Search results for: statistical estimation problem

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Stanely Nsubuga

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Background In Uganda, injection drug use is a growing but less studied problem. Preventing the transition to injection drug use may help prevent blood-borne viral transmission, but little is known about when and how people transition to injection drug use. A greater understanding of this transition process may aid in the country’s efforts to prevent the continued growth of injection drug use, HIV, and hepatitis C Virus (HCV) infection among people who inject drugs (PWID). Methods Using a rapid situation assessment framework, we conducted semi-structured interviews among 125 PWID (102 males and 23 females)—recruited through outreach and snow-ball sampling. Participants were interviewed about their experiences on when and how they transitioned into injection drug use and these issues were also discussed in 12 focus groups held with the participants. Results All the study participants started their drug use career with non-injecting forms including chewing, smoking, and sniffing before transitioning to injecting. Transitioning was generally described as a peer-driven and socially learnt behavior. The participants’ social networks and accessibility to injectable drugs on the market and among close friends influenced the time lag between first regular drug use and first injecting—which took an average of 4.5 years. By the age of 24, at least 81.6% (95.7% for females and 78.4% for males) had transitioned into injecting. Over 84.8% shared injecting equipment during their first injection, 47.2% started injecting because a close friend was already injecting, 26.4% desired to achieve a greater “high” (26.4%) which could reflect drug-tolerance, and 12% out of curiosity.

Keywords: People who Use Drugs, transition, injection drug use, Uganda

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Authors: Esam Jassim

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Industries using conventional fossil fuels have an interest in better understanding the mechanism of particulate formation during combustion since such is responsible for emission of undesired inorganic elements that directly impact the atmospheric pollution level. Fine and ultrafine particulates have tendency to escape the flue gas cleaning devices to the atmosphere. They also preferentially collect on surfaces in power systems resulting in ascending in corrosion inclination, descending in the heat transfer thermal unit, and severe impact on human health. This adverseness manifests particularly in the regions of world where coal is the dominated source of energy for consumption. This study highlights the behavior of calcium transformation as mineral grains verses organically associated inorganic components during pulverized coal combustion. The influence of existing type of calcium on the coarse, fine and ultrafine mode formation mechanisms is also presented. The impact of two sub-bituminous coals on particle size and calcium composition evolution during combustion is to be assessed. Three mixed blends named Blends 1, 2, and 3 are selected according to the ration of coal A to coal B by weight. Calcium percentage in original coal increases as going from Blend 1 to 3. A mathematical model and a new approach of describing constituent distribution are proposed. Analysis of experiments of calcium distribution in ash is also modeled using Poisson distribution. A novel parameter, called elemental index λ, is introduced as a measuring factor of element distribution. Results show that calcium in ash that originally in coal as mineral grains has index of 17, whereas organically associated calcium transformed to fly ash shown to be best described when elemental index λ is 7. As an alkaline-earth element, calcium is considered the fundamental element responsible for boiler deficiency since it is the major player in the mechanism of ash slagging process. The mechanism of particle size distribution and mineral species of ash particles are presented using CCSEM and size-segregated ash characteristics. Conclusions are drawn from the analysis of pulverized coal ash generated from a utility-scale boiler.

Keywords: coal combustion, inorganic element, calcium evolution, fluid dynamics

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Authors: Chen T. Chen, Hui L. Cheng

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Due to the different knowledge, experience and expertise of experts, they usually provide the different opinions in the group decision-making process. Therefore, it is an important issue to reach the group consensus of opinions of experts in group multiple-criteria decision-making (GMCDM) process. Because the subjective opinions of experts always are fuzziness and uncertainties, it is difficult to use crisp values to describe the real opinions of experts or decision-makers. It is reasonable for experts to use the linguistic variables to express their opinions. The hesitant fuzzy set are extended from the concept of fuzzy sets. Experts use the hesitant fuzzy sets can be flexible to describe their subjective opinions. In order to aggregate the hesitant fuzzy linguistic variables of all experts effectively, an adjustment method based on distance function will be presented in this paper. Based on the opinions adjustment method, this paper will present an effective approach to adjust the hesitant fuzzy linguistic variables of all experts to reach the group consensus. Then, a new hesitant linguistic GMCDM method will be presented based on the group consensus of hesitant fuzzy linguistic variables. Finally, an example will be implemented to illustrate the computational process to enhance the practical value of the proposed model.

Keywords: group multi-criteria decision-making, linguistic variables, hesitant fuzzy linguistic variables, distance function, group consensus

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Authors: Gajendra Kumar Mourya, Dinesh Bhatia, Akash Handique, Sunita Warjri, Syed Achaab Amir

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Nowadays, Medical imaging has become an integral part of modern healthcare. Abdominal CT images are an invaluable mean for abdominal organ investigation and have been widely studied in the recent years. Diagnosis of liver pathologies is one of the major areas of current interests in the field of medical image processing and is still an open problem. To deeply study and diagnose the liver, segmentation of liver is done to identify which part of the liver is mostly affected. Manual segmentation of the liver in CT images is time-consuming and suffers from inter- and intra-observer differences. However, automatic or semi-automatic computer aided segmentation of the Liver is a challenging task due to inter-patient Liver shape and size variability. In this paper, we present a technique for automatic segmenting the liver from CT images using Random Forest Classifier. Random forests or random decision forests are an ensemble learning method for classification that operate by constructing a multitude of decision trees at training time and outputting the class that is the mode of the classes of the individual trees. After comparing with various other techniques, it was found that Random Forest Classifier provide a better segmentation results with respect to accuracy and speed. We have done the validation of our results using various techniques and it shows above 89% accuracy in all the cases.

Keywords: CT images, image validation, random forest, segmentation

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Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

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Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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Authors: Zahra Khodaee

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Background and Objective: The attractive potential for tourism in the southern islands of Iran, Kish, and Qeshm and recently Hendurabi, are becoming more and more popular and object of increased attention from the investors. The Iranian coral reef islands, with the exception of Kish and Qeshm, have not undergone sufficient development. The southern islands of Iran have faced two problems with climate change and the desire for the presence of tourists. The lack of proper planning, inefficient management, and lack of adequate knowledge of ecosystems of offshore regions have severely damaged the world natural heritage. This study was conducted to consider the correlation of tourism, development, and ecosystem because there is a need for further addressing the ecotourism in coral islands. Method: Through qualitative research, this paper was used of library studies and field studies and surveying to study the physical (objective-subjective) physical factors of ecotourism development in Honduran Island. Using SPSS software and descriptive-analytical method was shown the results. The survey was conducted with the participation of 150 tourists on Kish islands, who were chosen at random and who expressed their desire to travel to Hendurabi Island. Information was gathered using SPSS software and unique statistical T-test. The questionnaire was put together using AMOS software to ensure that the questions asked were sufficiently relevant. Findings: The results of this study presented that physical factors affecting the development of ecotourism in two categories are objective and subjective factors because IFI factor = 0.911 and CFI Factor = 0.907 into the target community. Discussion and conclusion: The results were satisfactory in that they showed that eco-tourists attached importance to see views, quiet, secluded areas, tranquility security, quality of the area being visited, easy access to services these were the top criteria for those visiting the area while they adhere to environmental compliance. Developing Management of these regions should maintain appropriate utilization along with sustainable and ecological responsibility.

Keywords: ecotourism, coral reef island, development management, Hendurabi Island

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Authors: Rauf Razzaq, Kaiwu Dong, Muhammad Sharif, Ralf Jackstell, Matthias Beller

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Carbon dioxide (CO2), a key greenhouse gas produced from both anthropogenic and natural sources, has been recently considered to be an important C1 building-block for the synthesis of many industrial fuels and chemicals. Catalytic hydrogenation of CO2 using a heterogeneous system is regarded as an efficient process for CO2 valorization. In this regard CO2 reduction to CO via the reverse water gas shift reaction (RWGSR) has attracted much attention as a viable process for large scale commercial CO2 utilization. This process can generate syn-gas (CO+H2) which can provide an alternative route to direct CO2 conversion to methanol and/or liquid HCs from FT reaction. Herein, we report a highly active and selective silica supported copper catalyst with efficient CO2 reduction to CO in a slurry-bed batch autoclave reactor. The reactions were carried out at 200°C and 60 bar initial pressure with CO2/H2 ratio of 1:3 with varying temperature, pressure and fed-gas ratio. The gaseous phase products were analyzed using FID while the liquid products were analyzed by using FID detectors. It was found that Cu/SiO2 catalyst prepared using novel ammonia precipitation-urea gelation method achieved 26% CO2 conversion with a CO and methanol selectivity of 98 and 2% respectively. The high catalytic activity could be attributed to its strong metal-support interaction with highly dispersed and stabilized Cu+ species active for RWGSR. So, it can be concluded that reduction of CO2 to CO via RWGSR could address the problem of using CO2 gas in C1 chemistry.

Keywords: CO2 reduction, methanol, slurry reactor, synthesis gas

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Mabrouka Immhemd Al-Werfalli

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How are political alienation and corruption related? What is the nature of relationship linking corruption and political alienation? When citizens withdraw their loyalty from their political regime and leaders, they highlight their alienation from them. The link between corruption and political alienation is that the individual would intentionally involve in corruption particularly when a state of lawlessness prevails. This paper represents a challenge- how to gauge a link between political alienation culture of corruption and corruption. It aims to highlight the political alienation related factors that determine the levels of corruption in Libya. One of the most prominent reasons for the Libyan uprising in February 2011 was the pervasiveness of corruption. Corruption in Libya remained a significant problem despite a robust anti-corruption discourse and harsh legislation undertaken by the previous regime. The long-standing political corruption in Libya has offered ample opportunity for the evolution of a structure of negative values and morals. This has formed what is termed as a ‘culture of corruption’, which has induced people to accept and justify corrupt behavior. The paper is a part of a study concerns the phenomenon of political alienation in Libya which was based on a survey conducted in 2001 in the city of Benghazi. The finding shows that abuse of power, embezzlement and misuse of public funds for personal enrichment was thought to be rife within public bodies, institutions, companies, factories, banks and enterprises owned entirely or partially by the state.

Keywords: Libya, abuse of power, anti-corruption, corruption, culture of corruption, embezzlement, participation in corruption, political alienation

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Authors: Vijay Khopkar, Balaram Sahoo

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Material with high value of dielectric constant has application in the electronics devices. Existing lead based materials have issues such as toxicity and problem with synthesis procedure. Double perovskite structured barium iron niobate (BaFe0.5Nb0.5O3, BFN) is the lead-free material, showing a high value of dielectric constant. Origin of high value of the dielectric constant in BFN is not clear. We studied the dielectric behavior of polycrystalline BFN sample over wide temperature and frequency range. A BFN sample synthesis by conventional solid states reaction method and phase pure dens pellet was used for dielectric study. The SEM and TEM study shows the presence of grain and grain boundary region. The dielectric measurement was done between frequency range of 40 Hz to 5 MHz and temperature between 20 K to 500 K. At 500 K temperature and lower frequency, there observed high value of dielectric constant which decreases with increase in frequency. The dipolar relaxation follows non-Debye type polarization with relaxation straight of 3560 at room temperature (300 K). Activation energy calculated from the dielectric and modulus formalism found to be 17.26 meV and 2.74 meV corresponds to the energy required for the motion of Fe3+ and Nb5+ ions within the oxygen octahedra. Our study shows that BFN is the order disorder type ferroelectric material.

Keywords: barium iron niobate, dielectric, ferroelectric, non-Debye

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Authors: S. Teimouri, S. Abbasi

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Milk-fruit juice mixture is a type of soft drinks, which can be produced by mixing milk with pieces of fruits, fruit juices, or fruit juices concentrates. The major problem of these products, mainly the acidic ones, is phase separation which occurs during formulation and storage due to the aggregation of caseins at low pH Short-chain inulin (CLR), long-chain inulin (TEX), native inulin (IQ) and Long-chain inulin (TEX) and short-chain inulin (CLR) combined in different proportions (2o:80, 50:50, and 80:20) were added (2-10 %) to sourcherry juice-milk mixture and their stabilization mechanisms were studied with using rheological and microstructural observations. Stevioside as a bio-sweetener and sugar-replacer was added at last step. Finally, sensory analyses were taken place on stabilized samples. According to the findings, TEX stabilized the mixture at concentration of 8%. MIX and IQ reduced phase separation at high concentration but had not complete effect on stabilization. CLR did not effect on stabilization. Rheological changes and inulin aggregates formation were not observed in CLR samples during the one month storage period. However TEX, MIX and IQ samples formed inulin aggregates and became more thixotropic, elastic and increased the viscosity of mixture. The rate of the inulin aggregates formation and viscosity increasing was in the following order TEX > MIX > IQ. Consequently the mixture which stabilized with inulin and sweetened with stevioside had the prebiotic properties which may suggest to diabetic patients and children.

Keywords: prebiotic, inulin, casein, stabilization, stevioside

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Authors: Hanae Ait Hattani, Nohaila Ait Hattani

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Globalization, with the rapid technological progress, is affecting every life aspect. The 21st century higher education faces a major challenge in preparing well-rounded and competent graduates to compete in the global marketplace. Worldwide, educational policies work to develop the quality of instruction at all educational levels by focusing on promoting students’ qualifications and skills, considering both academic activities and non-academic attributes. In fact, extracurricular activities (ECAs) complement the academic curriculum and enhance the student experience by improving their interpersonal skills and attitudes. This study comes to examine the potential of extracurricular activities as a vital tool for soft skills’ development. Using empirical research, the study aims to measure and evaluate the extent to which university students’ engagement in extracurricular activities contribute in positively changing their learning experience, fostering their soft skills and fostering their behaviors and attitudes. Findings emanating from a questionnaire and semi-structured interviews add a number of contributions to the literature. They support the assumption suggesting that ECAs can be considered a valuable way to acquire, develop, and demonstrate softs skills that students today need to evidence in a variety of contexts, such as communication skills, team work, leadership, problem-solving, to name but a few.

Keywords: extracurricular activities (ECAs), soft skills, education, university, attitude

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Authors: Sunil Kumar, Uday C. Ghoshal

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Background and aims: Serotonin (5-hydroxtryptamine, 5-HT) is an important factor in gut function, playing key roles in intestinal peristalsis and secretion, and in sensory signaling in the brain-gut axis. Removal from its sites of action is mediated by a specific protein called the serotonin reuptake transporter (SERT). Polymorphisms in the promoter region of the SERT gene have effects on transcriptional activity, resulting in altered 5-HT reuptake efficiency. Functional polymorphisms may underlie disturbance in gut function in individuals suffering with disorders such as irritable bowel syndrome (IBS). The aim of this study was to assess the potential association between SERT polymorphisms and the diarrhea predominant IBS (D-IBS) phenotype Subjects: A total of 36 northern Indian female patients and 55 female northern Indian healthy controls (HC) were subjected to genotyping. Methods: Leucocyte DNA of all subjects was analyzed by polymerase chain reaction based technologies for SERT polymorphisms, specifically the insertion/deletion polymorphism in the promoter (SERT-P). Statistical analysis was performed to assess association of SERT polymorphism allele with the D-IBS phenotype. Results: The frequency of distribution of SERT-P gene was comparable between female patients with IBS and HC (p = 0.086). However, frequency of SERT-P deletion/deletion genotype was significantly higher in female patients with D-IBS compared to C-IBS and A-IBS [17/19 (89.5%) vs. 4/12 (33.3%) vs. 1/5 (20%), p=0.001, respectively]. The mucosal level of serotonin was higher in D-IBS compared to C-IBS and A-IBS [Median, range (159.26, 98.78–212.1) vs. 110.4, 67.87–143.53 vs. 92.34, 78.8–166.3 pmol/mL, p=0.001, respectively]. The mucosal level of serotonin was higher in female patients with IBS with SERT-P deletion/deletion genotype compared deletion/insertion and insertion/insertion [157.65, 67.87–212.1 vs. 110.4, 78.1–143.32 vs. 100.5, 69.1–132.03 pmol/mL, p=0.001, respectively]. Patients with D-IBS with deletion/deletion genotype more often reported symptoms of abdominal pain, discomfort (p=0.025) and bloating (p=0.039). Symptoms development following lactose ingestion was strongly associated with D-IBS and SERT-P deletion/deletion genotype (p=0.004). Conclusions: Significant association was observed between D-IBS and the SERT-P deletion/deletion genotype, suggesting that the serotonin transporter is a potential candidate gene for D-IBS in women.

Keywords: serotonin, SERT, inflammatory bowel disease, genetic polymorphism

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Authors: Amr AbdelAzim Ali, G. A. Elsheikh, Moutaz M. Hegazy

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Reaction wheels (RWs) are generally used as main actuator in the attitude control system (ACS) of spacecraft (SC) for fast orientation and high pointing accuracy. In order to achieve the required accuracy for the RWs model, the main characteristics of the RWs that necessitate analysis during the ACS design phase include: technical features, sequence of operating and RW control logic are included in function (behavior) model. A mathematical model is developed including the various errors source. The errors in control torque including relative, absolute, and error due to time delay. While the errors in angular velocity due to differences between average and real speed, resolution error, loose in installation of angular sensor, and synchronization errors. The friction torque is presented in the model include the different feature of friction phenomena: steady velocity friction, static friction and break-away torque, and frictional lag. The model response is compared with the experimental torque and frequency-response characteristics of tested RWs. Based on the created RW model, some criteria of optimization based control torque allocation problem can be recommended like: avoiding the zero speed crossing, bias angular velocity, or preventing wheel from running on the same angular velocity.

Keywords: friction torque, reaction wheels modeling, software in the loop, spacecraft attitude control

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Authors: Amare Worku, Harikrishnan Muralidharan

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The research for more environmentally friendly sources of energy is a result of growing environmental awareness. In this aspect, wind energy is a very good option and there are two different wind turbines, horizontal axis wind turbine (HAWT) and vertical axis turbine (VAWT). For locations outside of integrated grid networks, vertical axis wind turbines (VAWT) present a feasible solution. However, those turbines have several drawbacks related to various setups, VAWT has a very low efficiency when compared with HAWT, but they work under different conditions and installation areas. This paper reviewed numerous measurements taken to improve the efficiency of VAWT configurations, either directly or indirectly related to the performance efficiency of the turbine. Additionally, the comparison and advantages of HAWT and VAWT turbines and also the findings of the design methodologies used for the VAWT design have been reviewed together with efficiency enhancement revision. Most of the newly modified designs are based on the turbine blade structure modification but need other studies on behalf other than electromechanical modification. Some of the techniques, like continuous variation of pitch angle control and swept area control, are not the most effective since VAWT is Omni-directional, and so wind direction is not a problem like HAWT. Hybrid system technology has become one of the most important and efficient methods to enhance the efficiency of VAWT. Besides hybridization, the contra-rotating method is also good if the installation area is big enough in an urban area.

Keywords: wind turbine, horizontal axis wind turbine, vertical axis wind turbine, hybridization

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Authors: A. Soualem

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The design of multi stage deep drawing processes requires the evaluation of many process parameters such as the intermediate die geometry, the blank shape, the sheet thickness, the blank holder force, friction, lubrication etc..These process parameters have to be determined for the optimum forming conditions before the process design. In general sheet metal forming may involve stretching drawing or various combinations of these basic modes of deformation. It is important to determine the influence of the process variables in the design of sheet metal working process. Especially, the punch and die corner for deep drawing will affect the formability. At the same time the prediction of sheet metals springback after deep drawing is an important issue to solve for the control of manufacturing processes. Nowadays, the importance of this problem increases because of the use of steel sheeting with high stress and also aluminum alloys. The aim of this paper is to give a better understanding of the springback and its effect in various sheet metals forming process such as expansion and restraint deep drawing in the cup drawing process, by varying radius die, lubricant for two commercially available materials e.g. galvanized steel and Aluminum sheet. To achieve these goals experiments were carried out and compared with other results. The original of our purpose consist on tests which are ensured by adapting a U-type stretching-bending device on a tensile testing machine, where we studied and quantified the variation of the springback.

Keywords: springback, deep drawing, expansion, restricted deep drawing

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Authors: José Luis Gallizo, Pilar Gargallo, Ramon Saladrigues, Manuel Salvador

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This study offers an exploratory statistical analysis of the persistence of annual profits across a sample of firms from different European Union (EU) countries. To this end, a hierarchical Bayesian dynamic model has been used which enables the annual behaviour of those profits to be broken down into a permanent structural and a transitory component, while also distinguishing between general effects affecting the industry as a whole to which each firm belongs and specific effects affecting each firm in particular. This breakdown enables the relative importance of those fundamental components to be more accurately evaluated by country and sector. Furthermore, Bayesian approach allows for testing different hypotheses about the homogeneity of the behaviour of the above components with respect to the sector and the country where the firm develops its activity. The data analysed come from a sample of 23,293 firms in EU countries selected from the AMADEUS data-base. The period analysed ran from 1999 to 2007 and 21 sectors were analysed, chosen in such a way that there was a sufficiently large number of firms in each country sector combination for the industry effects to be estimated accurately enough for meaningful comparisons to be made by sector and country. The analysis has been conducted by sector and by country from a Bayesian perspective, thus making the study more flexible and realistic since the estimates obtained do not depend on asymptotic results. In general terms, the study finds that, although the industry effects are significant, more important are the firm specific effects. That importance varies depending on the sector or the country in which the firm carries out its activity. The influence of firm effects accounts for around 81% of total variation and display a significantly lower degree of persistence, with adjustment speeds oscillating around 34%. However, this pattern is not homogeneous but depends on the sector and country analysed. Industry effects depends also on sector and country analysed have a more marginal importance, being significantly more persistent, with adjustment speeds oscillating around 7-8% with this degree of persistence being very similar for most of sectors and countries analysed.

Keywords: dynamic models, Bayesian inference, MCMC, abnormal returns, persistence of profits, return on assets

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Authors: Salima Taleb, Kafila Boulaba, Ahlem Yousfi, Nada Taleb, Difallah Basma

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Introduction: Obesity is recognized as a cardiovascular risk factor. It is associated with cardio-metabolic diseases. Its prevalence is increasing significantly in both rich and poor countries. However, there are obese people who have no metabolic disturbance. So we think obesity is not always a risk factor for an abnormal metabolic profile that increases the risk of cardiometabolic problems. However, there is no definition that allows us to identify the individual group Metabolically Healthy but Obese (MHO). Objective: The objective of this study is to evaluate the relationship between MHO and some factors associated with it. Methods: A longitudinal study is a prospective cohort study of 600 participants aged ≥18 years. Metabolic status was assessed by the following parameters: blood pressure, fasting glucose, total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Body Mass Index (BMI) was calculated as weight (in kg) divided by height (m2), BMI = Weight/(Height)². According to the BMI value, our population was divided into four groups: underweight subjects with BMI <18.5 kg/m2, normal weight subjects with BMI = 18.5–24.9 kg/m², overweight subjects with BMI=25–29.9 kg/m², and obese subjects who have (BMI ≥ 30 kg/m²). A value of P < 0.05 was considered significant. Statistical processing was done using the SPSS 25 software. Results: During this study, 194 (32.33%) were identified as MHO among 416 (37%) obese individuals. The prevalence of the metabolically unhealthy phenotype among normal-weight individuals was (13.83%) vs. (37%) in obese individuals. Compared with metabolically healthy normal-weight individuals (10.93%), the prevalence of diabetes was (30.60%) in MHO, (20.59%) in metabolically unhealthy normal weight, and (52.29%) for metabolically unhealthy obese (p = 0.032). Blood pressure was significantly higher in MHO individuals than in metabolically healthy normal-weight individuals and in metabolically unhealthy obese than in metabolically unhealthy normal weight (P < 0.0001). Familial coronary artery disease does not appear to have an effect on the metabolic status of obese and normal-weight patients (P = 0.544). However, waist circumference appears to have an effect on the metabolic status of individuals (P < 0.0001). Conclusion: This study showed a high prevalence of metabolic profile disruption in normal-weight subjects and a high rate of overweight and/or obese people who are metabolically healthy. To understand the physiological mechanism related to these metabolic statuses, a thorough study is needed.

Keywords: metabolically health, obesity, factors associated, cardiovascular diseases

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Authors: U. Yerlikaya, R. T. Balkan

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In this research, a method is developed to obtain high-dimensional configuration space for path planning problems. In typical cases, the path planning problems are solved directly in the 3-dimensional (D) workspace. However, this method is inefficient in handling the robots with various geometrical and mechanical restrictions. To overcome these difficulties, path planning may be formalized and solved in a new space which is called configuration space. The number of dimensions of the configuration space comes from the degree of freedoms of the system of interest. The method can be applied in two ways. In the first way, the point clouds of all the bodies of the system and interaction of them are used. The second way is performed via using the clearance function of simulation software where the minimum distances between surfaces of bodies are simultaneously measured. A double-turret system is held in the scope of this study. The 4-D configuration space of a double-turret system is obtained in these two ways. As a result, the difference between these two methods is around 1%, depending on the density of the point cloud. The disparity between the two forms steadily decreases as the point cloud density increases. At the end of the study, in order to verify 4-D configuration space obtained, 4-D path planning problem was realized as 2-D + 2-D and a sample path planning is carried out with using A* algorithm. Then, the accuracy of the configuration space is proved using the obtained paths on the simulation model of the double-turret system.

Keywords: A* algorithm, autonomous turrets, high-dimensional C-space, manifold C-space, point clouds

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Authors: Diya Kohli, Amalia Ardeljan, Lexi Frankel, Jose Garcia, Lokesh Manjani, Omar Rashid

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Gonorrhea is the second most common sexually transmitted disease (STDs) in the United States of America. Gonorrhea affects the urethra, rectum, or throat and the cervix in females. Lymphoma is a cancer of the immune network called the lymphatic system that includes the lymph nodes/glands, spleen, thymus gland, and bone marrow. Lymphoma can affect many organs in the body. When a lymphocyte develops a genetic mutation, it signals other cells into rapid proliferation that causes many mutated lymphocytes. Multiple studies have explored the incidence of cancer in people infected with STDs such as Gonorrhea. For instance, the studies conducted by Wang Y-C and Co., as well as Caini, S and Co. established a direct co-relationship between Gonorrhea infection and incidence of prostate cancer. We hypothesize that Gonorrhea infection also increases the incidence of Lymphoma in patients. This research study aimed to evaluate the correlation between Gonorrhea infection and the incidence of Lymphoma. The data for the research was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. This database was utilized to evaluate patients infected with Gonorrhea versus the ones who were not infected to establish a correlation with the prevalence of Lymphoma using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for academic research. Standard statistical methods were applied throughout. Between January 2010 and December 2019, the query was analyzed and resulted in 254 and 808 patients in both the infected and control group, respectively. The two groups were matched by Age Range and CCI score. The incidence of Lymphoma was 0.998% (254 patients out of 25455) in the Gonorrhea group (patients infected with Gonorrhea that was Lymphoma Positive) compared to 3.174% and 808 patients in the control group (Patients negative for Gonorrhea but with Lymphoma). This was statistically significant by a p-value < 2.210-16 with an OR= 0.431 (95% CI 0.381-0.487). The patients were then matched by antibiotic treatment to avoid treatment bias. The incidence of Lymphoma was 1.215% (82 patients out of 6,748) in the Gonorrhea group compared to 2.949% (199 patients out of 6748) in the control group. This was statistically significant by a p-value <5.410-10 with an OR= 0.468 (95% CI 0.367-0.596). The study shows a statistically significant correlation between Gonorrhea and a reduced incidence of Lymphoma. Further evaluation is recommended to assess the potential of Gonorrhea in reducing Lymphoma.

Keywords: gonorrhea, lymphoma, STDs, cancer, ICD

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Authors: Pramod Ghadge, Swadesh Srivastava

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Revenue generation of a logistics company depends on how the logistics cost of a shipment is calculated. Logistics cost of a shipment is a function of distance & speed of the shipment travel in a particular network, its volumetric size and dead weight. Logistics billing is based mainly on the consumption of the scarce resource (space or weight carrying capacity of a carrier). Shipment’s size or deadweight is a function of product and packaging weight, dimensions and flexibility. Hence, to arrive at a standard methodology to compute accurate cost to bill the customer, the interplay among above mentioned physical attributes along with their measurement plays a key role. This becomes even more complex for an ecommerce company, like Flipkart, which caters to shipments from both warehouse and marketplace in an unorganized non-standard market like India. In this paper, we will explore various methodologies to define a standard way of billing the non-standard shipments across a wide range of size, shape and deadweight. Those will be, usage of historical volumetric/dead weight data to arrive at a factor which can be used to compute the logistics cost of a shipment, also calculating the real/contour volume of a shipment to address the problem of irregular shipment shapes which cannot be solved by conventional bounding box volume measurements. We will also discuss certain key business practices and operational quality considerations needed to bring standardization and drive appropriate ownership in the ecosystem.

Keywords: contour volume, logistics, real volume, volumetric weight

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Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

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Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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Authors: Abhiyan Paudel, Maheshwaran M Pillai

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This paper deals with the optimization and comparison of slender delta wing and blended wing body. The objective is to study the difference between the two wing types and analyze the various aerodynamic characteristics of both of these types.The blended-wing body is an aircraft configuration that has the potential to be more efficient than conventional large transport aircraft configurations with the same capability. The purported advantages of the BWB approach are efficient high-lift wings and a wide airfoil-shaped body. Similarly, symmetric separation vortices over slender delta wing may become asymmetric as the angle of attack is increased beyond a certain value, causing asymmetric forces even at symmetric flight conditions. The transition of the vortex pattern from being symmetric to asymmetric over symmetric bodies under symmetric flow conditions is a fascinating fluid dynamics problem and of major importance for the performance and control of high-maneuverability flight vehicles that favor the use of slender bodies. With the use of Star CCM, we analyze both the fluid properties. The CL, CD and CM were investigated in steady state CFD of BWB at Mach 0.3 and through wind tunnel experiments on 1/6th model of BWB at Mach 0.1. From CFD analysis pressure variation, Mach number contours and turbulence area was observed.

Keywords: Coefficient of Lift, Coefficient of Drag, CFD=Computational Fluid Dynamics, BWB=Blended Wing Body, slender delta wing

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Authors: S. Srikiran, Dharmala Venkata Padmaja, P. N. L. Pavani, R. Pola Rao, K. Ramji

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Technological advancements in the development of cutting tools and coolant/lubricant chemistry have enhanced the machining capabilities of hard materials under higher machining conditions. Generation of high temperatures at the cutting zone during machining is one of the most important and pertinent problems which adversely affect the tool life and surface finish of the machined components. Generally, cutting fluids and solid lubricants are used to overcome the problem of heat generation, which is not effectively addressing the problems. With technological advancements in the field of tribology, nano-level particulate solid lubricants are being used nowadays in machining operations, especially in the areas of turning and grinding. The present investigation analyses the effect of using nano-particulate graphite powder as lubricant in the turning of AISI 1040 steel under variable machining conditions and to study its effect on cutting forces, tool temperature and surface roughness of the machined component. Experiments revealed that the increase in cutting forces and tool temperature resulting in the decrease of surface quality with the decrease in the size of nano-particulate graphite powder as lubricant.

Keywords: solid lubricant, graphite, minimum quantity lubrication (MQL), nano–particles

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Mohanad Alhabo, Li Zhang, Naveed Nawaz

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Small cell deployment in 5G networks is a promising technology to enhance capacity and coverage. However, unplanned deployment may cause high interference levels and high number of unnecessary handovers, which in turn will result in an increase in the signalling overhead. To guarantee service continuity, minimize unnecessary handovers, and reduce signalling overhead in heterogeneous networks, it is essential to properly model the handover decision problem. In this paper, we model the handover decision according to Multiple Attribute Decision Making (MADM) method, specifically Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS). In this paper, we propose a hybrid TOPSIS method to control the handover in heterogeneous network. The proposed method adopts a hybrid weighting, which is a combination of entropy and standard deviation. A hybrid weighting control parameter is introduced to balance the impact of the standard deviation and entropy weighting on the network selection process and the overall performance. Our proposed method shows better performance, in terms of the number of frequent handovers and the mean user throughput, compared to the existing methods.

Keywords: handover, HetNets, interference, MADM, small cells, TOPSIS, weight

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Authors: Mahmoud Hassanin, Amita Gupta

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Background: During current practice, Thiopentone is not cost-effectively added to resources wastage, risk of drug error with antibiotics, short shelf life, infection risk, and risk of delay while preparing during category one cesarean section. There is no significant difference or preference to the other alternative as per current use. Aims and Objectives: Patient safety, Cost-effective use of trust resources, problem awareness, Consider improvising on the current practice. Methods: In conjunction with the local department survey results, many studies support the change. Results: More than 50%(15 from 29) are already using Propofol, more than 75% of the participant are willing to shift to Propofol if it becomes standard, and the cost analysis also revealed that Thiopentone 10 X500=£60 Propofol 10X200= £5.20, Cost of Thiopentone/year =£2190. Approximately GA in a year =35-40 could cost approximately £20 Propofol, given it is a well-established practice. We could save not only money, but it will be environmentally friendly also to avoid adding any carbon footprints. Recommendation: Thiopentone is rarely used as an induction agent for the category one Caesarean section in our obstetric emergency theatres. Most obstetric anesthetists are using Propofol. Keep both Propofol and thiopentone(powder not withdrawn) in the cat one cesarean section emergency drugs tray ready until the department completely changes the practice protocol. A further retrospective study is required to compare the outcomes for these induction agents through the local database.

Keywords: thiopentone, propofol, category 1 caesarean, induction agents

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Authors: Rui Liu, Pengyu Cui, Nan Jiang

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At present, there is much research on the application of centralized management and cross-integration application of basic geographic information. However, the idea of information integration and sharing between land, sea, and air navigation targets is not deeply applied into the research of navigation information service, especially in the information expression. Targeting at this problem, the paper carries out works about the expression pattern of navigation electronic map for ground vehicles under air and land united navigation mechanism. At first, with the support from multi-source information fusion of GIS vector data, RS data, GPS data, etc., an air and land united information expression pattern is designed aiming at specific navigation task of emergency rescue in the earthquake. And then, the characteristics and specifications of the united expression of air and land navigation information under the constraints of map load are summarized and transferred into expression rules in the rule bank. At last, the related navigation experiment is implemented to evaluate the effect of the expression pattern. The experiment selects evaluation factors of the navigation task accomplishment time and the navigation error rate as the main index, and make comparisons with the traditional single information expression pattern. To sum up, the research improved the theory of navigation electronic map and laid a certain foundation for the design and realization of united navigation system in the aspect of real-time navigation information delivery.

Keywords: navigation electronic map, united navigation, multi-element expression pattern, multi-source information fusion

Procedia PDF Downloads 175