Existence of solutions for hybrid differential equation with fractional order

In this paper, we study the existence of solutions for the following fractional hybrid differential equations involving Riemann-Liouville differential operators of order . An existence theorem for fractional hybrid differential equations is proved under mixed Lipschitz and Carathéodory conditions and using the Dhage point fixe theorem. Keywords: Quadratic perturbations;  Riemann-Liouville derivative;  Hybrid differential equation

Boundary value problems for hybrid differential equations

This note is motived from some papers treating  the hybrid differential equations. An existence theorem for this equation is proved. Some fundamental differential inequalities for hybrid differential equatins  are also established which are utilized to prove the existence of extremal solutions. Necessary tools are considered and the comparison principle is proved which will be useful for further study of qualitative behavior of solutions

Does the Adoption of EMR Systems Inflate Medicare Reimbursements?

The adoption of EMR systems has been argued to lead to physicians “upcoding” their patients to inflate insurance reimbursements. In this paper, we examine if the adoption of the Clinical Physician Order Entry (CPOE) system is associated with an increase in the complexity of the patients\u27 case mix that hospitals report (termed upcoding ). We make use of a staggered roll-out of the Recovery Audit Program to combat upcoding as a natural experiment to assess the impact of the adoption of the CPOE systems on the case mix that a hospital reports. We find that on average the adoption of CPOE systems is associated with an increase in the reported case mix of hospitals, and that the Audit program has had an effect on reducing the case mix that hospitals report to Medicare for reimbursement. Implications for preventing inflated reimbursements due to upcoding are discussed

Computer recommendations for an automatic approach and landing system for V/STOL aircraft. Volume 1 - Computer recommendations

Evaluation of digital computer for V/STOL aircraft automatic approach and landing syste

Is there an association between vitamin D and risk of stroke?: a North Indian study

Background: Vitamin D deficiency is present in India in epidemic proportions despite plenty of sunshine. Reduced plasma 25(OH) D concentrations as a diagnostic marker of vitamin D deficiency have been in past decade associated with several well-established risk factors for ischaemic stroke, such as arterial hypertension, thrombosis, atherosclerosis. The aims and objectives of this study was to compare the serum 25(OH) D levels between the first ever acute stroke patients and healthy controls.Methods: A cross-sectional, case control study was conducted in a tertiary care hospital in New Delhi situated in north India. Serum 25‑hydroxyvitamin D (25(OH) D) levels in 85 patients of ischemic stroke, presenting within 7 days of onset of stroke was measured and was compared with 70 age and gender matched controls.Results: The mean age was 61.02±11.58 years and 58.63±11.28 years in cases and controls respectively. Females constituted 37.6% of the total number of cases and 43.4% of the controls. The age and gender-distribution were comparable between the cases and controls. The median value (IQR) of serum 25(OH) vitamin D level was 7.94 ng/mL (4.59-14.00) in the cases and it was 8.82 ng/mL (5.59-14.70) in the controls. The difference between the serum 25(OH) vitamin D levels of the two groups was not found to be statistically significant.Conclusions: There is a high prevalence of biochemical hypo-vitaminosis D in apparently healthy Indians of all age and sex groups despite adequate sunshine. There is no association between low vitamin D levels and stroke

Gamma-D crystallin gene (CRYGD) mutation causes autosomal dominant congenital cerulean cataracts

Congenital cataracts are a major cause of bilateral visual impairment in childhood. We mapped the gene responsible for autosomal congenital cerulean cataracts to chromosome 2q33-35 in a four generation family of Moroccan descent. The maximum lod score (7.19 at recombination fraction theta=0) was obtained for marker D2S2208 near the g-crystallin gene (CRYG) cluster. Sequencing of the coding regions of the CRYGA, B, C, and D genes showed the presence of a heterozygous C>A transversion in exon 2 of CRYGD that is associated with cataracts in this family. This mutation resulted in a proline to threonine substitution at amino acid 23 of the protein in the first of the four Greek key motifs that characterise this protein. We show that although the x ray crystallography modelling does not indicate any change of the backbone conformation, the mutation affects a region of the Greek key motif that is important for determining the topology of this protein fold. Our data suggest strongly that the proline to threonine substitution may alter the protein folding or decrease the thermodynamic stability or solubility of the protein. Furthermore, this is the first report of a mutation in this gene resulting in autosomal dominant congenital cerulean cataracts

Does minimally invasive liver resection improve long-term survival compared to open resection for hepatocellular carcinoma? A systematic review and meta-analysis

Introduction: Minimally invasive liver surgery for hepatocellular carcinoma has gained widespread interest as an alternative to conventional open liver surgery. However, long-term survival benefits of this approach seem unclear. This meta-analysis was conducted to investigate long-term survival following minimally invasive liver surgery.Method: A systematic review was performed to identify studies comparing long-term survival after minimally invasive liver surgery and open liver surgery until January 2020. The I2 test was used to test for statistical heterogeneity and publication bias was assessed using Egger test. Random-effects meta-analysis was performed for all-cause 5-year (main outcome) and 3-year mortality, and disease-specific 5-year and 3-year mortality. Meta-regression was performed for the 5-year and 3-year survival outcomes with adjustment for study factors (region, design), annual center volume, patient factors (American Society of Anesthesiologists (ASA) grade, gender, age, body mass index, cirrhosis, tumor size, and number), and resection extent. Sensitivity analyses were performed on studies by study year, region, annual center volume, and resection type.Result: The review identified 50 relevant studies including 13,731 patients undergoing liver resection for hepatocellular carcinoma of which 4071 (25.8%) underwent minimally invasive liver surgery. Pooled analysis revealed similar all-cause (odds ratio: 0.83, 95% confidence interval: 0.70–1.11, p = 0.3) and disease-specific (odds ratio: 0.93, 95% confidence interval: 0.80–1.09, p = 0.4) 5-year mortality after minimally invasive liver surgery compared with open liver surgery. Sensitivity analysis of published studies from 2010 to 2019 demonstrated a significantly lower disease-specific 3-year mortality (odds ratio: 0.75, 95% confidence interval: 0.59–0.96, p = 0.022) and all-cause 5-year mortality (odds ratio: 0.63, 95% confidence interval: 0.50–0.81, p = 0.002). Meta-regression identified no confounding factors in all analyses.Conclusions: Improvement in minimally invasive liver surgery techniques over the past decade appears to demonstrate superior disease-specific mortality with minimally invasive liver surgery compared to open liver surgery. Therefore, minimally invasive liver surgery can be recommended as an alternative surgical approach for hepatocellular carcinoma

Effect of Finesse and Type of Aggregate on Flowability and Mechanical Properties of Foamed Concrete

This work’s goal is to investigate the influence of the type and size of fine aggregate on the characteristics of foamed concrete. Foamed concrete was produced, and its fresh and mechanical characteristics were investigated. It was found that the spread diameter decreased when the foam was added to mixes. With regards to sand grading, when the grading of sand decreased, the diameter of the flow decreased also. Strength improved for fineness sand and enabled the production of uniform and pore distribution, which enhanced the foamed concrete's strength. The increase in compressive strength reflects the other properties of concrete, like tensile strength, that also improved