Second-order plus dead-time systems are difficult to tune for a PID controller due to its special structure, especially the underdamped systems that have oscillatory responses. As a control technique with strong disturbance rejection ability, linear active disturbance rejection control is widely used as a substitute for PID controllers. This paper proposes a tuning formula for second-order linear active disturbance rejection control for underdamped second-order plus dead-time systems via internal model control. The formula is derived by minimizing the integral of time squared error index under certain robustness measure condition. Simulation results show that the linear active disturbance rejection controller tuned from the proposed formula can achieve satisfactory control performance for oscillatory systems.Novel coronavirus respiratory disease COVID-19 has caused havoc in many countries across the globe. In order to contain infection of this highly contagious disease, most of the world population is constrained to live in a complete or partial lockdown for months together with a minimal human-to-human interaction having far reaching consequences on countries' economy and mental well-being of their citizens. Hence, there is a need for a good predictive model for the health advisory bodies and decision makers for taking calculated proactive measures to contain the pandemic and maintain a healthy economy. This paper extends the mathematical theory of the classical Susceptible-Infected-Removed (SIR) epidemic model and proposes a Generalized SIR (GSIR) model that is an integrative model encompassing multiple waves of daily reported cases. Existing growth function models of epidemic have been shown as the special cases of the GSIR model. Dynamic modeling of the parameters reflect the impact of policy decisions, social awareness, and the availability of medication during the pandemic. GSIR framework can be utilized to find a good fit or predictive model for any pandemic. The study is performed on the COVID-19 data for various countries with detailed results for India, Brazil, United States of America (USA), and World. The peak infection, total expected number of COVID-19 cases and thereof deaths, time-varying reproduction number, and various other parameters are estimated from the available data using the proposed methodology. The proposed GSIR model advances the existing theory and yields promising results for continuous predictive monitoring of COVID-19 pandemic.The fracture repair process is known to be delayed in postmenopausal women, under estrogen-deficient status. Osteoporotic fracture mainly occurs in the metaphyseal region of the long bone; however, most studies on fracture healing have focused on the diaphyseal region. In this study, we compared the repair process between metaphysis and diaphysis of ovariectomized (OVX) and Sham mice, and analyzed the effects of short-term estrogen administration in OVX mice. Mice were divided into four experimental groups, including Sham, OVX, OVX + vehicle, and OVX + 17β-estradiol (E2). Bone apertures were formed in the tibial metaphysis and diaphysis. The samples were collected and examined by micro-computed tomography, and using histological, histochemical, and immunohistochemical analysis at different time points after the surgery. The cartilaginous callus was formed at the diaphysis site of both the groups, which was sequentially replaced by bone on the periosteum side. Medullary callus was formed in all the groups; however, the volume of the callus in OVX mice was significantly lesser (˜30%) than that in Sham mice. Furthermore, in the metaphysis, no differences were observed in the medullary callus and bone mineral density between the two groups from day 21 to 28. The diaphysis of OVX group was not completely repaired even by day 28. In both the sites of OVX mice, ALP activity and disappearance of Gr-1 positive cells were delayed compared to that of Sham. Estrogen administration improved medullary callus formation in the diaphysis, however not in the metaphysis. The effect of ovariectomy on the repair process in diaphysis was greater than that in metaphysis. Our findings clarify the differences between the metaphysis and diaphysis repair process using OVX mouse model and suggest that the estrogen sensitivities differ between the sites during the bone repair process.
  Pain management in trauma patients can be difficult due to their varied injuries and presence or absence of illicit substances in their systems.  https://www.selleckchem.com/products/VX-770.html  Additionally, trauma patients have variable lengths of stay. Limiting length of stay to what is medically necessary and preventing long-term dependence on narcotic medications are important in trauma patient care.
 
  We performed a retrospective review of 385 consecutive trauma activations at a Level II trauma center with urine toxicology screens from 2015. Main outcome measures recorded were urine toxicology results, average daily morphine milligram equivalents (MME), length of stay (LOS), injury severity score (ISS). We also recorded patient demographic information. Statistical analysis compared outcomes and demographics between trauma patients with positive urine toxicology screens to those with negative screens. Significance was set at p<0.05.
 
  Positive urine toxicology screens were present in 230/385 (59.7%) patients. The median (interquartile range (IQR)) for increased narcotic demands and longer length of stay in trauma patients. These findings may assist in developing treatment plans and setting expectations in this population. This information can also lead to proactive interventions aimed at minimizing narcotic use and shortening LOS in this population.
  Every year, approximately 500 000 patients in the United States present to emergency departments for treatment after an episode of self-harm. Evidence-based practices such as designing safer ED environments, safety planning, and discharge planning are effective for improving the care of these patients but are not always implemented with fidelity because of resource constraints. The aim of this study was to provide insight into how ED staff innovate processes of care and services by leveraging what is available on-site or in their communities.
 
  A total of 34 semi-structured qualitative phone interviews were conducted with 12 nursing directors, 11 medical directors, and 11 social workers from 17 emergency departments. Respondents comprised a purposive stratified sample recruited from a large national survey in the US. Interview transcripts were coded and analyzed using a directed content analysis approach to identify categories of strategies used by ED staff to care for patients being treated after self-harm.