question of splitting the tablet, and especially for tablets for the drugs with Narrow Therapeutic Index (NTI). For these drugs, any small increase in the amount ingested to a severe patient has risky consequences, especially in the elderly. I worked on this NTI project during my tenured year at the FDA. I reviewed over 200 commonly prescribed drugs, from the efficacy and safety perspective. My focus was identifying the Maximum Toxic Concentration (MTC), the Minimum Effective Concentration (MEC), Maximum Dose (Max D), and Minimum Dose (Min D). The therapeutic index (TI) was measured from the following equation: TI =MTC/MEC for all drugs. Also, I identified the various strengths available for each drug product and the scoring (if any). The analysis shows that the mean and standard deviation (SD) for all 64 scored tablets was 5.030 (± 2.79 units) and that all unscored drugs was 9.520 (± 14.22 units). As noted, there was more variability in the unscored tablets. This provided evidence that the drugs tending to be NTI were scored to titrate. However, patients, especially elderly, appear to be confused and having difficulty in accurately breaking the tablet scores. However, it is important to note that acetaminophen represents wide TI, maximum daily dose of 4,000 mg/day, and it is no-scored. However, levothyroxine which represents drug with NTI has 12 strengths and all are scored.

Aim Several cases of ertapenem-related neurotoxicity has been published in the current literature. However, studies evaluating the ertapenem blood concentration as a risk of these adverse events are scarce. We aimed to evaluate the relationship between the ertapenem concentration and the risk of neurological toxicity. Methods Retrospective study, including patients who underwent ertapenem treatment between october 2019 and february 2021. We excluded critical patients and those whose blood sample were not properly took in order to analyze ertapenem trough concentration. We also excluded patients whose clinical follow-up was not properly realized for the entire period of ertapenem treatment. The main outcome was the presence of any suspicious neurological side effect owing to ertapenem administration and its relationship with the plasma concentration. Secondary outcomes were to identify other clinical and analytical data contributing to a higher risk of neurotoxicity. Results Cohort was initially composed by 158 individuals. For the final analysis we evaluated 102 patients, reporting a neurological alteration in 13/102 (12.7%). Mean ertapenem trough plasma concentration was significantly higher in patients showing neurotoxicity in comparison with those who did not (37.8 mcg ml-1 SD±35.7 vs 14.6 mcg ml-1 SD±15.2; p=0.002). In multivariable logistic regression analysis, ertapenem plasma concentration (OR= 1.07; p=0.006), a moderate renal insuficiency (OR= 9.2; p=0.02) and a history of previous neurologic disease (OR=9.9;p=0.02) were identified as risk factors of neurological alteration during ertapenem treatment. Conclusions Identifying properly patients who may accumulate the antibiotic by determining their plasma levels could be helpful to minimize the risk of neurotoxicity.

L-asparaginase (L-ASNase) is an essential component of chemotherapy schemes due to its differential action over normal and leukemic cells. Recently, concerns on the performance of commercial formulations administered in developing countries have been reported. To address this problem, we developed a cell-based protocol to compare the activity of different L-ASNase formulations used in Colombia. We found three statistically different groups, ranging from full to no activity on leukemic cells using 0.05, 0.5 and 5.0 IU/mL concentrations. According to our results, we advise a preclinical evaluation for formulations of L-ASNase distributed in developing countries which could impact the outcome of patients.

We consider the coupled propagation of an optical field and its second harmonic in a quadratic nonlinear medium governed by a coupled system of Schrodinger equations. We prove the existence of ring-profiled optical vortex solitons appearing as solutions to a constrained minimization problem and as solutions to a min-max problem. In the case of the constrained minimization problem solutions are shown to be positive but the wave propagation constants undetermined, but in the min-max approach the wave propagation constants can be prescribed. The quadratic nonlinearity introduces some interesting properties not commonly observed in other coupled systems in the context of nonlinear optics, such as the system not accepting any semi-trivial solutions, meaning, that optical solitons cannot be observed when, say, one of the beams are off. Additionally, the second harmonic always remains positive.

Plant phyllosphere represents a hostile environment to many biocontrol agents but gives no less significance than rhizosphere in terms of plant health. Deploying biocontrol bacteria onto phyllosphere can be efficient to suppress diseases but also challenging due to the lack of knowledge on phyllosphere adaptive traits possessed by biocontrol bacteria. In this study, We demonstrated that a bacterium Rhodopseudomonas palustris strain GJ-22 colonizes plant phylloshere by forming cell aggregates. The formation of cell aggregates required production of exopolysaccharide (EPS) which depended on the function of the rpaI-rpaR quorum sensing (QS) mechanism mediated by the signal molecule p-coumaroyl-HSL. and then,Mutation of the EPS biosynthesis gene Exop1 or the signal molecule biosynthesis gene rpaI compromised the ability of GJ-22 to tolerate reactive oxygen intermediates (ROIs) H2O2 in vitro and to form cell aggregates in vivo. Both mutants failed to prime the plants with induced systemic resistance (ISR) against virus proliferation, but the ISR-priming ability can be restored by exogenous application of p-coumaroyl-HSL onto the mutant-inoculated leaves. This result indicates that QS mechanism also participates in the ISR-priming of GJ-22. Together the result revealed QS mediates the production of EPS and consequently leads to the formation of bacterial cell aggregation which is required for the onset of ISR which provides plant with pathogen resistance.

Background: In 2021–22, influenza A viruses dominated in Europe. The I-MOVE primary care network conducted a multicentre test-negative study to measure influenza vaccine effectiveness (VE). Methods: Primary care practitioners collected information on patients presenting with acute respiratory infection. Cases were influenza A(H3N2) or A(H1N1)pdm09 RT-PCR positive and controls were influenza virus negative. We calculated VE using logistic regression, adjusting for study site, age, sex, onset date, and presence of chronic conditions. Results: Between week 40 2021 and week 20 2022, we included over 11,000 patients of whom 253 and 1595 were positive for influenza A(H1N1)pdm09 and A(H3N2), respectively. Overall VE against influenza A(H1N1)pdm09 was 75% (95%CI: 43–89) and 81% (95%CI: 44–93) among those aged 15–64 years. Overall VE against influenza A(H3N2) was 29% (95%CI: 12–42) and 25% (95%CI: -41–61), 33% (95%CI: 14–49) and 26% (95% CI: -22 to 55) among those aged 0–14, 15–64 and over 65 years, respectively. The A(H3N2) VE among the influenza vaccination target group was 20% (95%CI: -6–39). All 53 sequenced A(H1N1)pdm09 viruses belonged to clade 6B.1A.5a.1. Among 410 sequenced influenza A(H3N2) viruses, all but 8 belonged to clade 3C.2a1b.2a.2. Discussion: Despite antigenic mismatch between vaccine and circulating strains for influenza A(H3N2) and A(H1N1)pdm09, 2021–22 VE estimates against circulating influenza A(H1N1)pdm09 were the highest within the I-MOVE network since the 2009 influenza pandemic. VE against A(H3N2) was lower than A(H1N1)pdm09, but at least one in five individuals vaccinated against influenza were protected against presentation to primary care with laboratory-confirmed influenza.

Is Esophageal Temperature Management Needed During Cryoballoon Ablation for Atrial Fibrillation?Bachir Lakkis MD, Marwan M. Refaat, MDDivision of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonRunning Title: Is Esophageal Temperature Management Needed During CBA for AF?Words: (excluding the title page and references): 462Keywords: Catheter Ablation, Atrial Fibrillation, Heart Diseases, Cardiovascular Diseases, Cardiac ArrhythmiasFunding: NoneDisclosures: NoneCorresponding Author:Marwan M. Refaat, MD, FACC, FAHA, FHRS, FASE, FESC, FACP, FAAMATenured Professor of MedicineDirector, Cardiovascular Fellowship ProgramDepartment of Internal Medicine, Cardiovascular Medicine/Cardiac ElectrophysiologyDepartment of Biochemistry and Molecular GeneticsAmerican University of Beirut Faculty of Medicine and Medical CenterPO Box 11-0236, Riad El-Solh 1107 2020- Beirut, LebanonUS Address: 3 Dag Hammarskjold Plaza, 8th Floor, New York, NY 10017, USAOffice: +961-1-350000/+961-1-374374 Extension 5353 or Extension 5366 (Direct)Atrial fibrillation (AF) is one of the most frequently occurring arrhythmias globally. Risk factors such as aging, hypertension, cardiac and pulmonary diseases, alcohol consumption, smoking, obesity and obstructive sleep apnea play an important role in the development of AF.(1-2) AF is a leading cause of ischemic stroke worldwide and is associated with increased mortality. (3) AF management depends on four pillars: risk factor management, anticoagulation depending on the CHA₂DS₂-VASc score, rate control and rhythm control. (4) The application of thermal energy in ablation, such as in cryoablation, can cause rare complications such as an esophageal injury, esophageal perforation and atrial-esophageal fistula. (5,6). Numerous technologies have been developed to avoid this problem and include esophageal temperature surveillance, using reduced temperatures, real time visualization of the esophagus in addition to making use of an esophageal cooling device. (7-9)In the current issue of the Journal of Cardiovascular Electrophysiology, Sink et al. have conducted a single-center pilot study to assess the utilization of an esophageal warming device to avoid the development of esophageal thermal injury (ETI) while utilizing cryoballoon ablation (CBA). Alternative studies have shown that using a cooling device has been beneficial in reducing the risk of ETI formation for patients undergoing RFA. (10,11) Thus, the authors have enrolled 42 patients undergoing CBA with AF refractory to medical therapy and have randomized them into 2 groups. In the first group, 23 patients undergoing CBA used an esophageal warming device such as esophageal heat-exchange tube (WRM) while the other 19 patients undergoing CBA used traditional luminal esophageal temperature (LET) to monitor the esophageal temperatures. The authors have conducted upper endoscopy monitoring of the esophagus the next day and subsequently, classified ETI into 4 grades. They have observed in the WRM group a paradoxical increase in ETI in comparison to the other group which used LET. Moreover, the authors have perceived a direct link between ETI formation, total freeze time and colder temperature usage. However, this study has several limitations, including the small population size. Furthermore, the study results are based on a single device employment which is EnsoETM® device (Attune Medical, Chicago, IL). Therefore, the effects of using other warming devices are not known.Overall, the authors should be praised on their efforts for conducting the first pilot study to evaluate the effects of using an esophageal warming device for patients undergoing CBA and for providing cardinal insight into the safety of utilizing such a device. In addition, the results of this study have tremendous clinical implications. Certainly, patients undergoing CBA might benefit from using higher temperature (above -51 °) and lower freezing time (<300 seconds) to avert developing ETI. Further studies incorporating more patients should be conducted to elucidate whether using an esophageal warming device is associated with a beneficial or a detrimental effect.References1. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century. Circulation Research. 2020;127(1):4-20. doi: doi:10.1161/CIRCRESAHA.120.316340.2. Maan A, Mansour M, Anter E, Patel VV, Cheng A, Refaat MM, Ruskin JN, Heist EK. Obstructive Sleep Apnea and Atrial Fibrillation: Pathophysiology and Implications for Treatment. Crit Pathw Cardiol Jun 2015; 14 (2): 81-5.3. Migdady I, Russman A, Buletko AB. Atrial Fibrillation and Ischemic Stroke: A Clinical Review. Semin Neurol. 2021;41(04):348-64.4. Chung MK, Refaat M, Shen WK, Kutyifa V, Cha YM, Di Biase L, Baranchuk A, Lampert R, Natale A, Fisher J, Lakkireddy DR. Atrial Fibrillation: JACC Council Perspectives. J Am Coll Cardiol. Apr 2020; 75 (14): 1689-1713.5. Kapur S, Barbhaiya C, Deneke T, Michaud GF. Esophageal Injury and Atrioesophageal Fistula Caused by Ablation for Atrial Fibrillation. Circulation. 2017;136(13):1247-55. doi: doi:10.1161/CIRCULATIONAHA.117.025827.6. D’Avila A, Ptaszek LM, Yu PB, Walker JD, Wright C, Noseworthy PA, Myers A, Refaat M, Ruskin JN: Left Atrial-Esophageal Fistula After Pulmonary Vein Isolation. Circulation May 2007; 115(17): e432-3.7. Dagres N, Anastasiou-Nana M. Prevention of atrial-esophageal fistula after catheter ablation of atrial fibrillation. Curr Opin Cardiol. 2011 Jan;26(1):1-5. doi: 10.1097/HCO.0b013e328341387d. PMID: 21099683.8. Leung LW, Gallagher MM, Santangeli P, Tschabrunn C, Guerra JM, Campos B, Hayat J, Atem F, Mickelsen S, Kulstad E. Esophageal cooling for protection during left atrial ablation: a systematic review and meta-analysis. J Interv Card Electrophysiol. 2020 Nov;59(2):347-355. doi: 10.1007/s10840-019-00661-5. Epub 2019 Nov 22. PMID: 31758504; PMCID: PMC7591442.9. Arruda, M.S., Armaganijian, L., Base, L.D., Rashidi, R. and Natale, A. (2009), Feasibility and Safety of Using an Esophageal Protective System to Eliminate Esophageal Thermal Injury: Implications on Atrial-Esophageal Fistula Following AF Ablation. Journal of Cardiovascular Electrophysiology, 20: 1272-1278. https://doi.org/10.1111/j.1540-8167.2009.01536.x10. Leung LW, Gallagher MM, Santangeli P, Tschabrunn C, Guerra JM, Campos B, Hayat J, Atem F, Mickelsen S, Kulstad E. Esophageal cooling for protection during left atrial ablation: a systematic review and meta-analysis. J Interv Card Electrophysiol. 2020 Nov;59(2):347-355. doi: 10.1007/s10840-019-00661-5. Epub 2019 Nov 22. PMID: 31758504; PMCID: PMC7591442.11. Tschabrunn CM, Attalla S, Salas J, Frankel DS, Hyman MC, Simon E, Sharkoski T, Callans DJ, Supple GE, Nazarian S, Lin D, Schaller RD, Dixit S, Marchlinski FE, Santangeli P. Active esophageal cooling for the prevention of thermal injury during atrial fibrillation ablation: a randomized controlled pilot study. J Interv Card Electrophysiol. 2022 Jan;63(1):197-205. doi: 10.1007/s10840-021-00960-w. Epub 2021 Feb 23. PMID: 33620619.

Many of the behaviors observed in actual systems are comparable to scale-free and small world structures in network research. In contrast to conventional hierarchical networks, the unusual fractal hierarchical network we created in this research has a pyramidal structure. The findings we get from this network are expanded to be applicable to arbitrary hierarchical networks. The average path length of unweighted and weighted hierarchical networks are the main topics of this paper. We demonstrate that, in the unweighted case, when the number of iterations z tends to infinity, the average path length is only related to the number of blocks of the hierarchical network. Additionally, in the weighted network, the average path length is related to the number of blocks r and the weighting factor w of the hierarchical network.

In this work, we modify the iterative Kurchatov's method to solve nonlinear equations with multiple roots, that is,for approximating the solutions of multiplicity grater than one. Its main feature is that you do not need to know a priori the multiplicity of the root, which does not appear in the iterative expression. We perform a dynamical analysis to see the behaviour of the proposed method. We also carry out some numerical experiments to confirm the theoretical results and compare the proposed method with other known schemes for multiple roots.

The growing demand for head magnetic resonance imaging (MRI) examinations, along with a global shortage of radiologists, has led to an increase in the time taken to report head MRI scans around the world. For many neurological conditions, this delay can result in increased morbidity and mortality. An automated triaging tool could reduce reporting times for abnormal examinations by identifying abnormalities at the time of imaging and prioritizing the reporting of these scans. In this work, we present a convolutional neural network for detecting clinically-relevant abnormalities in T 2-weighted head MRI scans. Using a validated neuroradiology report classifier, we generated a labelled dataset of 43,754 scans from two large UK hospitals for model training, and demonstrate accurate classification (area under the receiver operating curve (AUC) = 0.943) on a test set of 800 scans labelled by a team of neuroradiologists. Importantly, when trained on scans from only a single hospital the model generalized to scans from the other hospital (∆AUC ≤ 0.02). A simulation study demonstrated that our model would reduce the mean reporting time for abnormal examinations from 28 days to 14 days and from 9 days to 5 days at the two hospitals, demonstrating feasibility for use in a clinical triage environment.