Статті в журналах з теми "P versus NP problem"

Over the last few years, a new methodology to address the P versus NP problem has been developed, based on searching for borderlines between the nonefficiency of computing models (only problems in class P can be solved in polynomial time) and the presumed efficiency (ability to solve NP-complete problems in polynomial time). These borderlines can be seen as frontiers of efficiency, which are crucial in this methodology. “Translating,” in some sense, an efficient solution in a presumably efficient model to an efficient solution in a nonefficient model would give an affirmative answer to problem P versus NP. In the framework of Membrane Computing, the key of this approach is to detect the syntactic or semantic ingredients that are needed to pass from a nonefficient class of membrane systems to a presumably efficient one. This paper deals with tissue P systems with communication rules of type symport/antiport allowing the evolution of the objects triggering the rules. In previous works, frontiers of efficiency were found in these kinds of membrane systems both with division rules and with separation rules. However, since they were not optimal, it is interesting to refine these frontiers. In this work, optimal frontiers of the efficiency are obtained in terms of the total number of objects involved in the communication rules used for that kind of membrane systems. These optimizations could be easier to translate, if possible, to efficient solutions in a nonefficient model.

We continue with the functional approach to the P -versus- NP problem, begun in [J. C. Birget, Semigroups and one-way functions, Int. J. Algebra Comput. 25(1–2) (2015) 3–36; J. C. Birget, Infinitely generated semigroups and polynomial complexity, Int. J. Algebra Comput. 26(04) (2016) 727–750.] We previously constructed a monoid [Formula: see text] that is non-regular iff NP [Formula: see text] P . We now construct homomorphic images of [Formula: see text] with interesting properties. In particular, the homomorphic image [Formula: see text] of [Formula: see text] is finitely generated, and is non-regular iff P [Formula: see text] NP . The group of units of [Formula: see text] is the famous Richard Thompson group [Formula: see text].

Bennett and Gill [1981] showed that P A ≠ NP A ≠ coNP A for a random oracle A , with probability 1. We investigate whether this result extends to individual polynomial-time random oracles. We consider two notions of random oracles: p-random oracles in the sense of martingales and resource-bounded measure [Lutz 1992; Ambos-Spies et al. 1997], and p-betting-game random oracles using the betting games generalization of resource-bounded measure [Buhrman et al. 2000]. Every p-betting-game random oracle is also p-random; whether the two notions are equivalent is an open problem. (1) We first show that P A ≠ NP A for every oracle A that is p-betting-game random. Ideally, we would extend (1) to p-random oracles. We show that answering this either way would imply an unrelativized complexity class separation: (2) If P A ≠ NP A relative to every p-random oracle A , then BPP ≠ EXP. (3) If P A ≠ NP A relative to some p-random oracle A , then P ≠ PSPACE. Rossman, Servedio, and Tan [2015] showed that the polynomial-time hierarchy is infinite relative to a random oracle, solving a longstanding open problem. We consider whether we can extend (1) to show that PH A is infinite relative to oracles A that are p-betting-game random. Showing that PH A separates at even its first level would also imply an unrelativized complexity class separation: (4) If NP A ≠ coNP A for a p-betting-game measure 1 class of oracles A , then NP ≠ EXP. (5) If PH A is infinite relative to every p-random oracle A , then PH ≠ EXP. We also consider random oracles for time versus space, for example: (6) L A ≠ P A relative to every oracle A that is p-betting-game random.

Introduction: Nasal continuous positive airway pressure (CPAP) is the standard therapy for neonatal respiratory distress. It is delivered using nasal mask (NM) or nasal prong (NP), both of which can result in nasal trauma. The type of nasal interface used is an important determinant of nasal injury. The superiority of one over the other is debatable necessitating further research to identify the more efficacious, safe and convenient nasal continuous positive airway pressure (CPAP) interface. This study was conducted to compare the efficacy of NM Nasal continuous positive airway pressure (CPAP) versus NP CPAP. Methods: Sixty neonates < 37 weeks and having respiratory problems were alternately divided into two groups based on the respiratory support provided: Group A (NM CPAP) and Group B (NP CPAP). They were followed up on a daily basis during their NICU stay and placed on regular recall until three months of age. Between-group comparisons were done using Wilcoxon-Sign Rank Test and Proportion test. P-value ≤ 0.05 indicated statistical significance. Results: Patients in Group A (NM CPAP) showed significantly less number of days of CPAP therapy (P = 0.0033) and lesser failure rate (P = 0.0198) compared to those in Group B (NP CPAP). Incidence of complications was also lower in Group A than in Group B. Conclusion: NM CPAP is more efficacious and safer than NP CPAP for the treatment of respiratory problems in neonates.

The Traveling Salesman Problem (TSP) is a P versus NP key problem that can be generalized to some instances of other problems. Using the commercial state-of-the-art branch-and-bound mixed integer linear programming solver (LINGO) solves the TSP problem in an amount of time that is proportional to a quadratic multiplied by an exponential of base two as a function of the number of cities or destinations. My algorithm solves the problem in a quadratic amount of time as a function of the number of cities or destinations. My algorithm basically solves the problem by sorting the cells in the cost or distance matrix from lower to higher values, while checking for cycles. My algorithm performs on average 43.67% better than LINGO for 100 cities or destinations. In the interconnected world of the present and future, fast and reasonably good solutions are better than reaching (if ever) the global optimal solution.

BackgroundAnkylosing spondylitis (AS) is one of the most actual problems in modern rheumatology. AS is characterized by a violation of functional abilities, which causes a decrease in the quality of life and invalidation of patients. The main symptom of AS is chronic pain, which persists in some cases not only due to inflammation, but also due to the neuropathic component of pain, however, this issue needs additional investigation [1].ObjectivesTo assess functional status and its association with neuropathic pain in patients with AS.MethodsFollowing the principles of biomedical ethics, on the basis of informed consent, we clinically examined 133 patients (men - 71%) diagnosed with AS according to the modified New York criteria. The presence of neuropathic pain (NP) was assessed by the Leeds Neuropathic Pain Rating Scale (LANSS) and by the Diagnostic Questionnaire for Neuropathic Pain (DN4). Disease activity was assessed by the BASDAI (Bath Ankylosing Spondylitis Disease Assessment Index) and ASDAS (Ankylosing Spondylitis Disease Activity Score). Functional disorders in AS were evaluated according to the BASFI (Bath AS Functional Index) and BASMI (Bath Ankylosing Spondylitis Metrology Index). The HAQ (Health Assessment Questionnaire) questionnaire was used to assess functional capabilities.Statistical analysis was carried out by the methods of variational statistics in the SPSS22 software package (©SPSS Inc.). Significance of differences between groups (p) was measured using the Mann-Whitney test. Results are presented as mean with standard deviation (M±SD).ResultsIn patients with AS, the prevalence of NP according to the LANSS was 34.8%. Presence of NP in women was found significantly more often than in men: 52.3% versus 31.1%. According to DN4 data, 37.7% of patients have NP, and the ratio of women to men is 59.1 to 32.2. The NP according to both scales was found in 33.1% of AS patients, significantly more often in women than in men: 51.4% versus 29.7%.Moderate and high disease activity according to the BASDAI and ASDAS prevailed in our patients, and the average values were at the level of 5.5±1.7 and 3.54±0.83, respectively.Functional impairment according to the BASMI in patients with NP was significantly higher in comparing with the group without NP (4.0±2.1 versus 5.1±2.2; p<0.01). At the same time, according to the BASMI, it was established that among all patients with AS, the absence of functional disorders occurred only in 7.0% of patients, moderate disorders - in 68.3%, and severe disorders - in 24.7 % of patients. Pronounced functional disorders prevailed in the group of patients with NP (39.6% vs. 17%). Similar data were obtained by the BASFI (4.3±2.1 versus 6.6±1.6; p<0.01). The presence of functional disorders according to the BASFI was found in 70.7% of all AS patients. At the same time, functional disorders were found in 93.2% of patients with NP.The functional disability according to the HAQ in patients with NP was significantly higher than in the group without NP, which indicates that NP is associated with more pronounced functional disorders - 1.23±0.45 versus 0.91±0.51 (p<0, 01).ConclusionThe presence of NP in AS patients is a common phenomenon. NP has a close relationship with functional abilities in patients with AS and can be consider as a predictor of severe functional disorders.Reference[1]Zhou, L., Li, T., Wu, X., Lu, H., Lin, L., Ye, L., Yin, J., Zhao, J., Wang, X., Bian, J., & Xu, H. (2021). Assessment of Neuropathic Pain in Ankylosing Spondylitis: Prevalence and Characteristics.Pain and therapy,10(2), 1467–1479.https://doi.org/10.1007/s40122-021-00310-8Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Background. Due to its high morbidity and prevalence, the potential relationships of depression/anxiety symptoms in neck pain (NP) are not well demonstrated. Objectives. This study aimed to conduct a comprehensive estimation of controlled trials of psychological problems and to test hypotheses concerning whether NP was statistically relative to anxiety/depression symptoms. Methods. Chinese literature databases such as the China National Knowledge Infrastructure (CNKI), VIP Information (VIP), Chinese Biomedicine (CBM), and Wanfang Data (WANFANG) were scientifically searched for reports published until February 5, 2018. Controlled trials incorporating NP patients with anxiety/depression versus healthy people were contained. Two researchers screened each article and extracted data, respectively, and blinded to the findings of each other. Meta-analysis was conducted by the Cochrane Collaboration’s RevMan 5.3 and Stata 14.0 (Stata Corp LP, USA) software. Results. We identified 13 eligible studies involving 2339 patients and 3290 healthy people. Compared with healthy control participants, the findings indicated that depression/anxiety symptoms were more common or severe in NP patients (respectively, SMD = 0.89; 95% CI = (0.58, 1.20); P<0.01 and SMD = 0.92; 95% CI = (0.65, 1.20); and P<0.01), results from the pooled data demonstrated no statistical significance between depression/anxiety symptoms and gender in NP patients (resp., SMD = 0.16; 95% CI = (−0.18, 0.51); P=0.35 and SMD = −0.08; 95% CI = (−0.42, 0.27); and P=0.67), and the combined data of the incidence of depression or anxiety symptoms revealed significant difference between NP patients and healthy persons (resp., RR = 4.81; 95% CI = (3.30, 7.01); P<0.01 and RR = 3.29; 95% CI = (2.16, 5.00); and P<0.01). In addition, we did not find articles that met the inclusion criteria, which compared NP patients with other physical illnesses in terms of anxiety/depression symptoms. Conclusions. This meta-analysis suggests that anxiety/depression symptoms are associated with high morbidity in NP patients. We consider these reports support the viewpoint that nonspecific mechanisms mediate mental disturbances in NP. This study may have clinical value for NP, offering an underlying target for the prevention and treatment of anxiety/depression.

AbstractThe Massively Parallel Computation (MPC) model serves as a common abstraction of many modern large-scale data processing frameworks, and has been receiving increasingly more attention over the past few years, especially in the context of classical graph problems. So far, the only way to argue lower bounds for this model is to condition on conjectures about the hardness of some specific problems, such as graph connectivity on promise graphs that are either one cycle or two cycles, usually called the one cycle versus two cycles problem. This is unlike the traditional arguments based on conjectures about complexity classes (e.g., $$\textsf {P}\ne \textsf {NP}$$ P ≠ NP ), which are often more robust in the sense that refuting them would lead to groundbreaking algorithms for a whole bunch of problems. In this paper we present connections between problems and classes of problems that allow the latter type of arguments. These connections concern the class of problems solvable in a sublogarithmic amount of rounds in the MPC model, denoted by $$\textsf {MPC}(o(\log N))$$ MPC ( o ( log N ) ) , and the standard space complexity classes $$\textsf {L}$$ L and $$\textsf {NL}$$ NL , and suggest conjectures that are robust in the sense that refuting them would lead to many surprisingly fast new algorithms in the MPC model. We also obtain new conditional lower bounds, and prove new reductions and equivalences between problems in the MPC model. Specifically, our main results are as follows. Lower bounds conditioned on the one cycle versus two cycles conjecture can be instead argued under the $$\textsf {L}\nsubseteq \textsf {MPC}(o(\log N))$$ L ⊈ MPC ( o ( log N ) ) conjecture: these two assumptions are equivalent, and refuting either of them would lead to $$o(\log N)$$ o ( log N ) -round MPC algorithms for a large number of challenging problems, including list ranking, minimum cut, and planarity testing. In fact, we show that these problems and many others require asymptotically the same number of rounds as the seemingly much easier problem of distinguishing between a graph being one cycle or two cycles. Many lower bounds previously argued under the one cycle versus two cycles conjecture can be argued under an even more robust (thus harder to refute) conjecture, namely $$\textsf {NL}\nsubseteq \textsf {MPC}(o(\log N))$$ NL ⊈ MPC ( o ( log N ) ) . Refuting this conjecture would lead to $$o(\log N)$$ o ( log N ) -round MPC algorithms for an even larger set of problems, including all-pairs shortest paths, betweenness centrality, and all aforementioned ones. Lower bounds under this conjecture hold for problems such as perfect matching and network flow.

Objective After a viral infection in the nasal cavity or sinus, superimposed bacteria infection is likely to occur. Therefore the carriage rate of bacterial pathogen in the nasal cavity (NC), nasopharynx (NP), and ostiomeatal complex (OMC) were determined during wellness and upper respiratory viral infection. Methods There were 2 groups in the study. The control group was well with no nasal or sinus problems. The cohort group had an upper respiratory viral infection. The NC, NP, and OMC cultures were taken from each study group. Agars cultured were used to detect S. pneumoniae, H. influenzae, and M. catarrhalis. Statistical comparison was made between the groups. The bacterial pathogens were also compared between the various sites of culture within a group. Results There were 91 subjects in the study-51 subjects with an upper respiratory viral infection and 40 control participants. 59% of participants were female. There was no statistical difference in the rate of bacterial pathogen in the NP (p=0.2) or NC (p=0.06) between the control and cohort group. There was a significant increase (p<0.008) of bacterial pathogen in the OMC of viral illness group versus the control group. Bacterial pathogen present in the OMC had a similar pathogen in either the NC or NP. Conclusions This study defines the reservoir of bacteria in the NC or NP for the bacterial pathogen in the OMC during wellness and upper respiratory viral infection.

ABSTRACT In this study it is proposed the critical analysis of the creation of Artificial Intelligence (AI) and of Artificial General Intelligence (AGI). The unity of formal logic and rational dialectics is the methodological basis of the analysis. The main results of the analysis are as follows: (1) the model of man represents the unity of the two material aspects: “physiological body” (controllable aspect) and “psychical body” (controlling aspect); (2) the “psychical body” is the subsystem “subconsciousness + consciousness”; (3) in the comprehensive sense of the word, the thinking is an attribute of the complete system “physiological body + psychical body + environment”. (3) in the broad sense of the word, thinking and creativity are an essential feature of the subsystem “subconsciousness + consciousness”; (4) in the narrow (concise) sense of the word, thinking and creativity are the attribute of the instinct of the conservation (preservation, retention, maintenance) of life (i.e., the self-preservation instinct, the survival instinct); the instinct of the conservation of life exists in subconsciousness; (5) the instinct of life conservation is a system of elementary (basic) instincts; thinking is the attribute of the each elementary instinct; (6) the mechanism of thinking and the essence of creation cannot be cognized by men; (7) a computer as a device cannot think and create (in particular, it cannot prove theorems), because a computer does not have the subconsciousness; (8) the modeling of human thinking, Human Intellect, and the creation of AI and AGI are the impossible because the essential properties of the complete system “man + environment” cannot be cognized and modeled; (9) the existence of AI and AGI conflicts with the essence of the thinking; (10) the existence of AI and AGI contradict to formal-logical and rational-dialectical laws.

Gangguan fungsi pernafasan merupakan masalah yang sering muncul pada pasien Penyakit Paru Obstruktif Kronis (PPOK). Posisi orthopneic adalah intervensi nonfarmakologi yang dapat diberikan pada pasien PPOK. Akan tetapi, sejauh ini belum cukup bukti tentang pengaruh posisi orthopneic terhadap fungsi pernafasan karena outcome yang berbeda-beda. penelitian ini bertujuan untuk mengetahui pengaruh posisi orthopneic terhadap fungsi pernafasan pada pasien PPOK. Kriteria inklusi pada review ini adalah: studi eksperimental, pasien dewasa dengan PPOK derajat sedang sampai berat. Adapun keriteria ekslusi adalah pasien PPOK dengan ventilator dan penelitian pada orang sehat. Pencarian literatur menggunakan sistem database EBSCO, SCOPUS, Pubmed, SinceDirect dan Google Scholar dari tahun 2008 sampai 2019, berbahasa Inggris dan Indonesia. Hasil analisis 8 artikel didapatkan bahwa posisi orthopnneic efektif dalam meringankan atau menurunkan sensasi dispnea pada pasien PPOK dengan rata-rata penurunan (mean pre= 21,87 dan mean post= 20,80), memaksimalkan fungsi otot aksesoris pernafasan (Sternocleidomastoideus dan Scalenus) (SCM: USit= 4.80 dan SitAs= 7,92) dan (sc : USit= 9.44 dan SitAs= 15,29), meningkatkan volume tidal (NP = 0,7+0,2) dan (WAHS =0,8+0,3)(Kim et al., 2012) dan meningkatkan nilai APE 27,48% + 14,04%(Ritianingsih et al., 2011). meningatkan nilai maksimal inspirasi (64 ± 22 cmH2O with arm bracing versus 54 ± 24 cmH2O without arm bracing; P= 0.0001). dan maksimal ekspirasi (104 ± 37 cmH2O with arm bracing versus 92 ± 37 cmH2O without arm bracing; p = 0.0001). Gangguan utama pada pasien PPOK adalah proses ekspirasi yang memanjang akibat adanya obstruksi. Posisi orthopneic memaksimalkan fungsi otot aksesoris pernafasan, sehingga proses inspirasi dan ekspirasi menjadi maksimal.
 Kata kunci: Fungsi Pernafasan, Posisi Orthopneic, PPOK.
 Orthopneic Position Effects on Respiratory Function: Systematic Review
 
 Abstract. Impaired respiratory function is a problem that often arises in patients with Chronic Obstructive Pulmonary Disease (COPD). The orthopneic position is a non-pharmacological intervention that can be given to COPD patients. However, so far there is not enough evidence about the effect of orthopneic position on respiratory function due to different outcomes. This study aims to determine the effect of orthopneic position on respiratory function in COPD patients. The inclusion criteria for this review are: experimental studies, adult patients with moderate to severe COPD. The exclusion criteria are COPD patients with ventilators and studies in healthy people. A literature search using the EBSCO, SCOPUS, Pubmed, ScienceDirect, and Google Scholar database systems from 2008 to 2019, in English and Indonesian. The results of the analysis of 8 articles found that the orthopneic position is effective in relieving or decreasing dyspnea sensation in COPD patients with a mean decrease (mean pre = 21.87 and mean post = 20.80), maximizing the function of respiratory accessory muscles (Sternocleidomastoideus and Scalenus) ( SCM: USit = 4.80 and SitAs = 7.92) and (sc: USit = 9.44 and SitAs = 15.29), increasing the tidal volume (NP = 0.7 + 0.2) and (WAHS = 0.8 + 0 , 3) 7 and increase the APE value 27.48% + 14.04% 5. increase the maximum inspiration value (64 ± 22 cmH2O with arm bracing versus 54 ± 24 cmH2O without arm bracing; P = 0.0001). and maximal expiration (104 ± 37 cmH2O with arm bracing versus 92 ± 37 cmH2O without arm bracing; p = 0.0001). The main disorder in COPD patients is the process of expiration which is prolonged due to obstruction. The orthopneic position maximizes the function of respiratory accessory muscles so that the process of inspiration and expiration is maximized.
 Keywords: COPD, Orthopneic Position, Respiratory Function.

Category: Other Introduction/Purpose: The management of pain in patients with foot and ankle pain can be challenging. Cumulative data suggest that, in addition to nociceptive mechanisms, other neuropathic mechanisms can contribute to pain in a subset of people with osteoarthritis. Neuropathic mechanism include central sensitization or peripheral neuropathic hyper activated pain. Heterogeneous pain mechanisms may explain variable responses to recommended pain therapies. Accurate classification of pain phenotype using clinically feasible tools has potential to improve pain management. The PainDETECT score, a validated patient-report questionnaire was developed to identify neuropathic pain. A recent study found a prevalence of 23% of neuropathic pain following ORIF of Ankle fractures. The purpose of this study is to examine the prevalence of neuropathic pain (NP) in a variety of foot and ankle disorders. Methods: This is a cross-sectional study investigating the prevalence of NP in a population of patients undergoing foot and ankle surgery. The patient cohort will include 500 patients. Patients were prospectively reviewed, prior to their surgery, using a patient-self-report questionnaire (painDETECT). Patients’ demographics, diagnosis, comorbidities and functional scores were also prospectively collected. painDETECT score of less than 13 was considered as Nociceptive, score of more than 18 was considered as Neuropathic. Scores of 12 to 18 were considered as Unclear. ANOVA and Student’s t-tests were performed to compare the pain VAS scores, duration of pain prior to surgery, severity of the disease and the prevalence of NP, and among different foot and ankle procedures (bone versus tissue, elective versus trauma) and procedural regions (hindfoot/ankle, midfoot, forefoot). Results: A total of 116 patients were included in this preliminary study. 9 patients (7.7%) were diagnosed with neuropathic pain and 24 (20.6%) were Unclear according to their results in the painDETECT. There were 28 patients scheduled for surgery due to recent trauma, none of which had neuropathic pain. One patient with neuropathic pain was scheduled for excision of Morton’s neuroma and 2 patients for removal of foreign body or hardware. There was no significant correlation with age, BMI or smoking status nor with the patients’ functional scores. Patients with NP described their worst and current level of pain significantly higher than those with nociceptive pain. (9.4 Vs 7.4 for worst pain and 6.9 Vs 4.6 for current level in a scale from 0-10, p-value<0.05). Conclusion: A considerable number of the patients with foot and ankle problems requiring surgeries also has pain of a neuropathic mechanism. It is more common in chronic pain than in trauma. This should be evaluated pre-op and taken into attention when deciding on a surgical intervention or pain management.

P vs. NP problem is very important research direction in computation complexity theory. In this paper author, by an engineer’s viewpoint, establishes universal multiple-tape Turing-machine and k-homogeneous multiple-tape Turing-machine, and by them we can obtain an unified mathematical model for algorithm-tree, from the unified model for algorithm-tree, we can conclude that computation complexity for serial processing NP problem if under parallel processing sometimes we can obtain P=NP  in time-complexity, but that will imply another NP, non-deterministic space-complexity NP, i.e., under serial processing P≠NP  in space-complexity, and the result is excluded the case of NP problem that there exists a faster algorithm to replace the brute-force algorithm, and hence we can proof that under parallel processing time-complexity is depended on space-complexity, and vice verse, within P vs. NP problem, this point is just the natural property of P vs. NP problem so that “P≠NP ”.

Nonylphenol (NP) and octylphenol (OP) are pervasive environmental contaminants belonging to the broader class of compounds known as alkylphenols, with potential human toxic effects. Classified as “xenoestrogens,” NP and OP are able to interfere with the cell endocrine physiology via a direct interaction with the estrogen receptors. Here, using HepG2 cells in culture, the changes of the cell redox balance and mitochondrial activity induced by OP and NP have been investigated at μM concentrations, largely below those provoking acute toxicity, as those typical of environmental contaminants. Following 24 h cell exposure to both OP and NP, ROS production appeared significantly increased (p≤0.01), together with the production of higher NO oxides (p=0.003) and peroxynitrated protein-derivatives (NP versus CTR, p=0.003). The mitochondrial proton electrochemical potential gradient instead was decreased (p≤0.05), as the oxygen consumption by complex IV, particularly following incubation with NP (NP versus CTR, p=0.017). Consistently, the RT-PCR and Western blot analyses proved that the OP and NP can modulate to a different extent the expression of the inducible NOS (NP versus CTR, p≤0.01) and the endothelial NOS (OP versus CTR, p≤0.05), with a significant variation of the coupling efficiency of the latter (NP versus CTR, p≤0.05), a finding that may provide a novel clue to understand the specific xenoestrogenic properties of OP and NP.

Abstract Background: Cancer is a group of diseases characterized by the unregulated growth of cells, which can be hard to diagnose due to the high false negatives or positives derived from technical and human mistakes.The detection of solid tumors during resection surgery is also a common issue, so contrast agents are used for both cancer diagnosis and tumor visualization during surgery, facilitating the tumor resection procedure. Nevertheless, they cause long-term problems because they accumulate in specific tissues, low penetration, and rapid clearance from the circulation. It is necessary to study new contrast agents that improve tumor detection to address these issues.Here, we synthesized two different kinds of luminescent nanoparticles (LNPs) conjugated with chitosan (Ch) and functionalized with folic acid (FA) for breast cancer detection. We compared in vitro its physicochemical characteristics and effects on the proliferation of cancer cells. Evaluated its impact on the immune system in vivo and implemented a differential imaging process to resemble a refined 3D visualization of cluster cells using Light Sheet Microscopy. Results: Luminescent nanoparticles (LNPs) synthesized by sol-gel method and functionalized with FA using EDC-NHS coupling revealed high-intensity yellow emission at 540 nm wavelength with a quantum yield of ~ 36%. In vitro viability assay at different times with 293T epithelial cells, MDA-MB-231, and T-47D cancer cells demonstrated biocompatibility and high improvement of cellular uptake by LNP functionalized with FA for cancer cells versus normal cells. Light-sheet microscopy analysis of cell-LNP interactions to visualize tagged MDA-MB-231 clusters with LNP/Ch-FA showed positive interactions due to higher stability and adherence. Biodistribution and effects on the immune system by LNP/Ch-FA nanoparticles inoculated in mice were evaluated by flow cytometer analysis. LNP/Ch-FA were well tolerated in vivo. No adverse effects were observed macroscopically. Peripheral blood analysis from animals injected with LNP/Ch-FA after 2 or 6 days of the treatment showed that a single injection of the different NPs did not have any effects on the amount of circulating neutrophils or monocytes in peripheral blood when assessed 2 or 6 days after the injection. With T cells, the core NP induced a significant decrease in circulating T cells (-31%, p=0.045) that seemed specific to the CD4+ T cells (-33%, p=0.0479). However, conjugation of the NP to chitosan prevented this effect. Conclusions: Our work presented significant evidence that could allow a better understanding of LNPs conjugated with Ch and functionalized with FA for possible upcoming clinical applications that could work singly or in synergy with the present detection techniques to boost accuracy and precision for cancer detection without compromise the inmunosystem. Citation Format: Rodrigo Osorio-Arciniega, Eduardo Lucero-Meza, Bonifacio Can-Uc, Israel Rocha-Mendoza, Pierrick G.J. Fournier, Gustavo A Hirata, Patricia Juarez. Chitosan luminescent rare-earth doped nanoparticles as cancer cell tracking for imaging tumors and their immune response [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4147.

Проблема равенства классов P и NP сведена к решению задачи о сумме подмножеств⊆, множество целых положительных чисел без повторений. Доказана линейная (либо квадратичная ) разрешимость поставленной задачи, которая принадлежит классу NP-complete. Требуемое пространство равно Таким образом, линейная разрешимость и полнота subset sum problem подтверждают равенство классов P и NP.

Abstract: The P vs NP problem is one of the most significant open problems in computer science and mathematics. This problem asks whether every problem that can be solved in polynomial time can also be verified in polynomial time. The purpose of this research paper is to explore the P vs NP problem and its relevance in the analysis of algorithms. We will discuss the techniques used to design and analyze algorithms, such as divide-and-conquer, dynamic programming, and greedy algorithms, and their relation to the P vs NP problem. We will also examine some examples of polynomial-time algorithms and NP-hard problems and analyze their time and space complexity, addition to which we will analyze the NP-Complete Problem and finally looking the current scenario of the P & NP and stating its significance.

A Stroop negative priming (NP) task was used to assess immediate selective attention and priming in schizophrenia and schizoaffective disorder. Subject groups were comprised of 12 state hospital inpatients (41.8 ± 7.5 years of age), 11 outpatients (39.8 ± 7.5 years of age), and 16 controls (36.4 ± 11.7 years of age). Compared with the control group and the outpatients, inpatients failed to exhibit NP [F(2,36) = 6.09, p < .01], despite exhibiting equivalent Stroop RT interference (p > .05). Error rates did not differ significantly between the 3 groups. Although medication types and dosages were similar between the 2 patient groups, length of illness was significantly longer in the inpatients (19.8 years) than in the outpatients (12.4 years; p < .05). Positive symptom ratings were also significantly higher in the inpatients. The finding of reduced NP in the state hospital patients appears to be related to severity of symptomatology and chronicity of illness. (JINS, 2002, 8, 794–803.)

<strong>ABSTRACT</strong> The study was conducted in Ain Shams University Hospitals. It was a prospective randomized comparative study. Based on the results and data compared between the two groups preoperative dose of dexamethasone is recommended prior to total thyroidectomy operations, due to its beneficial effect in diminishing probability of occurrence of postoperative voice changes, pain and dyspepsia. <strong>Key words:</strong>Thyroid, Dexamethasone, cartilage, trachea, chemotherapy. <strong>REFERENCES</strong> Aburahma AF, Choueiri MA. Cranial and cervical nerve injuries after repeat carotid endarterectomy. J VascSurg ; : - . Andrianopoulos MV, Gallivan GJ, Gallivan KH. PVCM, PVCD, EPL, and irritable larynx syndrome: what are we talking about and how do we treat it? J Voice ; : - Apfel CC, Kranke P, Eberhart LH. Comparison of surgical site and patient&#39;s history with a simplified risk score for the prediction of postoperative nausea and vomiting. Anaesthesia. ; : &ndash; . Apfel CC, Stoecklein K, Lipfert P. PONV: a problem of inhalational anaesthesia? Best Pract Res ClinAnaesthesiol. ; : &ndash; . Audu P, Artz G, Scheid S, et al. Recurrent laryngeal nerve palsy after anterior cervical spine surgery: the impact of endotracheal tube cuff deflation, reinflation, and pressure adjustment. Anesthesiology. ; ( ): Awan SN, Helou LB, Stojadinovic A, Solomon NP. Tracking voice change after thyroidectomy: application of spectral/cepstral analyses. Clin Linguist Phon. ; . Aynehchi BB, McCoul ED, Sundaram K. Systematic review of laryngeal reinnervation techniques. Otolaryngol Head Neck Surg. Baker J. Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports. J Voice ;. Barczynski M, Konturek A, Stopa M, Honowska A, Nowak W. Randomized controlled trial of visualization versus neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy. World J Surg. Benninger MS, Crumley R, Ford CM, et al. Evaluation and treatment of the unilateral paralyzed vocal fold. Otolaryngol Head Neck Surg. Bergenfelz A, Jansson S, Kristoffersson A, et al. Complications to thyroid surgery: results as reported in a database from a multi- center audit comprising patients. Langenbecks Arch Surg. Bhattacharyya N, Fried MP. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngology Head Neck Surg ; &ndash; Bhattacharyya N, Fried MP. Surgical anatomy of thyroid gland. Arch Otolaryngol Head Neck Surg ; Bisgaard T, Klarskov B, Kehlet H, et al. Preoperative dexamethasone improves surgical outcome after laparoscopic cholecystectomy: a randomized double- blind placebo-controlled trial. Ann Surg. ; Cavicchi O, Caliceti U, Fernandez IJ, et al. Laryngeal neuromonitoring and neurostimulation versus neurostimulation alone in thyroid surgery: a randomized clinical trial. Head Neck. ; - Cavo JW. True vocal cord paralysis following intubation. Laryngoscope ;&nbsp; Clark OH, Levin KE, Zeng QH, Greenspan FS, Siperstein A. Thyroid cancer: the case for total thyroidectomy. Eur. J. Cancer Clin. Oncol. ; : Cohen MM, Duncan PG, DeBoer DP, et al. The postoperative interview:assessing risk factors for nausea and vomiting. AnesthAnalg. ; &ndash; . Cohen SM, Kim J, Roy N, Asche C, Courey M. Prevalence and causes of dysphonia in a large treatment-seeking population. Laryngoscope. Detsky AS. Sources of bias for authors of clinical practice guidelines. CMAJ. Dong CC, Macdonald DB, Akagami R, et al. Intraoperative facial motor evoked potential monitoring with transcranial electrical stimulation during skull base surgery. Clinical Neurophysiol. Dralle H, Sekulla C, Lorenz K, Brauckhoff M, Machens A. Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery. World J Surg. Eadie TL, Kapsner M, Rosenzweig J, Waugh P, Hillel A, Merati A. The role of experience on judgments of dysphonia. J Voice. ; ( ): - . 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Neurosci Lett. Gardiner KR, Russell CFJ. Thyroidectomy for thyroid malignancy. JR. Coll. Surg. Edinb. ; Golembiewski J, Chernin E, Chopra T. Prevention and treatment of postoperative nausea and vomiting. Am J Health Syst Pharm. ; &ndash; . &nbsp;Grant CS, Hay ID, Gough IR, Bergstralh EJ, Goellner JR, McConahey WM. Local recurrence inpapillary thyroid carcinoma: is extent of surgical resection important? Surgery. Grundfast KM, Harley E. Vocal cord paralysis. OtolaryngolClin North Am. Gurlekian JA, Franco HE, RodriguezL, et al. Sistemadeedici&oacute;n y an&aacute;lisis de habla para computador as personales. Informe LIS No. XXV, , . &nbsp;Halsted WS. The operative story of goitre the author&lsquo;s operation. Johns Hopkins Hosp. Rep. ; . Hartl DM, Travagli JP, Leboulleux S, Baudin E, Brasnu DF, Schlumberger M. Clinical review: current concepts in the management of unilateral recurrent laryngeal nerve paralysis after thyroid surgery. J ClinEndocrinolMetab. 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Jatzko Gr, Lisborg PH, Muller MG, Wette VM. recurrent nerve palsy after thyroid operations--principal nerve identification and a literature review. Surgery. Jeannon JP, Orabi AA, Bruch GA, Abdalsalam HA, Simo R. Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review. int J ClinPract ; : - . Johnson S, Goldenberg D. Intraoperative monitoring of the recurrent laryngeal nerve during revision thyroid surgery. Oto-laryngolClin North Am. Swapna Gurrapu and Estari Mamidala. In vitro HIV-Reverse Transcriptase Inhibition of Andrographolide Isolatedfrom Andrographis Paniculata. European Journal of Biomedical and Pharmaceutical Sciences. 2017. Volume 4, Issue 12. 516-522. Jung A, Schramm J. How to reduce recurrent laryngeal nerve palsy in anterior cervical spine surgery: a prospective observational study. Neurosurgery; . Kambic V, Radsel Z. intubation lesions of the larynx. Br J Anaesth ; : - . Kang YK, Park YH, Ryoo BY, Bang YJ, Cho KS, Shin DB, et al. Ramosetron for the prevention of cisplatin-induced acute emesis: a prospective randomized comparison with granisetron. J Int Med Res. ; &ndash; . Kierner AC, Aigner M, Burian M. The external branch of the superior laryngeal nerve: its topographicalanatomy as related to surgery of the neck. Arch Otolaryngol Head Neck Surg. ; ( ): - . Kikura M, Suzuki K, itagaki T, Takada T, Sato S. Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. Br J Anaesth ; Kolawole IK, Ishaq MS. Post-anaesthetic respiratory complaints following endotracheal anaesthesia in lower abdominal obstetric and gynaecology surgery. Niger J ClinPract ; : Kovac AL. Prevention and treatment of postoperative nausea and vomiting. Drugs. Kranke P, Apfel CC, Roewer N, et al. Reported data on granisetron and postoperative nausea and vomiting by Fujii et al. Are incredibly nice! AnesthAnalg.&nbsp; Lamade W, renz K, Willeke F, Klar E, Herfarth C. Effect of training on the incidence of nerve damage in thyroid surgery. Br J Surg ; : Lee HJ, Kwon JY, Shin SW, Kim CH, Baek SH, Baik SW, et al. Preoperatively administered ramosetron oral disintegrating tablets for preventing nausea and vomiting associated with patient-controlled analgesia in breast cancer patients. Eur J Anaesthesiol. Lee Y, Lin PC, Lai HY, Huang SJ, Lin YS, Cheng CR. Prevention of PONV with dexamethasone in female patients undergoing desflurane anesthesia for thyroidectomy. ActaAnaesthesiol Sin;. Liu Q, Djuricin G, Prinz RA. Total thyroidectomy for benign thyroid disease. Surgery ; . Lombardi CP, raffaelli M, D&rsquo;Alatri L, et al. Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery ;. Lombardi CP, Raffaelli M, De Crea C, D&rsquo;Alatri L, Maccora D, Marchese MR, et al. surgical techniques of thyroid gland Surgery ; - Lu YH, Hsieh MW, Tong YH. Unilateral vocal cord paralysis following endotracheal intubation--a case report. ActaAnaesthesiol Sin ; : - Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. ActaAnaesthesiol Scand. ; ( ): - . Mattioli F, Bergamini G, Alicandri-Ciufelli M, et al. The role of early voice therapy in the incidence of motility recovery in unilateral vocal fold paralysis. LogopedPhoniatrVocol. ; . McIvor NP, Flint DJ, Gillibrand J, Morton RP. Thyroid surgery and voice-related outcomes. Aust N Z JSurg. ; (): - . Meek P, Carding PN, Howard DH, Lennard TW. Voice change following thyroid and parathyroid surgery.JVoice. ; ( ): - . Melish JS. Thyroid disease. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physicial and Laboratory Examinations. rd ed. Boston, MA: Butterworths; . Mencke T, Echternach M, Plinkert PK, et al. Does the timing of tracheal intubation based on neuromuscular monitoring decrease laryngeal injury? A randomized, prospective, controlled trial. AnesthAnalg. Moore KL, Persaud TVN. The developing human. Clinically oriented thembroyology, edition. Philadelphia: Saunders; , p. - . Morris MJ, Christopher KL. Difficult-to-treat asthma or vocal cord dysfunction? Am J RespirCrit Care Med: ; author reply . Mortensen M, Carroll L, Woo P. Arytenoid adduction with medialization laryngoplasty versus injection or medialization laryngoplasty: the role of the arytenoidopexy. Laryngoscope. Neri G, Castiello F, Vitullo F, DE Rosa M, Ciammetti G, Croce A. Post-thyroidectomy dysphonia in patients with bilateral resection of the superior laryngeal nerve: a comparative spectrographic study. Actaotorhinolaryngol Ital : Nishimaki T, Suzuki T, Suzuki S, Kuwabara S, Hatakeyama K. outcomes of extended radical esophagectomy for thoracic esophageal cancer. J Am CollSurg.

Study Design: Retrospective cohort study. Objective: Factors that predict outcomes for adult cervical spine deformity (ACSD) have not been well defined. To compare ACSD patients with best versus worst outcomes. Methods: This study was based on a prospective, multicenter observational ACSD cohort. Best versus worst outcomes were compared based on Neck Disability Index (NDI), Neck Pain Numeric Rating Scale (NP-NRS), and modified Japanese Orthopaedic Association (mJOA) scores. Results: Of 111 patients, 80 (72%) had minimum 1-year follow-up. For NDI, compared with best outcome patients (n = 28), worst outcome patients (n = 32) were more likely to have had a major complication ( P = .004) and to have undergone a posterior-only procedure ( P = .039), had greater Charlson Comorbidity Index ( P = .009), and had worse postoperative C7-S1 sagittal vertical axis (SVA; P = .027). For NP-NRS, compared with best outcome patients (n = 26), worst outcome patients (n = 18) were younger ( P = .045), had worse baseline NP-NRS ( P = .034), and were more likely to have had a minor complication ( P = .030). For the mJOA, compared with best outcome patients (n = 16), worst outcome patients (n = 18) were more likely to have had a major complication ( P = .007) and to have a better baseline mJOA ( P = .030). Multivariate models for NDI included posterior-only surgery ( P = .006), major complication ( P = .002), and postoperative C7-S1 SVA ( P = .012); models for NP-NRS included baseline NP-NRS ( P = .009), age ( P = .017), and posterior-only surgery ( P = .038); and models for mJOA included major complication ( P = .008). Conclusions: Factors distinguishing best and worst ACSD surgery outcomes included patient, surgical, and radiographic factors. These findings suggest areas that may warrant greater awareness to optimize patient counseling and outcomes.

ABSTRACTNew diagnostic platforms often use nasopharyngeal or oropharyngeal (NP/OP) swabs for pathogen detection for patients hospitalized with community-acquired pneumonia (CAP). We applied multipathogen testing to high-quality sputum specimens to determine if more pathogens can be identified relative to NP/OP swabs. Children (&lt;18 years old) and adults hospitalized with CAP were enrolled over 2.5 years through the Etiology of Pneumonia in the Community (EPIC) study. NP/OP specimens with matching high-quality sputum (defined as ≤10 epithelial cells/low-power field [lpf] and ≥25 white blood cells/lpf or a quality score [q-score] definition of 2+) were tested by TaqMan array card (TAC), a multipathogen real-time PCR detection platform. Among 236 patients with matched specimens, a higher proportion of sputum specimens had ≥1 pathogen detected compared with NP/OP specimens in children (93% versus 68%;P&lt; 0.0001) and adults (88% versus 61%;P&lt; 0.0001); for each pathogen targeted, crossing threshold (CT) values were earlier in sputum. Both bacterial (361 versus 294) and viral detections (245 versus 140) were more common in sputum versus NP/OP specimens, respectively, in both children and adults. When available, high-quality sputum may be useful for testing in hospitalized CAP patients.

703 Background: Pancreatic ductal adenocarcinoma (PDAC) is the third-leading cause of cancer death in the United States with a 5-year survival rate of 13%. Recurrence rates are high following resection and optimization of neoadjuvant and adjuvant therapy remains under investigation, with the hypothesis that neoadjuvant/perioperative therapy may convert borderline resectable tumors to resectable and prevent progression of micro-metastases in the postoperative setting. Our study evaluates patient outcomes and models predictive and prognostic markers to assist with clinical decision-making in consideration of neoadjuvant therapy for resectable and borderline resectable pancreatic cancers. Methods: We performed a single-institution retrospective analysis of patients who underwent pancreatic resection between January 1, 2016 and December 31, 2020 (n=532). We excluded patients with unresectable disease or a non-PDAC diagnosis. Analysis of the remaining patients (n=175) was performed using automated and manual chart review, basic statistical comparisons with T-tests or Chi-squared tests, Kaplan-Meier Survival analyses, and Cox Proportional Hazard Testing using intention to treat analysis. Results: There were no significant differences (p&gt;0.05) the presenting demographics between the adjuvant (AJ, n=97) and neoadjuvant/perioperative (NP, n=76) groups. Patients were more likely to have a history of pancreatitis, a risk factor for PDAC development, in the NP group (p=0.0153). Patients in the AJ group included patients who ultimately did not receive the recommended adjuvant therapy for various reasons (n=25) and had overall worse performance status (p=0.004) and received less chemotherapy overall compared to the NP cohort (p=0.0003). Adjuvant therapy was more likely to be gemcitabine with capecitabine (n=37, p=0.0007) in the AJ group and gemcitabine with nab-paclitaxel (n=11, p=0.0018) in the NP group. In the neoadjuvant setting, 62% of patients received FOLFIRINOX and 28% received gemcitabine with nab-paclitaxel. Patients in the NP group were more likely to receive radiation (p=0016), including 6 patients who received neoadjuvant radiation. Median overall survival (33.9 [28.8-43.8] versus 38.2 [28.2-47.8] months) and progression free survival (21.1 [18.1-34.2] versus 16.6 [11.7-23.6] months) were not significantly different between the AJ and NP groups, respectively. Conclusions: These results demonstrate similar presenting characteristics between patients with resectable PDAC treated in a period when general practice shifted from adjuvant therapy to a neoadjuvant/perioperative approach. Although patients treated neoadjuvantly received more chemotherapy overall and the chemotherapy regimens differed between the groups, patients had similar outcomes in the two groups.

Abstract Introduction Neuropathic pain (NP) is a poorly studied but common complaint of burn survivors and severely limits patients in regard to quality of life and function well after their burn injury. Currently, there is a paucity of data on the association between NP and its sequelae with burn survivors in the literature. As such, the purpose of this study is to better understand the incidence of NP and associated factors on a national scale using the Burn Model System (BMS) National Database. Methods The BMS National Database was queried to identify burn patients responding to the primary outcome measure: numbness, pins and needles or burning sensations in three locations – (see Table 1) at enrollment, six months, 12 months, two years, and five years. The data were analyzed to determine the percent of the population reporting NP. Further subgroup analyses examined demographic and clinical characteristics associated with NP. Statistical analysis included non-parametric tests, Chi-square or Fisher’s exact, and regression analysis. Results A total of 915 patients at discharge were included in analysis. At discharge, two-thirds of patients (66.5%, n=608) experienced NP, with over half still reporting NP at 5-year follow-up (Table 1). Patients with NP had significantly higher PROMIS-29 pain interference and itch scores at all time points after six months. NP patients had significantly higher anxiety, depression, and sleep disturbance PROMIS-29 scores and were significantly less able to participate in social roles at all follow-up points (Figure 1). Multiple logistic regression demonstrated male sex, %TBSA burn size, and moderate-to-severe pain on a zero to ten pain scale to be significant predictors of NP at 6-month follow-up (M sex: OR 1.9, p=0.042; %TBSA: OR 1.03, p=.009; moderate-to-severe pain: OR 5.4, p&amp;lt; 0.001). At 12-month follow-up, %TBSA burn size and moderate-to-severe pain were found to be significantly predictive of NP (%TBSA: OR: 1.03, p=.002; moderate-to-severe-pain: OR: 4.13, p=0.002). At 24-month follow-up, ethnicity, and employment status were significant predictors of NP (ethnicity: OR 3.1, p=0.033; employment status OR 3.0, p=0.016). Conclusions The present study highlights the significant prevalence of NP in burn patients and the detrimental impacts on their physical, psychological, and social outcomes. The findings emphasize the importance of certain risk factors in NP and their role in enabling providers to provide more pointed and critical intervention. Moreover, the study supports a collaborative and comprehensive approach to treatment that accounts for the multifactorial nature of NP. Applicability of Research to Practice The study emphasizes the importance of identifying specific risk factors to enable targeted interventions in clinical practice. A collaborative and comprehensive treatment approach that addresses both physical symptoms and psychosocial factors is crucial for improving long-term outcomes in burn patients with NP.

We investigate the problem of when it is possible to efficiently construct an instance of a given language in P or NP, based on partial information provided about the desired instance. We model this problem by specifying a prefix and a length for the string to be produced. Our results suggest that it may be harder to find efficient constructors for languages in NP if more information is provided about the desired element (assuming that P is not equal to NP). Specifically, for large enough prefix functions, polynomial-time prefix-based constructors cannot exist for all languages in NP unless P=NP. For smaller prefix functions, the existence of such constructors cannot be determined using techniques that relativize, under the assumption that P≠NP. We also show through relativizations and other results, what appears to be a pattern of increasing difficulty for efficient construction as the prefix function increases within this range. For languages in P, however, the difficulty of construction first increases and then appears to decrease as the size of the prefix is increased. We also relate prefix-based construction to that based on more general parameter functions for the strings. In addition, we examine the related ranking problem in the same context, and prove some results about the existence of prefix-based rankers for languages in P and NP.

Background: Incorporation of point-of-care ultrasound (POCUS) in undergraduate medical education (UME) is expanding; however, its effective implementation is impeded by a lack of trained faculty. Recruitment of near-peer (NP) instructors is a potential solution, but there are concerns surrounding NP teaching effectiveness compared to faculty instruction. While some institutions have assessed supplemental NP instruction, or NP-taught sessions with strict faculty supervision, few if any have compared effectiveness of NP POCUS instruction alone to faculty instruction through a multi-dimensional assessment. The aim of this study was to compare the effectiveness of near-peer (NP) instruction to faculty instruction at an undergraduate medical education clinical POCUS session for third-year medical students. Methods: This was a randomized controlled trial where third-year medical students were assigned to one of two groups for a 90-minute POCUS session: NP instruction or faculty instruction. A pre- and post-session multiple-choice test and a post-session objective structured clinical examination (OSCE) were administered to assess conceptual and hands-on clinical POCUS knowledge gained. Students’ perceptions of the instructors and session were evaluated using a Likert scale. Results: Seventy-three students (66% of the class) participated; 36 taught by faculty and 37 by NP instructors. Both groups showed a significant score increase from pre-test to post-test (p =0.002); however, there was no significant difference between groups in post-test (p=0.27) nor OSCE scores (p=0.20). Student perceptions of instructor competency were not statistically significant. Conclusions: NP instructors were as effective at teaching clinical POCUS to third-year medical students as faculty instructors at our institution.

P systems with mitochondria enzymes layer computing is a recent version of P systems; it integrates a new feature inspired from the enzymes gate of a natural cell to the cell-like P systems. The model of a computational layer is well known as a problem of Non-Deterministic (NP-complete) in polynomial time. In this paper, we propose a P systems with enzymes to solve one of the most NP-hard problems, which is the determination of the maximal clique in a given undirected graph. In this context, the evolution strategy proposed is based on using objects under the control of enzymes placed on layers.

Problem to solve P=NP, using the coverage problem of a graph that is NP and convert it to P. In the mathematical discipline of graph theory, a vertex cover, simply a graph cover, is a set of vertices such that each edge of the graph is incident to at least one vertex of the set. The problem of finding the smallest vertex coverage in a graph is called the vertex coverage problem. In computational complexity theory, it has been shown that this is an NP-complete problem. An NPcomplete problem is that it is not known if it has a Polynomial solution. I have found an algorithm that proves that it is Polynomial.

Abstract. The physiologic and pathophysiologic importance of natriuretic peptides (NP) has been imperfectly defined. The diminished renal responses to exogenous atrial NP in heart failure have led to the perception that the endogenous NP system might be less effective and thus contribute to renal sodium retention in heart failure. This study tests the hypothesis that in experimental heart failure, the renal responses to an acute volume load are still dependent on the NP system. The specific antagonist HS-142-1 was used to block the effects of NP in a model of high-output heart failure induced by an aortocaval shunt. Plasma cGMP levels and renal cGMP excretion were significantly lower in shunted and sham-operated rats receiving HS-142-1, compared with vehicle-treated controls, indicating effective blockade of guanylate cyclase-coupled receptors. Baseline sodium excretion and urine flow rate were lower in HS-142-1-treated sham-operated rats (15.2 ± 1.1 μl/min versus 27.5 ± 3.1 μl/min with vehicle, P &lt; 0.001) and in HS-142-1-treated shunted rats (8.1 ± 1.3 μl/min versus 19.9 ± 2.3 μl/min with vehicle, P &lt; 0.001). After an acute volume load, the diuretic and natriuretic responses were attenuated by HS-142-1 in control and shunted rats. The renal responses were reduced by HS-142-1 to a significantly greater extent in shunted rats than in control rats. HS-142-1 did not induce any significant systemic hemodynamic changes in either group, nor did it alter renal blood flow. However, the GFR in HS-142-1-treated shunted rats was lower than that in vehicle-treated shunted rats, both at baseline (0.6 ± 0.3 ml/min versus 2.1 ± 0.4 ml/min with vehicle, P &lt; 0.05) and after an acute volume load (1.2 ± 0.4 ml/min versus 2.6 ± 0.4 ml/min with vehicle, P = 0.01), whereas no such effect was observed in control rats. These data indicate that the maintenance of basal renal function and the responses to acute volume loading are dependent on the NP system. The NP seem to be of particular importance for the maintenance of GFR in this model of experimental heart failure. These observations provide new insights into the importance of the renal NP system in heart failure.

In 2011, Horváth gave a new proof that the equation solvability problem over finite nilpotent groups and rings is in P. In the same paper, he asked whether his proof can be lifted to nilpotent algebras in general. We show that this is in fact possible for supernilpotent algebras with a Mal’cev term. However, we also describe a class of nilpotent, but not supernilpotent algebras with Mal’cev term that have co-NP-complete identity checking problems and NP-complete equation solvability problems. This proves that the answer to Horváth’s question is negative in general (assuming P[Formula: see text]NP).

The distributions of nitroprusside (NP) induced changes in vascular capacitance, arterial versus venous, are unknown. We measured canine ileal arterial and venous pressures and total (isolated loop) vascular volumes (scintigraphy), before and during NP infusion. NP sufficient to decrease perfusion pressure by 30% increased total vascular volume to 111 ± 3% (± SEM) of control (p &lt; 0.01). Increasing flow to restore perfusion pressure increased volume 4% more (p &lt; 0.01). Assuming a two-compartment model and on the basis of the literature data, changes in venous capacitance were estimated and compared with arterial capacitance. During constant-flow perfusion, NP increased venous volume by 10.0% (vs. 18.1%, arterial). When flow was increased to restore pressure, venous volume increased by another 3.7% (vs. 2.6%, arterial). Assuming an original arterial to venous volume ratio of 133/1033, the final, constant-pressure increase in venous volume was almost 4 times the arterial increase. In conclusion, the increase in vascular volume during NP infusion was due primarily to similar-magnitude, active increases in venous and arterial capacitances (i.e., rightward shifts in pressure-volume relations). However, as venous volume is so much larger than arterial, the NP-induced increase in venous volume was greater.Key words: blood volume distribution, pressure-volume relations, veins, arteries.

Aim. To investigate the impact of various wound dressings on wound bed neoangiogenesis in patients with different forms of diabetic foot syndrome (DFS). Subjects and methods. The clinical (local tissue oxygenation) and immunohistochemical (CD31) markers of foot soft tissue neoangiogenesis were evaluated in patients with DFS receiving negative pressure (NP) therapy and collagen-containing dressings (CCDs) versus standard treatment. 63 patients with neuropathic and neuroischemic (without critical ischemia) forms of DFS were examined after wound debridement. In the postoperative period, 21 patients received NP treatment, CCDs were applied to 21 patients, and 21 patients had standard treatment. Results. During NP therapy, there was statistically significantly intensified local microhemodynamics, as evidenced by transcutaneous oximetry (p &lt; 0.05); the remaining two groups showed no statistically significant differences in transcutaneous oxygen tension during the treatment. Immunohistochemical examination revealed a significant increase in the number of newly formed vessels, as shown by anti-CD31 antibody staining (p &lt; 0.05), in patients who had NP therapy and CCDs (p &lt; 0.05). Conclusion. Vacuum (NP) therapy versus standard therapy most effectively affects wound bed neoangiogenesis. This is reflected in the increased local tissue microhemodynamics, as confirmed by immunohistochemical examination.