A concept of initial cracking strength of concrete is elaborated in this study. A fracture model and associated methods for determining independent initial cracking strength and initial fracture toughness by using the three-point-bending (3-p-b) and wedge splitting (WS) concrete specimens are present. The initial cracking strength and initial fracture toughness can be simultaneously determined using a curve-fitting method from the proposed fracture model. All of the initial fracture curves can be obtained using the determined concrete materials. The initial loads of the 3-p-b and WS specimens can be predicted on the basis of the curves with ±15% ranges. Furthermore, analytical functions are used to obtain and determine the initial cracking strength and the initial fracture toughness of concretes directly. The determined values with ±15% ranges cover the most of initial loads of the 3-p-b and WS specimens.

The coronavirus disease-2019 (COVID-19) is an infectious respiratory disease attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has rapidly spread globally leading to a pandemic. Frequently, COVID-19 contributes to multiple cardiovascular diseases (CVD) including acute myocardial injury, myocarditis, arrhythmias and thromboembolism, due to excessive inflammation and endothelial dysfunction. Moreover, a large proportion of affected patients, especially for elderly patients have been reported to pre-exist comorbidities such as hypertension, diabetes and CVD. However, although some antiviral drugs targeted SARS-CoV-2 have been applied to clinical trial, a few of these investigational agents are associated with excess risk for cardiovascular events in prior studies of non-COVID-19 populations. The objective of this document is to introduce the cardiovascular complications caused by COVID-19 and related investigational therapies, as well as the potential consequences in patients with antiviral drugs and cardiovascular drugs, and then provide recommendations for a systematic approach on the care of patients with CVD during COVID-19 pandemic.

Background and Purpose: Lack of suitable experimental models hinders SARS-CoV-2 research. Reports denote SARS-CoV-2 uses ACE2, TMPRSS-2 as its primary receptors. However, SARS-CoV-2 clinical symptoms were also related to organs with poor or no expressions of primary receptors. Hence, using single-cell RNA sequencing data of human organoids, we analyzed expression levels of primary receptors and array of RNA receptors for their involvement in SARS-CoV-2 pathogenesis. Experimental Approach: From the gene expression omnibus (GEO) or array express database, normalized cell counts of human intestine coventional, intestine improved, prostate, kidney morizane, kidney takasato, brain, retinal, lung organoids were obtained. Individual cell types, RNA receptor expressions in ACE2 (+) and ACE2(-) cells were analyzed. Using immune enrichment analysis, immune pathway activation in ACE2(+) and ACE2(-) cells were determined. Key Results: ACE2 expression is abundant in all organoid, except prostate and brain, while TMPRSS2 is omnipresent. Innate immune component pathways are upregulated in ACE2 (+) cells in all organoids, except lung. Besides, expression of low-density lipoprotein receptor (LDLR) is highly enriched in ACE2 (+) cells in intestinal (conventional and improved), lung, and retinal organoids, with highest expression in lung organoids. Other than primary receptors, LDLR and HDLR might also exert crucial role SARS-CoV-2 pathogenesis. Conclusion and Implications: Mimicing Invivo niche, with array of cell types expressing primary and RNA receptors, immune pathways activation, human organoids will be suitable model for rapid SARS-CoV-2 translational research. Other than ACE2 and TMPRSS2, LDLR and HDLR with moonlighting functions can be useful targets in SARS-CoV-2 clinical management.

Abstract Purpose: to evaluate the safety and the efficacy of a modified Z-palatoplasty (ZPP) technique in management of post-surgical nasopharyngeal stenosis (NPS), describing its steps and results. Methods: This prospective study was conducted on patients with snoring± OSA due to acquired post-surgical NPS of grade Ι and ΙΙ. Surgical repair using a modified ZPP was employed on the patients and the pre and postoperative results were statistically compared and adverse events were recorded. Results: The grade of NPS improved significantly postoperatively (p= 0.00136) throughout a follow up of one year. Postoperatively, there was statistically significant improvement of AHI (p= 0.0005), VAS of nasal obstruction (p<0.0001) and VAS of snoring (p<0.0001). While transient VPI and dysphagia disappeared within 3 months postoperatively. Conclusion: The utilized procedure appears fast, low cost, and easily applicable, and it does not require implants, special tools or suture materials. Furthermore, it gives promising results, with tolerable pain, and rapid recovery without significant or persistent complications.

L’innalzamento delle temperature e la riduzione delle precipitazioni influiranno col passare del tempo sulla produttività agricola con un impatto pressoché negativo, inoltre, la non sostenibilità di alcune pratiche agricole con il riversamento degli scarti prodotti determina un concreto inquinamento che mette in serio rischio l’ecosistema naturale. Una delle soluzioni a queste tematiche potrebbe essere l’acquaponica, producendo cibo di qualità in maniera sostenibile e competitiva, un sistema che garantisce una maggiore resa e una maggiore velocità di crescita delle piante coltivate. Dunque, creare un ecosistema naturale in un ambiente artificiale produce uno spreco minimo, richiede input energetici limitati e produce impatti postivi sull’ambiente. In tali impianti l’acqua circola dalle vasche dei pesci raggiungendo e fertilizzando le piante, per tornare poi “depurata” nella vasca dei pesci pronta a eseguire nuovamente lo stesso ciclo. Questo consente di recuperare tutta l’acqua che le piante non sono state in grado di assorbire, riducendo del 90% il consumo acqua per kg di prodotto rispetto all’agricoltura tradizionale. Il seguente articolo intende valutare la fattibilità tecnica-economica di un sistema acquaponico mediante la realizzazione di un progetto preliminare di un’area ricadente nel comune di Alfano (SA). Il sistema progettato occupa una superficie netta di 1075 m2 di cui 36,6% di acquacoltura, 46,2% coltivazione piante e 17,2% vasche di raccolta; per una gestione efficiente dell’impianto sono previsti una serie di trattamenti: filtro meccanico a tamburo, filtrazione biologica e trattamento lampada UV. Infine, a seguito dell’analisi costi benefici effettuata è stato stimato un tempo di ritorno semplice dell’investimento pari a 3 anni e mezzo.  

The fatigue strength of component is known to highly depend on its surface quality and it is very necessary to develop a reliable appropriate mathematical model for fatigue strength assessment considering the effect of surface roughness. In this paper, different underlying physical mechanisms of roughness effect at different regions of specimen were studied by the fatigue test of 7N01 aluminium alloy. For quantitative analysis of the surface roughness effect, a revised stress field intensity approach for fatigue strength assessment of micro-size notch was proposed as the theoretical support. In the new model, a new form of weight function was built to adapt the characteristics of micro-size notch. In addition, the effect of the field radius is weakened fundamentally on solution of the stress field intensity and the difficulty of fatigue failure region definition in traditional method is overcome correspondingly in the proposed model, which makes the calculated field strength accurate and objective. Finally, to demonstrate the validity of the revised approach quantitatively, specimens with notches in conventional size have been subjected to stress field intensity calculation. The results show that the revised approach has a satisfactory accuracy compared with the other two traditional approaches from the perspective of quantitative analysis.

Surgery of the entire ear pinna even today presents a challenge to reconstructive surgeons, in the absence of a universally acceptable, quality construct for clinical use. In this article, the authors present a technique to generate a flexible, human-size ear with the aim to meet this limitation for ear reconstructive surgeries. The construct was engineered by using a decellularized goat ear cartilage. This was characterized by hematoxylin-eosin (H/E), diamidino-2-phenylindole (DAPI), Masson’s trichrome (MT), Alcian Blue (AB) staining and Scanning Electron Microscopy (SEM) for extracellular matrix (ECM) analysis. The decellularization protocol followed yielded complete removal of all cellular components without changing the properties of the ECM. In vivo biocompatibility of the ear, pinna showed demonstrable recellularization. Recellularization was tracked using HE, DAPI, MT, AB staining, toluidine staining, SEM, vascular-associated protein (VAP), and CD90+ expressing cells. VAP expression revealed specific vasculogenic pattern (angiogenesis). CD90+ expression reflected the presence of the stromal cell. The graft maintained the properties of ECM and displayed chondrocyte recruitment. In summary, the decellularized goat ear pinna (cartilage) exhibited xenograft biocompatibility, stable mechanical properties, and in vivo chondrocyte recruitment. Subsequently developed tissue-engineered ear pinna offer potential for cartilage flexibility and individualization of ear shape and size for clinical application.

pH-study is a routine procedure in some European laryngology offices to diagnose laryngopharyngeal reflux (LPR). Probe movements may complicate the testing leading to digestive symptoms and nose pains during the removal of the probe.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic continue to expand worldwide. The article focused on the broad spectrum antifungal itraconazole as antiviral prodrug with its possible role against SARS-CoV-2, via immunomodulation, anti-inflammatory actions, and direct role on the virus non-structural proteins

• COVID 19 patients with severe respiratory failure may require prolonged mechanical ventilation. Placement of a tracheostomy tube often becomes necessary for such patients. • The steps of tracheostomy procedure and post tracheostomy care of these patients can be classified as aerosol generating. • We performed percutaneous dilation tracheostomy in three clinically challenging COVID-19 patients in our ICU. • We developed guidelines aiming to minimise aerosolisation during and after the tracheostomy procedure to safeguard healthcare workers. Percutaneous tracheostomy was performed by a team of three experienced anaesthetists and an ICU nurse. • The decision of surgical or percutaneous tracheostomy should be dependent on the experience of the tracheostomy performer, health-care worker safety, resource availability, and patient-centred care. We believe our modified strategic approach for PCDT offers an extra level of safety to healthcare workers.

In Cystic Fibrosis (CF), correction of splicing defects represents an interesting therapeutic approach to restore normal CFTR function. In this study, we focused on ten common mutations/variants, 711+3A>G/C, 711+5G>A, 1863C>T, 1898+3A>G, 2789+5G>A, TG13T3, TG13T5, TG12T5 and 3120G>A that induce skipping of the corresponding CFTR exons 5, 9, 13, 16 and 18. To rescue the splicing defects we tested, in a minigene assay, a panel of modified U1 snRNAs, named Exon Specific U1s (ExSpeU1) that were engineered to bind to intronic sequences downstream of each defective exon. Using this approach, we show that all ten splicing mutations analysed are efficiently corrected by specific ExSpeU1s. Using cDNA-splicing competent minigenes, we also show that the ExspeU1-mediated splicing correction at the RNA level recovered the full-length CFTR protein for 1863C>T, 1898+3A>G, 2789+5G>A variants. In addition, detailed mutagenesis experiments performed on exon 13 led us to identify a novel intronic regulatory element involved in the ExSpeU1-mediated splicing rescue. These results provide a common strategy based on modified U1 snRNAs to correct exon skipping in a group of disease-causing CFTR mutations.

• Telephone consultations are effective in mild epistaxis and nasal trauma • Telephone follow-ups can save hospital attendances particularly in peritonsillar abscess and certain cases of otitis externa • Otitis externa and foreign bodies tend to require face-to-face consultations • Otitis externa was the most common reason for semi-urgent ENT consultation whilst social restrictions were in place

In this paper, we investigate an impulsive coupled system of fractional integro--differential equations having Caputo derivatives. The existence and uniqueness results of the system are obtained with the help of Kransnoselskii's type fixed point theorem. Different kinds of Ulam stabilities are discussed. An example is presented to support the results.

We discuss N-soliton solutions and analyze the Hirota N-soliton conditions, starting from Hirota bilinear forms. An algorithm to verify the Hirota conditions is proposed by factoring out common factors for the terms in the conditions and comparing degrees of the involved polynomials containing the common factors. Applications to a class of generalized KdV equations and a class of generalized higher-order KdV equations are made, together with all proofs of the existence of N-soliton solutions to each equation in two classes.

Abstract Groundwater contamination has become an environmental issue all around the world. The specific objective of the present study is to evaluate the risk assessment of groundwater for nitrate contamination and in addition to assess the suitability of groundwater for domestic and irrigation purposes in the semi-arid region. Thirty sample locations were identified based on the more active industrial and high-densified residential regions in the study area. To evaluate the drinking and irrigation fitness of groundwater by analysed water quality parameters such as pH, Electrical conductivity, total dissolved solids, Total hardness, calcium, magnesium, sodium, potassium, chloride, sulphate, fluoride, carbonate and bicarbonate. According to World Health Organization (WHO) 2011 and Bureau of Indian Standard (BIS) 2012 standards, the GIS Spatial analysis of groundwater parameters was carried out to identify each parameter high contaminated regions in the study area. Multivariate statistical analysis, such as principal component analysis, cluster analysis, and Pearson correlation matrix, was used to understand the relationship between water quality parameters. The Results show that 40% of samples are highly affected due to the high concentration of nitrate. The total non-carcinogenic health risks for male, women, and children are 40%, 50%, and 53.33%, respectively. It reveals that, children and women are at high risk than male in the study region. The major sources of contamination are discharges from the household, uncovered septic tanks, leachate from the waste dump, and excess utilization of fertilizers in the agriculture field.Keywords: Groundwater, GIS, Statistical analysis, Nitrate contamination, Risk assessmentIntroduction In the arid and semi-arid regions, groundwater is the most significant water sources for agriculture, domestic, and industrial activities. Natural and artificial source of groundwater contamination can be identified with human health, which are the most across the broad issues in arid and semi-arid regions in the world (Abbasnia et al., 2019 Busico et al., 2020 Balamurugan et al., 2020a, Shankar et al., 2019, Patil et al., 2020). It is essential to monitoring the human health, quality and amount of grains since it affects soils, crops, and the natural condition of ecosystem (Balamurugan et al., 2020b). About 80% of the health issues and diseases around the world are due to the consumption of contaminated water for domestic purposes (Adimalla et al., 2019a, Karunanidhi et al., 2019, Kavurmacı et al., 2020). Geogenic and human activities are the major sources of groundwater contamination in arid and semi-arid region. Among the many contaminants, nitrate contamination is the serious issue to monitor and evaluate its impact on human health. As it is highly soluble in water and easily spread groundwater contaminants all around the world (Adimalla et al., 2019c, Ahada and Suthar 2017, Mohanakavitha et al., 2019a, Mohanakavitha et al., 2019b, Nadikatla et al., 2020, Nhu et al., 2020, Ohwoghere-Asuma et al., 2019). In the southern part of India, rural and local residents are directly drawn from bore wells or open wells for drinking and agriculture uses. Their continuous consumption of groundwater with a high concentration of nitrate has seriously increased health issues. In recent years, numerous of research carried out the impact of nitrate contamination in drinking water and environmental issues. The elevated concentration of nitrate in drinking water can cause liver damage, blue baby syndrome for infants and cancers (Kaur et al., 2020, Khurshid et al., 2019, Taneja et al., 2019 and Thapa et al., 2019).Adimalla (2020) carried out the study on nitrate contamination in drinking water from the semi-arid region of south India and found that agricultural activities and animal waste disposal are the significant factors that deteriorate groundwater’s nature in the study region. Karunanidhi et al., (2019) investigated the potential health risk assessment in hard rock regions due to fluoride and nitration contamination. It also reveals that excess usage of synthetic fertilizers, cow dung used for fertilizer in the agriculture field is the source of groundwater contamination. Tian et al., (2019) studied the risk assessment of nitrate contamination in shallow groundwater. They stated that waste disposal from residential areas and modern agricultural activities are major sources of nitrate contamination in groundwater. Wagh et al., (2020) conducted a study on risk assessment of groundwater due to high nitrate contamination in kadava river basin, India and found that disposal of waste from resident area near river basin and modern agriculture activities are highly deteriorated the groundwater nature. Saurabh Shukla and Abhishek Saxena (2020) reviewed the sources and leaching of nitrate contamination in groundwater. They stated that isotopic studied with the help of statistical tools reveal a better result in the determination and identification of nitrate contamination than the geogenic factors studies. Nadikatla et al., (2019) evaluated the groundwater quality using the water quality index method in Srikakulam district, Andhra Pradesh, India. They found that, the entire groundwater quality is affected due to lack of improper sanitation facilities, sewage disposal and seepage runoffs.Statistical analysis was used to identify the major ions that contribute to deteriorate the nature of groundwater in the study region. In this domain, the correlation coefficient, principal component analysis (PCA), and hierarchical cluster analysis (HCA) are the most efficient methods to evaluate and gives a clear idea about the chemical composition of groundwater. Su et al., (2020) evaluated the impact of natural and anthropogenic activities of the groundwater using multivariate statistical techniques in Baotou city, china and found that, three cluster values reveal rock water interaction, sewage intrusion and evaporation are the factors that affect the nature of groundwater. Singh et al., (2020) conducted a study on multivariate analysis of groundwater in the agricultural dominates taluks in Punjab, India, and found that PCA analysis suggested that the chemical composition of groundwater gets disturbed by the process of rock water interactions and high impacts of anthropogenic activities. Sajil (2020) investigated the hydrogeochemical and multivariate statistical analysis of pollution sources in the groundwater near the Bhavani river basin, Tamilnadu and stated that, higher factor loadings for major ions indicate mixed influenced of natural and anthropogenic activities destroyed the quality of groundwater in the study region.From the above context, the specific objectives of the present study is (1) to evaluate the physio-chemical characterises of groundwater and compared with World Health Organisation (WHO) and Bureau of Indian Standards (BIS) (2) To determine the nitrate contamination in study area (3) To ascertain the vulnerable regions based on WQI index value (4) To identify the sources of contamination using statistical analysis. The present study’s results are useful for change effective approaches for enhancing the rural drinking water system in a nitrate prone zone.

In this article, by using the notion of newly defined $q_{1}q_{2}$-derivatives and integrals some new Simpson’s type inequalities for co-ordinated convex functions are shown. The outcomes raised in this paper are extensions and generalizations of the comparable results in the literature on Simpson’s inequalities for co-ordinated convex functions.

The goal of this paper is to study the number of limit cycles that can bifurcate from the periodic orbits of a linear center perturbed by nonlinear functions inside the class of all generalized Liénard di¤erential equations allowing discontinuities. In particular our results show that for any n 1 there are di¤erential equations of the form x¨+f(x; x_ )x_ +x+sgn(x_ )g(x) = 0, with f and g polynomials of degree n and 1 respectively, having [n=2] + 1 limit cycles, where [] denotes the integer part function.

The living energy consumption of residents has become an important technical index to promote the economic and social development strategy. In order to explore the future development trend of China’s per capita living energy consumption, this paper establishes a novel grey model to predict China’s per capita living energy consumption. Firstly, this article introduces the fractional accumulation operation and builds the discrete DGM (1,1, tα) model with fractional order accumulation model (abbreviated as FDGM (1,1, tα) model) on this basis. Secondly, the whale algorithm is introduced to solve the parameters of the FDGM (1,1, tα) model. Thirdly, the advantages of the FDGM (1,1, tα) model over the traditional grey models are illustrated by a real case. Fourthly, the metabolism mechanism is introduced into the FDGM (1,1, tα) model to enhance the prediction performance of the FDGM (1,1, tα) model. Finally, the FDGM (1,1, tα) model based on metabolism mechanism is used to predict China’s per capita living energy consumption from 2018 to 2029.

Predator-prey interaction is a fundamental feature in the ecological system. The majority of studies has addressed how competition and predation affect species coexistence. Recent field studies on vertebrate has shown that fear of predators can influence the behavioural pattern of prey populations and reduce their reproduction. A natural question arises whether species coexistence is still possible or not when predator induce fear on competing species. Based on the above observation, we propose a mathematical model of two competing prey-one predator system with the cost of fear that affect reproduction rate of both the prey population. To make the model more realistic, we incorporate intraspecific competition within the predator population. Biological justification of the model is shown through positivity and boundedness of solutions. Existence and stability of different boundary equilibria are discussed. Condition for the existence of coexistence equilibrium point is derived from showing uniform persistence. Local as well as a global stability criterion is developed. Bifurcation analysis is performed by choosing the fear effect as the bifurcation parameter of the model system. The nature of the limit cycle emerging through a Hopf bifurcation is indicated. Chaotic motion is observed when one of two prey has bigger competitive capacities than the other. Numerical experiments are carried out to test the theoretical results obtained for this model.

Modeling and prediction of soil hydrologic processes require the identification of soil moisture spatial-temporal patterns and effective methods allowing the data observations to be used across different spatial and temporal scales. This work presents a methodology for the combination of spatially- and temporally-extensive soil moisture data obtained in the Shale Hills Critical Zone Observatory (CZO) from 2004 to 2010. The soil moisture data sets were decomposed into spatial Empirical Orthogonal Function (EOF) patterns, and their relationship with various geophysical parameters was examined to determine the dominant factors contributing to the profiled soil moisture variability. The EOF analyses indicated that one or two EOFs of soil moisture could explain 76-89% of data variation. The primary EOF pattern had high values clustered in the valley region, and conversely low values located in the sloped hills. We suggest a novel approach to integrate the spatially-extensive manually measured datasets with the temporally-extensive automated monitored datasets based on the EOF analyses. Given the data accessibility, the current data merging framework has provided the methodology for the coupling of the mapped and monitored soil moisture datasets, as well as the conceptual coupling of slow and fast pedologic and hydrologic functions. This successful coupling implies that a combination of different extensive moisture data has provided interesting insights into our understanding of hydrological processes at multiple scales.

In this paper, a fourth-order accurate conservative finite difference scheme for solving the coupled nonlinear Schr\”odinger (CNLS) equations is proposed. Conservation of the discrete energy and masses, priori estimates, existence and uniqueness of numerical solutions, convergence with second-order in time and fourth-order in space as well as stability of the present scheme are proved by discrete energy method. A convergent iterative method for the present scheme is developed. Numerical experiments are given to support the theoretical analysis.

The aim of the present study is concerned with the effect of rotation of thermoelastic material with voids under the effect of three-phase-lag memory dependent heat transport law. The entire porous medium is rotating with a uniform angular velocity, where the bounding plane is subjected to a thermal shock and is free of tractions. Employing the normal mode analysis, the exact expressions for the displacement components, stresses, temperature distribution and change in volume fraction field have been depicted graphically in the presence and the absence of rotation and memory dependent derivative. The effect of void is also discussed in the literature survey.

In this study, we characterize the snowmelt hydrological response of nine nested headwater watersheds in southeast Wyoming by separating streamflow into three components using a combination of tracer and graphical approaches. First, continuous records of specific conductance (SC) from 2016 to 2018 were used to separate streamflow into direct runoff and baseflow components. Then, diurnal streamflow cycles occurring during the snowmelt season were used to graphically separate direct runoff into quickflow, representing water with the shortest residence time, and throughflow, representing water with longer residence time in the soil column and/or regolith layers before becoming streamflow. On average, annual streamflow was comprised of between 22% to 46% baseflow, 7% to 14% quickflow, and 46% to 55% throughflow across the watersheds. We then quantified hysteresis at both annual and daily timescales by plotting SC versus discharge. Annually, most watersheds showed negative, concave, anti-clockwise hysteretic direction suggesting faster flow pathways dominate streamflow on the rising limb of the annual hydrograph relative to the falling limb. At the daily timescale during snowmelt-induced diurnal streamflow cycles, hysteresis was negative, but with a clockwise direction implying that quickflow peaks generated from the concurrent daily snowmelt, with shorter residence times and lower specific conductance, arrive after throughflow peaks and preferentially contribute on the falling limb of diurnal cycles. Slope aspect and surficial geology were highly correlated with the partitioning of streamflow components. South-facing watersheds were more susceptible to early season snowmelt at slower rates, resulting in less direct runoff and more baseflow contribution. Conversely, north-facing watersheds had longer snow persistence and larger proportions of direct runoff and quickflow. Watersheds with surficial and bedrock geologies dominated by glacial deposits had a lower proportion of quickflow compared to watersheds with large percentages of metasedimentary rocks and glaciated bedrock.

Introduction: The prognosis of cystic fibrosis (CF) has dramatically changed over the past decade in France, mostly due to global improvements in specific care. Currently, the majority of French CF patients are adults, meaning they went through a transition process from a pediatric CF center to an adult CF center. To determine the impact of that transfer on clinical evolution, we report the transition procedure of our CF center in Lyon. Materials and Methods: From January 2006 to December 2016, 117 CF patients went through a standardized transition process from the pediatric to the adult CF center of Lyon. We compared the clinical evolution of the patients over 3 periods starting the year before transfer and ending the next year after transfer. Clinical data taken into account were FEV1%, BMI, pulmonary colonization, number of antibiotic courses, and number of days of hospitalization per year and outpatient visits per year. Results: No significant differences were observed between respiratory and nutritional status, pulmonary colonization, number of antibiotic courses, and numbers of hospitalizations and visits when comparing the 3 periods of observation (the year before, the year after and the next year after transfer) around transition. Conclusion: The standardized procedure of transition in Lyon is associated with the maintenance of a stable clinical status of our CF patients.