Search results for: early stage of design

Authors: Zohreh Rostami, Arezoo Khosravi, Mohammad Nikpoor Aghdam, Mahmood Salesi

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Background: Cardiovascular mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients have a strong relationship with baseline or progressive left ventricular hypertrophy (LVH) meanwhile in hemodialysis patients 10% decrement in left ventricular mass was associated with 28% reduction in cardiovascular mortality risk. In consonance with these arguments, we designed a study to measure morphological and functional echocardiographic variations early after transplantation. Method: The patients with normal renal function underwent two advanced echocardiographic studies to examine the structural and functional changes in left ventricular mass before and 3-month after transplantation. Results: From a total of 23 participants 21(91.3%) presented with left ventricular hypertrophy, 60.9% in eccentric and 30.4% in concentric group. Diastolic dysfunction improved in concentric group after transplantation. Both in pre and post transplantation global longitudinal strain (GLS)- average in eccentric group was more than concentric (-17.45 ± 2.75 vs -14.3 ± 3.38 p=0.03) and (-18.08 ± 2.6 vs -16.1 ± 2.7 p= 0.04) respectively. Conclusion: Improvement and recovery of left ventricular function in concentric group was better and sooner than eccentric after kidney transplantation. Although fractional shortening and diastolic function and GLS-4C in pre-transplantation in concentric group was worse than eccentric, but therapeutic response to kidney transplantation in concentric was more and earlier than eccentric group.

Keywords: chronic kidney disease, end stage renal disease, left ventricular hypertrophy, global longitudinal strain

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Authors: Ki Ok Choi, Sung Ho Hong, Dong Suck Kim, Don Mook Choi

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Rack type warehouses are different from general buildings in the kinds, amount, and arrangement of stored goods, so the fire risk of rack type warehouses is different from those buildings. The fire pattern of rack type warehouses is different in combustion characteristic and storing condition of stored goods. The initial fire burning rate is different in the surface condition of materials, but the running time of fire is closely related with the kinds of stored materials and stored conditions. The stored goods of the warehouse are consisted of diverse combustibles, combustible liquid, and so on. Fire detection time may be delayed because the residents are less than office and commercial buildings. If fire detectors installed in rack type warehouses are inadaptable, the fire of the warehouse may be the great fire because of delaying of fire detection. In this paper, we studied what kinds of fire detectors are optimized in early detecting of rack type warehouse fire by real-scale fire tests. The fire detectors used in the tests are rate of rise type, fixed type, photo electric type, and aspirating type detectors. We considered optimum fire detecting method in rack type warehouses suggested by the response characteristic and comparative analysis of the fire detectors.

Keywords: fire detector, rack, response characteristic, warehouse

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Authors: Kareem Saber

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Many products’ design instructors search for how to help students to develop their designs simply by reducing design stages and extrapolating simple design process forms to achieve design creativity. So, the researcher extrapolated a new design process form called “hierarchical design” which reduced design process into three stages and he had tried that methodology on about two hundred students. That trial had led to great results as students could develop their designs which characterized by creativity and innovation. That proved the success and effectiveness of the proposed methodology.

Keywords: mind mapping, morphological analysis, product design, design process

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Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.

Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease

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Authors: Md. Abu Sufian, Robiqul Islam, Imam Hossain Shajid, Mahesh Hanumanthu, Jarasree Varadarajan, Md. Sipon Miah, Mingbo Niu

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Coronary Heart Disease (CHD) remains a principal cause of global morbidity and mortality, characterized by atherosclerosis—the build-up of fatty deposits inside the arteries. The study introduces an innovative methodology that leverages cloud-based platforms like AWS Live Streaming and Artificial Intelligence (AI) to early detect and prevent CHD symptoms in web applications. By employing novel simulation processes and AI algorithms, this research aims to significantly mitigate the health and societal impacts of CHD. Methodology: This study introduces a novel simulation process alongside a multi-phased model development strategy. Initially, health-related data, including heart rate variability, blood pressure, lipid profiles, and ECG readings, were collected through user interactions with web-based applications as well as API Integration. The novel simulation process involved creating synthetic datasets that mimic early-stage CHD symptoms, allowing for the refinement and training of AI algorithms under controlled conditions without compromising patient privacy. AWS Live Streaming was utilized to capture real-time health data, which was then processed and analysed using advanced AI techniques. The novel aspect of our methodology lies in the simulation of CHD symptom progression, which provides a dynamic training environment for our AI models enhancing their predictive accuracy and robustness. Model Development: it developed a machine learning model trained on both real and simulated datasets. Incorporating a variety of algorithms including neural networks and ensemble learning model to identify early signs of CHD. The model's continuous learning mechanism allows it to evolve adapting to new data inputs and improving its predictive performance over time. Results and Findings: The deployment of our model yielded promising results. In the validation phase, it achieved an accuracy of 92% in predicting early CHD symptoms surpassing existing models. The precision and recall metrics stood at 89% and 91% respectively, indicating a high level of reliability in identifying at-risk individuals. These results underscore the effectiveness of combining live data streaming with AI in the early detection of CHD. Societal Implications: The implementation of cloud-based AI for CHD symptom detection represents a significant step forward in preventive healthcare. By facilitating early intervention, this approach has the potential to reduce the incidence of CHD-related complications, decrease healthcare costs, and improve patient outcomes. Moreover, the accessibility and scalability of cloud-based solutions democratize advanced health monitoring, making it available to a broader population. This study illustrates the transformative potential of integrating technology and healthcare, setting a new standard for the early detection and management of chronic diseases.

Keywords: coronary heart disease, cloud-based ai, machine learning, novel simulation techniques, early detection, preventive healthcare

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Authors: M. Pramila Devi, N. V. N. Indra Kiran

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Control charts, predominantly in the form of X-bar chart, are important tools in statistical process control (SPC). They are useful in determining whether a process is behaving as intended or there are some unnatural causes of variation. A process is out of control if a point falls outside the control limits or a series of point’s exhibit an unnatural pattern. In this paper, a study is carried out on four training algorithms for CCPs recognition. For those algorithms optimal structure is identified and then they are studied for type I and type II errors for generalization without early stopping and with early stopping and the best one is proposed.

Keywords: control chart pattern recognition, neural network, backpropagation, generalization, early stopping

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Authors: Dina C. Castro, Rossana Boyd, Eugenia Papadaki

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Immigration within and across continents is currently a global reality. The number of people leaving their communities in search for a better life for them and their families has increased dramatically during the last twenty years. Therefore, young children of the 21st century around the World are growing up in diverse communities, exposed to many languages and cultures. One consequence of these migration movements is the increased linguistic diversity in school settings. Depending on the linguistic history and the status of languages in the communities (i.e., minority-majority; majority-majority) the instructional approaches will differ. This session will discuss how bilingualism is addressed in early education programs in both minority-majority and majority-majority language communities, analyzing experiences in three countries with very distinct societal and demographic characteristics: Peru (South America), the United States (North America), and Italy (European Union). The ultimate goal is to identify commonalities and differences across the three experiences that could lead to a discussion of bilingualism in early education from a global perspective. From Peru, we will discuss current national language and educational policies that have lead to the design and implementation of bilingual and intercultural education for children in indigenous communities. We will also discuss how those practices are being implemented in preschool programs, the progress made and challenges encountered. From the United States, we will discuss the early education of Spanish-English bilingual preschoolers, including the national policy environment, as well as variations in language of instruction approaches currently being used with these children. From Italy, we will describe early education practices in the Bilingual School of Monza, in northern Italy, a school that has 20 years promoting bilingualism and multilingualism in education. While the presentations from Peru and the United States will discuss bilingualism in a majority-minority language environment, this presentation will lead to a discussion on the opportunities and challenges of promoting bilingualism in a majority-majority language environment. It is evident that innovative models and policies are necessary to prevent inequality of opportunities for bilingual children beginning in their earliest years. The cross-cultural examination of bilingual education experiences for young children in three part of the World will allow us to learn from our success and challenges. The session will end with a discussion of the following question: To what extent are early care and education programs being effective in promoting positive development and learning among all children, including those from diverse language, ethnic and cultural backgrounds? We expect to identify, with participants to our session, a set of recommendations for policy and program development that could ensure access to high quality early education for all bilingual children.

Keywords: early education for bilingual children, global perspectives in early education, cross-cultural, language policies

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Authors: Helen L. Hein, Joachim Schwarte

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As a pillar of sustainable development, ecology has become an important milestone in research community, especially due to global challenges like climate change. The ecological performance of products can be scientifically conducted with life cycle assessments. In the construction sector, significant amounts of CO₂ emissions are assigned to the energy used for building heating purposes. Therefore, sustainable construction materials for insulating purposes are substantial, whereby aerogels have been explored intensively in the last years due to their low thermal conductivity. Therefore, the WALL-ACE project aims to develop an aerogel-based thermal insulating plaster that would achieve minor thermal conductivities. But as in the early stage of development phases, a lot of information is still missing or not yet accessible, the ecological performance of innovative products bases increasingly on uncertain data that can lead to significant deviations in the results. To be able to predict realistically how meaningful the results are and how viable the developed products may be with regard to their corresponding respective market, these deviations however have to be considered. Therefore, a classification method is presented in this study, which may allow comparing the ecological performance of modern products with already established and competitive materials. In order to achieve this, an alternative calculation method was used that allows computing with lower and upper bounds to consider all possible values without precise data. The life cycle analysis of the considered products was conducted with an interval arithmetic based calculation method. The results lead to the conclusion that the interval solutions describing the possible environmental impacts are so wide that the result usability is limited. Nevertheless, a further optimization in reducing environmental impacts of aerogels seems to be needed to become more competitive in the future.

Keywords: aerogel-based, insulating material, early development phase, interval arithmetic

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Authors: Zhiyong Zheng, Xu Li, Liang Huang, Zhengliang Sun, Jianhua Xu

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Yaw angle plays a significant role in many vehicle safety applications, such as collision avoidance and lane-keeping system. Although the estimation of the yaw angle has been extensively studied in existing literature, it is still the main challenge to simultaneously achieve a reliable and cost-effective solution in complex urban environments. This paper proposes a multi-stage learning framework to estimate the yaw angle with a monocular camera, which can deal with the challenge in a more reliable manner. In the first stage, an efficient road detection network is designed to extract the road region, providing a highly reliable reference for the estimation. In the second stage, a variational auto-encoder (VAE) is proposed to learn the distribution patterns of road regions, which is particularly suitable for modeling the changing patterns of yaw angle under different driving maneuvers, and it can inherently enhance the generalization ability. In the last stage, a gated recurrent unit (GRU) network is used to capture the temporal correlations of the learned patterns, which is capable to further improve the estimation accuracy due to the fact that the changes of deflection angle are relatively easier to recognize among continuous frames. Afterward, the yaw angle can be obtained by combining the estimated deflection angle and the road direction stored in a roadway map. Through effective multi-stage learning, the proposed framework presents high reliability while it maintains better accuracy. Road-test experiments with different driving maneuvers were performed in complex urban environments, and the results validate the effectiveness of the proposed framework.

Keywords: gated recurrent unit, multi-stage learning, reliable estimation, variational auto-encoder, yaw angle

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Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

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The double burden of nutrition problem must be faced by Indonesia as developing country. The implemented program did not improve the nutritional status, therefore need to consider to utilize local potential. The objective of this research was to find out the effectivity of magnification model of early detect through local potential utilization in urban region, Semarang, Central Java, Indonesia. The research used an experimental design with the quantitative-qualitative approach. The population was all toddlers under five within the research region, sample determination by purposive sampling, as many as 216 toddlers. Quantitative data analysis used effectively criteria by Sugiono. Qualitative data was analyzed using NVivo. The optimization of local potential in the effort of nutrition status improvement shows number of nutrition case found was increased 225% (very effective), number of cases treated was increased 175% (very effective), number of cases counselled was increased 200% (effective), and number of cases that have improvement increase 75% (effective). The local potential need to be utilized in the effort of nutrition program improvement one of it is through the community empowerment, particularly health care and health high education institution as partner.

Keywords: early detection, nutrition status, local potential, health cadre

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Authors: S. Neelima, P. S. Subramanyam

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A distribution system is an interface between the bulk power system and the consumers. Among these systems, radial distributions system is popular because of low cost and simple design. In distribution systems, the voltages at buses reduces when moved away from the substation, also the losses are high. The reason for a decrease in voltage and high losses is the insufficient amount of reactive power, which can be provided by the shunt capacitors. But the placement of the capacitor with an appropriate size is always a challenge. Thus, the optimal capacitor placement problem is to determine the location and size of capacitors to be placed in distribution networks in an efficient way to reduce the power losses and improve the voltage profile of the system. For this purpose, in this paper, two stage methodologies are used. In the first stage, the load flow of pre-compensated distribution system is carried out using ‘dimension reducing distribution load flow algorithm (DRDLFA)’. On the basis of this load flow the potential locations of compensation are computed. In the second stage, Genetic Algorithm (GA) technique is used to determine the optimal location and size of the capacitors such that the cost of the energy loss and capacitor cost to be a minimum. The above method is tested on IEEE 9 and 34 bus system and compared with other methods in the literature.

Keywords: dimension reducing distribution load flow algorithm, DRDLFA, genetic algorithm, electrical distribution network, optimal capacitors placement, voltage profile improvement, loss reduction

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Authors: Ahmad Odeh, Ahmad Jrade

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Energy assessment is an evidently significant factor when evaluating the sustainability of structures especially at the early design stage. Today design practices revolve around the selection of material that reduces the operational energy and yet meets their displinary need. Operational energy represents a substantial part of the building lifecycle energy usage but the fact remains that embodied energy is an important aspect unaccounted for in the carbon footprint. At the moment, little or no consideration is given to embodied energy mainly due to the complexity of calculation and the various factors involved. The equipment used, the fuel needed, and electricity required for each material vary with location and thus the embodied energy will differ for each project. Moreover, the method and the technique used in manufacturing, transporting and putting in place will have a significant influence on the materials’ embodied energy. This anomaly has made it difficult to calculate or even bench mark the usage of such energies. This paper presents a model aimed at helping designers select the construction materials based on their embodied energy. Moreover, this paper presents a systematic approach that uses an efficient method of calculation and ultimately provides new insight into construction material selection. The model is developed in a BIM environment targeting the quantification of embodied energy for construction materials through the three main stages of their life: manufacturing, transportation and placement. The model contains three major databases each of which contains a set of the most commonly used construction materials. The first dataset holds information about the energy required to manufacture any type of materials, the second includes information about the energy required for transporting the materials while the third stores information about the energy required by tools and cranes needed to place an item in its intended location. The model provides designers with sets of all available construction materials and their associated embodied energies to use for the selection during the design process. Through geospatial data and dimensional material analysis, the model will also be able to automatically calculate the distance between the factories and the construction site. To remain within the sustainability criteria set by LEED, a final database is created and used to calculate the overall construction cost based on R.M.S. means cost data and then automatically recalculate the costs for any modifications. Design criteria including both operational and embodied energies will cause designers to revaluate the current material selection for cost, energy, and most importantly sustainability.

Keywords: building information modelling, energy, life cycle analysis, sustainablity

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Authors: Mok-Tan Ahn, Hyeok Choi, Joon-Hong Park

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Multi-stage drawing process is an important technique for forming a shape that cannot be molded in a single process. multi-stage drawing process in number of passes and the shape of the die are an important factor influencing the productivity and moldability of the product. The number and shape of the multi-path in the mold of the drawing process is very influencing the productivity and moldability of the product. Half angle of the die and mandrel affects the drawing force and it also affects the completion of the final shape. Thus reducing the number of pass and the die shape optimization are necessary to improve the formability of the billet. The purpose of this study, Analyzing the load on the die through the FEM analysis and in consideration of the formability of the material presents a die model.

Keywords: automotive reinforcing agent, multi-pass shape drawing, automotive parts, FEM analysis

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Authors: Desmond Young

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In building services electrical design, a key element of any project will be assessing the electrical load requirements. This needs to be done early in the design process to allow the selection of infrastructure that would be required to meet the electrical needs of the type of building. The type of building will define the type of assessment made, and the values applied in defining the maximum demand for the building, and ultimately the size of supply or infrastructure required, and the application that needs to be made to the distribution network operator, or alternatively to an independent network operator. The fact that this assessment needs to be undertaken early in the design process provides limits on the type of assessment that can be used, as different methods require different types of information, and sometimes this information is not available until the latter stages of a project. A common method applied in the earlier design stages of a project, typically during stages 1,2 & 3, is the use of benchmarks. It is a possibility that some of the benchmarks applied are excessive in relation to the current loads that exist in a modern installation. This lack of accuracy is based on information which does not correspond to the actual equipment loads that are used. This includes lighting and small power loads, where the use of more efficient equipment and lighting has reduced the maximum demand required. The electrical load can be used as part of the process to assess the heat generated from the equipment, with the heat gains from other sources, this feeds into the sizing of the infrastructure required to cool the building. Any overestimation of the loads would contribute to the increase in the design load for the heating and ventilation systems. Finally, with the new policies driving the industry to decarbonise buildings, a prime example being the recently introduced London Plan, loads are potentially going to increase. In addition, with the advent of the pandemic and changes to working practices, and the adoption of electric heating and vehicles, a better understanding of the loads that should be applied will aid in ensuring that infrastructure is not oversized, as a cost to the client, or undersized to the detriment of the building. In addition, more accurate benchmarks and methods will allow assessments to be made for the incorporation of energy storage and renewable technologies as these technologies become more common in buildings new or refurbished.

Keywords: energy, ADMD, electrical load assessment, energy benchmarks

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Authors: Nirupama Sam

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COVID-19, the greatest pandemic since the turn of the century, presents several issues for urban planners, the most significant of which is determining appropriate mitigation techniques for creating pandemic-friendly and resilient public spaces. The study is conducted in four stages. The first stage consisted of literature reviews to examine the evolution and transformation of public spaces during pandemics throughout history and the role of public spaces during pandemic outbreaks. The second stage is to determine the factors that influence the success of public spaces, which was accomplished by an analysis of current literature and case studies. The influencing factors are categorized under comfort and images, uses and activity, access and linkages, and sociability. The third stage is to establish the priority of identified factors for which a questionnaire survey of stakeholders is conducted and analyzing of certain factors with the help of GIS tools. COVID-19 has been in effect in India for the last two years. Kerala has the highest daily COVID-19 prevalence due to its high population density, making it more susceptible to viral outbreaks. Despite all preventive measures taken against COVID-19, Kerala remains the worst-affected state in the country. Finally, two live case studies of the hardest-hit localities, namely Subhash bose park and Napier Museum park in the Ernakulam and Trivandrum districts of Kerala, respectively, were chosen as study areas for the survey. The responses to the questionnaire were analyzed using SPSS for determining the weights of the influencing factors. The spatial success of the selected case studies was examined using the GIS interpolation model. Following the overall assessment, the fourth stage is to develop strategies and guidelines for planning public spaces to make them more efficient and robust, which further leads to improved quality, safety and resilience to future pandemics.

Keywords: urban design, public space, covid-19, post-pandemic, public spaces

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Authors: G. Sirbiladze, B. Ghvaberidze, B. Matsaberidze

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A fuzzy vehicle routing problem is considered in the possibilistic environment. A new criterion, maximization of expectation of reliability for movement on closed routes is constructed. The objective of the research is to implement a two-stage scheme for solution of this problem. Based on the algorithm of preferences on the first stage, the sample of so-called “promising” routes will be selected. On the second stage, for the selected promising routes new bi-criteria problem will be solved - minimization of total traveled distance and maximization of reliability of routes. The problem will be stated as a fuzzy-partitioning problem. Two possible solutions of this scheme are considered.

Keywords: vehicle routing problem, fuzzy partitioning problem, multiple-criteria optimization, possibility theory

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Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

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Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

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Authors: Shilpa Sondkar, Maithili Patil, Atharva Potnis

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The current health care landscape desires efficiency and patient satisfaction for optimal performance. Medical appointment booking apps have increased the overall efficiency of clinics, hospitals, and e-health marketplaces while simplifying processes. These apps allow patients to connect with doctors online. Not only are mobile doctor appointment apps a reliable and efficient solution, but they are also the future of clinical progression and a distinct new stage in the patient-doctor relationship. Compared to the usual queuing method, the web-based appointment system could significantly increase patients' satisfaction with registration and reduce total waiting time effectively.

Keywords: appointment, patient, scheduling, design and development, Figma

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Authors: Bounmediene Farida, Nouani Abdelouahab, Bellal Mouloud

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The present study examined the influence of two production parameters namely genetic factor (race) and physiological factors (stage of lactation) on the composition of the traditional goat cheese made using the enzyme extract of caprine origin and commercial rennet. The results obtained show that the goat cheese of the Alpine race is richer in fat and protein than Saanen and Local breeds. Similar variations were observed depending on the stage of lactation for the third stage. Thus, analysis of the products obtained show that there is no difference in quality between the cheeses obtained with rennet and those obtained with goat coagulase. In addition, principal component analysis (PCA) made from individuals (races and stages of lactation) and variables (physicochemical parameters goat cheese) divides people into two groups: The first group includes cheeses races Alpine, Saanen and local third stages of lactation. This group corresponds to samples of the richest cheese in a useful matter. The second group includes cheeses from the three races in the second stage of lactation. This group corresponds to cheeses that have low contents in a useful matter.

Keywords: goat cheese, goat coagulase, rennet, coagulation

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Authors: Shraddha Jadhav

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We are entering a new age in the built environment where we expect our buildings to deliver far more than just a place to work or live. It is widely believed that sustainable building design strategies create improved occupants’ comfort & satisfaction with respect to thermal comfort & indoor environmental quality. Yet this belief remains a hypothesis with little empirical support. IT buildings cater to more than 3000 users at a time. Nowadays people spend 90% of the time inside offices. These sustainable IT office buildings should provide the occupants with maximum comfort for better work productivity. Such green rated buildings fulfill all the criteria at the designing stage, but do they really work as expected at the occupancy stage. The aim of this paper is to evaluate whether green IT buildings provide the required comfort level as expected at the design stage. Building Occupants are a rich source of information for evaluating their comfort level in the building and to find out the solutions for their discomfort. This can be achieved by carrying out Post Occupancy Evaluation after the building has been occupied for more than a year or two. The technique consists of qualitative methods like questionnaire surveys & observations and quantitative methods like field measurements, photographs. Post Occupancy Evaluation was carried out in a Green (Platinum rated) IT building in Pune. 30 samples per floor were identified for the questionnaire survey. The core questions access occupant satisfaction with thermal comfort in the work area and measures adopted for making it comfortable were identified. The Mean Radiant Temperature of the same samples was taken to compare the quantitative and qualitative results. The survey was used to evaluate the occupant thermal comfort in a green office building and identify areas needing improvement. The survey has been designed in reference to ASHRAE standard 55-2010 & ISHRAE 10001:2017 IEQ and was further refined to suit the user of the building.

Keywords: green office building, building occupant, thermal comfort, POE, user satisfaction, survey

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Mahmoud Reza Hosseini

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The universe is in a continuous expansion process, resulting in the reduction of its density and temperature. Also, by extrapolating back from its current state, the universe at its early times has been studied known as the big bang theory. According to this theory, moments after creation, the universe was an extremely hot and dense environment. However, its rapid expansion due to nuclear fusion led to a reduction in its temperature and density. This is evidenced through the cosmic microwave background and the universe structure at a large scale. However, extrapolating back further from this early state reaches singularity which cannot be explained by modern physics and the big bang theory is no longer valid. In addition, one can expect a nonuniform energy distribution across the universe from a sudden expansion. However, highly accurate measurements reveal an equal temperature mapping across the universe which is contradictory to the big bang principles. To resolve this issue, it is believed that cosmic inflation occurred at the very early stages of the birth of the universe According to the cosmic inflation theory, the elements which formed the universe underwent a phase of exponential growth due to the existence of a large cosmological constant. The inflation phase allows the uniform distribution of energy so that an equal maximum temperature could be achieved across the early universe. Also, the evidence of quantum fluctuations of this stage provides a means for studying the types of imperfections the universe would begin with. Although well-established theories such as cosmic inflation and the big bang together provide a comprehensive picture of the early universe and how it evolved into its current state, they are unable to address the singularity paradox at the time of universe creation. Therefore, a practical model capable of describing how the universe was initiated is needed. This research series aims at addressing the singularity issue by introducing an energy conversion mechanism. This is accomplished by establishing a state of energy called a “neutral state”, with an energy level which is referred to as “base energy” capable of converting into other states. Although it follows the same principles, the unique quanta state of the base energy allows it to be distinguishable from other states and have a uniform distribution at the ground level. Although the concept of base energy can be utilized to address the singularity issue, to establish a complete picture, the origin of the base energy should be also identified. This matter is the subject of the first study in the series “A Conceptual Study for Investigating the Creation of Energy and Understanding the Properties of Nothing” which is discussed in detail. Therefore, the proposed concept in this research series provides a road map for enhancing our understating of the universe's creation from nothing and its evolution and discusses the possibility of base energy as one of the main building blocks of this universe.

Keywords: big bang, cosmic inflation, birth of universe, energy creation

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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Authors: Zengda Li

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The tectonic evolution of the Beishan orogen, which forms part of the Central Asian Orogenic Belt, remains debated. This study reports the identification of three Triassic granitic plutons representing two distinct stages of magmatism in southern Beishan orogen. Zircon U–Pb dating constrains the early stage as 238–237 Ma and the late stage as 229–227 Ma. The granitoids belong to high-K calc-alkaline and shoshonitic series and exhibit alkalic-calcic and calc-alkalic features, and are weakly peraluminous rocks. Most of these granitoids are highly fractionated I-type and A-type granites. They have relatively high Isr values (0.7049–0.7086) and weak negative εNd(t) values of −1.5 to −2.1, with young Nd model ages of 1.04–0.91 Ga, indicating a crustal contribution. They also show markedly positive zircon εHf(t) values (+3.4 to +11.8) and two-stage Hf model ages of 1.06–0.69 Ga, indicating a mixture of mantle and crustal components. The lithospheric mantle beneath this region incorporating older subducted materials was metasomatized by fluids or melts. Partial melting of the metasomatized lithospheric mantle resulted in underplated magmas, which provided the heat and material input to generate the granitoids. The Middle Triassic granitic plutons show moderate negative Eu anomalies, enrichment of LILEs and depletion in Nb, Ta, and Ti suggesting partial melting of crustal components in response to the underplated mantle-derived magmas, probably linked to lithospheric delamination and asthenospheric upwelling. The Late Triassic granitic plutons show characteristics of post-orogenic granite with strong negative anomalies of Eu, Ba, Nb, Sr, P, and Ti, indicating fractional crystallization and crustal contamination during the emplacement process.

Keywords: Triassic, magmatism, geochronology, petrogenesis, Beishan orogen

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Authors: Shamim Mushtaq, Moazzam Shahid

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Breast cancer (BC) claims the lives of half a million women every year and is the most common cause of death in the developing world. In 2019, it was estimated that BC alone accounts for 15% of all cancer deaths in younger women (aged < 45 years old) with advanced-stage lung metastasis. According to the World Health Organization & International Union against Cancer, in Asia, a high number of cancer-related deaths will be observed in 2020, whereas the burden will be reduced in Western countries due to awareness about the disease, better health facilities and advanced treatments. In the last 15 years, it has been reported that the incidence of BC has increased by 1.1% among Asian compared to the US population from 2003 to 2012. To date, several BC biological subtypes have been reported so far, which are associated with different treatment responses. The heterogeneity and diversity of BC reflected these different subtypes, including Luminal A (23.7% prevalence) and B (38.8% prevalence) that have pathological estrogen receptor (ER+)-positive tumors, the human epidermal growth factor receptor 2 (HER2) (11.2% prevalence) and triple-negative breast cancer (TNBC) (25% prevalence). According to Shaukat Khanum Memorial Cancer Hospital and Research Centre – Pakistan, ten years of data showed that among 636 BC patients, 30.5% had TNBC who were <40 years of age, which is an extremely alarming situation. Therefore, there is a dire need to explore and develop therapeutic targets for the treatment of early TNBC. Since the last decade, unfortunately, there has been little success in understanding the complexity of TNBC and in discovering new biological therapeutic targets. However, conventional chemotherapy is the only choice of treatment for TNBC patients. Many investigators revealed advances in multi-omics (multiple "omes", e.g., genome, proteome, transcriptome, epigenome, and microbiome) which were later identified as actionable targets and increased prevalence in TNBC patients. However, various drugs have been identified so far which are related to a particular diagnostic and prognostic biomarker. For example, Epidermal growth factor receptor ( EGFR or ErbB-1), HER-2/neu (ErbB-2), HER-3 (ErbB-3), and HER-4 (ErbB-4). Protein Transglin-2 (TAGLN 2 ) and Profilins-1 (Pfn-1 ) are the ubiquitously expressed large family of proteins present in all eukaryotes, enabling actin cytoskeletal reorganization. It is known that the oncogenic transformation of cells is accompanied by alteration in the actin cytoskeleton. There are causal connections between altered expression of actin cytoskeletal regulators and cancer progression. Our case-control study identified TAGLN-2 and Pfn-1 proteins in TNBC blood by mass spectrometry. Both TAGLN-2 and Pfn-1 proteins are differentially expressed in early and advanced stages of TNBS patients, which could be potential predictors or therapeutic targets for TNBC.

Keywords: TNBC, blood biomarkers, mass spectrometry, qPCR, ELISA

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Authors: Amirhossein Khazali, Mohsen Kalantar

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Energy storage units can play an important role to provide an economic and secure operation of future energy systems. In this paper, a stochastic energy and reserve market clearing scheme is presented considering storage energy units. The approach is proposed to deal with stochastic and non-dispatchable renewable sources with a high level of penetration in the energy system. A two stage stochastic programming scheme is formulated where in the first stage the energy market is cleared according to the forecasted amount of wind generation and demands and in the second stage the real time market is solved according to the assumed scenarios.

Keywords: energy and reserve market, energy storage device, stochastic programming, wind generation

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Authors: Hosein Alimadadi, Fatemeh Farahmand, Ali Jafarian, Nasir Fakhar, Mohammad Hassan Sohouli, Neda Raeesi

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Backgroundsː Regarding the important role of liver transplantation as the only treatment in many cases of end-stage liver disease in children, the aim of this study is to investigate the complications of liver transplantation and their management in children referred to the Children's Medical Center. Methods: This study is a cross-sectional study on pediatric patients who have undergone liver transplants in the years 2016 to 2021. The indication for liver transplantation in this population was confirmed by a pediatric gastroenterologist, and a liver transplant was performed by a transplant surgeon. Finally, information about the patient before and after the transplantation was collected and recorded. Results: A total of 53 patients participated in this study, including 25 (47.2%) boys and 28 (52.8%) girls. The most common causes of liver transplantation were cholestatic and metabolic diseases. The most common early complication of liver transplantation in children was acute cellular rejection (ACR) and anastomotic biliary stricture. The most common late complication in these patients was an infection which was observed in 56.6% of patients. Among the drug side effects, neurotoxicity (convulsions) was seen more in patients, and 15.1% of the transplanted patients died. Conclusion: In this study, the most common early complication of liver transplantation in children was ACR and biliary stricture, and the most common late complication was infection. Neurotoxicity (convulsions) was the most common side effect of drugs.

Keywords: liver transplantation, complication, infection, survival rate

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Authors: Zeynep Aytaç, Nuri Yücel

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Today, as the need for high efficiency and fuel-efficient engines have increased, centrifugal compressor designs are expected to be high-efficient and have high-pressure ratios than ever. The present study represents a design methodology of centrifugal compressor placed in a mini jet engine for the design and off-design points with the utilization of computational fluid dynamics (CFD) and compares the performance characteristics at the mentioned two points. Although the compressor is expected to provide the required specifications at the design point, it is known that it is important for the design to deliver the required parameters at the off-design point also as it will not operate at the design point always. It was observed that the obtained mass flow rate, pressure ratio, and efficiency values are within the limits of the design specifications for the design and off-design points. Despite having different design inputs for the mentioned two points, they reveal similar flow characteristics in the general frame.

Keywords: centrifugal compressor, computational fluid dynamics, design point, off-design point

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Authors: Shih-Heng Sun, Hsiu-Yu Chang

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“Family centered service model” becomes mainstream in early intervention. Family outcome should be evaluated in addition child improvement in terms of outcome evaluation in early intervention. The purpose of this study is to develop a surveys to evaluate family outcomes in early intervention. Method: “Family Outcomes Survey- Revised Taiwan Version” (FOS-RT) was developed through translation, back-translation, and review by the original author. Expert meeting was held to determine the content validity. Two hundred and eighty six parent-child dyads recruited from 10 local Early Intervention Resource Centers (EIRC) participated in the study after they signed inform consent. The results showed both parts of FOS-RT exhibits good internal consistency and test-retest reliability. The result of confirmatory factor analysis indicated moderate fit of 5 factor structure of part A and 3 factor structure of part B of FOS-RT. The correlation between different sessions reached moderate to high level reveals some sessions measure similar latent trait of family outcomes. Correlation between FOS-RT and Parents‘ Perceived Parenting Skills Questionnaire was calculated to determine the convergence validity. The moderate correlation indicates the two assessments measure different parts of early intervention outcome although both assessments have similar sub-scales. The results of this study support FOS-RT is a valid and reliable tool to evaluate family outcome after the family and children with developmental disability receive early intervention services.

Keywords: early intervention, family service, outcome evaluation, parenting skills, family centered

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Authors: Emad Mohammed Sani

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Women encounter exclusion and discrimination in varying degrees, particularly those who marry as minors. The detrimental custom of getting married young is still prevalent worldwide and affects millions of people. It has been less common over time, although it is still widespread in underdeveloped nations. Oromia Regional State is the region in Ethiopia with the highest proportion of child brides. This study aimed at evaluating the effects of early marriage on its survivors’ life conditions – specifically, empowerment and household decision-making – in Eastern Hararghe Zone of Oromia Region. This study employed community-based cross-sectional study design. It adopted mixed method approach – survey, in-depth interview and focus group discussion (FGD) – to collect, analyses and interpret data on early marriage and its effects on household decision-making processes. Narratives and analytical descriptions were integrated to substantiate and/or explain observed quantitative results, or generate contextual themes. According to this study, married women who were married at or after the age of eighteen participated more in household decision-making than child brides. Child brides were more likely to be victims of violence and other types of spousal abuse in their marriages. These changes are mostly caused by an individual's age at first marriage. Delaying marriage had a large positive impact on women's empowerment at the household level, and age at first marriage had a considerable negative impact. In order to advance women's welfare and emancipation, we advise more research to concentrate on the relationship between the home and the social-structural forms that appear at the individual and communal levels.

Keywords: child-bride, early marriage, women, ethiopia

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