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We develop a new framework for distributed power control for wireless data based on the economic principles of utility and pricing. Utility is defined as the measure of satisfaction that a user derives from accessing the wireless data network. Properties of utility functions are introduced and a specific function, based on throughput per terminal battery lifetime including forward error control, is presented and shown to conform to those properties. Users enter into a non-cooperative game to maximize their individual utilities by adjusting their transmitter powers. A unique Nash equilibrium for the above game is shown to exist but is not Pareto efficient. A pricing function is then introduced which leads to Pareto improvements for the non-cooperative game.

A 49-year-old female with history of hypertension, diabetes, and stage 4 chronic kidney disease presented to our facility 1 month prior for shortness of breath and hypoxia to 80%. Reverse transcription-polymerase chain reaction (RT-PCR) performed on nasopharyngeal swab resulted positive for SARS-CoV-2 infection. She was treated with supplemental oxygen and convalescent plasma during her 2 weeks admission. She was discharged on with 2 L of home oxygen. The D-dimer on admission and at the time of discharge was 1765 and 3486 ng/mL, respectively.Two weeks after discharge, she returned to our hospital with a 3 days history of excruciating diffuse abdominal pain melena and hematemesis. D-dimer was 12 444 ng/mL ,and fibrinogen was 184 mg/dL. Non-contrast CT scan revealed distended proximal jejunum with mural thickening (Fig. 1a). Exploratory laparotomy showed transmural ischemia at proximal jejunum (Fig. 1b), and 59 cm of jejunum was resected. Per the pathology report, microvascular thrombi that were partially organized within the submucosa (Fig. 2a) and cytologic changes suggestive of viral inclusion within the cytoplasm of glandular epithelial cell (Fig. 2b) were seen. Nasal swab RT-PCR test was negative for SARS-CoV-2 this time. She never had atrial arrhythmia shown on telemetry during these two admissions.Acute thromboembolic effects have been reported in COVID-19 infected patients leading to ischemic stroke, myocardial infarction,

Context:Widespread vitamin D insufficiency raises concerns regarding the reliability of reference intervals for serum calcium.Objective:We sought to determine the reference intervals for serum total calcium in pediatric subjects without vitamin D [25-hydroxyvitamin D [25(OH)D]] deficiency [20 ng/mL (50 nmol/L)].Design and Participants:This was a retrospective study of laboratory data obtained from all patients at The Children's Hospital of Philadelphia from July 1, 2011, through June 30, 2012. Patients in the renal unit, the endocrine unit, or a critical care unit were excluded. Total serum calcium was determined using a colorimetric assay and serum 25(OH)D was determined by liquid chromatography tandem mass spectrometry. We ascertained 4629 subjects who had a serum 25(OH)D between 20 and 80 ng/mL (50–200 nmol/L) and a serum calcium level determined within 30 days of the 25(OH)D measurement. For comparison, we used data from an unselected cohort of patients (n = 106 220).Results:Parametric analyses generated age-specific reference intervals for serum total calcium for each of several age groups (0–90 d old, 91–180 d old, 181–365 d old, 1–3 y old, 4–11 y old, and 12–19 y old). A two-way ANOVA with Tukey's correction showed significant differences between the lower limits of normal (P < .001) and the normal range (P < .001) but not for the upper limit of normal for these subjects compared with unselected subjects. Student's t tests revealed significant differences at all ages between calcium concentrations in those with 25(OH)D values between 20 and 30 ng/mL and those with 25(OH)D values between 30 and 80 ng/mL.Conclusions:These reference intervals refine previous normal ranges that likely included subjects with vitamin D deficiency.

BACKGROUND Studies have suggested that atrial fibrillation (AF) in patients with rheumatic diseases (RD) may be due to inflammation. AIM To determine the highest association of AF among hospitalized RD patients and to determine morbidity and mortality associated with AF in hospitalized patients with RD. METHODS The National inpatient sample database from October 2015 to December 2017 was analyzed to identify hospitalized patients with RD with and without AF. A subgroup analysis was performed comparing outcomes of AF among different RD. RESULTS The prevalence of AF was 23.9% among all patients with RD ( n = 3949203). Among the RD subgroup, the prevalence of AF was highest in polymyalgia rheumatica (33.2%), gout (30.2%), and pseudogout (27.1%). After adjusting for comorbidities, the odds of having AF were increased with gout (1.25), vasculitis (1.19), polymyalgia rheumatica (1.15), dermatopolymyositis (1.14), psoriatic arthropathy (1.12), lupus (1.09), rheumatoid arthritis (1.05) and pseudogout (1.04). In contrast, enteropathic arthropathy (0.44), scleroderma (0.96), ankylosing spondylitis (0.96), and Sjorgen’s syndrome (0.94) had a decreased association of AF. The mortality, length of stay, and hospitalization costs were higher in patients with RD having AF vs without AF. Among the RD subgroup, the highest mortality was found with scleroderma (4.8%), followed by vasculitis (4%) and dermatopolymyositis (3.5%). CONCLUSION A highest association of AF was found with gout followed by vasculitis, and polymyalgia rheumatica when compared to other RD. Mortality was two-fold higher in patients with RD with AF.

Poly[lignin-g-(1-phenylethylene)] graft copolymers synthesized by free-radical, graft copolymerization on lignin and verified by fractionation, infrared spectroscopy, and solubility change possess macromolecular surface activity as indicated by their capacity to form stable emulsions between incompatible fluid phases, to adhesively bond to wood surfaces, and to change the contact angle of water on coated wood. The surface activity of the copolymer changes with its composition. As the weight percent lignin in the copolymerization reaction product increases beyond 20 wt %, the amount of the emulsion phase formed in a water-benzene mixture decreases. Maple wood flour could be solvent-coated with a copolymer and both coated and uncoated maple flour could be extruded through a stranding plate into a wood-filled composite with polystyrene. Physical property tests show that composite control samples are about 3% stiffer and less deformable than are the copolymer composites when dry and about 5 or more percent more deformable than are the copolymer composites when wet, showing that the copolymer coating increased the wet strength. The copolymer samples are always denser than are the controls. Copolymer coating on wood filler decreases the swelling in the composite, the partial molar volume of the imbibed water, and the dimensional change in the solid. These effects cause increase in the density of the copolymer composite upon imbibition of water. Coating the wood component of the composite with a copolymer creates a hydrophobic barrier that produces a decrease in water imbibition into the composite, which will not disappear in 20 or more years of water immersion. Expansion in water is highly dependent on the direction of extrusion. The length expands about 1%, the width expands about five times as much, and the thickness expands over 10 times as much as does the length. This differential expansion may be due to the 22% reduction in the width and a 71% reduction in the thickness of the melt as it passes through the die and the alignment of the long axis of the fiber with the direction of flow through the die. The reaction product is a thermoplastic solid stable below 200°C and thermoformable at between 150 and 180°C. Products which contain between 10 and 50 wt % lignin are heterogeneous solids.

The Michael addition reaction of N,N'-l,4-phenylene bis(maleimide) (PBM) with 4,4'-diamino diphenyl methane (DDM) at 1:1, 1: 1.5 and 1:2 molar ratios was carried out in melt at 125-130'C. The resultant polyimide oligomers (PBM-DDM) were characterized by elemental analysis, number of amino and imino groups, IR spectral studies, number average molecular weight, by non-aqueous conductometric titration, and thermogravimetry. These polyimide oligomers were used to cure epoxy resin, namely diglycidyl ether of bisphenol-A, and studied by differential scanning calorimetry (DSC). The unreinforced PBM-DDM epoxy-cured products have also been prepared and characterized. A preliminary study of glass reinforcement based on the PBM-DDM epoxy system has also been established.

ST-elevation myocardial infarction (STEMI) and heart failure (HF) are common, big-budget, debilitating and expanding diseases. Cardiovascular diseases, especially STEMI and heart failure have been known to cause 17.3 million deaths worldwide annually. Hyponatremia, delineated as a serum sodium (sNa) concentration <135 mmol/l, is a frequently seen electrolyte disturbance in practice and the prevalence, clinical impact; the prognostic factor of low SNa in STEMI/heart failure patients vary widely. The aim of this review is to assess its existence and comparing survival difference between hypo and normonatremic patients.A comprehensive review of the published articles was conducted using database PubMed. We found a total of over 1400 articles. The inclusion criteria used for this review were age >65 years, published within the last 10 years, written in English, performed on human subjects and of studies such as reviews and randomized controlled trials (RCTs), especially for heart failure MeSH words. By applying this inclusion criterion, we found out 40 relevant articles which included 26 cohort studies, four clinical trials, four review articles, and six RCTs. In the analysis of 7,06,899 patients with STEMI/heart failure, hyponatremia was significantly linked to causing all-cause mortality, both short and long term (hazard ratio [HR] as continuous variable: 1.06; 95% confidence interval [CI]: 1.01-1.11; P = 0.026; HR as categorical variable: 1.71; 95% CI: 1.06-2.75; P = 0.028). The rates of rehospitalization were also higher (odds ratio, 1.68; 95% confidence interval, 1.32-2.14) along with prolonged hospital stays as well as a greater cost burden as compared to patients with normal serum sodium. It was existent not only in patients with reduced ejection fraction (HFrEF) but also in subjects with preserved ejection fraction (HFpEF) (HR 1.40, 95% CI 1.12 to 1.75, P = 0.004). Rise of first follow-up and discharge sodium does seem to have positive linkage on survival as well (hazard ratio [HR] 0.429, 95% CI 0.191-0.960, P = 0.04).Hyponatremia is the most frequently encountered electrolyte abnormality in clinical practice and has a poor prognosis in both STEMI and heart failure patients. It exacerbates both short and long term mortality, rehospitalization rates, as well as the average length of stay in the hospital. Although it is still a mystery whether hyponatremia is just a marker of iller patients or the core of poor prognosis in patients with STEMI and HF, one thing is certain: timely recognition of patients at risk for developing hyponatremia could help to commence early treatment.