Integrating freelance models with fractional derivatives, and artificial neural networks: A comprehensive approach to advanced computation.

In order to improve results, this work investigates how the Freelance Model (FM), Fractional Derivative (FD), and Artificial Neural Network (ANN) may all function together. We suggest a new method that combines the varied skills of freelancers with the precision of fractional derivatives and the adaptability of neural networks to maximize the benefits of each. This proposed strategy provides a new perspective to the computational methodologies and holds a promising impact on diverse industries. Future developments and applications can be made possible by this promising path toward enhanced performance in complex systems and data-driven areas. Twenty neurons have been selected and data has been trained and validated in the, following manner 70 %, 15 % and 15 %. The consistency of method has been shown using the correlation/regression and histograms in order to solve the model. The results presented here not only validate the efficacy of our approach but also open avenues for further exploration and advancements in the dynamic field of advanced computation.

Comparison of Predator-Prey Model and Hawk-Dove Game for Modelling Leukemia.

Game theory is an excellent mathematical tool to describe the interaction between the immune system and cancerous leukocytes (c.leu). The feature of cancerous leukocytes to differentiate and mutate to give rise to leukemia is in the domain of ecological models as well. In this work, the dynamic of leukemia is described and compared by two models: firstly by a simple probabilistic mathematical model using the zero-sum two player game of Hawk and Dove, and secondly by Leslie Predator Prey model of ecology. The main goal of this study is to compare the results of both models and then discuss the treatment of leukemia i.e., Hematopoietic Stem cell transplant with the best model among them. Hawk and Dove model also describes the cell to cell interaction of cancerous leukocytes and healthy leukocytes (leu) after diagnoses and the condition of the patient before and after treatments. In this work, Hematopoietic Stem cell transplant is discussed by using concepts of a zero-sum three player game. Also, both models will be characterized by determining the stability properties, identifying basins of attraction, and locating the equilibrium points to see, at what extent the patient's survival is possible with leukemia in its body. Results for both models will be presented graphically.

Does freelancing have a future? Mathematical analysis and modeling.

During the past few years, freelancing has grown exponentially due to the pandemic and subsequent economical changes in the world. In fact, in the last ten years, a drastic increase in freelancing has been observed; people quit their jobs to be their own boss. There are various reasons for this: downsizing of employees, not having fun in their jobs, unemployment, part time work to earn more, etc. Observing this vast change, many individuals on Facebook/YouTube, NGOs, and government departments started teaching freelancing as a course; to date, thousands of youngsters have been trained to start their careers as freelancers. It has been observed that the ratio of informed freelancers is more successful than those who start their careers independently. We construct a compartmental model to explore the influence of information on the expansion of freelancing in this article, which was motivated by this surge in freelancing. Following that, the model is subjected to dynamical analysis utilizing dynamical systems and differential equation theory. To validate our analytical conclusions, we used numerical simulation.

The clinical characteristics and outcomes of patients with pulmonary hypertension in association with hyperthyroid state: A systematic review.

BACKGROUND: Pulmonary hypertension (PHTN) may occur in thyroid disorders, especially in hypothyroidism. However, there is increasing evidence of PHTN in hyperthyroidism (HTH). The etiology, clinical course, management, and factors associated with outcomes of PHTN in the setting of HTH are unascertained. This systematic review consolidates available evidence on patients with HTH who developed PHTN. METHODS: We conducted a systematic review on English articles from PubMed, Scopus, and Google Scholar reporting PHTN in patients with hyperthyroidism. Data were analyzed and reported in Microsoft Excel 2020, SPSS version 26, and Jamovi version 1.2. RESULTS: We identified 589 patients with PHTN in the setting of HTH. Etiologies included Grave disease 66.7%), toxic multinodular goiter (TMNG) (16.8%), drug-induced HTH (0.3%), thyroiditis(0.8%), and toxic adenoma(0.1%). Most patients did not receive any specific management for PHTN and were managed by antithyroid treatment (97.4%). Outcomes of PHTN were reported in 181 patients, with a 94% recovery rate. Pulmonary artery pressures (PAP) before and after HTH management ranged from 22.5 to 75 mm Hg and from 24 to 50 mm Hg, respectively. Outcome analysis performed on data from case reports and series with individually identifiable data revealed a 67.6% female preponderance. An estimated 73.5% of the patients had PHTN at the initial presentation of HTH, which was associated with a better resolution rate of PHTN(OR: 12, P-value: 0.048). TRAB was positive in 47% patients with no clinical difference in outcomes. antiTG AB was reported positive in 29.4%, all of whom had an improvement, compared to an 83.3% improvement rate in those with negative antiTG AB. Various etiologies and treatments did not have any significant differences in the outcome of PHTN. CONCLUSIONS: PHTN can be present at the initial diagnosis of HTH, which is associated with better outcomes of PHTN. There is a clear female preponderance in the development of PHTN. However, resolution rates seem to be better in males. Although TRAB is associated with the development of PHTN, it does not seem to affect the outcomes. PHTN in patients with HTH does not need any specific management, with >90% resolution with antithyroid therapy. Whether any specific antithyroid therapy has a better outcome in PHTN needs to be explored prospectively.

Cognitive status as a robust predictor of repeat falls in older Veterans in post-acute care.

BACKGROUND: While repeat falls are common in post-acute care (PAC), risk factors have not been fully elucidated. AIMS: The objective of thids study is to evaluate the contribution of cognitive function to repeat falls in older PAC Veterans. METHODS: Data were collected from medical records for 91 single and 30 repeat fallers over 5 consecutive years (2011-2016). RESULTS: After controlling for demographic and medical factors, lower Mini-Mental State Exam (MMSE) score was associated with increased odds of repeat falls. MMSE scores below 20 (with age held constant at the mean) were associated with a greater than 50% chance of a repeat fall (compared to 24.7% base rate). Admission for a neurologic reason further increased risk. DISCUSSION: PAC Veterans who experience a fall have an increased risk of repeat falls with concomitant cognitive dysfunction and/or admission for neurologic reasons. CONCLUSIONS: Results support tailoring multi-component interventions for those with cognitive dysfunction utilizing standardized mental status screening upon admission.

Quality Assurance Audit Of Intra-Oral Periapical Radiographs At The Undergraduate Dental School.

BACKGROUND: The three fundamental principles of radiation protection are justification, dose optimization or limitation and subsequently following the As Low as Reasonably Practicable- (ALARP) principle. Quality assurance (QA) program for dental radiography is important in order to yield results with maximum diagnostic value, minimize errors, aid in interpretation, avoid unnecessary repetition of radiographs and therefore, additional radiation exposure. METHODS: This standard based audit was conducted at an undergraduate and postgraduate teaching hospital. One thousand and sixty four intra oral periapical radiographs were graded according to the set standards by NRPB by 3 examiners. Data were analyzed with SPSS-24. RESULTS: Out of the 532 conventional periapical radiographs, 313 radiographs were Grade 1, 177 radiographs were Grade 2 and 42 radiographs were Grade 3, requiring a repeat radiograph. For 532 digitally taken periapical radiographs, 255 radiographs were Grade 1, 192 radiographs were Grade 2 and 85 radiographs were Grade 3 and diagnostically unacceptable. Considering the aforementioned results, the findings of the first cycle did not meet the standards. CONCLUSIONS: According to the results of the quality assurance audit, the radiographs were below the standards set by NRPB. Recommendations were made for improvement measures in the radiology department and plan to re-audit after six months.

Rare complication of milk-alkali ingestion: severe pancreatitis and acute kidney injury in a chronic hypocalcaemic patient with DiGeorge's syndrome.

Injudicious use of over-the-counter calcium supplements has resulted in increased incidences of hypercalcaemia and related complications. We present a case of acute pancreatitis in a chronic hypocalcaemic patient of DiGeorge's syndrome. The patient came into the ED with sepsis syndrome, right upper quadrant and epigastric pain and no obvious source of infection. Lab results and imaging were indicative of acute pancreatitis. There was severe renal dysfunction. The patient needed haemodialysis and had a prolonged stay in intensive care. The medical history was negative for biliary duct pathology or alcohol use. The patient had vomiting and diarrhoea in the nursing home for about a week, but she continued to receive her regular medications that included the calcium supplements and thiazide diuretics. It is likely that a complex interplay between calcium supplementation, dehydration and thiazide diuretics resulted in the development of acute pancreatitis and severe renal dysfunction in a chronic hypocalcaemic patient.

Impact of an auditory hallucinations simulation on trainee and newly qualified clinical psychologists: A mixed-methods cross-sectional study.

Simulation training is an effective teaching tool enabling learners to gain a subjective understanding of a range of skills. Our aim in this study was to pilot and evaluate a newly designed simulation of auditory hallucinations as a future training tool for clinicians. This was a mixed-methods study in two parts. In Phase 1, trainee and qualified clinical psychologists (N = 25) attended the London-based immersive art exhibition, Altered States of Consciousness, which included an auditory hallucinations simulation. The exhibition aimed to improve understanding of what it feels like to hear voices by providing members of the public with an individualized simulation of auditory hallucinations. Participants completed pre/post-exhibition measures of their mood and attitudes towards auditory hallucinations and other unusual sensory experiences. In Phase 2, a subgroup of Phase 1 participants (N = 15) took part in a semi-structured interview and completed the post-exhibition questions again approximately 6 months later. Post-exhibition, there were significant increases in understanding what it feels like to hear voices (large effect), compassion towards people who hear voices (large effect), and comfort talking to people who hear voices (medium effect). Scores were partially maintained at follow-up. Participants reported that the simulation provided numerous benefits to their training and clinical practice, including increases in subjective understanding, compassion, and confidence, and suggested several future training applications for the simulation, including with a range of health care professionals. Therefore, we conclude that this simulation has potential for training clinical psychologists and other health care professionals who work with people who experience auditory hallucinations.

Effect of interferon-alpha, ribavirin, pentoxifylline, and interleukin-18 antibody on hepatitis C sera-stimulated hepatic stellate cell proliferation.

Chronic hepatitis C virus (HCV) infection is a major cause of liver fibrosis ultimately leading to cirrhosis. Hepatic stellate cell (HSC) proliferation is crucial in fibrosis development. Current antiviral treatment for HCV involves interferon-alpha (IFN-alpha) and Ribavirin combination therapy. IL-18, a novel cytokine of the IL-1 family of cytokines, is involved in inflammation and may be important in HCV-related inflammation. We hypothesize that block of one of the crucial events will block fibrosis due to HCV. The effect of HCV patient sera with and without IFN-alpha, ribavirin, and IL-18 antibody on HSC proliferation was assessed by [(3)H]-thymidine incorporation assays. Western analysis was used to assess the effect of pentoxifylline (PTX) on c-Jun immediate early gene phosphorylation (p-c-Jun formation). We demonstrate that HCV patient sera-stimulated HSC proliferation. Ribavirin with or without IFN-alpha significantly decreased HCV sera-stimulated HSC proliferation by 50%. Western analysis revealed that HCV serum increased p-c-Jun levels, which were decreased with Ribavirin and PTX. ELISA results showed an elevation of IL-18 levels in HCV sera when compared to normal sera. IL-18 did not stimulate HSC proliferation. However, IL-18 antibody significantly decreased patient sera-stimulated HSC proliferation. In conclusion, Ribavirin decreased HSC proliferation and may act by decreasing p-c-Jun levels in HSCs. IL-18 alone did not stimulate HSC proliferation but IL-18 antibody decreased stimulation, suggesting that IL-18 may work in conjunction with some other factor to increase HSC proliferation.