Noise pollution is an emerging global problem therefore, it is imperative to determine noise level especially in the urban environment and its implications on human health. The objectives of this study were i) to assess the urban noise pollution and traffic density of Chiniot and Jhang and ii) to determine non-auditory health effects of noise pollution on the residents of both cities. Noise pollution was examined from 181 locations (103 from Jhang and 78 from Chiniot) and categorized into hospitals, educational, religious and recreational, residential, industrial areas, and traffic intersections. Noise levels measurements were taken using integrated sound level meter. The urban noise data showed 82% of the sites in Jhang and 95% in Chiniot exceeded the noise limits set by NEQS-Pak and WHO. Moreover, higher intensity of noise pollution (≥ 100 dB) was recorded in Chiniot (17 sites) than in Jhang (1 site). Regression analysis showed relatively strong relationship of traffic density with noise at Chiniot (R2 = 0.48) compared to Jhang (R2 = 0.31). However, spatial variability of noise with traffic density was observed at both cities. Survey study revealed that all the respondents in Jhang and Chiniot suffered from many noise related health problems such as annoyance (53 and 51%), depression (45 and 47%), dizziness (61 and 65%), headache (67 and 64%), hypertension (71 and 56%), hearing loss (53 and 56%), physiological stress (65 and 65%), sleeplessness (81 and 84%), and tinnitus (70 and 62%) due to noise, respectively. It is concluded that noise pollution is higher in Chiniot due to high traffic density resulted from higher population density and cottage industry. It is recommended that vehicles maintenance, family and urban planning could be effective measures to reduce urban noise pollution.

Patient-to-image registration is currently mostly done in a semi-automated way. Fully automating this task can enhance surgical workflow and reduce human errors. Here, we present a novel solution with a nasal stent utilized to minimally invasively position spherical fiducials inside the nasopharynx and aimed for neurosurgery with electromagnetic navigation. The assembly was deployed into the pharyngeal region of a human specimen. The spherical fiducials are automatically detected in anatomy by integrated magnetic sensors while in preoperative imagery with a proposed u-net deep network. Temporal dislocation of the markers was measured interdaily after two brainstem procedures with CT imaging follow-ups. The u-net was trained to differentiate markers from other structures located in CT images. The ground-truth data was created from 22 CTs of phantoms, cadavers and swine. The dataset is split into 12, 5 and 5 for training, validation and testing, respectively. The dice coefficient was used as a similarity measure. The fiducial registration error resulted in 0.53±0.1 mm and 0.44±0.04 mm for the first and the second procedure, respectively. The fiducial positions deviated from the intraday baseline with the mean ± standard deviation 0.29±0.20 mm and 1.32±0.30 mm. The dice coefficient was 0.976, 0.878 and 0.764 during the training, validation and testing. The nasopharyngeal stent shows a potential for a stable marker fixation. The u-net can be adequately employed to segment titanium spherical fiducials.

Background: Invasive lobular carcinoma (ILC) comprises 10-15% of breast tumors and is the second most common histological type after invasive ductal carcinoma (IDC). Patients with ILC are often diagnosed at an older age and more advanced stage than those with IDC. Late recurrences and worse long-term survival suggest the need for improved approaches to treatment optimization and exploration of molecular pathways unique to ILC. Although previous reports have described comprehensive transcriptomic profiling of ILC, these were limited by small sample sizes. Furthermore, differential gene expression between ILC and IDC within genomic risk groups and molecular subtypes has yet to be explored. Here we characterize differential gene expression between ILC and IDC in a large, age-matched patient subset categorized by 70-gene signature/MammaPrint (MP) risk and 80-gene signature/BluePrint (BP) subtype. Methods: The prospective FLEX Registry (NCT03053193) includes stage I-III primary invasive breast cancer patients who receive MP/BP testing and consent to full transcriptome and clinical data collection. This sub-analysis included 450 ILC patients enrolled from 2017 to present. Compared with a random selection of IDC patients (n=450, mean age, 60 years), ILC patients were older (mean, 63 years, p ± 1.0 were considered significant. Results: ILC represented 13% of FLEX cases (n=450/3562), and were 81% lymph node-negative, 99% ER+, 94% HER2-negative, and 68% MP Low Risk (LR). By BP, ILC were 99% Luminal, 1% HER2, and Conclusions: Here we report differential clinical and molecular characteristics between ILC and IDC in a large, age-matched patient subset. Regardless of MP risk, expression of CDH1 was lower in ILC compared with IDC. Approximately one-third of ILCs were MP HR, and we report a greater number and diversity of DEGs between HR ILC and HR IDC compared with LR tumors, in particular genes related to TGFβ signaling. TGFβ pathway genes play a variety of roles in the tumor microenvironment, including induction of angiogenesis, fibroblast growth factor stimulation, and inhibition and/or exclusion of an immune response. These results suggest that therapeutic strategies targeting the TGFβ pathway may be future avenues of exploration in ILC, although further studies are warranted to characterize underlying molecular mechanisms. Citation Format: Beth-Ann Lesnikoski, Jennifer A. Crozier, Gordan Srkalovic, Patricia Robinson, Clodia Osipo, Kaylan Banda, Heather M. Kling, Josien Haan, William Audeh, FLEX Investigators Group. Differential gene expression in luminal-type invasive lobular carcinoma and invasive ductal carcinoma by MammaPrint risk stratification [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS18-03.

Increasing the incidence of caesarean section is not in line with professional and deontological guidelines. Elective cesarean section prevents primordial prevention of chronic cardiovascular, gastrointestinal, imunological, endocrinologicalmorbidity by peripartal programming. Elective non-medical indicated caesarean section is not a procedure that respects deontological, clinical etics, scientific and professional principles. It is like an unacceptable surgery outside the scope of medical ethics. Clientelism in high-risk clinical obstetric medicine is not a professional and deontologically correct category: a physician shouldnotbeaprovider on request of healthypregnant women with the potential to have a medically incorrect procedure and complications associated with it and to put a healthy pregnant/maternity and child status in the patient's status. Thefinancial, social, political and cultural components must not outweigh good clinical practice and themoral principles ofmedicine.

Violent video game playing is a consistent risk factor for aggression, but research on its psychopathology and trait underpinnings are primarily based on community or university student samples, thus the ecological validity to adjudicated and juvenile justice system-involved youth lacks clarity. This is an important void in the literature because relative to youth in the general population, adjudicated and detained youth evince greater psychopathology, more severe delinquency and violence histories, and clinical psychopathic features. Negative binomial regression models using data from 252 youth in residential placements found that several psychopathic features are significantly associated with violent video gaming. The role of psychopathy operated differently across gender and arrest chronicity, and across models remorselessness emerged as an important correlate. Given the desensitization that can occur with violent video game play, it is of particular concern among delinquent youth with psychopathic personality features.

Introduction: The Republic of Croatia (HR) has significantly invested in monitoring the quality of inland bathing areas during the past 10 years. The aim of this paper was to analyze the results obtained during the 2014-2019 period and to compare them with the Region (non-European Union [EU] countries neighboring Croatia) and EU. Moreover, bathing water quality data at two bathing areas of Zagreb (lakes Jarun and Bundek) were processed in more detail.Methods: The quality of inland bathing areas in the HR is monitored in five rivers and five lakes in nine Croatian counties; 19 of the 35 monitored sites are located in Zagreb County. Escherichia coli (EC) was determined by EN ISO 9308-3: 1998, while intestinal enterococci (ENT) were defined by EN ISO 7899-2: 2000. Statistical processing of the results was performed using the Microsoft Excel Statistical Package (Redmond, USA) and Statistica 13.5. (Stat.Sof.Inc., Tulsa, USA); the significance level was set to p < 0.05.Results: During the study period, the worst Croatian inland water quality was recorded in 2019 (excellent quality for only 25.9% of the bathing areas), while the best quality was recorded in 2015 (excellent quality in 57.1%). On average (2014-2019), the share of bathing areas with excellent quality in Croatia was 46.3% (i.e., under the EU average of 85.3%); with no poor locations (EU average was nearly 2%). A significant positive correlation was found between fecal indicators (EC&ENT) and the amount of precipitation, while a negative correlation with water and air temperature in lakes.Conclusions: The quality of Croatian inland bathing areas is significantly lower than the European average, while EU water quality is improving. Regarding the countries bordering Croatia, Italy, Slovenia, and Hungary have achieved better results, while Montenegro, Serbia, and Bosnia and Herzegovina are still in the process of developing the monitoring of the bathing water quality.

The American College of Rheumatology guidance for management of pediatric patients with multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 have been recently published. The guidance was prepared by the multidisciplinary Task Force and provide a very rational approach to management of this condition. There is, however, one area in which we are in disagreement.

We provide the necessary and sufficient conditions for a generalized Nevanlinna function $Q$ ($Q\in N_{\kappa }\left( \mathcal{H} \right)$) to be a Weyl function (also known as a Weyl-Titchmarch function). We also investigate an important subclass of $N_{\kappa }(\mathcal{H})$, the functions that have a boundedly invertible derivative at infinity $Q'\left( \infty \right):=\lim \limits_{z \to \infty}{zQ(z)}$. These functions are regular and have the operator representation $Q\left( z \right)=\tilde{\Gamma}^{+}\left( A-z \right)^{-1}\tilde{\Gamma},z\in \rho \left( A \right)$, where $A$ is a bounded self-adjoint operator in a Pontryagin space $\mathcal{K}$. We prove that every such strict function $Q$ is a Weyl function associated with the symmetric operator $S:=A_{\vert (I-P)\mathcal{K}}$, where $P$ is the orthogonal projection, $P:=\tilde{\Gamma} \left( \tilde{\Gamma}^{+} \tilde{\Gamma} \right)^{-1} \tilde{\Gamma}^{+} $. Additionally, we provide the relation matrices of the adjoint relation $S^{+}$ of $S$, and of $\hat{A}$, where $\hat{A}$ is the representing relation of $\hat{Q}:=-Q^{-1}$. We illustrate our results through examples, wherein we begin with a given function $Q\in N_{\kappa }\left( \mathcal{H} \right)$ and proceed to determine the closed symmetric linear relation $S$ and the boundary triple $\Pi$ so that $Q$ becomes the Weyl function associated with $\Pi$. 2020 Mathematics Subject Classification. 34B20, 47B50, 47A06, 47A56

Above-threshold ionization spectra from cesium are measured as a function of the carrier-envelope phase (CEP) using laser pulses centered at 3.1  μm wavelength. The directional asymmetry in the energy spectra of backscattered electrons oscillates three times, rather than once, as the CEP is changed from 0 to 2π. Using the improved strong-field approximation, we show that the unusual behavior arises from the interference of few quantum orbits. We discuss the conditions for observing the high-order CEP dependence, and draw an analogy with time-domain holography with electron wave packets.

Let S be a symmetric linear relation in the Pontyagin space (K, [., .]) and let Π = (H,Γ0,Γ1) be the corresponding boundary triple. We prove that the corresponding Weyl function Q satisfies Q ∈ Nκ(H). Conversely, for regular Q ∈ Nκ(H), we find linear relation S ( A, where A is representing self-adjoint linear relation of Q, and we prove that Q is the Weyl function of the relation S. We also prove  = kerΓ1, where  is the representing relation of the Q̂ := −Q−1. In addition, if we assume that the derivative at infinity Q ′ (∞) := lim z→∞ zQ(z) is a boundedly invertible operator then we are able to decompose A,  and S in terms of S, i.e. we express relation matrices of A,  and S in terms of S, which is a bounded operator in this case.

The current world trends and the global market require production organizations to increase the quality while reducing the costs of their products. In most cases, traditional production technologies of spiral drill bits (SD) cannot meet these expectations, as they most often fulfil only one of the set requirements. Thus, the cost of a SD produced with the rolling technology is low, but its quality is also much lower than that of the drills produced with the grinding technology whose cost is also much higher. The grooves of the SDs produced with our new technological method have advantages over the grooves produced with the rolling technology or grinding technology, and the savings in the material and grinding wheel are higher compared to the SDs produced with the grinding technology. This paper presents an analysis of the application of this new technological process for producing SD grooves.

Abstract The significance and methods of measuring inefficiency of local communities has been gaining prominence in the last decade. The purpose of this paper is to empirically investigate the level of technical inefficiency in the sample of local communities in Bosnia and Herzegovina (BiH) for the year of 2017. We implement parametric stochastic frontier analysis (SFA) to conduct an input-oriented stochastic parametric approach to measuring technical inefficiency of local communities in BiH. The results of our work are complementary to previous research indicating relative technical inefficiency of local communities in BiH. On average, BiH local communities’ total expenditures can be reduced by 46.8 percent without reducing output levels to achieve the result of the local community on the best practice frontier. Since our analysis and selection of variables are driven by data availability, the future research plans to include more variables.

We use the epidemic threshold parameter, R0\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathcal {R}}}_{0}$$\end{document}, and invariant rectangles to investigate the global asymptotic behavior of solutions of the density-dependent discrete-time SI epidemic model where the variables Sn\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$S_{n}$$\end{document} and In\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$I_{n}$$\end{document} represent the populations of susceptibles and infectives at time n=0,1,…\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$n = 0,1,\ldots $$\end{document}, respectively. The model features constant survival “probabilities” of susceptible and infective individuals and the constant recruitment per the unit time interval [n,n+1]\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$[n, n+1]$$\end{document} into the susceptible class. We compute the basic reproductive number, R0\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathcal {R}}}_{0}$$\end{document}, and use it to prove that independent of positive initial population sizes, R0<1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathcal {R}}}_{0}<1$$\end{document} implies the unique disease-free equilibrium is globally stable and the infective population goes extinct. However, the unique endemic equilibrium is globally stable and the infective population persists whenever R0>1\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\mathcal {R}}}_{0}>1$$\end{document} and the constant survival probability of susceptible is either less than or equal than 1/3 or the constant recruitment is large enough.