Gender Disparity in Academic Trauma Surgery: The Current State of Affairs.

INTRODUCTION: Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America. MATERIAL AND METHODS: FRIEDA was used to identify trauma surgery programs. A thorough website review of each program obtained further information on faculty members, including their name, age, gender, and faculty rank. Trauma surgeons with an MD or DO qualification and a faculty rank of Professor, Associate Professor, or Assistant Professor were selected for inclusion in this study. SCOPUS was used to assess the H-index and the number of publications and citations of surgeons. RESULTS: The total number of programs included was 136, consisting of 715 faculty members. Less than a quarter (n = 166; 23.2%) comprised females and less than one-fifth (n = 30; 19%) of female surgeons were Professors. The difference in the research productivity of male and female trauma surgeons was statistically significant (P < .05), with the average H-index being 10 vs 7.5, respectively, amongst the top 50 surgeons of both genders. Based on a multiple regression analysis, academic rank was significantly associated (P < .05), and gender was not significantly associated (P > .05) with H-index. CONCLUSION: Gender disparity exists in the field of trauma surgery, as noted in senior faculty ranks and leadership positions. Female-inclusive state policies, appropriate mentorship, and supportive institutions can help to bridge this gap.

Patterns of Change in Nucleotide Diversity Over Gene Length.

Nucleotide diversity at a site is influenced by the relative strengths of neutral and selective population genetic processes. Therefore, attempts to estimate Effective population size based on the diversity of synonymous sites demand a better understanding of their selective constraints. The nucleotide diversity of a gene was previously found to correlate with its length. In this work, I measure nucleotide diversity at synonymous sites and uncover a pattern of low diversity towards the translation initiation site of a gene. The degree of reduction in diversity at the translation initiation site and the length of this region of reduced diversity can be quantified as "Effect Size" and "Effect Length" respectively, using parameters of an asymptotic regression model. Estimates of Effect Length across bacteria covaried with recombination rates as well as with a multitude of translation-associated traits such as the avoidance of mRNA secondary structure around translation initiation site, the number of rRNAs, and relative codon usage of ribosomal genes. Evolutionary simulations under purifying selection reproduce the observed patterns and diversity-length correlation and highlight that selective constraints on the 5'-region of a gene may be more extensive than previously believed. These results have implications for the estimation of effective population size, and relative mutation rates, and for genome scans of genes under positive selection based on "silent-site" diversity.

Socio-economic factors determine maternal and neonatal outcomes in women with peripartum cardiomyopathy: A study of the ESC EORP PPCM registry.

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a global disease with substantial morbidity and mortality. The aim of this study was to analyze to what extent socioeconomic factors were associated with maternal and neonatal outcomes. METHODS: In 2011, >100 national and affiliated member cardiac societies of the European Society of Cardiology (ESC) were contacted to contribute to a global PPCM registry, under the auspices of the ESC EORP Programme. We investigated the characteristics and outcomes of women with PPCM and their babies according to individual and country-level sociodemographic factors (Gini index coefficient [GINI index], health expenditure [HE] and human developmental index [HDI]). RESULTS: 739 women from 49 countries (Europe [33%], Africa [29%], Asia-Pacific [15%], Middle East [22%]) were enrolled. Low HDI was associated with greater left ventricular (LV) dilatation at time of diagnosis. However, baseline LV ejection fraction did not differ according to sociodemographic factors. Countries with low HE prescribed guideline-directed heart failure therapy less frequently. Six-month mortality was higher in countries with low HE; and LV non-recovery in those with low HDI, low HE and lower levels of education. Maternal outcome (death, re-hospitalization, or persistent LV dysfunction) was independently associated with income. Neonatal death was significantly more common in countries with low HE and low HDI, but was not influenced by maternal income or education attainment. CONCLUSIONS: Maternal and neonatal outcomes depend on country-specific socioeconomic characteristics. Attempts should therefore be made to allocate adequate resources to health and education, to improve maternal and fetal outcomes in PPCM.

Diagnostic dilemmas and challenges in the management of myasthenia in infants and toddlers: A case report.

Myasthenia in the infancy and toddler age group is rare and often presents a challenge to treating pediatric neurologists. Our report addresses the challenges encountered when distinguishing myasthenia in infants and toddlers from similar illnesses, as well as the differentiation between congenital myasthenia, transient myasthenia, and autoimmune myasthenia. We present four cases of myasthenia between the ages of 10 and 30 months. The diagnosis and management of these cases were challenging due to the variability in clinical presentation. Four cases of myasthenia were diagnosed, with three having autoimmune myasthenia and one having congenital myasthenic syndrome. One patient initially tested negative for acetylcholine receptor antibodies, but later tested positive after 4 months and had a rare facial diplegia finding. The patient with congenital myasthenic syndrome had a novel genetic mutation, DPAGT1 homozygous variants, and also had false positive acetylcholine receptor antibodies. These cases highlight the importance of genetic testing for all infants and toddlers suspected of having myasthenia.

A rare concurrent incidence of adult-onset acute disseminated encephalomyelitis and antiphospholipid antibody syndrome: A case report.

INTRODUCTION: Acute disseminated encephalomyelitis (ADEM) is a demyelinating immune-mediated condition of the central nervous system, whereas antiphospholipid antibody syndrome (APLA) is an autoimmune disorder accompanied by thrombosis and pregnancy-related problems. We present a unique case of a 30-year-old female with ADEM coexisting with APLA, highlighting the importance of early identification and specialized care. PRESENTATION OF CASE: We present a case of a 30-year-old woman with a history of hypertension, multiple miscarriages, and non-compliance with medication, who presented with altered consciousness and weakness in all four limbs. Laboratory tests revealed positive anti-cardiolipin and lupus anticoagulant antibodies, confirming APLA. A neurological examination revealed increased limb tone, heightened reflexes, and extensor plantar responses. MRI revealed confluent white matter lesions that were consistent with ADEM. The patient received prompt treatment with intravenous methylprednisolone and then received oral prednisone, leading to a rapid improvement in neurological status. DISCUSSION: The intricate interaction between ADEM and APLA remains enigmatic. The plausible connection between "molecular mimicry" and weakened blood-brain barrier, substantiated by antiphospholipid antibodies, may help explain their concurrent occurrence. CONCLUSION: This case highlights the significance of early diagnosis and management of the rare and complex coexistence of ADEM and APLA to attain optimal outcomes, as well as the significance of careful examination for simultaneous autoimmune markers in individuals presenting with neurological disturbances.

Benzimidazole-Based Schiff Base Hybrid Scaffolds: A Promising Approach to Develop Multi-Target Drugs for Alzheimer's Disease.

A series of benzimidazole-based Schiff base derivatives (1-18) were synthesized and structurally elucidated through 1H NMR, 13C NMR and HREI-MS analysis. Subsequently, these synthetic derivatives were subjected to evaluation for their inhibitory capabilities against acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). All these derivatives showed significant inhibition against AChE with an IC50 value in the range of 123.9 ± 10.20 to 342.60 ± 10.60 µM and BuChE in the range of 131.30 ± 9.70 to 375.80 ± 12.80 µM in comparison with standard Donepezil, which has IC50 values of 243.76 ± 5.70 µM (AChE) and 276.60 ± 6.50 µM (BuChE), respectively. Compounds 3, 5 and 9 exhibited potent inhibition against both AChE and BuChE. Molecular docking studies were used to validate and establish the structure-activity relationship of the synthesized derivatives.

The divergence of mutation rates and spectra across the Tree of Life.

Owing to advances in genome sequencing, genome stability has become one of the most scrutinized cellular traits across the Tree of Life. Despite its centrality to all things biological, the mutation rate (per nucleotide site per generation) ranges over three orders of magnitude among species and several-fold within individual phylogenetic lineages. Within all major organismal groups, mutation rates scale negatively with the effective population size of a species and with the amount of functional DNA in the genome. This relationship is most parsimoniously explained by the drift-barrier hypothesis, which postulates that natural selection typically operates to reduce mutation rates until further improvement is thwarted by the power of random genetic drift. Despite this constraint, the molecular mechanisms underlying DNA replication fidelity and repair are free to wander, provided the performance of the entire system is maintained at the prevailing level. The evolutionary flexibility of the mutation rate bears on the resolution of several prior conundrums in phylogenetic and population-genetic analysis and raises challenges for future applications in these areas.

Patterns of change in nucleotide diversity over gene length.

Nucleotide diversity at a site is influenced by the relative strengths of neutral and selective population genetic processes. Therefore, attempts to identify sites under positive selection require an understanding of the expected diversity in its absence. The nucleotide diversity of a gene was previously found to correlate with its length. In this work, I measure nucleotide diversity at synonymous sites and uncover a pattern of low diversity towards the translation initiation site (TIS) of a gene. The degree of reduction in diversity at the TIS and the length of this region of reduced diversity can be quantified as "Effect Size" and "Effect Length" respectively, using parameters of an asymptotic regression model. Estimates of Effect Length across bacteria covaried with recombination rates as well as with a multitude of fast-growth adaptations such as the avoidance of mRNA secondary structure around TIS, the number of rRNAs, and relative codon usage of ribosomal genes. Thus, the dependence of nucleotide diversity on gene length is governed by a combination of selective and non-selective processes. These results have implications for the estimation of effective population size and relative mutation rates based on "silent-site" diversity, and for pN/pS-based prediction of genes under selection.

Wind turbine blades fault diagnosis based on vibration dataset analysis.

Globally, wind turbines play a significant role in generating sustainable and clean energy. Ensuring optimal performance and reliability is crucial to minimize failures and reduce operating and maintenance costs. However, due to their conventional design, identifying faults in wind turbines is challenging. This dataset provides vibration data for faulty wind turbine blades, which covers common vibration excitation mechanisms associated with various faults and operating conditions, including wind speed. The introduced faults in the wind turbine blades include surface erosion, cracked blade, mass imbalance, and twist blade fault. This data article serves as a valuable resource for validating condition monitoring methods in industrial wind turbine applications and facilitates a better understanding of vibration signal characteristics associated with different faults.

Darcy Forchheimer flow of CMC-water based hybrid nanofluid due to a rotating stretchable disk.

The flow of fluid over a spinning disk has a broad scope of numerous applications. It is employed in various things, including medical equipment, the braking system of cars, gas turbines, plastic films, and glass production. As a result of these applications, we considered the phenomena of Darcy Forchheimer's three-dimensional flow on TiO2-Fe3O4 nanoparticles suspended in based CMC-water fluid. The influence of thermal radiation and convective conditions is studied. Moreover, the Buongiorno model is utilized to compute the Brownian motion and the thermophoretic effect. To generate the non-dimensionalized governing equations, suitable alterations are put into use. These equations are then utilized with Matlab BVP4c. Graphs are used to analyze the behavior of velocity distributions, and thermal and concentration profiles at different parameter values. In addition, the solutions to the flow problem have been analyzed in terms of several other physical variables on velocity, temperature, concentration, drag force, heat, and mass transfer. According to the findings, it is clear that an escalates in the value of the rotation parameter leads to an increase in the radial velocity and axial velocity. In contrast, an opposite pattern is followed in the Forchheimer number. Finally, some engineering quantities are evaluated numerically and presented in tabular forms.

Irreversibility analysis with hybrid cross nanofluid of stagnation point and radiative flow ( T i O 2 + C u O ) based on engine oil past a stretchable sheet.

The present study addressed the physical significance of the entropy generation for the mixed convection time-dependent flow of cross-hybrid nanoliquid due to the stretched surface at a stagnation point. The Plot for heat transport is discoursed by applying the role of thermal radiation under convective conditions. For hybrid nanofluid, engine oil is used as a base liquid with copper (II) oxide C u O and titanium dioxide T i O 2 nanoparticles. The existing model is framed in the highly partial differential equation system. The governing equations have been transformed into a set of ODS's using a similar scaling operation. Following this, the resulting ODEs are solved numerically through the BVP4c. The primary goal of this research is to analyze the results of varying the stretching ratio parameter ( λ ), Weissenberg parameter ( W e ), thermal radiation ( R d ), and Biot number ( B i ) for both pure T i O 2 and CuO +  T i O 2 / E O hybrid nanofluid, on the velocity, temperature, drag force, heat transfer as well as entropy generation, and Bejan number was studied. A drop in velocity is observed with increasing values of the W e and upsurge in velocity for rising value of unsteady parameter ( A ), while increasing values of both of these parameters are associated with rising temperatures. Copper and titanium oxide nanoparticles are used to increase Engine oil (EO) thermal enactment, making it a more useful base fluid. Further, some significant industrial and engineering applications are related to the present problem discourse.

Irreversibility analysis of radiative flow of Prandtl nanofluid over a stretched surface in Darcy-Forchheimer medium with activation energy and chemical reaction.

This communication elaborates the irreversibility analysis of the flow of Prandtl nanofluid along with thermal radiation past a permeable stretched surface embedded in a Darcy-Forchheimer medium. The activation and chemical impressions along with effects of thermophoretic and Brownian motion are as well examined. The flow symmetry of the problem is modeled mathematically and leading equations are rehabilitated into nonlinear ordinary differential equations (ODEs) through the assistance of suitable similarity variables. The Keller-box technique in MATLAB is employed to draw the impacts of the contributing elements on the velocity field, temperature distribution, and concentration. The impact of the Prandtl fluid parameter has mounting performance for the velocity whereas conflicting behavior is examined in the temperature profile. The achieved numerical results are matched correspondingly with the present symmetrical solutions in restrictive cases and fantastic agreement is scrutinized. In addition, the entropy generation uplifts for the growing values of the Prandtl fluid parameter, thermal radiation, and Brinkman number and decreases for growing numbers of the inertia coefficient parameter. It is also discovered that the coefficient of friction decreases for all parameters involved in the momentum equation. Features of nanofluids can be found in a variety of real-world fields, including microfluidics, industry, transportation, the military, and medicine.

Numerical analysis of magnetohydrodynamics Casson nanofluid flow with activation energy, Hall current and thermal radiation.

In this study we analyzed the flow, heat and mass transfer behavior of Casson nanofluid past an exponentially stretching surface under the impact of activation energy, Hall current, thermal radiation, heat source/sink, Brownian motion and thermophoresis. Transverse magnetic field with the assumption of small Reynolds number is implemented vertically. The governing partial nonlinear differential equations of the flow, heat and mass transfer are transformed into ordinary differential equations by using similarity transformation and solved numerically by using Matlab bvp4c package. The impact of each of the Hall current parameter, thermal radiation parameter, heat source/sink parameter, Brownian motion parameter, Prandtl number, thermophoresis parameter and magnetic parameter on velocity, concentration and temperature, is discussed through graphs. The skin friction coefficient along the x-and z-directions, the local Nusselt number and the Sherwood number are calculated numerically to look into the inside behavior of the emerging parameters. It is witnessed that the flow velocity is a diminishing function of the thermal radiation parameter and the behavior has observed in the case of Hall parameter. Moreover, mounting values of Brownian motion parameter reduce the nanoparticle concentration profile.

Simulation of Prandtl Nanofluid in the Mixed Convective Flow of Activation Energy with Gyrotactic Microorganisms: Numerical Outlook Features of Micro-Machines.

The physiological systems and biological applications that have arisen during the past 15 years depend heavily on the microscale and nanoscale fluxes. Microchannels have been utilized to develop new diagnostic assays, examine cell adhesion and molecular transport, and replicate the fluid flow microenvironment of the circulatory system. The various uses of MHD boundary flow in engineering and technology are extensive, ranging from MHD power generators and the polymer industry to MHD flow meters and pumps and the spinning of filaments. In this investigation, the (Magnetohydrodynamic) MHD flow of Prandtl nanofluid is investigated along with mixed convection, energy activation, microorganism, and chemical reaction. The flow model is considered through partial differential equations in dimensionless form which is then integrated numerically via considering the Bvp4c technique. The outcome is numerous emerging physical parameters over velocity profile, temperature, mass concentration, and microorganism with the separate pertinent quantities such as the Prandtl fluid parameter, elastic fluid parameter, magnetic field, mixed convection parameter, activation energy, chemical reaction, Brownian motion, thermophoretic force, Prandtl number, and Schmidt number. The friction factor, rate of heat transfer and Sherwood number, and density of microbes are revealed numerically and graphically. The outcomes indicate that the Prandtl fluid parameter and elastic fluid parameter tend to enhance the velocity profile. It is also noted that the Prandtl fluid parameter depreciates the thermal rate with the addition of the concentration profile while the opposite trend is recorded for activation energy. Obtained numerical outcomes are correspondingly compared with the current statistics in limiting cases and a close match is obtained.

Effects of activation energy and chemical reaction on unsteady MHD dissipative Darcy-Forchheimer squeezed flow of Casson fluid over horizontal channel.

The impact of chemical reaction and activation energy plays a vital role in the analysis of fluid dynamics and its thermal properties. The application of the flow of fluid is significantly considered in nuclear reactors, automobiles, manufacturing setups, electronic appliances etc. This study explores the impacts of activation energy and chemical reaction on the magnetohydrodynamic Darcy-Forchheimer squeezed Casson fluid flow through a porous material across the horizontal channel where the two parallel plates are assumed to be in motion. By using similarity variables, partial differential equations are converted to ordinary differential equations. Numerical method is applied using MATLAB to solve the problems and acquire the data for velocity field, thermal distribution, and concentration distribution. The graphs indicate that fluid velocity and temperature increases as the plates are brought closer. In addition, there was a correlation between a rise in the Hartmann number and a decrease in the fluid's velocity because of the existence of strong Lorentz forces. The temperature and the concentration of the liquid will increase due to the Brownian motion. When the Darcy-Forchheimer and activation energy parameters are both increased, the velocity and concentration decreases.

Scrutinization of second law analysis and viscous dissipation on Reiner-RivlinNanofluid with the effect of bioconvection over a rotating disk.

In comparison to Newtonian fluids, non-Newtonian fluids have fascinating features in heat transportation. Here, newly type of Reiner-Rivlinnanoliquid flow over the revolving disk for viscous dissipation (VD) is being explored in a multiple-slip effect. The inclusion of gyrotactic microorganisms in the nanoliquid enhances the tendency of the nanoparticles. The idea of the intended model is enhanced by considering in the impact of activation energy, thermal radiative, heated convective conditions and entropy minimization. The system of nonlinear PDE is constructed into nonlinear ODE's by applying the von-Karman similarity method and later solved numerically using the BVP4c solver which is considered to study the complicated ordinary differential equations. TheInfluence of various parameters is elaborated and plotted physically through the graphical illustration. By contrasting the reported data in the restricted form to a previously published article, the accuracy of the current model has examined. The impact of a non-Newtonian fluid parameter over the velocity field appeared to showdpreciation in it. The results elucidate that when the wall slip coefficient is larger more torque is needed to maintain constant disk revaluation. Surface heat transmission and wall skin friction are computed for a wide variety of factors. These flows have several real world-applications, including modeling cases that occur in oceanography and geophysics, various industrial fields (such as lumber production).

Comprehensive Analysis of Feature Extraction Methods for Emotion Recognition from Multichannel EEG Recordings.

Advances in signal processing and machine learning have expedited electroencephalogram (EEG)-based emotion recognition research, and numerous EEG signal features have been investigated to detect or characterize human emotions. However, most studies in this area have used relatively small monocentric data and focused on a limited range of EEG features, making it difficult to compare the utility of different sets of EEG features for emotion recognition. This study addressed that by comparing the classification accuracy (performance) of a comprehensive range of EEG feature sets for identifying emotional states, in terms of valence and arousal. The classification accuracy of five EEG feature sets were investigated, including statistical features, fractal dimension (FD), Hjorth parameters, higher order spectra (HOS), and those derived using wavelet analysis. Performance was evaluated using two classifier methods, support vector machine (SVM) and classification and regression tree (CART), across five independent and publicly available datasets linking EEG to emotional states: MAHNOB-HCI, DEAP, SEED, AMIGOS, and DREAMER. The FD-CART feature-classification method attained the best mean classification accuracy for valence (85.06%) and arousal (84.55%) across the five datasets. The stability of these findings across the five different datasets also indicate that FD features derived from EEG data are reliable for emotion recognition. The results may lead to the possible development of an online feature extraction framework, thereby enabling the development of an EEG-based emotion recognition system in real time.

Efficacy Of Alpha-Adrenergic Receptor Antagonists In The Treatment Of Distal Ureteric Stones: A Paediatric Study.

BACKGROUND: European association of urology (EAU) recommended α- blockers for managing distal ureteric stones in the paediatric population. This paper will help to understand the efficacy of Silodosin as a medical expulsive agent for distal ureteric stones in children, along with the required time duration of stone expulsion. METHODS: Forty participants were enrolled and evaluated for complaints, pain severity, associated symptoms, and ultrasound was done to confirm the position and size of the distal stone. Follow-ups were scheduled after every 7 days (1 week) for redo ultrasound and assessment of the stone position. Data was entered and analyzed in the SPSS version 23. To evaluate the significance of data chi-square test was performed, p-value <0.005 was considered significant. RESULTS: The minimum and maximum age limits recorded are 3 years and 18 years respectively with a mean age of 9.5±4.5 years and mean stone size was measured as 0.6±0.1 cm. Distribution of stone size indicated the minimum size of 0.4 cm and maximum of 1.0 cm stone in study subjects. Maximum stone expulsion was reported within 14 days or an initial 2 follow-up scans. CONCLUSIONS: The efficacy of Silodosin and medical expulsive therapy evaluated the effect on pain management as pain episodes declined with Silodosin treatment and spontaneous passage of stones were increased within the first 14 days of treatment. This study will be a beneficial contribution in literature especially in a developing country population where paediatric urolithiasis is on expansion and ongoing.

Acute dysphagia: A rare initial symptom of lateral medullary syndrome: A case report.

Introduction and importance: A unique etiology of stroke, lateral medullary syndrome (LMS), is a consequence of posterior inferior cerebellar artery or vertebral artery thromboembolic conditions. LMS patients present particularly with ipsilateral hyperalgesia, ipsilateral ataxia, and Horner's syndrome. Our case signifies that neurogenic origin should always be considered in the absence of local causes of dysphagia. Early diagnosis could prevent LMS complications, including neurological disabilities. A scarcity of research related to dysphagia in LMS, and its outcomes exists. Therefore, the objective is to investigate the clinical course in a patient afflicted with severe dysphagia following a diagnosis of (LMS). This would encourage further research, thus improving management and treatment strategies. Case presentation: We report a case of a 45-year-old male, a smoker for 20 years, who presented with a single, unique complaint of acute dysphagia for 9 days. According to our knowledge, this is among very few reported cases of LMS with dysphagia being the rare initial complaint. The neurological issues associated with dysphagia gradually improved with the administration of antiplatelet; clopidogrel and lipid-lowering drug; rosuvastatin and the patient was discharged. Atypical presentation in LMS could be supported by the presence of lateral medullary infarct which was confirmed by MRI (Magnetic Resonance Imaging). Clinical discussion: Dysphagia is a common complaint in multiple gastrointestinal (GI) settings. However, in cases where the GI causes are excluded, as described here, diagnosis of LMS becomes tough. Conclusion: The diagnosis of LMS was queried owing to the presentation of the single most important common symptom, with no other characteristic manifestations of LMS.