The success of the left ventricular assist device (LVAD) as a treatment for terminal left-side heart failure is still restrained by some severe complications associated with mechanical circulatory support. Pump thrombus still affects many patients. It is associated with high morbidity and mortality. The therapeutic options include augmentation of anticoagulation and antiplatelet medication, intravenous or catheter-guided thrombolysis, and pump exchange. Heart transplantation would be a desirable option in this population, but unfortunately, it is only theoretical given the increasing number of LVAD implants and decreasing number of organ donors. A retrograde washout maneuver may be a treatment option in pre-pump thrombosis in selected patients. Therefore, the decision should be made on an individual basis after balancing the risks and benefits of different treatment approaches.

IgE sensitization profile in patients withNetherton syndromeEnrico Scalaa, Angelo Giuseppe Condorellib, Alessandro Scalac, Elisabetta Caprinia, Biagio Didonaa, Roberto Paganellid, Daniele Castigliae,aClinical and Laboratory Molecular Allergy Unit – IDI - IRCCS, Rome, ItalybGenodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalycFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore – ROMA, ItaliadInternal Medicine,  UniCamillus, International Medical University, 00131 Rome, Italy.eLaboratory of Molecular and Cell Biology, IDI-IRCCS, Rome, Italy

Background: The global epidemiology of asthma among COVID-19 patients presents striking geographic differences defining high and low [asthma and COVID-19] co-occurrence prevalence zones (1). The objective of the present study was to compare asthma prevalence among hospitalized COVID-19 patients in major global hubs across the world with the application of common inclusion criteria and definitions. Methods: We built a network of six academic hospitals in Stanford (Stanford University)/USA, Frankfurt (Goethe University), Giessen (Justus Liebig University) and Marburg (Philipps University)/Germany, and Moscow (Clinical Hospital 52 in collaboration with Sechenov University)/Russia. We collected clinical and laboratory data for patients hospitalized due to COVID-19. Comorbidities reported were based on the 2020 International Classification of Diseases-10th Revision codes. Results: Asthmatics were overrepresented among hospitalized COVID-19 patients in Stanford and underrepresented in Moscow and Germany as compared to the prevalence among adults in the local community. Asthma prevalence was similar among ICU and hospital non-ICU patients, which implied that the risk for developing severe COVID-19 was not higher among asthmatics. The number of males and comorbidities was higher among COVID-19 patients in the Stanford cohort, and the most frequent comorbidities among these asthma patients were other chronic inflammatory airway disorders such as chronic obstructive pulmonary disease (COPD). Conclusion: Observed disparity in COVID-19-associated risk among asthmatics across countries and continents is connected to varying prevalence of underlying comorbidities, particularly COPD. Public health policies in the future will need to consider comorbidities with an emphasis on COPD for prioritization of vaccination and preemptive treatment.

Anti-neutrophil cytoplasmic antibody (ANCA) -associated vasculitis is a group of systemic small vessel vasculitis characterized by the detection of ANCA in serum, which mainly affects small vessels (arterioles, arterioles, venules, and capillaries)but may also have middle artery involvement. We report a case of ANCA -associated vasculiti

Abstract We report a case of cauda equina syndrome (CES) caused by an epidural metastasis of breast cancer, which oddly mimicked a large disc sequestrum leading to misdiagnosis. To our knowledge, it is the first report of the direct metastasis of breast cancer to epidural space.

The vertebrate photoperiodic neuroendocrine system uses photoperiod as a proxy to time annual rhythms in reproduction. To investigate seasonal adaptation in mammals, the hinge region and the first part of the transmembrane domain of the Tshr gene were sequenced for 278 common vole (Microtus arvalis) specimens from 15 localities in Western Europe, and 28 localities in Eastern Europe. Forty-nine single nucleotide polymorphisms (SNPs; 22 intronic, 27 exonic) were found, with weak or zero correlation with pairwise geographical distance, latitude, longitude and altitude. By applying a temperature threshold to the local photoperiod-temperature ellipsoid, we obtained a predicted critical photoperiod (pCPP) as a proxy for spring onset of local primary food production (grass). The pCPP obtained explains the distribution of genetic variation in Tshr in Western Europe through highly significant correlations. Thus, Tshr, which plays a pivotal role in the sensitivity of the mammalian photoperiodic neuroendocrine system, was targeted by natural selection, resulting in optimized timing of seasonal reproduction.

The existence of an approximate solution to the fourth-order boundary value problem (BVP) \begin{eqnarray} u^{(4)}(t) = h(t)f(u(t))+g(t), \quad t \in [0, 1], \nonumber\\ u(0) = \alpha, u^{\prime}(1)= \beta, u(1) = \gamma, u^{\prime\prime}(0) = \delta, \nonumber \end{eqnarray} is investigated using a new inverse operator, where $f,g,h \in C( \mathbb{R}, \mathbb{R})$, and $\alpha, \beta, \gamma$ and $\delta$ are real numbers. As an application, we apply the inverse operator and ADM to study the existence of an approximate solution of the Cantilever beam equation whose one end simply-supported with other end fixed \begin{eqnarray} u^{(4)}(t) = h(t)f(u(t))+g(t), \quad t \in [0, 1], \nonumber\\ u(0) = 0, u^{\prime}(1)= 0, u(1) = 0, u^{\prime\prime}(0) = 0, \nonumber \end{eqnarray} where $f,g$ and $h \in C( \mathbb{R}, \mathbb{R})$. Our examples shows that the proposed inverse operator and the application ADM gives very less errors in the obtained approximate solution when compared to the exact solution of the Cantilever beam problems.

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is commonly associated with asthma. Treatment of CRSwNP includes intranasal and systemic corticosteroids, with non-responsive patients commonly considered for endoscopic sinus surgery (ESS). This nationwide register-based study evaluated the incidence, prevalence, and treatment burden of CRSwNP in Finland, and their association with the presence and severity of comorbid asthma. Methods: Electronic health records of patients diagnosed with CRSwNP between 1.1.2012-31.12.2018 in Finnish specialty and primary care were included in the study. The patients were divided into subgroups based on presence, severity, and control of asthma: no asthma, mild to moderate asthma, severe controlled asthma, and severe uncontrolled asthma. A mean cumulative count of ESS was calculated over time per subgroup. Results: The prevalence of CRSwNP increased from 602.2 to 856.7 patients per 100 000 population between years 2012 and 2019 (p < 0.001). A total of 18 563 patients (59.9% male) had incident CRSwNP between 2012 and 2019, with 27% having asthma, 6% having severe asthma, and 1.5% having severe uncontrolled asthma. In the no asthma, severe controlled asthma, and severe uncontrolled asthma subgroups, systemic corticosteroids were used by 54.1%, 94.9% and 99.3% (p < 0.001), respectively, while the ESS count three years post diagnosis was 0.49, 0.68 and 0.80, respectively. Conclusions: The prevalence of CRSwNP showed a significant increase in the recent decade in Finland. Comorbid asthma, and in particular severe asthma, increased the probability of receiving systemic corticosteroids and undergoing ESS. Thus, improved management of CRSwNP in patients with comorbid asthma is urgently needed.

The worldwide ecosystem of communication, information, and new-age technologies are using the Internet of Things (IoT) which connect devices or things on the Internet with each other from any location. IoT has seen tremendous expansion in its applications and services over the last few years. This has generated the attention of device manufacturers along with corporate vendors, and individual investors, which have resulted in a rapid influx of new-age businesses. As the adoption and use of IoT devices are increasing, these things on the Internet are being used in almost every area of our life. Since confidential data and information are involved, securing the IoT devices has become the prime is gaining more and more importance. Security assessments of smart cities and homes running IoT devices require appropriate security controls to mitigate threats and risks due to the smart technology deployments. This research focuses on the IoT device firmware to secure the smart home environment. The authors present a security framework for conducting IoT firmware analysis and investigations that revealed hardcoded user IDs and passwords as well as sensitive information for further attacks and compromise of the IoT devices. The authors proposed a hypothesis to analyze real-time datasets generated from IoT search engines based on keywords as per device types, locations, and manufacturers. The outcome exposed device owners taking 11-13 months to upgrade firmware even among the IoT manufacturers only HP and Cisco were consistently delivering firmware upgrades to secure the IoT devices.

In this paper,we mainly establish existence and uniqueness of positive solution for the Hadamard-type fractional two-point boundary value problem (\mathcal{D}^{α}_{1^{+}}x(t))’‘+λ^2 \mathcal{D}^{α}_{1^{+}}x(t)+f(t,x(t),-\mathcal{D}^{α}_{1^{+}}x(t))=0, t∈ (1,e), x(1)=x’(1)=x’(e)=0 , \mathcal{D}^{α+1}_{1^{+}}x(1)=\mathcal{D}^{α+1}_{1^{+}}x(e)=0, by using the fixed point theorems. In addition, we also study the Ulam-Hyers-Rassias stability of the related problem. On the other hand, when f(t,u,v) is singular at u=0 and v=0, we study the existence and uniqueness of its solution. Finally, some examples are included to show the applicability of our results.

In this work, we extend the theory of differential equations through a new way. To do this, we give an idea of differential–anti-differential equations and dene ordinary as well as partial derivative{anti-derivative operator with a base function to solve several types of such equations. The operator is applied to construct several Auxiliary equations for a Homogeneous differential–anti-differential equations. The roots, of the Auxiliary equations, are then inserted in the base function to get exact solutions of the corresponding equations. The process can be used to solve both Homogeneous linear and non-linear ordinary as well as partial differential–anti- differential equations. The technique has special property that it can solve several different types of differential equations including continuity, Heat, Wave, Laplace, Schrodinger, Euler, Blasius differential equations.

The nodes and their connection relationships (CRs) are the two main parts for a complex dynamical network (CDN). In existing theoretical studies about the outer synchronization, the nodes are considered as the main part of synchronization phenomena mainly associated by coupling effect of CRs between nodes. However, if the CRs between nodes are time-varying, they can also be regarded as one dynamic system coupled with the nodes, and thus their state may evolve with time and maybe assist the nodes to achieve the outer synchronization. From the angle of large-scale systems, a CDN can be regarded as two interconnected subsystems, one of which is the node subsystem (NS) and the other is the link subsystem (LS). Hence, how the whole dynamic of LS contributes to the outer synchronization of NS is one of worthy research problem. In this paper, the two CDNs are considered with the unknown interaction. In each CDN, the dynamics of NS is modelled as the vector differential equation, the LS is modelled as the Riccati matrix differential equation, and the two kinds of differential equations are coupled with each other. By employing the above dynamic models of CDNs and the synthesized coupling terms in the two LSs, the adaptive controller of NS is synthesized for the response CDN. The results show that the outer synchronization happens when the two LSs tracking the synthesized auxiliary dynamic tracking targets. Finally, the numerical simulation is given to show the effectiveness of the theoretical results in this paper.

With an expanding number of institutions participating in the global education market, verifying the legitimacy of academic achievements such as CVs and certificates has grown more difficult. Blockchain is an enabling technology that has the potential to help solve this issue. This research presents a blockchain-based achievement record system that generates a verified record of accomplishments. Using the unique characteristics afforded by Blockchain technology (public Ethereum Blockchain) and smart contracts, the proposed solution intends to make the process of certificate authentication and validation more reliable, easy, and fast. The system’s design and structure, as well as its components and tools, are described. The system is then evaluated through a series of experiments to determine its usability, effectiveness, performance, and cost. A score of 77.1 was obtained on the System Usability Scale (SUS) test. In addition, an examination of End-User Computing Satisfaction (EUCS) revealed that participants deemed the system to be extremely useful and user-friendly. We show that this method is a major advance over older systems, being both more user-friendly and efficient, through a literature review. We also provide a thorough cost study and outline the benefits and drawbacks of various blockchain systems.

Background: Aortic root aneurysms are traditionally treated by open surgery methods, which significantly increase the risk of postoperative complications. Elderly patients with a history of previous cardiac surgery have a higher risk of postoperative events and demand more careful supervision during hospitalization. Materials & Methods: We report a case of a 72‐year‐old female patient with aortic root aneurysm and a previous history of cardiac surgery (CABG) with a high risk for EuroSCORE II (15,52%). The postoperative period was uneventful. Discussion and Conclusion: We use this case to discuss the effectiveness and short‐term results of this procedure in patients with high risk. Keywords: aortic aneurysm, CABG, hemiarch reconstruction

In this paper, we give a general and weak sufficient condition to guaranteeing the existence and infinite homoclinic solutions for some classes of differential equations, in particular for a class of Hamiltonian systems. We illustrate our main theoretical results by an application.

Background Anxiety is a primary concern affecting the prognosis of CABG patients. Relieving anxiety is thus a component of management in patients with CABG. Also, patients with bypass surgery express compromise in exercise tolerance. We use two feasible and cost-effective treatment techniques to know the improvement in symptoms of anxiety and exercise tolerance. Objective To evaluate the efficacy of chair aerobics and pranayama on anxiety in patients who underwent CABG. We hypothesized that there would be an improvement in anxiety in CABG patients after receiving the interventions. Methods In a total of 21 screened, 16 met eligibility requirements. These were randomized into two, group A and group B. Group A is treated with progressive chair aerobics, and group B with nadisodhana pranayama. Both groups were given standardised cardiac rehabilitation techniques. The duration was fifteen minutes of activity along with phase 1 cardiac rehabilitation. The treatment session was given once a day in the morning. The intervention starts from the post-operative day 3 to post-operative day 7. The anxiety is measured by the tool “hospital anxiety and depression scale”. The exercise capacity of the patient was measured by a 6-minute walk test. Heart rate is estimated to know the somatic and physiologic components of anxiety. Took all the outcome measures before the surgery and on post-operative day 7 by a blinded outcome assessor. Results: The results showed that the improvement in the p-value of HADS anxiety, depression, and heart rate of both groups is less than 0.05. The 6-minute walk test showed better improvement in the chair aerobics group with a p-value less than 005. Registration: The trial is prospectively registered in CTRI. The trial registration number is CTRI/2021/09/037008.

Let $H_n$ be a linear hexagonal chain with $n$ hexagons. In this paper, we give a decomposition theorem of Laplacian polynomial of weighted graphs and obtain that the Laplacian spectrum of $H_n$ consists of the eigenvalues of a symmetric tridiagonal matrices of order $4n+2$ and the Laplacian eigenvalues of $2n$ $K_2s$. Together with the relationship between the roots and coefficients of the characteristic polynomials of the above matrices, explicit formula of the Kirchhoff index of $H_n$ is derived. We also give the number of spanning trees of $H_n$, and show that the Kirchhoff index of $H_n$ is approximately one half of its Wiener index.

Patient satisfaction is a necessary and commonly used indicator for measuring the high quality of healthcare. Patient happiness affects medical outcomes, patient retention, and claims of medical malpractice. It affects the best fitness care timely, green, and targeted shipping by the affected person. Patient satisfaction, as a result, is a proxy but a perfectly effective indicator for the success of doctors and hospitals. Deep poverty, socio-economic inequality and bigotry are those social variables effect individual, family, neighborhood, structural and demographic level and multi-sector and multistage procedures are mandatory to address socio-economic health determinants (Sakib, 2022).Some above-mentioned elements in some dermatological exercise skills should emphasize the unique potential of skin exercise:Many dermatological disorders are characterized by chronic. Thus the IAL’s long-term conditions and / or systemic treatment restrictions for heat management. It is expected that more than one-third of one-third fail to take the prescribed medication, especially for chronic problems. It can also lead to poor compliance as well as the failure of treatment and thus the happiness of the badly affected person.People can also come to a dermatologist with high expectations for a final treatment for all their pores and skin problems. Experience tells us that we cannot guarantee such a solution. This service ends up in a big gap between the company and the service seeker, the main reason being lack of patient happiness.Poor communication with doctors, lack of empathy, and chronic problems can lead to dissatisfaction.Patients, especially young people, want short-term solutions to their problems and are therefore more likely to be dissatisfied. Older people between the ages of 35 and 49, who form a core part of the new client group, have the lowest happiness rate of affected people compared to other age groups.Recent interest in aesthetic therapy has transformed the situation into a massive one. These ”victims” who are healthy in any other case have a better level of expectation. Aesthetic dermatology is also cared for with the help of other athletes, including excellent clinics and non-medical professionals, who may not necessarily be bound by the ethical policies of the medical profession. They regularly host exaggerated claims, prominent advertisements which increase expectations and later disappointment.Even people are planning and implementing robotics in healthcare (Sakib, 2022) and blockchain technology in healthcare supply chain (Sakib, 2022). Even the effect of industrialization in health and environment is also considered. For example, even the effect of oil and gas development in Nigeria in health and environment is also highly considered (Sakib, 2021).Satisfaction with the professional job of a dermatologist and the happiness of the affected person does not address the need to complement each other. We rate the joy of our work through our expertise, participation in CMEs, meetings, learning new skills, and keeping pace with new technology. Not all of these factors usually apply to the patient. Ultimately, however, whether or not a patient is satisfied with a health practitioner’s technique depends on specific non-medical factors such as listening to him or her, the speed of presentation, and the way we speak and point.Background:Improvements in the field of dermatology resumed from the early to mid-19th century, when several bacteria and fungi were discovered. American dermatology originated in New York City in 1836, when Henry Degate Buckley, MD (1803-1872), the primary American dermatologist, opened the Broome Street Infirmary for skin diseases.However, the importance of dermatology as science has now shifted within the United States from the early 1800s to the late 1800s, when skin diseases had to be linked to the overall anatomy of patients. The whole thing became more mainstream. The first American Dermatological Association was formed in 1886.In the early 20th century, German dermatology greatly influenced American dermatology through a couple of lectures. By 1932, the American Board of Dermatology was established. In 1937, the Society for Investigative Ghetto Dermatology was founded, and in 1938 the American Academy of Dermatology and Cepheology (now the American Academy of Dermatology) was founded. The 1930s also saw a large influx of Germans and various European Jews fleeing Nazi oppression, which led to the rise of American dermatology.It wasn’t until the 20th century that truly effective treatment plans were devised to deal with dermatological conditions. These key pills later include quinacrine, para-aminobenzoic acid, dipson, hydrocortisone, benzoyl peroxide, grezo-flavine, methotrexate, and five-fluorouracil.Recommendation and Conclusion:Dermatological rehabilitation guidelines are based primarily on the International Classification of Work, Disability and Health (ICF), which includes contextual elements, including the physical environment, socioeconomic conditions, and the non-public view of the affected person. Are The guidelines providing specific recommendations for personal rehabilitation conditions, workers’ bodies, devices, treatment methods, and diagnoses? They help medical doctors, victims, and public organizations to get acquainted and make decisions. The modern guides are a common accuracy received from experts, with a large participation of social coverage businesses, and reflect the growing importance of indicators that are the result of compromises between conflicting occupations in clinical development and there are financial restrictions. On the contrary. The consequences of allocating financial resources within the health gadget are discussed.Patient pride is a mindset. While this no longer ensures that the victim will remain loyal to the physician or hospital, it is a strong motivating issue. Patient satisfaction is an indirect or proxy indicator of the highest quality of performance of the most effective medical doctor or health facility. Delivering focused care to the affected person requires that we provide care in a specific way, now not just anytime or in general, but continuously. This should happen to every affected person at all times.That’s the decent thing to do, and it should end there. The standard is no longer linear and generally not climbing. One should strive to provide superior care and surpass every patient’s expectations.

Virgin olive oils (VOO) obtained from olives grown in different regions of our country, under changing climatic conditions, show different sensory and chemical properties. Due to the fact that primary production is affected by climatic and agricultural conditions and VOOs are supplied to the market by only physical processing. In order to determine whether these deviations are due to climatic conditions, VOOs were obtained from the olive samples collected from 39 orchards in four Region where VOO production is intense in Turkey. Analyzes were carried out regarding the quality and purity criteria of the VOOs. Samples were collected in 2017/18-2020/21 harvest years (-2 on-2 off). The maturity index (MI) values of olives and free fatty acidity (FFA), fatty acid ethyl esters (FAEE), delta-7-stigmastenol values of olive oils ranged between 0.94-4.15 and 0.07-1.27 (in oleic acid %), 1.56-27.32 mg/kg, 0.16-1.14%, respectively. Delta-7-stigmastenol values in 21 samples were outside the limit specified in the legislation (0.50-1.14%). The Fatty acid methyl esters (FAME) and FAEE of all olive oil samples were within the specified limits. In the study, multiple regression analysis was performed to investigate whether there is a relationship between climate data and delta-7-stigmastenol values by years. According to this result, it has been determined that the delta-7-stigmastenol value is high when the annual average relative humidity is low and the annual average temperature is high. There is an urgent need to make forward-looking plans due to climate change.

Aim There is still only little knowledge about alterations of blood concentrations of psychotropic drugs during pregnancy, the transfer of psychotropic drugs into breast-milk and the effects on exposed children. Methods We investigated changes in concentrations of psychopharmacological medication during pregnancy and lactation in serum and breast milk at different time points in a naturalistic sample of 60 mothers and observed the development of the exposed children in the first 12 months. Results We found a decrease in serum concentrations from the first to the second trimester of amitriptyline, duloxetine, escitalopram, quetiapine and sertraline. Citalopram stayed rather stable during pregnancy, sertraline levels interestingly increased again from the second to the third trimester. Highest concentration-by-dose-ratios in breast milk were found for venlafaxine as well as lamotrigine, lowest for quetiapine and clomipramine. Similarly, clomipramine and quetiapine showed lowest milk/serum-penetration-ratios. Regarding the birth outcome measures in children we found no significant differences between in utero exposed compared to non-exposed new-borns. There were no significant differences in the development in the first 12 months. Conclusion Psychotropic medication in the peripartum needs a balancing of risks and benefits and a continuous therapeutic drug monitoring (TDM) can be a guidance for clinicians to monitor drug alteration patterns, which are likely to occur due to physiological pregnancy-associated changes in pharmacokinetics. Accordingly, TDM can optimize a medication in pregnancy and lactation with the lowest but effective dose.

Beta-lactam antibiotics are a relatively common cause of immune thrombocytopenia. Cross-reactivity of them in patient with drug-induced immune thrombocytopenia is rarely reported. Here, we describe the case of a 79-year-old male patient experienced thrombocytopenia after receiving piperacillin-tazobactam for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Fortunately, the patient was able to successfully challenge with meropenem and cefotiam. However, after the cefoperazone-sulbactam was administered, the patient experienced thrombocytopenia again. Therefore, there are cross-reactions of platelet-relative antibodies between piperacillin-tazobactam and cefoperazone-sulbactam. Although the exact responsible antibodies remain unknown and need further investigation, attention should be paid to the role of chemical structure similarities in determining the risk of immune thrombocytopenia among beta-lactams in the clinical setting.

Background: Immune checkpoint inhibitors (ICIs), including anti-PD-1/L1 therapy and anti-CTLA-4 therapy, are associated with a unique spectrum of immune-related adverse events (irAEs). The association and clinical features of ICIs-related biliary disorders are not well characterized. Methods: Data were extracted from the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. Bile duct and gallbladder diseases were defined by the Medical Dictionary for Regulatory Activities (MedDRA). We performed disproportionality analysis using reporting odds ratios (ROR) and information component (IC). The result was defined as a signal if the lower limit of the 95% confidence interval for ROR is over 1 and the number of cases ≥5, or the lower limit of 95% confidence interval for the IC (IC025)>0. Results: 906 reports of ICI-related bile duct and gallbladder events were identified. The mean age was 64.8±12.1 years and the AEs occurred more in men (60.1% vs 39.9%). ICIs were associated with increased reporting of bile duct diseases (ROR 3.35, 95%CI 3.07-3.66; IC0251.41), especially cholangitis (ROR 5.52, 95% CI 4.94-6.17; IC0251.93); while we didn’t identify signal of gallbladder disease (ROR 0.96, 95%CI 0.86-1.08; IC025 -0.22). PD-1/L1 inhibitors and combination regimen were associated with a spectrum of distinct classes of bile duct disease while anti-CTLA-4 therapy (ipilimumab) had no association with any bile duct and gallbladder diseases. Conclusions: PD-1/L1 inhibitors showed increased reporting of cholangiopathy, especially for cholangitis. Physicians should be aware of this potential adverse event.

Objective: Infertility is a complex disease, which has a significant impact on medicine, social psychology and economy. There is no unified conclusion on the choice of drug treatment. Our goal is to investigate the actual drug treatment mode of reproductive assistance patients in China, focusing on the trend and rationality of sex hormone use in the past five years. Method：We conducted a cross-sectional analysis of the data from the hospital prescription analysis cooperation project supervised by the China Medical Association during 2016 to 2020. Results: Among the 225225 patients included in this study, the top three cities were Guangzhou, Shanghai and Zhengzhou. In five years, the average age is 32.99 years old. There were 11 kinds of main therapeutic drugs used. The top five were urotropin for injection, different progesterone preparations, chorionic gondotrophin for injection, dydrogesterone and triptorelin for injection. Although the total dosage of urotropin was the highest, it showed a downward trend. The dosage of progesterone and didroxyprogesterone showed an upward trend, among which progesterone showed the fastest upward trend. Conclusion: The average age of patients has not increased significantly, while the opportunity cost of women’s childbirth has increased, which seriously hinders the realization of childbearing intention. The overall medication selection is reasonable. The dosage of first-line urotropin and chorionic gonadotropin recommended by the guidelines is also high in this study, but the dosage of oral first-line treatment of ovarian stimulation in unexplained infertility is low, and the dosage of progesterone is gradually increasing.

Using soil survey database, the current study aims to determine the optimum feasible land surface for grape cultivation in order to increase and optimize production. Proper management of land resources requires micro-level assessment. The study area is village Rahud in the drought-prone zone of Nashik district, Maharashtra, India. The village’s current land use and land cover data point to proper soil resource management for fallow land reclamation. The revenue map was used to create the base map. The NBSS and LUP criteria are used to assess the suitability of a soil location for grape production. The study area’s varied land use/cover and slope components were used to gather detailed soil samples and measure soil hydrological parameters. The spatial variation of soil physical, chemical, and hydrological parameters was assessed using soil sample collection and analysis. To assess quantitative and spatial variation of soil suitability for grape cultivation Geoinformatics and statistical approaches were used. The standards raster database was used for ranking and parametric evaluation and spatial assessment. Highly suitable land accounts 22.95 % of the entire village, moderately suitable land is 27.11 % and marginally suitable land covers 22.67 %. Fallow land contains marginally appropriate classes and is ideal for converting into suitable class application if the proper soil measures followed.