Late night salivary cortisol and cortisone should be the initial screening test for Cushing’s syndrome

Endogenous Cushing’s syndrome (CS) poses considerable diagnostic challenges. Although late night salivary cortisol (LNSC) is recommended as a first line screening investigation, it remains the least widely used test in many countries. The combined measurement of LNSC and late-night salivary cortisone (LNS cortisone) has shown to further improve diagnostic accuracy1. We present a retrospective study in a tertiary referral centre comparing LNSC, LNS cortisone, overnight dexamethasone suppression test, low dose dexamethasone suppression test and 24-hour urinary free cortisol results of patients investigated for CS. Patients were categorised into those who had CS (21 patients) and those who did not (33 patients).LNSC had a sensitivity of 95% and a specificity of 91%. LNS cortisone had a specificity of 100% and a sensitivity of 86%. With an optimal cut-off for LNS cortisone of >14.5 nmol/l the sensitivity was 95.2%, and the specificity was 100% with an area under the curve of 0.997, for diagnosing CS. Saliva collection is non-invasive and can be carried out at home.We therefore advocate simultaneous measurement of LNSC and LNS cortisone as the first-line screening test to evaluate patients with suspected CS

The complex X-ray spectrum of NGC 4507

XMM-Newton and Chandra/HETG spectra of the Compton-thin (NH 4x10^{23} cm^{-2}) Seyfert 2 galaxy, NGC 4507, are analyzed and discussed. The main results are: a) the soft X-ray emission is rich in emission lines; an (at least) two--zone photoionization region is required to explain the large range of ionization states. b) The 6.4 keV iron line is likely emitted from Compton-thick matter, implying the presence of two circumnuclear cold regions, one Compton-thick (the emitter), one Compton-thin (the cold absorber). c) Evidence of an Fe xxv absorption line is found in the Chandra/HETG spectrum. The column density of the ionized absorber is estimated to be a few x10^{22} cm^{-2}.Comment: accepted for publication in A&

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

An IoT Monitoring Design System of Road Overweight Vehicles Based on Raspberry Pi

The overload vehicles are the basic challenge of the road users because they caused many harms for roads in addition to increasing  the accidents ratio on the roads. There are many peoples are dead every day due to collapsing of roads. Automatic monitoring system became necessary and highly demand to overcome this problem. This paper presented a  design of wireless monitoring system based on Raspberry Pi model and used camera for monitoring any case of  breaking the law. The design in this paper is a low cost design because it has simple structure. The system established a database to archive all the cases of infirming the allowed legal weight limit of the road. The camera will captures an image when the vehicle's weight is out of allowed limit, the data is sent directly to the database which includes the date ,time, weight and the path of the captured image. A web page is used to provide an easy monitoring of the system. The system is experimentally tested several times and the obtained results show that the system has good performance and accurate results..

Fully Interactive and Refined Resolution Simulations of the Martian Dust Cycle by the MarsWRF Model

The MarsWRF model is set up with fully interactive dust at 5° × 5° and 2° × 2 resolution. The latter allows for a better representation of topography and other surface properties. An infinite reservoir of surface dust is assumed for both resolutions. For 5° × 5°, surface dust lifting by wind stress takes place over broad areas, occurring in about 20% of the model's grid cells. For 2° × 2°, it is more spatially restricted, occurring in less than 5% of the grid cells, and somewhat reminiscent of the corridors Acidalia-Chryse, Utopia-Isidis, and Arcadia-West of Tharsis. The onset times of major dust storms—large regional storms or global dust storm events (GDEs)—do not exhibit much interannual variability, typically occurring at around L 260°. However, their magnitude does show significant interannual variability—with only small regional storms in some years, large regional storms in others, and some years with GDEs—owing to the interaction between major dust lifting regions at low latitudes. The latter is consistent with observed GDEs having several active dust lifting centers. The agreement between the model's surface dust distribution and observation-based dust cover index maps is potentially better for 2° × 2°. For the latter, there is also significant surface dust lifting by wind stress in the aphelion season that is largely confined to the Hellas basin. It has a recurring time pattern of 2–7 sols, possibly resulting from the interaction between midlatitude baroclinic systems and local downslope flows.First of all, our warmest thanks go to the PlanetWRF development team for providing the MarsWRF model free of chargetousandtheirproactiveattitude in general. We thank Andy Heaps, National Centre for Atmospheric Science (NCAS), Department of Meteorology, University of Reading, UK, for his helpful advice regarding the data visualization using cf‐Python. We would also like to thank Michael Mischna, Alexandre Kling, and the Associate Editor Claire Newman for their several detailed and insightful comments and suggestions that helped to significantly improve the quality of the paper. M. P. Z. acknowledges the partial support by the Spanish State Research Agency (AEI) project MDM2017‐0737 Centro de Astrobiología (CSIC‐INTA), Unidad de Excelencia María de Maeztu. Internally, we would liketoexpressourgreatestthankstothe High‐Performance Computing, Division of Information Technology, United Arab Emirates University. Our particularthanks goto Asma AlNeyadi, Anil Thomas, and Nithin Damodaran for their intensive and continuous support in technically demanding questions. Also, we would like to thank the Digitization Unit, UAEU Libraries, for the digitization of auxiliary data on the observationalrecordoftheatmospheric T15 temperature and vertical weighting functions of Viking/IRTM. In addition, we thank UAEU Libraries for their assistance in making supporting data of this article available online. In particular, we are grateful to Digitization Technician Shireen M. Wolied, Fadl M. Musa/Digital Library Service, and Student Muhammad Abdul Rahim Sami Ullah

Review on analog RF performance of advanced MOSFET

Aggressive gate-length downscaling of the metal-oxide-semiconductor field-effect transistor (MOSFET) has been the main stimulus for the growth of the integrated circuit industry. This downscaling, which has proved beneficial to digital circuits, is primarily the result of the need for improved circuit performance and cost reduction and has resulted in tremendous reduction of the carrier transit time across the channel, thereby resulting in very high cut-off frequencies. It is only in recent decades that complementary metal-oxide-semiconductor (CMOS) field-effect transistor (FET) has been considered as the radio frequency (RF) technology of choice. In this review, the status of the digital, analog and RF figures of merit (FoM) of silicon-based FETs is presented. State-of-the-art devices with very good performance showing low values of drain-induced barrier lowering, sub-threshold swing, high values of gate transconductance, Early voltage, cut-off frequencies, and low minimum noise figure, and good low-frequency noise characteristic values are reported. The dependence of these FoM on the device gate length is also shown, helping the readers to understand the trends and challenges faced by shorter CMOS nodes. Device performance boosters including silicon-on-insulator substrates, multiple-gate architectures, strain engineering, ultra-thin body and buried-oxide and also III-V and 2D materials are discussed, highlighting the transistor characteristics that are influenced by these boosters. A brief comparison of the two main contenders in continuing Moore's law, ultra-thin body buried-oxide and fin field-effect transistors are also presented. The authors would like to mention that despite extensive research carried out in the semiconductor industry, silicon-based MOSFET will continue to be the driving force in the foreseeable future