Search results for: mortality rate

Authors: Pei-Fan Mu

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Background: Lung cancer is the most common cancer with the highest mortality rate. Patients with lung cancer under chemotherapy treatment experience life-threatening uncertainty. This study was based on the broaden-and-build theory using intentionality reflection of the body and internalization of positive prioritization strategies to enhance positive emotions of patients with lung cancer. Purpose: The purpose of this study was to use a quasi-experimental research design to examine the effectiveness of the enhancing positive emotion program. Method: Data were collected from a medical center in Taiwan. Fifty-four participants with lung cancer were recruited. Thirty participants were in the experiential group receiving the two weeks program. The content of the program includes awareness and understanding of the symptom experience, co-existing with illness and establishing self-identity, cognitive-emotion adjustment and establishing a new body schema, and symptom management to reach spiritual well-being. Twenty-four participants were in the control group receiving regular nursing care. Baseline, one month later and two months later, programmed measurements of symptoms of distress, positive emotion, and psychological well-being. Results: These two weeks of enhancing the positive emotion program resulted in a significantly improved positive emotion score for the experimental group compared to the control group. The findings of this study indicated that the positive emotion had significant differences between the two groups. There were no differences in symptom distress between the two groups. Discussion: The findings indicated that the enhancing positive emotion program could help patients enhance their life-threatening facing conditions.

Keywords: positive emotion, lung cancer, experimental design, symptom distress

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Authors: Rudy Bahouth, Farouk Benmeddour, Emmanuel Moulin, Jamal Assaad

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Guided ultrasonic waves are used in Non-Destructive Testing (NDT) and Structural Health Monitoring (SHM) for inspection and damage detection. Recently, wireless data transmission using ultrasonic waves in solid metallic channels has gained popularity in some industrial applications such as nuclear, aerospace and smart vehicles. The idea is to find a good substitute for electromagnetic waves since they are highly attenuated near metallic components due to Faraday shielding. The proposed solution is to use ultrasonic guided waves such as Lamb waves as an information carrier due to their capability of propagation for long distances. In addition to this, valuable information about the health of the structure could be extracted simultaneously. In this work, the reliable frequency bandwidth for communication is extracted experimentally from dispersion curves at first. Then, an experimental platform for wireless communication using Lamb waves is described and built. After this, coherent demodulation algorithm used in telecommunications is tested for Amplitude Shift Keying, On-Off Keying and Binary Phase Shift Keying modulation techniques. Signal processing parameters such as threshold choice, number of cycles per bit and Bit Rate are optimized. Experimental results are compared based on the average Bit Error Rate. Results have shown high sensitivity to threshold selection for Amplitude Shift Keying and On-Off Keying techniques resulting a Bit Rate decrease. Binary Phase Shift Keying technique shows the highest stability and data rate between all tested modulation techniques.

Keywords: lamb waves communication, wireless communication, coherent demodulation, bit error rate

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Authors: S. Saroop, D. Allopi

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In the area of civil infrastructure, there is an urgent need to apply technologies that deliver infrastructure sustainably in a way that is cost-effective. Civil engineering projects can have a significant impact on ecological and social systems if not correctly planned, designed and implemented. It can impact climate change by addressing the issue of flooding and sustainability. Poor design choices now can result in future generations to live in a climate with depleted resources and without green spaces. The objectives of the research study were to rate the sensitivity of various greener infrastructure technologies that can be used in township infrastructure, at the various stages of the project. This paper discusses the Green Township Infrastructure Design Toolkit, that is used to rate the sustainability of infrastructure service projects. Various case studies were undertaken on a range of infrastructure projects to test the sensitivity of various design solution against sustainability criteria. The Green reporting tools ensure efficient, economical and sustainable provision of infrastructure services.

Keywords: eco-efficiency, green infrastructure, green technology, infrastructure design, sustainable development

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Authors: Alain Villemeur

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The relationships between the profit share in income on the one hand and the growth rates of output and employment on the other hand have been studied for 17 advanced economies since 1961. The vast majority (98%) of annual values for the profit share fall between 20% and 40%, with an average value of 33.9%. For the 17 advanced economies, Gross Domestic Product and productivity growth rates tend to fall as the profit share in income rises. For the employment growth rates, the relationships are complex; nevertheless, over long periods (1961-2000), it appears that the more job-creating economies are Australia, Canada, and the United States; they have experienced a profit share close to 1/3. This raises a number of questions, not least the value of 1/3 for the profit share and its role in macroeconomic fundamentals. To explain these facts, an endogenous growth model is developed. This growth and distribution model reconciles the great ideas of Kaldor (economic growth as a chain reaction), of Keynes (effective demand and marginal efficiency of capital) and of Ricardo (importance of the wage-profit distribution) in an economy facing creative destruction. A production function is obtained, depending mainly on the growth of employment, the rate of net investment and the profit share in income. In theory, we show the existence of incentives: an incentive for job creation when the profit share is less than 1/3 and another incentive for job destruction in the opposite case. Thus, increasing the profit share can boost the employment growth rate until it reaches the value of 1/3; otherwise lowers the employment growth rate. Three key findings can be drawn from these considerations. The first reveals that the best GDP and productivity growth rates are obtained with a profit share of less than 1/3. The second is that maximum job growth is associated with a 1/3 profit share, given the existence of incentives to create more jobs when the profit share is less than 1/3 or to destroy more jobs otherwise. The third is the decline in performance (GDP growth rate and productivity growth rate) when the profit share increases. In conclusion, increasing the profit share in income weakens GDP growth or productivity growth as a long-term trend, contrary to the trickle-down hypothesis. The employment growth rate is maximum for a profit share in income of 1/3. All these lessons suggest macroeconomic policies considering the profit share in income.

Keywords: advanced countries, GDP growth, employment growth, profit share, economic policies

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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Authors: Manal Suleiman, George Abu-Aqil, Uraib Sharaha, Klaris Riesenberg, Itshak Lapidot, Ahmad Salman, Mahmoud Huleihel

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Klebsiella pneumoniae is one of the most aggressive multidrug-resistant bacteria associated with human infections resulting in high mortality and morbidity. Thus, for an effective treatment, it is important to diagnose both the species of infecting bacteria and their susceptibility to antibiotics. Current used methods for diagnosing the bacterial susceptibility to antibiotics are time-consuming (about 24h following the first culture). Thus, there is a clear need for rapid methods to determine the bacterial susceptibility to antibiotics. Infrared spectroscopy is a well-known method that is known as sensitive and simple which is able to detect minor biomolecular changes in biological samples associated with developing abnormalities. The main goal of this study is to evaluate the potential of infrared spectroscopy in tandem with Random Forest and XGBoost machine learning algorithms to diagnose the susceptibility of Klebsiella pneumoniae to antibiotics within approximately 20 minutes following the first culture. In this study, 1190 Klebsiella pneumoniae isolates were obtained from different patients with urinary tract infections. The isolates were measured by the infrared spectrometer, and the spectra were analyzed by machine learning algorithms Random Forest and XGBoost to determine their susceptibility regarding nine specific antibiotics. Our results confirm that it was possible to classify the isolates into sensitive and resistant to specific antibiotics with a success rate range of 80%-85% for the different tested antibiotics. These results prove the promising potential of infrared spectroscopy as a powerful diagnostic method for determining the Klebsiella pneumoniae susceptibility to antibiotics.

Keywords: urinary tract infection (UTI), Klebsiella pneumoniae, bacterial susceptibility, infrared spectroscopy, machine learning

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Authors: Yaacoub Tina, Youssef Roua, Radoi Emanuel, Burel Gilles

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Recently, low-complexity sub-Nyquist sampling schemes based on the Finite Rate of Innovation (FRI) theory have been introduced to sample parametric signals at minimum rates. The multichannel modulating waveforms (MCMW) is such an efficient scheme, where the received signal is mixed with an appropriate set of arbitrary waveforms, integrated and sampled at rates far below the Nyquist rate. In this paper, the MCMW scheme is adapted to the special case of ultra wideband (UWB) channel estimation, characterized by dense multipaths. First, an appropriate structure, which accounts for the bandpass spectrum feature of UWB signals, is defined. Then, a novel approach to decrease the number of processing channels and reduce the complexity of this sampling scheme is presented. Finally, the proposed concepts are validated by simulation results, obtained with real filters, in the framework of a coherent Rake receiver.

Keywords: coherent rake receiver, finite rate of innovation, sub-nyquist sampling, ultra wideband

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Authors: Muhammad Shoaib, Hassan M Al-Swaidan

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Saudi Arabia is the major date producer in the world. In order to maximize the production from date tree, pruning of the date trees is required annually. Large amount of this agriculture waste material (palm tree fronds) is available in Saudi Arabia and considered as an ideal source as a precursor for production of activated carbon (AC). The single step procedure for the preparation of micro porous activated carbon (AC) from Saudi date tree fronds using mixture of gases (N2 and CO2) is carried out at carbonization/activation temperature at 850°C and at different ramp rates of 10, 20 and 30 degree per minute. Alloy 330 horizontal reactor is used for tube furnace. Flow rate of nitrogen and carbon dioxide gases are kept at 150 ml/min and 50 ml/min respectively during the preparation. Characterization results reveal that the BET surface area, pore volume, and average pore diameter of the resulting activated carbon generally decreases with the increase in ramp rate. The activated carbon prepared at a ramp rate of 10 degrees/minute attains larger surface area and can offer higher potential to produce activated carbon of greater adsorption capacity from agriculture wastes such as date fronds. The BET surface areas of the activated carbons prepared at a ramp rate of 10, 20 and 30 degree/minute after 30 minutes activation time are 1094, 1020 and 515 m2/g, respectively. Scanning electron microscopy (SEM) for surface morphology, and FTIR for functional groups was carried out that also verified the same trend. Moreover, by increasing the ramp rate from 10 and 20 degrees/min the yield remains same, i.e. 18%, whereas at a ramp rate of 30 degrees/min the yield increases from 18 to 20%. Thus, it is feasible to produce high-quality micro porous activated carbon from date frond agro waste using N2 carbonization followed by physical activation with CO2 and N2 mixture. This micro porous activated carbon can be used as adsorbent of heavy metals from wastewater, NOx SOx emission adsorption from ambient air and electricity generation plants, purification of gases, sewage treatment and many other applications.

Keywords: activated carbon, date tree fronds, agricultural waste, applied chemistry

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Authors: Muhammad Idrees, Masroor Abro, Sikandar Almani

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Presently, the increasing CO₂ concentration in the atmosphere has been taken as one of the major challenges faced by the modern world. The average CO₂ in the atmosphere reached the highest value of 414.72 ppm in 2021, as reported in a conference of the parties (COP26). This study focuses on (i) the comparative study of MEA, NaOH, Acetic acid, and Na₂CO₃ in terms of their CO₂ capture performance, (ii) the significance of adding various frothing agents achieving improved absorption capacity of Na₂CO₃ and (iii) the overall economic evaluation of process with the help of Aspen Plus. The results obtained suggest that the addition of frothing agents significantly increased the absorption rate of dilute sodium carbonate such that from 45% to 99.9%. The effect of temperature, pressure and flow rate of liquid and flue gas streams on CO₂ absorption capacity was also investigated. It was found that the absorption capacity of Na₂CO₃ decreased with increasing temperature of the liquid stream and decreasing flow rate of the liquid stream and pressure of the gas stream.

Keywords: CO₂, absorbents, frothing agents, process simulation

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

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Authors: Joseph George, Anne Kotteswara Roa

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Skin disease is one of the most common and popular kinds of health issues faced by people nowadays. Skin cancer (SC) is one among them, and its detection relies on the skin biopsy outputs and the expertise of the doctors, but it consumes more time and some inaccurate results. At the early stage, skin cancer detection is a challenging task, and it easily spreads to the whole body and leads to an increase in the mortality rate. Skin cancer is curable when it is detected at an early stage. In order to classify correct and accurate skin cancer, the critical task is skin cancer identification and classification, and it is more based on the cancer disease features such as shape, size, color, symmetry and etc. More similar characteristics are present in many skin diseases; hence it makes it a challenging issue to select important features from a skin cancer dataset images. Hence, the skin cancer diagnostic accuracy is improved by requiring an automated skin cancer detection and classification framework; thereby, the human expert’s scarcity is handled. Recently, the deep learning techniques like Convolutional neural network (CNN), Deep belief neural network (DBN), Artificial neural network (ANN), Recurrent neural network (RNN), and Long and short term memory (LSTM) have been widely used for the identification and classification of skin cancers. This survey reviews different DL techniques for skin cancer identification and classification. The performance metrics such as precision, recall, accuracy, sensitivity, specificity, and F-measures are used to evaluate the effectiveness of SC identification using DL techniques. By using these DL techniques, the classification accuracy increases along with the mitigation of computational complexities and time consumption.

Keywords: skin cancer, deep learning, performance measures, accuracy, datasets

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Naina Mahajan, Bikram Pal Kaur

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The purpose of traffic accident analysis is to find the possible causes of an accident. Road accidents cannot be totally prevented but by suitable traffic engineering and management the accident rate can be reduced to a certain extent. This paper discusses the classification techniques C4.5 and ID3 using the WEKA Data mining tool. These techniques use on the NH (National highway) dataset. With the C4.5 and ID3 technique it gives best results and high accuracy with less computation time and error rate.

Keywords: C4.5, ID3, NH(National highway), WEKA data mining tool

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Authors: Nixon Kuruvila, H. V. Ravindra

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Wire-cut Electro Discharge Machining (WEDM) is a special form of conventional EDM process in which electrode is a continuously moving conductive wire. The present study aims at determining parametric influence and optimum process parameters of Wire-EDM using Taguchi’s Technique and Genetic algorithm. The variation of the performance parameters with machining parameters was mathematically modeled by Regression analysis method. The objective functions are Dimensional Accuracy (DA) and Material Removal Rate (MRR). Experiments were designed as per Taguchi’s L16 Orthogonal Array (OA) where in Pulse-on duration, Pulse-off duration, Current, Bed-speed and Flushing rate have been considered as the important input parameters. The matrix experiments were conducted for the material Oil Hardened Non Shrinking Steel (OHNS) having the thickness of 40 mm. The results of the study reveals that among the machining parameters it is preferable to go in for lower pulse-off duration for achieving over all good performance. Regarding MRR, OHNS is to be eroded with medium pulse-off duration and higher flush rate. Finally, the validation exercise performed with the optimum levels of the process parameters. The results confirm the efficiency of the approach employed for optimization of process parameters in this study.

Keywords: dimensional accuracy (DA), regression analysis (RA), Taguchi method (TM), volumetric material removal rate (VMRR)

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Authors: Jularat Chumnaul

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In forensic science, corpses from various homicides are different; there are both complete and incomplete, depending on causes of death or forms of homicide. For example, some corpses are cut into pieces, some are camouflaged by dumping into the river, some are buried, some are burned to destroy the evidence, and others. If the corpses are incomplete, it can lead to the difficulty of personally identifying because some tissues and bones are destroyed. To specify gender of the corpses from skeletal remains, the most precise method is DNA identification. However, this method is costly and takes longer so that other identification techniques are used instead. The first technique that is widely used is considering the features of bones. In general, an evidence from the corpses such as some pieces of bones, especially the skull and pelvis can be used to identify their gender. To use this technique, forensic scientists are required observation skills in order to classify the difference between male and female bones. Although this technique is uncomplicated, saving time and cost, and the forensic scientists can fairly accurately determine gender by using this technique (apparently an accuracy rate of 90% or more), the crucial disadvantage is there are only some positions of skeleton that can be used to specify gender such as supraorbital ridge, nuchal crest, temporal lobe, mandible, and chin. Therefore, the skeletal remains that will be used have to be complete. The other technique that is widely used for gender specifying in forensic science and archeology is skeletal measurements. The advantage of this method is it can be used in several positions in one piece of bones, and it can be used even if the bones are not complete. In this study, the classification and cluster analysis are applied to this technique, including the Kth Nearest Neighbor Classification, Classification Tree, Ward Linkage Cluster, K-mean Cluster, and Two Step Cluster. The data contains 507 particular individuals and 9 skeletal measurements (diameter measurements), and the performance of five methods are investigated by considering the apparent error rate (APER). The results from this study indicate that the Two Step Cluster and Kth Nearest Neighbor method seem to be suitable to specify gender from human skeletal remains because both yield small apparent error rate of 0.20% and 4.14%, respectively. On the other hand, the Classification Tree, Ward Linkage Cluster, and K-mean Cluster method are not appropriate since they yield large apparent error rate of 10.65%, 10.65%, and 16.37%, respectively. However, there are other ways to evaluate the performance of classification such as an estimate of the error rate using the holdout procedure or misclassification costs, and the difference methods can make the different conclusions.

Keywords: skeletal measurements, classification, cluster, apparent error rate

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: Peng Zhang, Lihui Zheng, Xiangchun Wang, Xiaopan Kou

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Quantitative research on the main control factors of lost circulation has few considerations and single data source. Using Unmanned Intervention Algorithm to find the main control factors of lost circulation adopts all measurable parameters. The degree of lost circulation is characterized by the loss rate as the objective function. Geological, engineering and fluid data are used as layers, and 27 factors such as wellhead coordinates and WOB are used as dimensions. Data classification is implemented to determine function independent variables. The mathematical equation of loss rate and 27 influencing factors is established by multiple regression method, and the undetermined coefficient method is used to solve the undetermined coefficient of the equation. Only three factors in t-test are greater than the test value 40, and the F-test value is 96.557%, indicating that the correlation of the model is good. The funnel viscosity, final shear force and drilling time were selected as the main control factors by elimination method, contribution rate method and functional method. The calculated values of the two wells used for verification differ from the actual values by -3.036m3/h and -2.374m3/h, with errors of 7.21% and 6.35%. The influence of engineering factors on the loss rate is greater than that of funnel viscosity and final shear force, and the influence of the three factors is less than that of geological factors. Quantitatively calculate the best combination of funnel viscosity, final shear force and drilling time. The minimum loss rate of lost circulation wells in Shunbei area is 10m3/h. It can be seen that man-made main control factors can only slow down the leakage, but cannot fundamentally eliminate it. This is more in line with the characteristics of karst caves and fractures in Shunbei fault solution oil and gas reservoir.

Keywords: drilling and completion, drilling fluid, lost circulation, loss rate, main controlling factors, unmanned intervention algorithm

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact, might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visits, with subsequent readmission and additional procedures. While some authors found no increase in SSI following bile spillage (BS) compared to non-bile spillage cases, others found bile spillage to be associated with SSI. Therefore we sought to examine whether bile spillage is indeed associated with an increased risk of postoperative wound infections after laparoscopic cholecystectomy. I hypothesize that patients who experience BS during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing Laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per CDC-defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non-bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and was absent in the rest i.e.92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in nonbile spillage cases, SSI was found in 8 cases (8.7%). However, it was statistically not significant (p-value>0.05). Eleven (92%) cases were superficial SSI and one was an organ-space infection. No mortality or 30-day readmission. Spillage of Gallbladder content does not lead to an increase in SSIs. However as the rate of SSI is still higher, Surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage thorough peritoneal irrigation with normal saline should be done.

Keywords: organ space infection, Laparoscopic cholecystectomy, biliary spillage, surgical site infection

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Authors: Bhawana, Roshan Kamal Topno, Maneesh Kumar, Major Madhukar, Krishna Pandey, Ganesh Chandra Sahoo, Manas Ranjan Dikhit, Surya Suman, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

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Viral co-infection is now very common across taxa and environments that are involved in congenital infections. Herpes simplex virus (HSV) and Rubella are the two serious viral infections, well categorized in TORCH Syndrome. Here we had endeavoured the seroprevalence of co-infection of HSV and Rubella. Systematic tests have been performed to check the virulence pattern of the co-infection. The study was conducted at Department of Virology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, Bihar, India during January 2018-July 2018. 299 newly cases were attended with the sign and symptoms of HSV and Rubella. After taking written consent forms from all the subjects, blood samples were collected for serological detection. ELISA was performed to detect the presence of IgM antibody level. 12 patients were found to be IgM positive from each HSV and Rubella infection. The findings of our study showed that 6 patients were positive for both HSV and rubella and hence were co-infected. Such co-infection causes severe health problems as it leads to the mortality rate of the patients during viral infectivity. Epidemiologically, proper screening should be needed to check any chance of occurrence of such co-infection in the affected regions in large scale and take suitable preventive approach to decrease the case totality. Concern has to be given to aid proper diagnosis and treatment in order to decrease the spread of HSV and Rubella co-infection.

Keywords: HSV, Rubella, seroprevalence, co-infection, ELISA, viral infectivity

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Authors: Yosra Baaziz, Moez Labidi

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Given limited research on monetary policy rules in revolutionary countries, this paper challenges the suitability of the Taylor rule in characterizing the monetary policy behavior of the Tunisian Central Bank (BCT), especially in turbulent times. More specifically, we investigate the possibility that the Taylor rule should be formulated as a threshold process and examine the validity of such nonlinear Taylor rule as a robust rule for conducting monetary policy in Tunisia. Using quarterly data from 1998:Q4 to 2013:Q4 to analyze the movement of nominal short-term interest rate of the BCT, we find that the nonlinear Taylor rule improves its performance with the advent of special events providing thus a better description of the Tunisian interest rate setting. In particular, our results show that the adoption of an appropriate nonlinear approach leads to a reduction in the errors of 150 basis points in 1999 and 2009, and 60 basis points in 2011, relative to the linear approach.

Keywords: policy rule, central bank, exchange rate, taylor rule, nonlinearity

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Authors: Gylych Jelilov

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This paper investigates the effect of foreign debt on economic growth. Example has been chosen from Africa, Nigeria. By conducting cointegration test we have tested for a long-run relationship between. GDP = Real gross domestic product, EXTDEBT = External debt, INT = Interest rate, CAB = Current account balance, and EXCHR = Real exchange rate over the period 1990 to 2012. It was found out by the study that there is a negative but insignificant relationship between external debt and real gross domestic product. While a positive relationship exists between external debt and economic growth. Also, showed a negative and significant relationship between interest rate and real gross domestic product and there was a positive but insignificant relationship between current account balance and real gross domestic product.

Keywords: economic growth, foreign debt, Nigeria, sustainable development, economic stability

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Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes

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Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.

Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis

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Authors: Marwa Ben Abdessalem, Amin Zribi, Ammar Bouallègue

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In this paper, a Joint Source Channel coding scheme based on LDPC codes is investigated. We consider two concatenated LDPC codes, one allows to compress a correlated source and the second to protect it against channel degradations. The original information can be reconstructed at the receiver by a joint decoder, where the source decoder and the channel decoder run in parallel by transferring extrinsic information. We investigate the performance of the JSC LDPC code in terms of Bit-Error Rate (BER) in the case of transmission over an Additive White Gaussian Noise (AWGN) channel, and for different source and channel rate parameters. We emphasize how JSC LDPC presents a performance tradeoff depending on the channel state and on the source correlation. We show that, the JSC LDPC is an efficient solution for a relatively low Signal-to-Noise Ratio (SNR) channel, especially with highly correlated sources. Finally, a source-channel rate optimization has to be applied to guarantee the best JSC LDPC system performance for a given channel.

Keywords: AWGN channel, belief propagation, joint source channel coding, LDPC codes

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Authors: Ho-Jun Jo, Wook-Won Kim, Yong-Sung Kim, Jin-O Kim

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The application of ESS (Energy Storage Systems) in the future grids has been the solution of the microgrid. However, high investment costs necessitate accurate modeling and control strategy of ESS to justify its economic viability and further underutilization. Therefore, the reasonable control strategy for ESS which is subjected to generator and usage helps to curtail the cost of investment and operation costs. The rated frequency in power system is decreased when the load is increasing unexpectedly; hence the thermal power is operated at the capacity of only its 95% for the Governor Free (GF) to adjust the frequency as reserve (5%) in practice. The ESS can be utilized with governor at the same time for the frequency response due to characteristic of its fast response speed and moreover, the cost of ESS is declined rapidly to the reasonable price. This paper presents the ESS control strategy to extend usage of the ESS taken account into governor’s ramp rate and reduce the governor’s intervention as well. All results in this paper are simulated by MATLAB.

Keywords: micro grid, energy storage systems, ramp rate, control strategy

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Authors: Ratthiwa Deewan, Visanu Tanboonchuy

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The optimal conditions for green synthesis of zero-valent (G-NZVI) synthesis are investigated in this study using a Box Behnken design. The factors that were used in the study consisted of 3 factors as follows: the iron solution to mango peel extract ratio (1:1-1:3), feeding rate of mango peel extracts (1-5 mL/min), and agitation speed (300-30 rpm). The results showed that the optimization of conditions using the regression model was appropriate. The optimal conditions of the synthesis of G-NZVI for arsenate removal are the iron solution to mango peel extract ratio of 1:1, the feeding rate of mango peel extract at 5 mL/min, and the agitation speed rate of 300 rpm, which was able to arsenate removal of 100%.

Keywords: Box Behnken design, arsenate removal, green nano zero valent iron, arsenic

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Authors: Sabuj Kanti Mazumder, Mazlan Abd Ghaffar, Simon Kumar Das

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In this study, we analyzed the effects of water temperature and diet on the growth properties and gastric emptying period of juvenile Malabar blood snapper (Lutjanus malabaricus) over a 30day experimental period. Fish were collected from a local hatchery of Pulau Ketam, Selangor, Malaysia and immediately transferred to flow-through sea water system and subjected to four different temperatures (22, 26, 30, and 34 °C) and two diets (formulated pellet and shrimp). Body weight gain, food consumption, food conversion ratio, food consumption efficiency, specific growth rate, relative growth rate, daily growth rate, and gastric emptying period were significantly influenced by temperature and diet (P<0.05). The best food conversion ratio was with the shrimp group recorded at 30°C (1.33±0.08). The highest growth rate was observed in the shrimp group at 30°C (3.97±0.57% day-1), and the lowest was observed in the formulated pellet group at 22°C (1.63±0.29% day-1). No significant difference was observed between the groups subjected to temperatures of 26 and 30°C. Similarly, the lowest gastric emptying period was detected in the shrimp group at 30°C (16h), where the proportion of meal residues in the stomach decreased from 100% to less than 8% after 12h of starvation. A significantly longer gastric emptying period was observed in the formulated pellet group at 22°C (28h). Overall, the best results were observed on shrimp group subjected to a 30°C temperature. The data obtained from this study suggest that a shrimp diet fed on L. malabaricus at 30°C will optimize the commercial production of this commercially important fish species.

Keywords: aquaculture, diet, digestion rate, growth, Malabar blood snapper

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Authors: Amir Doustgani

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Melt electrospinning is a safe and simple technique for the production of micro and nanofibers which can be an alternative to conventional solvent electrospinning. The effects of various melt-electrospinning parameters, including molecular weight, electric field strength, flow rate and temperature on the morphology and fiber diameter of polylactic acid were studied. It was shown that molecular weight was the predominant factor in determining the obtainable fiber diameter of the collected fibers. An orthogonal design was used to examine process parameters. Results showed that molecular weight is the most effective parameter on the average fiber diameter of melt electrospun PLA nanofibers and the flow rate has the less important impact. Mean fiber diameter increased by increasing MW and flow rate, but decreased by increasing electric field strength and temperature. MFD of optimized fibers was below 100 nm and the result of software was in good agreement with the experimental condition.

Keywords: fiber formation, processing, spinning, melt blowing

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Authors: Hamim Abbas, Jean Luc-Hornick, Isabelle Dufrasne

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Feed costs constitute over 60% of total expenses in organic layer poultry production, with feed protein supply being a significant concern. Alfalfa-based dehydrated silage pellets are mainly diets composed of leaves (ABSP), which are non-conventional protein sources that could enhance profits by reducing feed costs and ensuring consistent availability. This experiment studied the effects on the performances of Novogen Brown light layers of a commercial control diet replaced with 10% ABSP. After a 21-day trial, this diet (ABSP) has improved the laying rate, yolk color of eggs, feed conversion rate, ω−3 (PUFAs) and ω−6/ω−3 ratio (P<0.05) while the body weight and egg weight were degraded with the substitution of the ABSP in the diet(P>0.05). The laying rate showed a tendency to increase (P=0.06). These findings suggest that ABSP can replace at least 10% of the feed in organic layer diets without compromising production parameters negatively.

Keywords: alfalfa, silage, pellet, organic layers

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Authors: Jorge Martinez, Brandon Roberts, Holly Payton Toca

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Background: Therapeutic hypothermia (TH) is the international standard of care for all comatose patients after cardiac arrest, but criticism focuses on poor outcomes. We sought to develop criteria to identify American urban patients more likely to benefit from TH. Methods: Retrospective chart review of 107 consecutive adults undergoing TH in downtown New Orleans from 2010-2014 yielded records for 99 patients with all 44 survivors or families contacted up to four years. Results: 69 males and 38 females with a mean age of 60.2 showed 63 dead (58%) and 44 survivors (42%). Presenting cardiac rhythm was divided into shockable (Pulseless Ventricular Tachycardia, Ventricular Fibrillation) and non-shockable (Pulseless Electrical Activity, Asystole). Presenting in shockable rhythms with ROSC <20 minutes were 21 patients with 15 (71%) survivors (p=.001). Time >20 minutes until ROSC in shockable rhythms had 5 patients with 3 survivors (78%, p=0.001). Presenting in non-shockable rhythms with ROSC <20 minutes were 54 patients with 18 survivors (33%, p=.001). ROSC >20 minutes in non-shockable rhythms had 19 patients with 2 survivors (8%, p=.001). Survivors of shockable rhythms showed 19 (100%) living post TH. 15 survivors (79%, n=19, p=.001) had CPC score 1 or 2 with 4 survivors (21%, n=19) having a CPC score of 3. A total of 25 survived non-shockable rhythm. Acute survival of patients with non-shockable rhythm showed 18 expired <72 hours (72%, n=25) with long-term survival of 4 patients (5%, n=74) and CPC scores of 1 or 2 (p=.001). Interestingly, patients with time to ROSC <20 minutes exhibiting more than one loss of sustained ROSC showed 100% mortality (p=.001). Patients presenting with shockable >20 minutes ROSC had overall survival of 70% (p=.001), but those undergoing >3 cardiac rhythm changes had 100% mortality (p=.001). Conclusion: Patients presenting with shockable rhythms undergoing TH had overall acute survival of 70% followed by long-term survival of 100% after 4 years. In contrast, patients presenting with non-shockable rhythm had long-term survival of 5%. TH is not recommended for patients presenting with non-shockable rhythm and requiring greater than 20 minutes for restoration of ROSC.

Keywords: cardiac rhythm changes, Pulseless Electrical Activity (PEA), Therapeutic Hypothermia (TH)

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