Search results for: p-hub median problem

Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky

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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.

Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity

Procedia PDF Downloads 187

Authors: Halil Ibrahim Demir, Caner Erden, Abdullah Hulusi Kokcam, Mumtaz Ipek

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Process planning, scheduling, and due date assignment are three important manufacturing functions which are studied independently in literature. There are hundreds of works on IPPS and SWDDA problems but a few works on IPPSDDA problem. Integrating these three functions is very crucial due to the high relationship between them. Since the scheduling problem is in the NP-Hard problem class without any integration, an integrated problem is even harder to solve. This study focuses on the integration of these functions. Sum of weighted tardiness, earliness, and due date related costs are used as a penalty function. Random search and hybrid metaheuristics are used to solve the integrated problem. Marginal improvement in random search is very high in the early iterations and reduces enormously in later iterations. At that point directed search contribute to marginal improvement more than random search. In this study, random and genetic search methods are combined to find better solutions. Results show that overall performance becomes better as the integration level increases.

Keywords: process planning, genetic algorithm, hybrid search, random search, weighted due-date assignment, weighted scheduling

Procedia PDF Downloads 343

Authors: Maatoug Hassine, Mourad Hrizi

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In this paper, we consider a geometric inverse source problem for the heat equation with Dirichlet and Neumann boundary data. We will reconstruct the exact form of the unknown source term from additional boundary conditions. Our motivation is to detect the location, the size and the shape of source support. We present a one-shot algorithm based on the Kohn-Vogelius formulation and the topological gradient method. The geometric inverse source problem is formulated as a topology optimization one. A topological sensitivity analysis is derived from a source function. Then, we present a non-iterative numerical method for the geometric reconstruction of the source term with unknown support using a level curve of the topological gradient. Finally, we give several examples to show the viability of our presented method.

Keywords: geometric inverse source problem, heat equation, topological optimization, topological sensitivity, Kohn-Vogelius formulation

Procedia PDF Downloads 281

Authors: Muhammad Umair, Syed Qasim Gilani

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A technique using Independent Component Analysis (ICA) for blind receiver signal processing is investigated. The problem of the receiver signal processing is viewed as of signal equalization and implementation imperfections compensation. Based on this, a model similar to a general ICA problem is developed for the received signal. Then, the use of ICA technique for blind signal equalization in the time domain is presented. The equalization is regarded as a signal separation problem, since the desired signal is separated from interference terms. This problem is addressed in the paper by over-sampling of the received signal. By using ICA for equalization, besides channel equalization, other transmission imperfections such as Direct current (DC) bias offset, carrier phase and In phase Quadrature phase imbalance will also be corrected. Simulation results for a system using 16-Quadraure Amplitude Modulation(QAM) are presented to show the performance of the proposed scheme.

Keywords: blind equalization, blind signal separation, equalization, independent component analysis, transmission impairments, QAM receiver

Procedia PDF Downloads 192

Authors: Xiaofei Hu, Zhiyu Cai, Weian Yao

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V-notch problem under dynamic loading condition is considered in this paper. In the time domain, the precise time domain expanding algorithm is employed, in which a self-adaptive technique is carried out to improve computing accuracy. By expanding variables in each time interval, the recursive finite element formulas are derived. In the space domain, a Symplectic Analytical Singular Element (SASE) for V-notch problem is constructed addressing the stress singularity of the notch tip. Combining with the conventional finite elements, the proposed SASE can be used to solve the dynamic stress intensity factors (DSIFs) in a simple way. Numerical results show that the proposed SASE for V-notch problem subjected to dynamic loading condition is effective and efficient.

Keywords: V-notch, dynamic stress intensity factor, finite element method, precise time domain expanding algorithm

Procedia PDF Downloads 156

Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

Procedia PDF Downloads 132

Authors: Veronica Diaz Quezada

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In this article, the performance and errors are featured and analysed in the limit problems solving of a real-valued function, in correspondence to competency-based education in engineering careers, in the south of Chile. The methodological component is contextualised in a qualitative research, with a descriptive and explorative design, with elaboration, content validation and application of quantitative instruments, consisting of two parallel forms of open answer tests, based on limit application problems. The mathematical competences and errors made by students from five engineering careers from a public University are identified and characterized. Results show better performance only to solve routine-context problem-solving competence, thus they are oriented towards a rational solution or they use a suitable problem-solving method, achieving the correct solution. Regarding errors, most of them are related to techniques and the incorrect use of theorems and definitions of real-valued function limits of real variable.

Keywords: engineering education, errors, limits, mathematics competences, problem solving

Procedia PDF Downloads 125

Authors: Babak H. Tabrizi, Seyed Farid Ghaderi

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Concurrent planning of project scheduling and material ordering has been increasingly addressed within last decades as an approach to improve the project execution costs. Therefore, we have taken the problem into consideration in this paper, aiming to maximize schedules quality robustness, in addition to minimize the relevant costs. In this regard, a bi-objective mathematical model is developed to formulate the problem. Moreover, it is possible to utilize the all-unit discount for materials purchasing. The problem is then solved by the constraint method, and the Pareto front is obtained for a variety of robustness values. The applicability and efficiency of the proposed model is tested by different numerical instances, finally.

Keywords: e-constraint method, material ordering, project management, project scheduling

Procedia PDF Downloads 271

Authors: Boris Melnikov, Ye Zhang, Dmitrii Chaikovskii

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This study explores the pseudo-geometric version of the extensively researched Traveling Salesman Problem (TSP), proposing a novel generalization of existing algorithms which are traditionally confined to the geometric version. By adapting the "onion husk" method and introducing auxiliary algorithms, this research fills a notable gap in the existing literature. Through computational experiments using randomly generated data, several metrics were analyzed to validate the proposed approach's efficacy. Preliminary results align with expected outcomes, indicating a promising advancement in TSP solutions.

Keywords: optimization problems, traveling salesman problem, heuristic algorithms, “onion husk” algorithm, pseudo-geometric version

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Authors: Regita P. Permata, Ulfa S. Nuraini

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Traveling Salesman Problem (TSP) is the most studied problem in combinatorial optimization. In simple language, TSP can be described as a problem of finding a minimum distance tour to a city, starting and ending in the same city, and exactly visiting another city. In product distribution, companies often get problems in determining the minimum distance that affects the time allocation. In this research, we aim to apply TSP heuristic methods to simulate nodes as city coordinates in product distribution. The heuristics used are sub tour reversal, nearest neighbor, farthest insertion, cheapest insertion, nearest insertion, and arbitrary insertion. We have done simulation nodes using Euclidean distances to compare the number of cities and processing time, thus we get optimum heuristic method. The results show that the optimum heuristic methods are farthest insertion and nearest insertion. These two methods can be recommended to solve product distribution problems in certain companies.

Keywords: Euclidean, heuristics, simulation, TSP

Procedia PDF Downloads 108

Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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Authors: M. Bouinoun, M. Bouhadef

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The present study is concerned with the problem of determining the shape of the free surface flow in a hydraulic channel which has an uneven bottom. For the mathematical formulation of the problem, the fluid of the two-dimensional irrotational steady flow in water is assumed inviscid and incompressible. The solutions of the nonlinear problem are obtained by using the usual conformal mapping theory and Hilbert’s technique. An experimental study, for comparing the obtained results, has been conducted in a hydraulic channel (subcritical regime and supercritical regime).

Keywords: free-surface flow, experiments, numerical method, uneven bottom, supercritical regime, subcritical regime

Procedia PDF Downloads 361

Authors: Vesna Kirandziska, Nevena Ackovska, Ana Madevska Bogdanova

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The problem of emotion recognition is a challenging problem. It is still an open problem from the aspect of both intelligent systems and psychology. In this paper, both voice features and facial features are used for building an emotion recognition system. A Support Vector Machine classifiers are built by using raw data from video recordings. In this paper, the results obtained for the emotion recognition are given, and a discussion about the validity and the expressiveness of different emotions is presented. A comparison between the classifiers build from facial data only, voice data only and from the combination of both data is made here. The need for a better combination of the information from facial expression and voice data is argued.

Keywords: emotion recognition, facial recognition, signal processing, machine learning

Procedia PDF Downloads 297

Authors: H. Mashhady, H. A. Manzoori, M. Doosti, M. Fatollahi

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This study reports a descriptive research in the form of a genre analysis of postgraduates' theses and dissertations at three Iranian universities, including Ferdowsi, Tehran, and Tarbiat Moddares universities. The researchers sought to depict the generic structure of “statement of the problem” section of PhD dissertations and MA theses. Moreover, researchers desired to find any probable variety based on the year the dissertations belonged, to see weather genre-consciousness developed among Iranian postgraduates. To obtain data, “statement of the problem” section of 90 Ph.D. dissertations and MA theses from 2001 to 2013 in Teaching English as a Foreign Language (TEFL) at above-mentioned universities was selected. Frequency counts was employed for the quantitative method of data analysis, while genre analysis was used as the qualitative method. Inter-rater reliability was found to be about 0.93. Results revealed that students in different degrees at each of these universities used various generic structures for writing “statement of the problem”. Moreover, comparison of different time periods (2001-2006, and 2007-2013) revealed that postgraduates in the second time period, regardless of their degree and university, employed more similar generic structures which can be optimistically attributed to a general raise in genre awareness.

Keywords: genre, genre analysis, Ph.D. and MA dissertations, statement of the problem, generic structure

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Authors: Eylem Koç, Hasan Arda Burhan

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Location selection presents a crucial decision problem in today’s business world where strategic decision making processes have critical importance. Thus, location selection has strategic importance for companies in boosting their strength regarding competition, increasing corporate performances and efficiency in addition to lowering production and transportation costs. A right choice in location selection has a direct impact on companies’ commercial success. In this study, a store location selection problem of Carglass Turkey which operates in vehicle glass branch is handled. As this problem includes both tangible and intangible criteria, Analytic Network Process (ANP) was accepted as the main methodology. The model consists of control hierarchy and BOCR subnetworks which include clusters of actors, alternatives and criteria. In accordance with the management’s choices, five different locations were selected. In addition to the literature review, a strict cooperation with the actor group was ensured and maintained while determining the criteria and during whole process. Obtained results were presented to the management as a report and its feasibility was confirmed accordingly.

Keywords: analytic network process (ANP), BOCR, multi-actor decision making, multi-criteria decision making, real-life problem, location selection

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Authors: Mintu Philip, Renumol V. G.

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An introductory programming course is a major challenge faced in Computing Education. Many of the introductory programming courses fail because student concentrate mainly on writing programs using a programming language rather than involving in problem solving. Computational thinking is a general approach to solve problems. This paper proposes a new preliminary course that aims to develop computational thinking skills in students, which may help them to become good programmers. The proposed course is designed based on the four basic components of computational thinking - abstract thinking, logical thinking, modeling thinking and constructive thinking. In this course, students are engaged in hands-on problem solving activities using a new problem solving model proposed in this paper.

Keywords: computational thinking, computing education, abstraction, constructive thinking, modelling thinking

Procedia PDF Downloads 427

Authors: Teklay Gebrecherkos

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Background: Serological testing for SARS-CoV-2 plays an important role in epidemiological studies, in aiding the diagnosis of COVID-19 and assess vaccine responses. Little is known about the dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune assays (LFIAs) and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. Results: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in the positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increase in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly from 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibodies at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. Conclusions: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of serum assays before implementation. Factors associated with failure to seroconvert need further research.

Keywords: COVID-19, antibody, rapid diagnostic tests, ethiopia

Procedia PDF Downloads 58

Authors: A. Guezane-Lakoud, S. Bensebaa

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In this paper, we study a boundary value problem of nonlinear fractional differential equation. Existence and positivity results of solutions are obtained.

Keywords: positive solution, fractional caputo derivative, Banach contraction principle, Avery and Peterson fixed point theorem

Procedia PDF Downloads 391

Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos

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Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.

Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder

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Authors: Aquil Ahmed, Srikant Gupta, Irfan Ali

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In this paper, we study a multi-objective capacitated transportation problem (MOCTP) with mixed constraints. This paper is comprised of the modelling and optimisation of an MOCTP in a fuzzy environment in which some goals are fractional and some are linear. In real life application of the fuzzy goal programming (FGP) problem with multiple objectives, it is difficult for the decision maker(s) to determine the goal value of each objective precisely as the goal values are imprecise or uncertain. Also, we developed the concept of linearization of fractional goal for solving the MOCTP. In this paper, imprecision of the parameter is handled by the concept of fuzzy set theory by considering these parameters as a trapezoidal fuzzy number. α-cut approach is used to get the crisp value of the parameters. Numerical examples are used to illustrate the method for solving MOCTP.

Keywords: capacitated transportation problem, multi objective linear programming, multi-objective fractional programming, fuzzy goal programming, fuzzy sets, trapezoidal fuzzy number

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Authors: T. Toathom, M. Munlin, P. Sugunnasil

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The traveling salesman problem (TSP) is one of the best-known problems in optimization problem. There are many research regarding the TSP. One of the most usage tool for this problem is the genetic algorithm (GA). The chromosome of the GA for TSP is normally encoded by the order of the visited city. However, the traditional chromosome encoding scheme has some limitations which are twofold: the large solution space and the inability to encapsulate some information. The number of solution for a certain problem is exponentially grow by the number of city. Moreover, the traditional chromosome encoding scheme fails to recognize the misplaced correct relation. It implies that the tradition method focuses only on exact solution. In this work, we relax some of the concept in the GA for TSP which is the exactness of the solution. The proposed work exploits the relation between cities in order to reduce the solution space in the chromosome encoding. In this paper, a second order GA is proposed to solve the TSP. The term second order refers to how the solution is encoded into chromosome. The chromosome is divided into 2 types: the high order chromosome and the low order chromosome. The high order chromosome is the chromosome that focus on the relation between cities such as the city A should be visited before city B. On the other hand, the low order chromosome is a type of chromosome that is derived from a high order chromosome. In other word, low order chromosome is encoded by the traditional chromosome encoding scheme. The genetic operation, mutation and crossover, will be performed on the high order chromosome. Then, the high order chromosome will be mapped to a group of low order chromosomes whose characteristics are satisfied with the high order chromosome. From the mapped set of chromosomes, the champion chromosome will be selected based on the fitness value which will be later used as a representative for the high order chromosome. The experiment is performed on the city data from TSPLIB.

Keywords: genetic algorithm, traveling salesman problem, initial population, chromosomes encoding

Procedia PDF Downloads 250

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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Authors: Shao-Yuan Huang

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We study the shape of the bifurcation curve of positive solutions for the semipositone problem with the Minkowski-curvature operator. The Minkowski-curvature problem plays an important role in certain fundamental issues in differential geometry and in the special theory of relativity. In addition, it is well known that studying the multiplicity of positive solutions is equivalent to studying the shape of the bifurcation curve. By the shape of the bifurcation curve, we can understand the change in the multiplicity of positive solutions with varying parameters. In this paper, our main technique is a time-map method used in Corsato's PhD Thesis. By this method, studying the shape of the bifurcation curve is equivalent to studying the shape of a certain function T with improper integral. Generally speaking, it is difficult to study the shape of T. So, in this paper, we consider two cases that the nonlinearity is convex or concave. Thus we obtain the following results: (i) If f''(u) < 0 for u > 0, then the bifurcation curve is C-shaped. (ii) If f''(u) > 0 for u > 0, then there exists η>β such that the bifurcation curve does not exist for 0 η. Furthermore, we prove that the bifurcation is C-shaped for L > η under a certain condition.

Keywords: bifurcation curve, Minkowski-curvature problem, positive solution, time-map method

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Authors: Kemal Polat

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In this study, it has been estimated whether there is skin by using RBG values obtained from the camera and k-nearest neighbor (k-NN) classifier. The dataset used in this study has an unbalanced distribution and a linearly non-separable structure. This problem can also be called a big data problem. The Skin dataset was taken from UCI machine learning repository. As the classifier, we have used the k-NN method to handle this big data problem. For k value of k-NN classifier, we have used as 1. To train and test the k-NN classifier, 50-50% training-testing partition has been used. As the performance metrics, TP rate, FP Rate, Precision, recall, f-measure and AUC values have been used to evaluate the performance of k-NN classifier. These obtained results are as follows: 0.999, 0.001, 0.999, 0.999, 0.999, and 1,00. As can be seen from the obtained results, this proposed method could be used to predict whether the image is skin or not.

Keywords: k-NN classifier, skin or non-skin classification, RGB values, classification

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Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

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Authors: Boumesbah Asma, Chergui Mohamed El-amine

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Since it has been shown that the multi-objective minimum spanning tree problem (MOST) is NP-hard even with two criteria, we propose in this study a hybrid NSGA-II algorithm with an exact mutation operator, which is only used with low probability, to find an approximation to the Pareto front of the problem. In a connected graph G, a spanning tree T of G being a connected and cycle-free graph, if k edges of G\T are added to T, we obtain a partial graph H of G inducing a reduced size multi-objective spanning tree problem compared to the initial one. With a weak probability for the mutation operator, an exact method for solving the reduced MOST problem considering the graph H is then used to give birth to several mutated solutions from a spanning tree T. Then, the selection operator of NSGA-II is activated to obtain the Pareto front approximation. Finally, an adaptation of the VNS metaheuristic is called for further improvements on this front. It allows finding good individuals to counterbalance the diversification and the intensification during the optimization search process. Experimental comparison studies with an exact method show promising results and indicate that the proposed algorithm is efficient.

Keywords: minimum spanning tree, multiple objective linear optimization, combinatorial optimization, non-sorting genetic algorithm, variable neighborhood search

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Authors: Xiaoman Dong

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The refugee problem has a long history, but the scale and severity of modern refugee crises demand us to consider if the progress of political history exacerbates the refugee problem. This paper argues that although sovereignty owes its legitimacy to the protection of human rights, the modern state system complicates the refugee problem by first introducing then blurring the line between human rights and civil rights, and making national identity indispensable to basic livelihood and dignity. This paper first explains the source of the modern state system’s legitimacy by putting it in the context of social contract theories and the politics of nation-building. It then discusses how states create the concept of statelessness, which leads to more violations on human rights. Using historical records of the League of Nations High Commission for Refugees and the United Nations High Commissioner for Refugees, this paper reveals that neither the refugee problem of the Cold-War period nor the current refugee crisis is collateral damage of war, but rather the consequence of intentional exclusionary policies produced out of political interests. Finally, it contends that if the modern state system is to sustain, it cannot prioritize the protection of civil rights of a particular group over the protection of basic human rights of all.

Keywords: burden sharing, human rights, legitimacy of state, positive externality, sovereignty

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Authors: Arun Joshi

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The present study deals with the report of Gangamopteriscyclopteroides from the Barakar Formation of Simlong Open Cast Mine, Rajmahal Area, Rajmahal Basin, Jharkhand, India. The genus Gangamopteriscomprises leaves which are simple, entire, symmetrical or asymmetrical, linear, lanceolate, elliptical, obovate in shape, apex broadly rounded, obtuse, acute, acuminate or mucronate, base petiolate or contracted, midrib absent. Median region occupied by subparallel veins with anastomoses of elongate or hexagonal outline. Secondary veins arise from median veins by repeated dichotomy, arched, bifurcating and anasotomosing network. The present work is significant as it represents the presence of Glossopteris flora (250- 290 ma) which is mainly responsible for the formation of coal. Coal is one of the major fuels for power production through thermal power plants. The Glossopteris flora is one of the major floras that occupied the southern continent during Carboniferous- Permian time. This southern continent is also known as Gondwana comprising Australia, South Africa, Antarctica, Madagascar and India. There is a vast geological reserve of coal with favorable stripping ratio available at the Simlong Block but the area comes under the most naxalite prone area and thus the mine has been running in an unplanned manner. It has got the potential of becoming a big project with higher capacity and is well suited for enhancing production which can be helpful in the economic growth of the country. Though, the present record is scanty, it shows the presence of Glossopteris flora responsible for the formation of coal in the Coalmine. However, there are fears of fossils disappearing from this area as the state government of Jharkhand has given out a mining lease in the area to private companies. Therefore, it is very necessary to study such coal forming vegetation and their systematic study from the area to generate a new palaeobotanical database, palaeoenvironmental interpretation, basinal correlation and for the understanding of evolutionary perspectives.

Keywords: Barakar formation, coal, Glossopteris flora, Gondwana, India, Naxalite, Rajmahal Basin

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Authors: Sanja Jovanovic, Aleksandar Simic, Ognjan Skrobic, Dragan Masulovic, Aleksandra Djuric-Stefanovic

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Introduction: Achalasia is an idiopathic primary esophageal motility disorder characterized by esophageal peristalsis and impaired swallow-induced relaxation of the lower esophageal sphincter (LES). It is a rare disease that affects both genders with an incidence of 1/100.000 and a prevalence rate of 10/100,000 per year. Objective: Laparoscopic Heller myotomy (LHM) represents a therapy of choice for patients with achalasia, providing excellent outcomes. The aim of this study was to evaluate the significance of computed tomography (CT) in analyzing achalasia subtypes and timed barium esophagogram (TBE) in evaluation of LHM success, as a part of standardized diagnostic protocol. Method: Fifty-one patients with achalasia, confirmed by manometric studies, in addition to standardized diagnostic methods, underwent CT and TBE. CT was done with multiplanar reconstruction, measuring the wall thickness above the esophago-gastric junction in the axial plane. TBE was performed preoperatively and two days postoperatively swallowing low-density barium sulfate, and plane upright frontal films were performed 1, 2 and 5 minutes after the ingestion. In all patients, LHM was done, and pre and postoperative height and weight of the barium column were compared. Results: According to CT findings we divided patients into 3 subtypes of achalasia according to wall thickness: < 4mm as subtype one, between 4 - 9mm as II, and > 10 mm as subtype 3. Correlation of manometric results, as a reference values, and CT findings indicated CT sensitivity of 90% and specificity of 70 % in establishing subtypes of achalasia. The preoperative values of TBE at 1, 2 and 5 minutes were: median barium column height 17.4 ± 7.4, 15.9 ± 6.2 and 13.9 ± 6.2 cm; median column width 5 ± 1.5, 4.7 ± 1.6 and 4.5 ± 1.8 cm respectively. LHM significantly reduced these values (height 7 ± 4.6, 5.8 ± 4.2, 3.7 ± 3.4 cm; width 2.9 ± 1.3, 2.6 ± 1.3 and 2.4 ± 1.4 cm), indicating the quantitative estimates of emptying as excellent (p value < 0.01). Conclusion: CT has high sensitivity and specificity in evaluation of achalasia subtypes, and can be introduced as an additional method for standardized evaluation of these patients. The quantitative assessment of TBE based on measurements of the barium column is an accurate and beneficial method, which adequately estimates esophageal emptying success of LHM.

Keywords: achalasia, computed tomography, esophagography, myotomy

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Authors: Arun Kumar, Neelesh Haulder

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This paper identifies and resolves some key issues relating to a specific aspect within the supply chain logistics of the public health care industry in the Republic of Mauritius. The analysis and the proposed solution are performed using soft systems methodology (SSM). Through the application of this relevant systematic approach at problem solving, the aim is to obtain an in-depth analysis of the problem, incorporating every possible world view of the problem and consequently to obtain a well explored solution aimed at implementing relevant changes within the current supply chain logistics of the health care industry, with the purpose of tackling the key identified issues.

Keywords: soft systems methodology, CATWOE, healthcare, logistics

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