THE DISCRETE LAPLACIAN ACTING ON 3-FORMS

In the current paper, we study the discrete Laplacian acting on 3-forms. We establish a new criterion of essential self-adjointness using the Nelson lemma. Moreover, we give an upper bound on the infimum of the essential spectrum

THE DISCRETE LAPLACIAN OF A 3-SIMPLICIAL COMPLEX

In this paper, We introduce the notion of oriented tetrahedrons especially tetrahedrons in a connected oriented locally finite graph. This framework then permits to define the Laplace operator on this structure of the 3-simplicial complex. We develop the notion of X-completeness for the graphs, based on the cut-off functions. Moreover, We study essential self-adjointness of the discrete Laplacian from the X-completeness geometric hypothesis

Land use/land cover change along the Eastern Coast of the UAE and its impact on flooding risk

This study was conducted to investigate the spatiotemporal changes of land use/land cover (LULC) along the eastern coast of the United Arab Emirates (UAE) over a 20-year period using an integration of remote sensing and Geographic Information Systems techniques. The impact of land use change on flooding potential was also investigated through hydrologic model simulations. Landsat images of the years 1996, 2006 and 2016 were processed and analyzed. Change detection was carried out to assess changes in the built-up areas. Furthermore, the impact of urbanization on flooding was assessed using a hydrologic model in two major watersheds of Fujairah Emirate. It was observed that for the period 1996–2006 the vegetation and the built-up areas had increased at a rate of 11.23% and 24.56%, respectively. For the period 2006–2016, this expansion more than doubled in terms of the vegetation class (27.51%) and slightly increased for the built-up class (28.98%). The change detection analysis revealed that urbanization has mostly occurred along the coastal boundary. Hydrologic model simulations quantified the role of urbanization in increasing the flooding potential. The increase depends on watershed characteristics and the rate of change in urbanization and the magnitude of the rainfall event

Performance evaluation of secured versus non-secured EIGRP routing protocol

Routing is the process of forwarding data across an inter-network from a designated source to a final destination.Along the way from source to destination, at least one intermediate node is considered. Due to the major role that routing protocols play in computer network infrastructures, special cares have been given to routing protocols with built-in security constraints.In this paper, we evaluate the performance of EIGRP routing protocol in the case of secured and non-secured routing traffic.This is done through studying and analyzing EIGRP routing traffic with and without security rules.A network model of four Cisco routers, from both software and hardware perspectives, has been employed and a traffic generation and analysis tools have been developed and used to generate traffic data and to measure the delay for performance evaluation.The results show that the average delay in the secured case can become significantly larger than the unsecured case even in steady state conditions.The differences between the delays are exponential and reach a steady state towards the end of the experiment

Pathogenic and Non-Pathogenic Microbial Presence in Ventilator Associated Pneumonia Patients in Intensive Care Unit and Safety Protocols Under Surveillance of Healthcare Provider: A Research Study

Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection that is associated with longer stays in intensive care units (ICUs) and under mechanical ventilation for more than 48 hours. This article explores the prevalence and impact of VAP on mortality and morbidity, emphasizing the microbial associations involved in hospital-acquired infections. Various infections, including Lung infections, surgical site infections, sepsis, and urinary tract infections, are discussed, along with their associated microorganisms. Diagnostic criteria for VAP and related infections are outlined, highlighting the importance of microbiological testing for accurate diagnosis. The underlying factors for VAP acquisition in ICU patients are identified, and prompt antibiotic initiation is emphasized as a critical first-line defense against VAP. In this study, we have populated data from 100 ICU patients, among which 45 were suffering from VAP. It was found that female patients (57.40%) were more affected than male patients (30.43%). The decreasing PaO2 level was seen to be the early sign of infection. It was found that the time of ventilation was the major factor influencing the VAP. The most common organism causing infection in our study was found to be Staphylococcus Aureus (45.1%). The prognosis of early-onset VAP was 35.55% while compared to Late-onset VAP 64.44%. When compared to VAP and Non-VAP patients there was not very huge difference with 55% and 45% respectively. The other factor was age and position. Implementation of Prevention strategies, such as protective environments and HEPA filtration systems, is proposed to reduce VAP incidence. Proper diagnosis, treatment, and prevention are crucial to combatting VAP and enhancing patient outcomes in hospital settings

BLOOM: A 176B-Parameter Open-Access Multilingual Language Model

Large language models (LLMs) have been shown to be able to perform new tasks based on a few demonstrations or natural language instructions. While these capabilities have led to widespread adoption, most LLMs are developed by resource-rich organizations and are frequently kept from the public. As a step towards democratizing this powerful technology, we present BLOOM, a 176B-parameter open-access language model designed and built thanks to a collaboration of hundreds of researchers. BLOOM is a decoder-only Transformer language model that was trained on the ROOTS corpus, a dataset comprising hundreds of sources in 46 natural and 13 programming languages (59 in total). We find that BLOOM achieves competitive performance on a wide variety of benchmarks, with stronger results after undergoing multitask prompted finetuning. To facilitate future research and applications using LLMs, we publicly release our models and code under the Responsible AI License

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

STIELTJES CRITERION FOR DISCRETE LAPLACIAN ON 3-SIMPLICIAL COMPLEX

In this paper, we continue the discussion of the question of essential self-adjointness for the discrete Laplacian acting on 3-simplicial complex. We establish a new criterion using Stieltjes vectors approach

A performance comparison of MD5 authenticated routing traffic with EIGRP, RIPv2 & OSPF

Routing is the process of forwarding data across an inter-network from a designated source to a final destination. Along the way from source to destination, at least one intermediate node is considered. Due to the major role that routing protocols play in computer network infrastructures, special cares have been given to routing protocols with built-in security constraints. In this paper, we conduct performance evaluation comparisons on MD5 authenticated routing traffic with respect to EIGRP, RIPv2 and OSPF protocols. A network model of four Cisco routers has been employed with an ON/OFF traffic model used to describe text files transmissions over the network. Eventually, analysis tool has been developed and used to measure the average delay time and average jitter. The collected results show that the average delay time and jitter in the secured MD5 case can become significantly larger when compared to the non-secured case even in steady state conditions. Among all, the secured OSPF protocol shows the highest performance even when the system is extremely overloaded