Search results for: elderly care service model

Authors: Najia Zulfiqar

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Imparting moral education is the need of time, considering the obvious moral decline in society. Recent research shows the downfall of moral competence among university students. The main objective of the present study was to develop moral development intervention strategies for undergraduate students of Sports and Physical Education. Using an interpretative phenomenological approach, insight into field-specific moral issues was gained through interviews with 7 subject experts and a focus-group discussion session with 8 students. Two research assistants who were trained in qualitative interviewing collected, transcribed and analyzed data into the MAXQDA software using content and discourse analyses. The identified moral issues in Sports and Physical Education were sports gambling and betting, pay-for-play, doping, coach misconduct, tampering, cultural bias, gender equity/nepotism, bullying/discrimination, and harassment. Next, intervention modules were developed for each moral issue based on hypothetical situations, and followed by guided reflection and dilemma discussion questions. The third moral development strategy was community services that included posture screening, diet plan for different age groups, open fitness ground training, exercise camps for physical fitness, balanced diet awareness camp, gymnastic camp, shoe assessment as per health standards, and volunteering for public awareness at the playground, gymnasium, stadium, park, etc. The intervention modules were given to four subject specialists for expert validation who were from different backgrounds within Sport Sciences. Upon refinement and finalization, four students were presented with these intervention modules and questioned about accuracy, relevance, comprehension, and content organization. Iterative changes were made in the content of the intervention modules to tailor them to the moral development needs of undergraduate students. This intervention will strengthen positive moral values and foster mature decision-making about right and wrong acts. As this intervention is easy to apply as a remedial tool, academicians and policymakers can use this to promote students’ moral development.

Keywords: community service, dilemma discussion, morality, physical education, university students.

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Authors: Armin Nabaei, M. Omair Ahmad, M. N. S. Swamy

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Many facial expression and emotion recognition methods in the traditional approaches of using LDA, PCA, and EBGM have been proposed. In recent years deep learning models have provided a unique platform addressing by automatically extracting the features for the detection of facial expression and emotions. However, deep networks require large training datasets to extract automatic features effectively. In this work, we propose an efficient emotion detection algorithm using face images when only small datasets are available for training. We design a deep network whose feature extraction capability is enhanced by utilizing several parallel modules between the input and output of the network, each focusing on the extraction of different types of coarse features with fined grained details to break the symmetry of produced information. In fact, we leverage long range dependencies, which is one of the main drawback of CNNs. We develop this work by introducing a Dynamic Soft-Margin SoftMax.The conventional SoftMax suffers from reaching to gold labels very soon, which take the model to over-fitting. Because it’s not able to determine adequately discriminant feature vectors for some variant class labels. We reduced the risk of over-fitting by using a dynamic shape of input tensor instead of static in SoftMax layer with specifying a desired Soft- Margin. In fact, it acts as a controller to how hard the model should work to push dissimilar embedding vectors apart. For the proposed Categorical Loss, by the objective of compacting the same class labels and separating different class labels in the normalized log domain.We select penalty for those predictions with high divergence from ground-truth labels.So, we shorten correct feature vectors and enlarge false prediction tensors, it means we assign more weights for those classes with conjunction to each other (namely, “hard labels to learn”). By doing this work, we constrain the model to generate more discriminate feature vectors for variant class labels. Finally, for the proposed optimizer, our focus is on solving weak convergence of Adam optimizer for a non-convex problem. Our noteworthy optimizer is working by an alternative updating gradient procedure with an exponential weighted moving average function for faster convergence and exploiting a weight decay method to help drastically reducing the learning rate near optima to reach the dominant local minimum. We demonstrate the superiority of our proposed work by surpassing the first rank of three widely used Facial Expression Recognition datasets with 93.30% on FER-2013, and 16% improvement compare to the first rank after 10 years, reaching to 90.73% on RAF-DB, and 100% k-fold average accuracy for CK+ dataset, and shown to provide a top performance to that provided by other networks, which require much larger training datasets.

Keywords: computer vision, facial expression recognition, machine learning, algorithms, depp learning, neural networks

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Authors: L. Matthewman, J. Nowlan

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Background: Holistic or Integrative Psychology emphasizes the interdependence of physiological, spiritual and psychological dynamics. Studying “wholeness and well-being” from a systems perspective combines innovative psychological science interventions with Eastern orientated healing wisdoms and therapies. The literature surrounding holistic/integrative psychology focuses on multi-stage interventions in attempts to enhance the mind-body experiences of well-being for participants. This study proposes a new single stage model as an intervention for UG/PG students, time-constrained workplace employees and managers/leaders for improved well-being and life enhancement. The main research objective was to investigate participants’ experiences of holistic and mindfulness interventions for impact on emotional well-being. The main research question asked was if single stage holistic interventions could impact on psychological well-being. This is of consequence because many people report that a reason for not taking part in mind-body or wellness programmes is that they believe that they do not have sufficient time to engage in such pursuits. Experimental Approach: The study employed a mixed methods pre-test/post-test research design. Data was analyzed using descriptive statistics and interpretative phenomenological analysis. Purposive sampling methods were employed. An adapted mindfulness measurement questionnaire (MAAS) was administered to 20 volunteer final year UG student participants prior to the single stage intervention and following the intervention. A further post-test longitudinal follow-up took place one week later. Intervention: The single stage model intervention consisted of a half hour session of mindfulness, yoga stretches and head and neck massage in the following sequence: Mindful awareness of the breath, yoga stretches 1, mindfulness of the body, head and neck massage, mindfulness of sounds, yoga stretches 2 and finished with pure awareness mindfulness. Results: The findings on the pre-test indicated key themes concerning: “being largely unaware of feelings”, “overwhelmed with final year exams”, “juggling other priorities” , “not feeling in control”, “stress” and “negative emotional display episodes”. Themes indicated on the post-test included: ‘more aware of self’, ‘in more control’, ‘immediately more alive’ and ‘just happier’ compared to the pre-test. Themes from post-test 2 indicated similar findings to post-test 1 in terms of themes. but on a lesser scale when scored for intensity. Interestingly, the majority of participants reported that they would now seek other similar interventions in the future and would be likely to engage with a multi-stage intervention type on a longer-term basis. Overall, participants reported increased psychological well-being after the single stage intervention. Conclusion: A single stage one-off intervention model can be effective to help towards the wellbeing of final year UG students. There is little indication to suggest that this would not be generalizable to others in different areas of life and business. However this study must be taken with caution due to low participant numbers. Implications: Single stage one-off interventions can be used to enhance peoples’ lives who might not otherwise sign up for a longer multi-stage intervention. In addition, single stage interventions can be utilized to help participants progress onto longer multiple stage interventions. Finally, further research into one stage well-being interventions is encouraged.

Keywords: holistic/integrative psychology, mindfulness, well-being, yoga

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Authors: Abbas Kamalibandpey, Alain Beland, Joseph Mukendi Kabuya

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Since a rock mass is a discontinuum medium, its behaviour is governed by discontinuities such as faults, joint sets, lithologic contact, and bedding planes. Thus, rock slope stability analysis in jointed rock masses is largely dependent upon discontinuities constitutive equations. This paper studies the difference between the Mohr-Coulomb (MC) and the Barton-Bandis (BB) joint constitutive numerical models for lithological contacts and joint sets. For the rock in these models, generalized Hoek-Brown criteria have been considered. The joint roughness coefficient (JRC) and the joint wall compressive strength (JCS) are vital parameters in the BB model. The numerical models are applied to the rock slope stability analysis in the Mont-Wright (MW) mine. The Mont-Wright mine is owned and operated by ArcelorMittal Mining Canada (AMMC), one of the largest iron-ore open pit operations in Canada. In this regard, one of the high walls of the mine has been selected to undergo slope stability analysis with RS2D software, finite element method. Three piezometers have been installed in this zone to record pore water pressure and it is monitored by radar. In this zone, the AMP-IF and QRMS-IF contacts and very persistent and altered joint sets in IF control the rock slope behaviour. The height of the slope is more than 250 m and consists of different lithologies such as AMP, IF, GN, QRMS, and QR. To apply the B-B model, the joint sets and geological contacts have been scanned by Maptek, and their JRC has been calculated by different methods. The numerical studies reveal that the JRC of geological contacts, AMP-IF and QRMS-IF, and joint sets in IF had a significant influence on the safety factor. After evaluating the results of rock slope stability analysis and the radar data, the B-B constitutive equation for discontinuities has shown acceptable results to the real condition in the mine. It should be noted that the difference in safety factors in MC and BB joint constitutive models in some cases is more than 30%.

Keywords: barton-Bandis criterion, Hoek-brown and Mohr-Coulomb criteria, open pit, slope stability

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Authors: Mohamed Thani Ibouroi, Ali Cheha, Claudine Montgelard, Veronique Arnal, Dawiyat Massoudi, Guillelme Astruc, Said Ali Ousseni Dhurham, Aurelien Besnard

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The Livingstone's flying fox (Pteropus livingstonii) and the Comorian fruit bat (P.seychellensis comorensis) are two endemic fruit bat species among the mostly threatened animals of the Comoros archipelagos. Despite their role as important ecosystem service providers like all flying fox species as pollinators and seed dispersers, little is known about their ecologies, population genetics and structures making difficult the development of evidence-based conservation strategies. In this study, we assess spatial distribution and ecological niche of both species using Species Distribution Modeling (SDM) based on the recent Ensemble of Small Models (ESMs) approach using presence-only data. Population structure and genetic diversity of the two species were assessed using both mitochondrial and microsatellite markers based on non-invasive genetic samples. Our ESMs highlight a clear niche partitioning of the two sympatric species. Livingstone’s flying fox has a very limited distribution, restricted on steep slope of natural forests at high elevation. On the contrary, the Comorian fruit bat has a relatively large geographic range spread over low elevations in farmlands and villages. Our genetic analysis shows a low genetic diversity for both fruit bats species. They also show that the Livingstone’s flying fox population of the two islands were genetically isolated while no evidence of genetic differentiation was detected for the Comorian fruit bats between islands. Our results support the idea that natural habitat loss, especially the natural forest loss and fragmentation are the important factors impacting the distribution of the Livingstone’s flying fox by limiting its foraging area and reducing its potential roosting sites. On the contrary, the Comorian fruit bats seem to be favored by human activities probably because its diets are less specialized. By this study, we concluded that the Livingstone’s flying fox species and its habitat are of high priority in term of conservation at the Comoros archipelagos scale.

Keywords: Comoros islands, ecological niche, habitat loss, population genetics, fruit bats, conservation biology

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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People with diabetes mellitus are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defences. People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defences in diabetes. People who have minimally elevated blood sugar levels experience worse outcomes with infections. Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalisation and recovery times. A study was done in a tertiary care unit in eastern India. Patients with type 2 diabetes mellitus infection were recruited in the study. A total of 520 cases of Type 2 Diabetes Mellitus were recorded out of which 200 infectious cases was included in the study. All subjects underwent detailed history & clinical examination. Microbiological samples were collected from respective site of the infection for microbial culture and antibiotic sensitivity test. Out of the 200 infectious cases urinary tract infection(UTI) was found in majority of the cases followed by diabetic foot ulcer (DFU), respiratory tract infection(RTI) and sepsis. It was observed that Escherichia coli was the most commonest pathogen isolated from UTI cases and Staphylococcus aureus was predominant in foot ulcers followed by other organisms. Klebsiella pneumonia was the major organism isolated from RTI and Enterobacter aerogenes was commonly observed in patients with sepsis. Isolated bacteria showed differential sensitivity pattern against commonly used antibiotics. The majority of the isolates were resistant to several antibiotics that are usually prescribed on an empirical basis. These observations are important, especially for patient management and the development of antibiotic treatment guidelines. It is recommended that diabetic patients receive pneumococcal and influenza vaccine annually to reduce morbidity and mortality. Appropriate usage of antibiotics based on local antibiogram pattern can certainly help the clinician in reducing the burden of infections.

Keywords: antimicrobial resistance, diabetic foot ulcer, respiratory tract infection, urinary tract infection

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Authors: Burhan Khan

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Objective: This study aims to enhance the body of knowledge about the vulnerabilities of child waste pickers in solid waste management. The primary objective of this research is to investigate the occupational menaces and their potential harm to the health of child waste pickers. Material and Methods: The present study design is descriptive in nature and involves children aged 5 through 14, who were rummaging through garbage in the roads and streets of Aligarh city, Uttar Pradesh. The researcher adopted an empirical approach to interview 65 participants (27 boys and 38 girls) across Aligarh city, Uttar Pradesh. The majority of the participants are Muslims (76.9 %), scheduled Castes (13.8 %), and Hindus (9.2 %). Out of 65 participants, 73.8% of children were migrated within the last five years. The primary data were analysed by utilising descriptive statistics, including frequencies, cross-tabs, means, and percentages. Results: The results show that the vast majority of children (87.7%) have experienced superficial injuries or open wound at their work. More than 32% were suffering from respiratory problems such as coughing, wheezing and short of breath, close to 37% reported skin problems like allergy, irritation and bruising and 4.6% had eye problems such as pain and irritation in eyes. Nearly 78% of children lift and carry a heavy load like large garbage bags. Over 83% informed that they sort through refuse in a filthy environment such as open dumpsites, effluents, and runnels. Conclusion: This research provides pieces of evidence of how children are being tormented in the rag-picking sector. It has been observed that child rag pickers are susceptible to injuries or illnesses due to work-related risks and toxic environment. In India, there is no robust policy to address the concerns of waste pickers and laws to protect their rights. Consequently, these deprived communities of rag pickers, especially children, have become more vulnerable over time in India. Hence, this research paper calls for a quick response to the exigencies of child rag picker by developing a holistic approach that deals with education, medical care, sanitation, and nutrition for child rag pickers.

Keywords: child rag pickers, health impairments, occupational hazards, toxic environment

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Authors: Solene Masloh, Anne Chevrel, Maxime Culot, Leonardo Scapozza, Magali Zeisser-Labouebe

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The limited stability of clinically proven therapeutic antibodies limits their administration by the parenteral route. However, oral administration remains the best alternative as it is the most convenient and less invasive one. Obtaining a targeted treatment based on biologics, which can be orally administered, would, therefore, be an ideal situation to improve patient adherence and compliance. Nevertheless, the delivery of macromolecules through the intestine remains challenging because of their sensitivity to the harsh conditions of the gastrointestinal tract and their low permeability across the intestinal mucosa. To address this challenge, this project aims to demonstrate that targeting receptor-mediated endocytosis followed by transcytosis could maximize the intestinal uptake and transport of large molecules, such as Nanofitins. These affinity proteins of 7 kDa with binding properties similar to antibodies have already demonstrated retained stability in the digestive tract and local efficiency. However, their size does not allow passive diffusion through the intestinal barrier. Nanofitins having a controlled affinity for membrane receptors involved in the transcytosis mechanism used naturally for the transport of large molecules in humans were generated. Proteins were expressed using ribosome display and selected based on affinity to the targeted receptor and other characteristics. Their uptake and transport ex vivo across viable porcine intestines were investigated using an Ussing chambers system. In this paper, we will report the results achieved while addressing the different challenges linked to this study. To validate the ex vivo model, first, we proved the presence of the receptors targeted in humans on the porcine intestine. Then, after the identification of an optimal way of detection of Nanofitins, transport experiments were performed on porcine intestines with viability followed during the time of the experiment. The results, showing that the physiological process of transcytosis is capable of being triggered by the binding of Nanofitins on their target, will be reported here. In conclusion, the results show that Nanofitins can be transported across the intestinal barrier by triggering the receptor-mediated transcytosis and that the ex vivo model is an interesting technique to assess biologics absorption through the intestine.

Keywords: ex-vivo, Nanofitins, oral administration, transcytosis

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Authors: Anjana Aggarwal, Sheilja Walia

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Prevalence of obesity and overweight is increasing due to sedentary lifestyles and busy schedules of people that spend less time on physical exercise. To reduce weight, people are finding easier and more convenient ways. The easiest solution is the use of dietary supplements and fat burners. These are products that decrease body weight by increasing the basal metabolic rate. Various reports have been published on the consumption of fat burners leading to heart palpitations, seizures, anxiety, depression, psychosis, bradycardia, insomnia, muscle contractions, hepatotoxicity, and even liver failure. Case reports and series are reporting that the ingredients present in the fat burners caused acute liver failure (ALF) and hepatic toxicity in many cases. Another contributing factor is the absence of regulations from the Food and Drug Administration on these products, leading to increased consumption and a higher risk of liver diseases among the population. This systematic review aims to attain a better understanding of the dietary supplements used globally to reduce weight and document the case reports/series of acute liver failure caused by the consumption of fat burners. Electronic databases like PubMed, Cochrane, Google Scholar, etc., will be systematically searched for relevant articles. Various websites of dietary products and brands that sell such supplements, Journals of Hepatology, National and international projects launched for ALF, and their reports, along with the review of grey literature, will also be done to get a better understanding of the topic. After discussing with the co-author, the selection and screening of the articles will be performed by the author. The studies will be selected based on the predefined inclusion and exclusion criteria. The case reports and case series that will be included in the final list of the studies will be assessed for methodological quality using the CARE guidelines. The results from this study will provide insights and a better understanding of fat burners. Since the supplements are easily available in the market without any restrictions on their sale, people are unaware of their adverse effects. The consumption of these supplements causes acute liver failure. Thus, this review will provide a platform for future larger studies to be conducted.

Keywords: acute liver failure, dietary supplements, fat burners, weight loss supplements

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Authors: Yan Lu, Song Hong, Janakiraman Udaiyappan, Aarti Nagayach, Quoc-Viet A. Duong, Masao Morita, Shun Saito, Yuichi Kobayashi, Yuhai, Zhao, Hongying Peng, Nicholas B. Pham, Walter J Lukiw, Christopher A. Vuong, Nicolas G. Bazan

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Aims: Neurodegeneration and behavior dysfunction occurs in patients with Alzheimer's Disease (AD), and as the disease progresses many patients develop cognitive impairment. 5XFAD mouse model of AD is widely used to study AD pathogenesis and treatment. This study aimed to investigate the effect of maresin like 1 (MaR-L1) treatment in AD pathology using 5XFAD mice. Methods: We tested 12-month-old male 5XFAD mice and wild type control mice treated with MaR-L1 in a battery of behavioral tasks. We performed open field test, beam walking test, clasping test, inverted grid test, acetone test, marble burring test, elevated plus maze test, cross maze test and novel object recognition test. We also studied neuronal loss, amyloid β burden, and inflammation in the brains of 5XFAD mice using immunohistology and Western blotting. Results: MaR-L1 treatment to the 5XFAD mice showed improved cognitive function of 5XFAD mice. MaR-L1 showed decreased anxiety behavior in open field test and marble burring test, increased muscular strength in the beam walking test, clasping test and inverted grid test. Cognitive function was improved in MaR-L1 treated 5XFAD mice in the novel object recognition test. MaR-L1 prevented neuronal loss and aberrant inflammation. Conclusion: Our finding suggests that behavioral abnormalities were normalized by the administration of MaR-L1 and the neuroprotective role of MaR-L1 in the AD. It also indicates that MaR-L1 treatment is able to prevent and or ameliorate neuronal loss and aberrant inflammation. Further experiments to validate the results are warranted using other AD models in the future.

Keywords: Alzheimer's disease, motor and cognitive behavior, 5XFAD mice, Maresin Like 1, microglial cell, astrocyte, neurodegeneration, inflammation, resolution of inflammation

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Authors: Sergio Haram Sarmiento, Arcady Ponosov

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Based on appropriate multivariate statistical methodology, we suggest a generic framework for efficient parameter estimation for ordinary differential equations and the corresponding nonlinear models. In this framework classical linear regression strategies is refined into a nonlinear regression by a locally linear modelling technique (known as metamodelling). The approach identifies those latent variables of the given model that accumulate most information about it among all approximations of the same dimension. The method is applied to several benchmark problems, in particular, to the so-called ”power-law systems”, being non-linear differential equations typically used in Biochemical System Theory.

Keywords: principal component analysis, generalized law of mass action, parameter estimation, metamodels

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Authors: Abderahman Efhialelbum

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The period since the fall of the Berlin Wall on November 9, 1989, and the collapse of the former Soviet Union in December 1985 has seen a major change in the economies and labour markets of Eastern Europe. The events also had reverberating effects across Asia and South America and parts of Africa, including Libya. This article examines the typologies and the models of transition economies. Also, it sheds light on the Libyan transition in particular and the impact of Qadhafi’s regime on the transition process. Finally, it illustrates how the Libyan transition process followed the trajectory of other countries using economic indicators such as free trade, property rights, and inflation.

Keywords: transition, economy, typology, model, Libya

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Authors: Zelal Polat, Şebnem Harsa, Semra Ülkü

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Lactic acid exists in nature optically in two forms, L(+), D(-)-lactic acid, and has been used in food, leather, textile, pharmaceutical and cosmetic industries. Moreover, L(+)-lactic acid constitutes the raw material for the production of poly-L-lactic acid which is used in biomedical applications. Microbially produced lactic acid was aimed to be recovered from the fermentation media efficiently and economically. Among the various downstream operations, ion exchange chromatography is highly selective and yields a low cost product recovery within a short period of time. In this project, Lactobacillus casei NRRL B-441 was used for the production of L(+)-lactic acid from whey by fermentation at pH 5.5 and 37°C that took 12 hours. The product concentration was 50 g/l with 100% L(+)-lactic acid content. Next, the suitable resin was selected due to its high sorption capacity with rapid equilibrium behavior. Dowex marathon WBA, weakly basic anion exchanger in OH form reached the equilibrium in 15 minutes. The batch adsorption experiments were done approximately at pH 7.0 and 30°C and sampling was continued for 20 hours. Furthermore, the effect of temperature and pH was investigated and their influence was found to be unimportant. All the adsorption/desorption experiments were applied to both model lactic acid and biomass free fermentation broth. The ion exchange equilibria of lactic acid and L(+)-lactic acid in fermentation broth on Dowex marathon WBA was explained by Langmuir isotherm. The maximum exchange capacity (qm) for model lactic acid was 0.25 g La/g wet resin and for fermentation broth 0.04 g La/g wet resin. The equilibrium loading and exchange efficiency of L(+)-lactic acid in fermentation broth were reduced as a result of competition by other ionic species. The competing ions inhibit the binding of L(+)-lactic acid to the free sites of ion exchanger. Moreover, column operations were applied to recover adsorbed lactic acid from the ion exchanger. 2.0 M HCl was the suitable eluting agent to recover the bound L(+)-lactic acid with a flowrate of 1 ml/min at ambient temperature. About 95% of bound L(+)-lactic acid was recovered from Dowex marathon WBA. The equilibrium was reached within 15 minutes. The aim of this project was to investigate the purification of L(+)-lactic acid with ion exchange method from fermentation broth. The additional goals were to investigate the end product purity, to obtain new data on the adsorption/desorption behaviours of lactic acid and applicability of the system in industrial usage.

Keywords: fermentation, ion exchange, lactic acid, purification, whey

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Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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Authors: Roberto Cabezas H

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The current work shows the methodology developed to create narrative lighting spaces for the multimedia performance piece 'cluster: the vanished paradise.' This empirical research is focused on exploring unconventional roles for machines in subjective creative processes, by delving into the semantics of data and machine intelligence algorithms in hybrid technological, creative contexts to expand epistemic domains trough human-machine cooperation. The creative process in scenic and performing arts is guided mostly by intuition; from that idea, we developed an approach to embed collective intuition in computational creative systems, by joining the properties of Generative Adversarial Networks (GAN’s) and Fuzzy Clustering based on a semi-supervised data creation and analysis pipeline. The model makes use of GAN’s to learn from phenomenological data (data generated from experience with lighting scenography) and algorithmic design data (augmented data by procedural design methods), fuzzy logic clustering is then applied to artificially created data from GAN’s to define narrative transitions built on membership index; this process allowed for the creation of simple and complex spaces with expressive capabilities based on position and light intensity as the parameters to guide the narrative. Hybridization comes not only from the human-machine symbiosis but also on the integration of different techniques for the implementation of the aided design system. Machine intelligence tools as proposed in this work are well suited to redefine collaborative creation by learning to express and expand a conglomerate of ideas and a wide range of opinions for the creation of sensory experiences. We found in GAN’s and Fuzzy Logic an ideal tool to develop new computational models based on interaction, learning, emotion and imagination to expand the traditional algorithmic model of computation.

Keywords: fuzzy clustering, generative adversarial networks, human-machine cooperation, hybrid collective data, multimedia performance

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Authors: Jihene Jebeniani

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We proposed an approach combining both the techniques of experimental economy and the flexibility of discrete choice models in order to test the loss aversion. Our main objective was to test the loss aversion of the Cumulative Prospect Theory (CPT). We developed an experimental laboratory in the context of the financial investments that aimed to analyze the attitude towards the risk of the investors. The study uses the lotteries and is basing on econometric modeling. The estimated model was the ordered probit.

Keywords: risk aversion, behavioral finance, experimental economic, lotteries, cumulative prospect theory

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Authors: Faiza Abdul Latip

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One of the ultimate goals of any nation is to produce competitive manpower and this includes Philippines. Inclination in the field of Mathematics has a significant role in achieving this goal. However, Mathematics, as considered by most people, is the most difficult subject matter along with its topics to learn. This could be manifested from the low performance of students in national and international assessments. Educators have been widely using learning style models in identifying the way students learn. Moreover, it could be the frontline in knowing the difficulties held by each learner in a particular topic specifically concepts pertaining to fractions. However, as what many educators observed, students show difficulties in doing mathematical tasks and in great degree in dealing with fractions most specifically in the district of Datu Odin Sinsuat, Maguindanao. This study focused on the Datu Odin Sinsuat district grade six pupils’ learning styles along with their achievements and difficulties in learning concepts on fractions. Five hundred thirty-two pupils from ten different public elementary schools of the Datu Odin Sinsuat districts were purposively used as the respondents of the study. A descriptive research using the survey method was employed in this study. Quantitative analysis on the pupils’ learning styles on the Kolb’s Learning Style Inventory (KLSI) and scores on the mathematics diagnostic test on fraction concepts were made using this method. The simple frequency and percentage counts were used to analyze the pupils’ learning styles and their achievements on fractions. To determine the pupils’ difficulties in fractions, the index of difficulty on every item was determined. Lastly, the Kruskal-Wallis Test was used in determining the significant difference in the pupils’ achievements on fractions classified by their learning styles. This test was set at 0.05 level of significance. The minimum H-Value of 7.82 was used to determine the significance of the test. The results revealed that the pupils of Datu Odin Sinsuat districts learn fractions in varied ways as they are of different learning styles. However, their achievements in fractions are low regardless of their learning styles. Difficulties in learning fractions were found most in the area of Estimation, Comparing/Ordering, and Division Interpretation of Fractions. Most of the pupils find it very difficult to use fraction as a measure, compare or arrange series of fractions and use the concept of fraction as a quotient.

Keywords: difficulties in fraction, fraction, Kolb's model, learning styles

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Authors: S. Assengone Otogo Be, A. Fahs, L. Belec, T. A. Nguyen Tien, G. Louarn, J-F. Chailan

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Glass fiber-reinforced composite materials have gradually developed in all sectors ranging from consumer products to aerospace applications. However, the weak point is most often the fiber/matrix interface, which can reduce the durability of the composite material. To solve this problem, it is essential to control the interphase and improve our understanding of the adhesion mechanism at the fibre/matrix interface. The interphase properties depend on the nature of the sizing applied on the surface of the glass fibers during their manufacture in order to protect them, facilitate their handling, and ensure fibre/matrix adhesion. The sizing composition, and in particular the nature of the coupling agent and the film-former affects the mechanical properties and the durability of composites. The aim of our study is, therefore, to develop and study composite materials with simplified sizing systems in order to understand how the main constituents modify the mechanical properties and the durability of composites from the nanometric to the macroscopic scale. Two model systems were elaborated: an epoxy matrix reinforced with simplified-sized glass fibres and an epoxy coating applied on glass substrates treated with the same sizings as fibres. For the sizing composition, two configurations were chosen. The first configuration possesses a chemical reactivity to link the glass and the matrix, and the second sizing contains non-reactive agents. The chemistry of the sized glass substrates and fibers was analyzed by FT-IR and XPS spectroscopies. The surface morphology was characterized by SEM and AFM microscopies. The observation of the surface samples reveals the presence of sizings which morphology depends on their chemistry. The evaluation of adhesion of coated substrates and composite materials show good interfacial properties for the reactive configuration. However, the non-reactive configuration exhibits an adhesive rupture at the interface of glass/epoxy for both systems. The interfaces and interphases between the matrix and the substrates are characterized at different scales. Correlations are made between the initial properties of the sizings and the mechanical performances of the model composites.

Keywords: adhesion, interface, interphase, materials composite, simplified sizing systems, surface properties

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Authors: Sandra Pietri, Helene Dubout, Sabrina Ena, Candice Hoste, Enrico Bastianelli

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Bone Therapeutics is a bone cell therapy company addressing high unmet medical needs in the field of bone fracture repair, more specifically in non-union and delayed-union fractures where the bone repair process is impaired. The company has developed a unique allogeneic osteoblastic cell product (ALLOB®) derived from bone marrow which is currently tested in humans in the indication of delayed-union fractures. The purpose of our study was to directly compare ALLOB® vs. non-differentiated mesenchymal stem cells (MSC) for their in vitro osteogenic characteristics and their in vivo osteogenic potential in order to determine which cellular type would be the most adapted for bone fracture repair. Methods: Healthy volunteers’ bone marrow aspirates (n=6) were expended (i) into BM-MSCs using a complete MSC culture medium or (ii) into ALLOB® cells according to its manufacturing process. Cells were characterized in vitro by morphology, immunophenotype, gene expression and differentiation potential. Additionally, their osteogenic potential was assessed in vivo in the subperiosteal calvaria bone formation model in nude mice. Results: The in vitro side-by-side comparison studies showed that although ALLOB® and BM-MSC shared some common general characteristics such as the 3 minimal MSC criteria, ALLOB® expressed significantly higher levels of chondro/osteoblastic genes such as BMP2 (fold change (FC) > 100), ALPL (FC > 12), CBFA1 (FC > 3) and differentiated significantly earlier than BM-MSC toward the osteogenic lineage. Moreover the bone formation model in nude mice demonstrated that used at the same cellular concentration, ALLOB® was able to induce significantly more (160% vs.107% for control animals) bone formation than BM-MSC (118% vs. 107 % for control animals) two weeks after administration. Conclusion: Our side-by-side comparison studies demonstrated that in vitro and in vivo, ALLOB® displays superior osteogenic capacity to BM-MScs and is therefore a better candidate for the treatment of bone fractures.

Keywords: gene expression, histomorphometry, mesenchymal stem cells, osteogenic differentiation potential, preclinical

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Authors: Abdulatif Abdulsalam, Mohamed Shaban

Abstract:

This paper introduces interfacing and replication of electronic tools based on the MATLAB/ SIMULINK mock-up package. Mock-up components contain dc-dc converters, power issue rectifiers, motivation machines, dc gear, synchronous gear, and more entire systems. Power issue rectifier model includes solid state device models. The tools are the clear-cut structure and mock-up of complex energetic systems connecting with power electronic machines.

Keywords: power electronics, machine, MATLAB, simulink

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Authors: Francisco Liaño-Carrera, José Isaac Ramírez-Macías, David Salas-Monreal, Mayra Lorena Riveron-Enzastiga, Marcos Rangel-Avalos, Adriana Andrea Roldán-Ubando

Abstract:

The construction of most coastal infrastructure developments around the world are usually made considering wave height, current velocities and river discharges; however, little effort has been paid to surveying sediment transport during dredging or the modification to currents outside the ports or marinas during and after the construction. This study shows a complete survey during the construction of one of the largest ports of the Gulf of Mexico. An anchored Acoustic Doppler Current Velocity profiler (ADCP), a towed ADCP and a combination of model outputs were used at the Veracruz port construction in order to describe the hourly sediment transport and current modifications in and out of the new port. Owing to the stability of the system the new port was construction inside Vergara Bay, a low wave energy system with a tidal range of up to 0.40 m. The results show a two-current system pattern within the bay. The north side of the bay has an anticyclonic gyre, while the southern part of the bay shows a cyclonic gyre. Sediment transport trajectories were made every hour using the anchored ADCP, a numerical model and the weekly data obtained from the towed ADCP within the entire bay. The sediment transport trajectories were carefully tracked since the bay is surrounded by coral reef structures which are sensitive to sedimentation rate and water turbidity. The survey shows that during dredging and rock input used to build the wave breaker sediments were locally added (< 2500 m²) and local currents disperse it in less than 4 h. While the river input located in the middle of the bay and the sewer system plant may add more than 10 times this amount during a rainy day or during the tourist season. Finally, the coastal line obtained seasonally with a drone suggests that the southern part of the bay has not been modified by the construction of the new port located in the northern part of the bay, owing to the two subsystem division of the bay.

Keywords: Acoustic Doppler Current Profiler, construction around coral reefs, dredging, port construction, sediment transport monitoring,

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Authors: Christina Peristeri, Tobias Berg, Domenico Caridi, Paul Hutcheson, Robert Winstanley

Abstract:

In recent years the demand for rapid innovations in the automotive industry has led to the need for accelerated simulation procedures while retaining a detailed representation of the simulated phenomena. The project’s aim is to create a fast transient workflow for external aerodynamic CFD simulations of road vehicles. The geometry used was the SAE Notchback Closed Cooling DrivAer model, and the simulation results were compared with data from wind tunnel tests. The meshes generated for this study were of two types. One was a mix of polyhedral cells near the surface and hexahedral cells away from the surface. The other was an octree hex mesh with a rapid method of fitting to the surface. Three different grid refinement levels were used for each mesh type, with the biggest total cell count for the octree mesh being close to 1 billion. A series of steady-state solutions were obtained on three different grid levels using a pseudo-transient coupled solver and a k-omega-based RANS turbulence model. A mesh-independent solution was found in all cases with a medium level of refinement with 200 million cells. Stress-Blended Eddy Simulation (SBES) was chosen for the transient simulations, which uses a shielding function to explicitly switch between RANS and LES mode. A converged pseudo-transient steady-state solution was used to initialize the transient SBES run that was set up with the SIMPLEC pressure-velocity coupling scheme to reach the fastest solution (on both CPU & GPU solvers). An important part of this project was the use of FLUENT’s Multi-GPU solver. Tesla A100 GPU has been shown to be 8x faster than an Intel 48-core Sky Lake CPU system, leading to significant simulation speed-up compared to the traditional CPU solver. The current study used 4 Tesla A100 GPUs and 192 CPU cores. The combination of rapid octree meshing and GPU computing shows significant promise in reducing time and hardware costs for industrial strength aerodynamic simulations.

Keywords: CFD, DrivAer, LES, Multi-GPU solver, octree mesh, RANS

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Authors: Z. Goosen, E. J. Cilliers

Abstract:

Referring to the entire green network within urban environments, at all spatial scales, green infrastructure is considered as an important constituent of sustainable development within urban areas through planning for a healthy environment and simultaneously improving quality of life for the people. Green infrastructure has made its appearance internationally in terms of the infrastructural urban environment focussing on ecological systems and sustaining society while building with nature. Within South Africa, the terminology of green infrastructure has, however, not continuously been entertained, mainly due to more pressing realities and challenges faced within urban areas of South Africa that include but are not limited to basic service provision, financial constraints and a lack of guiding policies and frameworks. But the notion of green infrastructure planning has changes, creating a newfound movement within urban areas of South Africa encouraging green infrastructure for urban resilience. Although green infrastructure is not an entirely new concept within the local context of South Africa, the benefits thereof constantly needs to be identified in order to measure the value of green infrastructure. Consequently challenges faces within urban areas of South Africa, in terms of human and nature, could be restored through focussing on a sustainable green infrastructure approach. This study does not focus on the pressing challenges and realities faced within urban areas of South Africa but rather aims solely on improving a green infrastructure approach within urban areas of South Africa. At the outset, the study will commence by introducing the concept of a green infrastructure approach by means of a local and international comparison. This will ensure an improved conceptual understanding of green infrastructure within a local South African context. The green infrastructure concept will be elaborated on through the inclusion of South African case study evaluations. The selected case studies will illustrate existing green infrastructure implementation within South Africa along with the benefits provided through the implementation thereof in terms of human (the people) and nature (the natural environment). As green infrastructure within South Africa continues to remain a fairly new concept with moderate levels of implementation thereof, room for improving on the approach in terms of implementation and maintenance exist. For this reason, the study will conclude with alternative green infrastructure suggestions and approaches to possibly be enforced within South Africa, led by international best practices.

Keywords: green infrastructure, international best practices, sustainability, urban South Africa

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

Abstract:

Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: N. Bachok, N. L. Aleng, N. M. Arifin, A. Ishak, N. Senu

Abstract:

The problem of laminar fluid flow which results from the shrinking of a permeable surface in a nanofluid has been investigated numerically. The model used for the nanofluid incorporates the effects of Brownian motion and thermophoresis. A similarity solution is presented which depends on the mass suction parameter S, Prandtl number Pr, Lewis number Le, Brownian motion number Nb and thermophoresis number Nt. It was found that the reduced Nusselt number is decreasing function of each dimensionless number.

Keywords: Boundary layer, nanofluid, shrinking sheet, Brownian motion, thermophoresis, similarity solution

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Authors: Ahmedou Moulaye Idriss, Tfeil Yahya, Tamas Ungi, Gabor Fichtinger

Abstract:

Image-guided therapy (IGT) plays a crucial role in minimally invasive procedures for liver interventions. Accurate segmentation of the liver and precise needle placement is essential for successful interventions such as needle aspiration. In this study, we propose a deep learning-based liver 3D slicer designed to enhance segmentation accuracy and facilitate needle aspiration procedures. The developed 3D slicer leverages state-of-the-art convolutional neural networks (CNNs) for automatic liver segmentation in medical images. The CNN model is trained on a diverse dataset of liver images obtained from various imaging modalities, including computed tomography (CT) and magnetic resonance imaging (MRI). The trained model demonstrates robust performance in accurately delineating liver boundaries, even in cases with anatomical variations and pathological conditions. Furthermore, the 3D slicer integrates advanced image registration techniques to ensure accurate alignment of preoperative images with real-time interventional imaging. This alignment enhances the precision of needle placement during aspiration procedures, minimizing the risk of complications and improving overall intervention outcomes. To validate the efficacy of the proposed deep learning-based 3D slicer, a comprehensive evaluation is conducted using a dataset of clinical cases. Quantitative metrics, including the Dice similarity coefficient and Hausdorff distance, are employed to assess the accuracy of liver segmentation. Additionally, the performance of the 3D slicer in guiding needle aspiration procedures is evaluated through simulated and clinical interventions. Preliminary results demonstrate the effectiveness of the developed 3D slicer in achieving accurate liver segmentation and guiding needle aspiration procedures with high precision. The integration of deep learning techniques into the IGT workflow shows great promise for enhancing the efficiency and safety of liver interventions, ultimately contributing to improved patient outcomes.

Keywords: deep learning, liver segmentation, 3D slicer, image guided therapy, needle aspiration

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Authors: Jayanth Abishek Subramanian, Ramin Dabirian, Ilias Gavrielatos, Ram Mohan, Ovadia Shoham

Abstract:

Downcomers are important conduits for multiphase flow transfer from offshore platforms to the seabed. Uncertainty in the predictions of the pressure drop of multiphase flow between platforms is often dominated by the uncertainty associated with the prediction of holdup and pressure drop in the downcomer. The objectives of this study are to conduct experimental and theoretical scale-up study of the downcomer. A 4-in. diameter vertical test section was designed and constructed to study two-phase flow in downcomer. The facility is equipped with baffles for flow area restriction, enabling interchangeable annular slot openings between 30% and 61.7%. Also, state-of-the-art instrumentation, the capacitance Wire-Mesh Sensor (WMS) was utilized to acquire the experimental data. A total of 76 experimental data points were acquired, including falling film under 30% and 61.7% annular slot opening for air-water and air-Conosol C200 oil cases as well as gas carry-under for 30% and 61.7% opening utilizing air-Conosol C200 oil. For all experiments, the parameters such as falling film thickness and velocity, entrained liquid holdup in the core, gas void fraction profiles at the cross-sectional area of the liquid column, the void fraction and the gas carry under were measured. The experimental results indicated that the film thickness and film velocity increase as the flow area reduces. Also, the increase in film velocity increases the gas entrainment process. Furthermore, the results confirmed that the increase of gas entrainment for the same liquid flow rate leads to an increase in the gas carry-under. A power comparison method was developed to enable evaluation of the Lopez (2011) model, which was created for full bore downcomer, with the novel scale-up experiment data acquired from the downcomer with the restricted area for flow. Comparison between the experimental data and the model predictions shows a maximum absolute average discrepancy of 22.9% and 21.8% for the falling film thickness and velocity, respectively; and a maximum absolute average discrepancy of 22.2% for fraction of gas carried with the liquid (oil).

Keywords: two phase flow, falling film, downcomer, wire-mesh sensor

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Authors: Giorgi Methodishvili, Iuliia Methodishvili

Abstract:

In this paper product development algorithm is used to determine the optimal management of financial resources in company. Aspects of financial management considered include put initial investment, examine all possible ways to solve the problem and the optimal rotation length of profit. The software of given problems is based using greedy algorithm. The obtained model and program maintenance enable us to define the optimal version of management of proper financial flows by using visual diagram on each level of investment.

Keywords: management, software, optimal, greedy algorithm, graph-diagram

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Authors: Eronini Iheanyi Umez-Eronini

Abstract:

Most studies and existing implementations of compressed air energy storage (CAES) coupled with a wind farm to overcome intermittency and variability of wind power are based on bulk or centralized CAES plants. A dynamic model of a hybrid wind farm with wind turbines and distributed CAES, consisting of air storage tanks and compressor and expander trains at each wind turbine station, is developed and simulated in MATLAB. An ad hoc supervisory controller, in which the wind turbines are simply operated under classical power optimizing region control while scheduling power production by the expanders and air storage by the compressors, including modulation of the compressor power levels within a control range, is used to regulate overall farm power production to track minute-scale (3-minutes sampling period) TSO absolute power reference signal, over an eight-hour period. Simulation results for real wind data input with a simple wake field model applied to a hybrid plant composed of ten 5-MW wind turbines in a row and ten compatibly sized and configured Diabatic CAES stations show the plant controller is able to track the power demand signal within an error band size on the order of the electrical power rating of a single expander. This performance suggests that much improved results should be anticipated when the global D-CAES control is combined with power regulation for the individual wind turbines using available approaches for wind farm active power control. For standalone power plant fuel electrical efficiency estimate of up to 60%, the round trip electrical storage efficiency computed for the distributed CAES wherein heat generated by running compressors is utilized in the preheat stage of running high pressure expanders while fuel is introduced and combusted before the low pressure expanders, was comparable to reported round trip storage electrical efficiencies for bulk Adiabatic CAES.

Keywords: hybrid wind farm, distributed CAES, diabatic CAES, active power control, dynamic modeling and simulation

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

Abstract:

Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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