A new class of copulas having dependence range larger than FGM-type copulas

We propose a new bivariate symmetric copula with positive and negative dependence properties. The main features of the proposed copula are its simple mathematical structure, wider dependence range compared to FGM copula and its generalizations, and no lower and upper tail dependence. The maximum range of Spearman's Rho of the proposed copula is [-0.5866,0.5866], which improves the dependence range of the FGM copula and its various generalizations. A new bivariate Rayleigh distribution is developed using the proposed copula, and some statistical properties have been studied. A real data set is analyzed to illustrate the proposed bivariate distribution's relevance in practical contexts.Comment: 13 pages, 3 figures, 2 table

Bivariate Tempered Space-Fractional Poisson Process and Shock Models

In this paper, we introduce a bivariate tempered space-fractional Poisson process (BTSFPP) by time-changing the bivariate Poisson process with an independent tempered $\alpha$-stable subordinator. We study its distributional properties and its connection to differential equations. The L\'{e}vy measure for the BTSFPP is also derived. A bivariate competing risks and shock model based on the BTSFPP for predicting the failure times of the items that undergo two random shocks is also explored. The system is supposed to break when the sum of two types of shocks reaches a certain random threshold. Various results related to reliability such as reliability function, hazard rates, failure density, and the probability that the failure occurs due to a certain type of shock are studied. We show that for a general L\'{e}vy subordinator, the failure time of the system is exponentially distributed with mean depending on the Laplace exponent of the L\'{e}vy subordinator when the threshold has geometric distribution. Some special cases and several typical examples are also demonstrated.Comment: 16 pages, 6 figure

Trypanosoma evansi u deva, magaraca i pasa u Indiji: usporedba rezultata pretrage lančanom reakcijom polimerazom i svjetlosnim mikroskopom

The objective of the present study was to compare two methods: PCR and blood smear examination for sensitive and specific detection of Trypanosoma evansi in camels, donkeys and dogs. Out of 131 blood samples tested, (61 camels, 44 donkeys and 26 dogs), 26 samples (21 camels, 3 donkeys and 2 dogs) were detected positive by PCR. Blood smear examination revealed the T. evansi organisms in only two camels.Svrha ovoga istraživanja bila je usporediti osjetljivost i specifičnost lančane reakcije polimerazom i pretrage krvnih razmazaka svjetlosnim mikroskopom za dokazivanje vrste Trypanosoma evansi u deva, magaraca i pasa. Od 131 pretraženoga krvnoga uzorka (61 od deva, 44 od magaraca i 26 od pasa), 26 uzoraka (21 od deva, tri od magaraca i dva od pasa) bilo je pozivno na osnovi pretrage lančanom reakcijom polimerazom. Pretragom krvnih razmazaka svjetlosnim mikroskopom T. evansi dokazana je samo u dvije deve

Trypanosoma evansi u deva, magaraca i pasa u Indiji: usporedba rezultata pretrage lančanom reakcijom polimerazom i svjetlosnim mikroskopom

The objective of the present study was to compare two methods: PCR and blood smear examination for sensitive and specific detection of Trypanosoma evansi in camels, donkeys and dogs. Out of 131 blood samples tested, (61 camels, 44 donkeys and 26 dogs), 26 samples (21 camels, 3 donkeys and 2 dogs) were detected positive by PCR. Blood smear examination revealed the T. evansi organisms in only two camels.Svrha ovoga istraživanja bila je usporediti osjetljivost i specifičnost lančane reakcije polimerazom i pretrage krvnih razmazaka svjetlosnim mikroskopom za dokazivanje vrste Trypanosoma evansi u deva, magaraca i pasa. Od 131 pretraženoga krvnoga uzorka (61 od deva, 44 od magaraca i 26 od pasa), 26 uzoraka (21 od deva, tri od magaraca i dva od pasa) bilo je pozivno na osnovi pretrage lančanom reakcijom polimerazom. Pretragom krvnih razmazaka svjetlosnim mikroskopom T. evansi dokazana je samo u dvije deve

Innovative investigation of zinc oxide nanoparticles used in dentistry

Dental caries is a major lifestyle concern as dental components affect the face of an individual. The issue of tooth decay occurs in every age group throughout the globe. Researchers are probing incipient implements and techniques to develop filling agents for decayed teeth. Zinc oxide (ZnO) powder is utilized mostly as a filling agent. Nanotechnology enhanced the efficiency of compounds of metal oxides utilized for dental caries. The present study aims to investigate the properties of ZnO nanoparticles (NPs) synthesized chemically (using ZnCl2 and NaOH) as well as biologically (using aqueous leaf extract of Murraya paniculata). The XRD patterns confirm that ZnO NPs have a hexagonal crystalline structure with particle sizes of 47 nm and 55 nm for chemically and biologically synthesized NPs, respectively. The FE-SEM data confirm the nanorod and spherical/cubical shape morphologies for the chemically and biologically synthesized ZnO NPs, respectively. FTIR data show the peaks between 4000 and 450 cm(-1) of the functional groups of -OH, C-O, -C-H-, and Zn-O bonds. The UV-Vis absorption study indicates a peak around 370 nm and a hump around 360 nm corresponding to the chemically and biologically synthesized ZnO NPs, respectively. An antibacterial bioassay was performed and compared with commercially available ZnO bulk powder against tooth decaying pathogens, viz., Streptococcus mutans, Staphylococcus aureus, E. coli, and Lactobacillus fermentum, and found that both ZnO NPs had results closer to those of the standard drug (rifampicin). Thus, the synthesized ZnO NPs may be utilized as nano-drugs for the application of tooth decaying filling agents. Even biologically synthesized ZnO NPs may be considered more environmentally friendly and less toxic to human health concerns.UGC, New DelhiUniversity Grants Commission, UGC; University of Lucknow, L

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

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

Robotic nephroureterectomy in the management of upper tract urothelial cancer: inching toward standard of care?

Upper-tract urothelial carcinoma is a relatively rare malignancy. Current guidelines strongly recommend radical nephroureterectomy with bladder cuff excision and template-based lymph node dissection for all high-risk upper-tract urothelial carcinomas. Although the open approach is still considered the standard of care, evolution of minimally invasive approaches especially the robotic-assisted approach, has been found to be oncologically equivalent. Since its initial description in 2006, the surgical technique as well as the robotic surgical system has gone through a major evolution. With well-established advantages of the minimally invasive approach, robotic radical nephroureterectomy also has the ability to address both upper and lower urinary tract simultaneously without the need of patient repositioning, standardized single docking technique, ease of performing crucial steps like excision of ureterovesical junction and bladder cuff with watertight cystotomy closure, allowing perioperative instillation of intra-vesical chemotherapy. Robot-assisted radical nephro-ureterectomy and template-based lymph node dissection is gradually emerging as the current standard of care to achieve the best possible oncologic and functional outcomes. In this review article we are focusing on the evolution of this approach in the management of upper-tract urothelial carcinoma along with a review of oncologic outcomes