Search results for: thread lift procedure

Authors: Kelly F. Delgado-De Agrela, Sonia E. Ruiz, Marco A. Santos-Santiago

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An approach is proposed for the design of regular buildings equipped with non-linear viscous dissipating devices. The approach is based on a direct-displacement seismic design method which satisfies seismic performance objectives. The global system involved is formed by structural regular moment frames capable of supporting gravity and lateral loads with elastic response behavior plus a set of non-linear viscous dissipating devices which reduce the structural seismic response. The dampers are characterized by two design parameters: (1) a positive real exponent α which represents the non-linearity of the damper, and (2) the damping coefficient C of the device, whose constitutive force-velocity law is given by F=Cvᵃ, where v is the velocity between the ends of the damper. The procedure is carried out using a substitute structure. Two limits states are verified: serviceability and near collapse. The reduction of the spectral ordinates by the additional damping assumed in the design process and introduced to the structure by the viscous non-linear dampers is performed according to a damping reduction factor. For the design of the non-linear damper system, the real velocity is considered instead of the pseudo-velocity. The proposed design methodology is applied to an 8-story steel moment frame building equipped with non-linear viscous dampers, located in intermediate soil zone of Mexico City, with a dominant period Tₛ = 1s. In order to validate the approach, nonlinear static analyses and nonlinear time history analyses are performed.

Keywords: based design, direct-displacement based design, non-linear viscous dampers, performance design

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Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

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Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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Authors: Agoston Restas

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Introduction: In case of managing disasters decision makers can face many times such a special situation where any pre-sign of the drastically change is missing therefore the improvised decision making can be required. The complexity, ambiguity, uncertainty or the volatility of the situation can require many times the improvisation as decision making. It can be taken at any level of the management (strategic, operational and tactical) but at tactical level the main reason of the improvisation is surely time pressure. It is certainly the biggest problem during the management. Methods: The author used different tools and methods to achieve his goals; one of them was the study of the relevant literature, the other one was his own experience as a firefighting manager. Other results come from two surveys that are referred to; one of them was an essay analysis, the second one was a word association test, specially created for the research. Results and discussion: This article proves that, in certain situations, the multi-criteria, evaluating decision-making processes simply cannot be used or only in a limited manner. However, it can be seen that managers, directors or commanders are many times in situations that simply cannot be ignored when making decisions which should be made in a short time. The functional background of decisions made in a short time, their mechanism, which is different from the conventional, was studied lately and this special decision procedure was given the name recognition-primed decision. In the article, author illustrates the limits of the possibilities of analytical decision-making, presents the general operating mechanism of recognition-primed decision-making, elaborates on its special model relevant to managers at tactical level, as well as explore and systemize the factors that facilitate (catalyze) the processes with an example with fire managers.

Keywords: decision making, disaster managers, recognition primed decision, model for making decisions in emergencies

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Authors: Kimiyo Shimomai, Mihoko Harada

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This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

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Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.

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Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.

Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays

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Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

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Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: age incidence, breast carcinoma, fine needle aspiration, hail region

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Authors: Leila Mohammadi

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This paper presents the impact of persuasive communication implemented by fertility clinics websites, and how this information influences women at their decision-making for undertaking this procedure. The influential factors for women decisions to do social egg freezing (SEF) are analyzed from a framing theory perspective, with a specific focus on the impact of persuasive information on women’s decision making. This study follows a quantitative approach. A two-phase survey has been conducted to examine the interest rate to undertake SEF. In the first phase, a questionnaire was available during a month (May 2015) to women to answer whether or not they knew enough information of this process, with a total of 230 answers. The second phase took place in the two last weeks of July 2015. All the respondents were invited to a seminars called ‘All about egg freezing’ and afretwards they were requested to answer the second questionnaire. After the seminar, in which they were given an extensive amount of information about egg freezing, a total of 115 women replied the questionnaire. The collected data during this process were analyzed using descriptive statistics. Most of the respondents changed their opinion in the second questionaire which was after receiving information. Although in the first questionnaire their self-evaluation of having knowledge about this process and the implemented technologies was very high, they realized that they still need to access more information from different sources in order to be able to make a decision. The study reached the conclusion that persuasive and framed information by clinics would affect the decisions of these women. Despite the reasons women have to do egg freezing and their motivations behind it, providing people necessary information and unprejudiced data about this process (such as its positive and negative aspects, requirements, suppositions, possibilities and consequences) would help them to make a more precise and reasonable decision about what they are buying.

Keywords: decision making, fertility clinics, framing theory, persuasive information, social egg freezing

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Authors: Ahmed A. Alghamdi

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Single-walled carbon nanotubes (SWCNTs) are an outstanding material for applications in thermoelectric power generation, nanoelectronics, electrochemical energy storage, photovoltaics, and light emission. They are ultra-lightweight and possess electrical as well as thermal conductivity, flexibility, and mechanical strength. SWCNT is applicable in water treatment, brine desalination, removal of heavy metal ions associated with pollutants, and oil-water separation. Carbon nanotube (CNT) is believed to tackle the trade-off issue between permeability, selectivity, and fouling issues in membrane filtration applications. Studying these CNT structures, as well as their interconnection in nanotechnology, assists in finding the precise position to be placed for water desalination. Reverse osmosis (RO) has been used globally for desalination, resulting in purified water. Thin film composite (TFC) membranes were utilized in the RO process for desalination. The sheet thickness increases the salt rejection and decreases the water flux when CNT is utilized as a support layer to this membrane. Thus, through a temperature-induced phase separation technique (TIPS), axially aligned SWCNT (AASWCNT) is fabricated, and its use enhances the salt rejection and water flux at short reaction times with a modified procedure. An evaluation was conducted and analogized with prior works in the literature, which exhibited that the prepared TFC membrane showed a better outcome.

Keywords: single-walled carbon nanotubes, thin film composite, axially aligned swcnt, temperature induced phase separation technique, reverse osmosis

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Authors: P. Comendador, I. Garcia, S. Orozco, L. Santamaria, M. Amutio, G. Lopez, M. Olazar

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In situ CO₂ capture in steam reforming processes has been studied in the last years as an alternative for increasing H₂ yields and H₂ purity in the product stream. For capturing the CO₂ at the reforming conditions, CaO-based sorbents are usually employed due to their properties at high temperature, low cost and high availability. However, the challenge is to develop high-capacity (gCO₂/gsorbent) materials that retain their capacity over cycles of operation. Besides, since the objective is to capture the CO₂ generated in situ, another key aspect is the sorption dynamics, which means that, in order to efficiently use the sorbent, it has to capture the CO₂ at a rate equal to or higher than the generation rate. In this work, different CaO-based materials have been prepared to aim at meeting these criteria. First, and by using the wet mixing method, different inert materials (Mg, Ce and Al) were combined with CaO. Second, and with the inert material selected (Mg), the effect of its concentration in the final material was studied. Transversally, the calcination temperature was also evaluated. It was determined that the wet mixing method is a simple procedure suitable for the preparation of CaO sorbents mixed with inert materials. The materials prepared by mixing the CaO with Mg have shown satisfactory anti-sintering properties and adequate sorption kinetics for their application in steam reforming processes. Regarding the concentration of Mg in the solid, it was concluded that high values contribute to the stability but at the expense of losing sorption capacity. Finally, it was observed that high calcination temperatures negatively affected the sorption properties of the final materials due to the decrease in the pore volume and the specific surface area.

Keywords: calcination temperature effect, CO₂ capture, Mg-Ce-Al stabilizers, Mg varying concentration effect, Sorbent stabilization

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Authors: Nelson Igaba, C. Onaga, S. Hlongwane

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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

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Authors: Amina Farooq, Nauman Zafar Butt

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This paper is about methods and tools for counting particles of interest, such as cells. A microfluidic system with interconnected electronics on a flexible substrate, inlet-outlet ports and interface schemes, sensitive and selective detection of cells specificity, and processing of cell counting at polymer interfaces in a microscale biosensor for use in the detection of target biological and non-biological cells. The development of fluidic channels, planar fluidic contact ports, integrated metal electrodes on a flexible substrate for impedance measurements, and a surface modification plasma treatment as an intermediate bonding layer are all part of the fabrication process. Magnetron DC sputtering is used to deposit a double metal layer (Ti/Pt) over the polypropylene film. Using a photoresist layer, specified and etched zones are established. Small fluid volumes, a reduced detection region, and electrical impedance measurements over a range of frequencies for cell counts improve detection sensitivity and specificity. The procedure involves continuous flow of fluid samples that contain particles of interest through the microfluidic channels, counting all types of particles in a portion of the sample using the electrical differential counter to generate a bipolar pulse for each passing cell—calculating the total number of particles of interest originally in the fluid sample by using MATLAB program and signal processing. It's indeed potential to develop a robust and economical kit for cell counting in whole-blood samples using these methods and similar devices.

Keywords: impedance, biochip, cell counting, microfluidics

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Authors: Amit Kumar, Bhupendra Pratap Singh, Manoj Singh, Monika Punia, Krishan Kumar, V. K. Jain

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Ambient concentrations of volatile organic compounds (VOCs) were investigated in order to find out temporal variations and their ozone forming potentials (OFP) at rural site in Delhi National Capital Region during summer 2013. Sampling was performed for continuous five days, to identify the differences in working days and weekend VOCs concentration levels. Sampling and analytical procedure for VOCs were done using National Institute for Occupational Safety and Health (NIOSH) standard method. On each sampling day, VOCs samples were collected for 3-hours in the morning, afternoon and evening. There has been observed a noticeable contrast in the concentration of VOCs levels between working days and weekend. However, most of the VOCs showed diurnal fluctuations with higher concentrations in the morning and evening as compared to afternoon which might be due to change in meteorology. The results showed that mean toluene/benzene and m-/p-xylene/benzene ratios were higher in the afternoon while it was lower during morning and evening. The relative contribution of the VOCs to ozone formation, total propylene equivalent concentrations and OFP were calculated. Toluene was the most contributing organic contaminant to ozone formation as well as ambient VOCs concentrations. Results obtained in current study demonstrate that ozone formation at rural site in Delhi is probably limited by the emissions of VOCs.

Keywords: VOCs, rural, NIOSH, ozone forming potential, propylene equivalent concentration

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Authors: Omar bin Mihat

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The number of sudden deaths is increasing over the past years. These deaths occur not during physical activities but upon cessation. Post-mortem confirms these deaths as cardiac arrest non-specifically. Congenital heart disease is a condition undiagnosed whereby only surface upon physical exertion leading to sudden death is unavoidable. Channelopathy, a condition that refers to any disease from the defect in iron-channel function, particularly the sodium-potassium pump, during the cessation of the exercise can be controlled. The derivation of heart rate return (HRrtn) is a procedure of a control cooling down process according to the heart rate (HR). Empirically, potassium rises linearly with intensity and falls sharply upon abrupt cessation of exertion, resulting in fatal arrhythmia due to hypokalaemia. It is vital that the flux of potassium should be maintained within the normal range during physical activities. To achieve this, the dosage of physical exertion (exercise) should be identified. Various percentages of the intensity of maximum heart rate (MHR) will precipitate different adaptations and remodeling of various organs. 70% of MHR will surface physiological adaptations, including enhancement of endurance, fitness level, and general health, and there was no significant rise of serum potassium (K+) during the entire phase of the treadmill brisk walk at a different rate of perceived exertion (RPE) from the subject of various fitness background. There was also no significant rise in blood pressure (BP) during the entire phase of the treadmill brisk walk, substantiating 70% MHR is the safe dosage across different parameters of health and fitness level.

Keywords: potassium, maximal heart rate, exercise dosage, fitness level

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Authors: Faraidoon Rahmanzai, Mizuki Takigawa, Yu Bomura, Shigeyuki Date

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To obtain the high quality and essential workability of mortar, different types of superplasticizers are used. The superplasticizers are the chemical admixture used in the mix to improve the fluidity of mortar. Many factors influenced the superplasticizer to disperse the cement particle in the mortar. Nature and amount of replaced cement by slag, mixing procedure, delayed addition time, and heat stimulation technique of superplasticizer cause the varied effect on the fluidity of the cementitious material. In this experiment, the superplasticizers were heated for 1 hour under 60 °C in a thermostatic chamber. Furthermore, the effect of delayed addition time of heat stimulated superplasticizers (SP) was also analyzed. This method was applied to two types of polycarboxylic acid based ether SP (precast type superplasticizer (SP2) and ready-mix type superplasticizer (SP1)) in combination with a partial replacement of normal Portland cement with blast furnace slag (BFS) with 30% w/c ratio. On the other hands, the fluidity, air content, fresh density, and compressive strength for 7 and 28 days were studied. The results indicate that the addition time and heat stimulation technique improved the flow and air content, decreased the density, and slightly decreased the compressive strength of mortar. Moreover, the slag improved the flow of mortar by increasing the amount of slag, and the effect of external temperature of SP on the flow of mortar was decreased. In comparison, the flow of mortar was improved on 5-minute delay for both kinds of SP, but SP1 has improved the flow in all conditions. Most importantly, the transition points in both types of SP appear to be the same, at about 5±1 min.  In addition, the optimum addition time of SP to mortar should be in this period.

Keywords: combined effect, delay addition, heat stimulation, flow of mortar

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Authors: Lucero Luciano, Cesar Celis, Jose Ramos

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Polygeneration improves energy efficiency and reduce both energy consumption and pollutant emissions compared to conventional generation technologies. A polygeneration system is a variation of a cogeneration one, in which more than two outputs, i.e., heat, power, cooling, water, energy or fuels, are accounted for. In particular, polygeneration systems integrating solar energy and water desalination represent promising technologies for energy production and water supply. They are therefore interesting options for coastal regions with a high solar potential, such as those located in southern Peru and northern Chile. Notice that most of the Peruvian and Chilean mining industry operations intensive in electricity and water consumption are located in these particular regions. Accordingly, this work focus on the design and integration of a polygeneration system producing industrial heating, cooling, electrical power and water for an industrial plant. The design procedure followed in this work involves integer linear programming modeling (MILP), operational planning and dynamic operating conditions. The technical and economic feasibility of integrating renewable energy technologies (photovoltaic and solar thermal, PV+CPS), thermal energy store, power and thermal exchange, absorption chillers, cogeneration heat engines and desalination technologies is particularly assessed. The polygeneration system integration carried out seek to minimize the system total annual cost subject to CO2 emissions restrictions. Particular economic aspects accounted for include investment, maintenance and operating costs.

Keywords: desalination, design and integration, polygeneration systems, renewable energy

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Authors: Azadeh Rouhandeh, Chris Joslin, Zhen Qu, Yuu Ono

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The centre of rotation of the hip joint is needed for an accurate simulation of the joint performance in many applications such as pre-operative planning simulation, human gait analysis, and hip joint disorders. In human movement analysis, the hip joint center can be estimated using a functional method based on the relative motion of the femur to pelvis measured using reflective markers attached to the skin surface. The principal source of errors in estimation of hip joint centre location using functional methods is soft tissue artefacts due to the relative motion between the markers and bone. One of the main objectives in human movement analysis is the assessment of soft tissue artefact as the accuracy of functional methods depends upon it. Various studies have described the movement of soft tissue artefact invasively, such as intra-cortical pins, external fixators, percutaneous skeletal trackers, and Roentgen photogrammetry. The goal of this study is to present a non-invasive method to assess the displacements of the markers relative to the underlying bone using optical motion capture data and tissue thickness from ultrasound measurements during flexion, extension, and abduction (all with knee extended) of the hip joint. Results show that the artefact skin marker displacements are non-linear and larger in areas closer to the hip joint. Also marker displacements are dependent on the movement type and relatively larger in abduction movement. The quantification of soft tissue artefacts can be used as a basis for a correction procedure for hip joint kinematics.

Keywords: hip joint center, motion capture, soft tissue artefact, ultrasound depth measurement

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: Navneet Kaur, S. D. Tiwari

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Magnetic nanoparticles possess fascinating properties which make their behavior unique in comparison to corresponding bulk materials. Superparamagnetism is one such interesting phenomenon exhibited only by small particles of magnetic materials. In this state, the thermal energy of particles become more than their magnetic anisotropy energy, and so particle magnetic moment vectors fluctuate between states of minimum energy. This situation is similar to paramagnetism of non-interacting ions and termed as superparamagnetism. The magnetization of such systems has been described by Langevin function. But, the estimated fit parameters, in this case, are found to be unphysical. It is due to non-consideration of particle size distribution. In this work, analysis of magnetization data on NiO nanoparticles is presented considering the effect of particle size distribution. Nanoparticles of NiO of two different sizes are prepared by heating freshly synthesized Ni(OH)₂ at different temperatures. Room temperature X-ray diffraction patterns confirm the formation of single phase of NiO. The diffraction lines are seen to be quite broad indicating the nanocrystalline nature of the samples. The average crystallite size are estimated to be about 6 and 8 nm. The samples are also characterized by transmission electron microscope. Magnetization of both sample is measured as function of temperature and applied magnetic field. Zero field cooled and field cooled magnetization are measured as a function of temperature to determine the bifurcation temperature. The magnetization is also measured at several temperatures in superparamagnetic region. The data are fitted to an appropriate expression considering a distribution in particle size following a least square fit procedure. The computer codes are written in PYTHON. The presented analysis is found to be very useful for estimating the particle size distribution present in the samples. The estimated distributions are compared with those determined from transmission electron micrographs.

Keywords: anisotropy, magnetization, nanoparticles, superparamagnetism

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Authors: Eliska Oberhofnerova, Milos Panek, Stepan Hysek, Martin Lexa

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Nowadays the use of wood, both indoors and outdoors, is constantly increasing. However wood is a natural organic material and in the exterior is subjected to a degradation process caused by abiotic factors (solar radiation, rain, moisture, wind, dust etc.). This process affects only surface layers of wood but neglecting some of the basic rules of wood protection leads to increased possibility of biological agents attack and thereby influences a function of the wood element. The process of wood degradation can be decreased by proper surface treatment, especially in the case of less naturally durable wood species, as spruce. Modern coating systems are subjected to many requirements such as colour stability, hydrophobicity, low volatile organic compound (VOC) content, long service life or easy maintenance. The aim of this study is to evaluate the colour stability of spruce wood (Picea abies), as the basic parameter indicating the coating durability, treated with two layers of transparent natural oil wood stain and exposed to outdoor conditions. The test specimens were exposed for 2 years to natural weathering and 2000 hours to artificial weathering in UV-chamber. The colour parameters were measured before and during exposure to weathering by the spectrophotometer according to CIELab colour space. The comparison between untreated and treated wood and both testing procedures was carried out. The results showed a significant effect of coating on the colour stability of wood, as expected. Nevertheless, increasing colour changes of wood observed during the exposure to weathering differed according to applied testing procedure - natural and artificial.

Keywords: colour stability, natural and artificial weathering, spruce wood, transparent coating

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Authors: Idrissa Kayijuka

Abstract:

The logistic regression and Cox regression models (proportional hazard model) at present are being employed in the analysis of prospective epidemiologic research looking into risk factors in their application on chronic diseases. However, a theoretical relationship between the two models has been studied. By definition, Cox regression model also called Cox proportional hazard model is a procedure that is used in modeling data regarding time leading up to an event where censored cases exist. Whereas the Logistic regression model is mostly applicable in cases where the independent variables consist of numerical as well as nominal values while the resultant variable is binary (dichotomous). Arguments and findings of many researchers focused on the overview of Cox and Logistic regression models and their different applications in different areas. In this work, the analysis is done on secondary data whose source is SPSS exercise data on BREAST CANCER with a sample size of 1121 women where the main objective is to show the application difference between Cox regression model and logistic regression model based on factors that cause women to die due to breast cancer. Thus we did some analysis manually i.e. on lymph nodes status, and SPSS software helped to analyze the mentioned data. This study found out that there is an application difference between Cox and Logistic regression models which is Cox regression model is used if one wishes to analyze data which also include the follow-up time whereas Logistic regression model analyzes data without follow-up-time. Also, they have measurements of association which is different: hazard ratio and odds ratio for Cox and logistic regression models respectively. A similarity between the two models is that they are both applicable in the prediction of the upshot of a categorical variable i.e. a variable that can accommodate only a restricted number of categories. In conclusion, Cox regression model differs from logistic regression by assessing a rate instead of proportion. The two models can be applied in many other researches since they are suitable methods for analyzing data but the more recommended is the Cox, regression model.

Keywords: logistic regression model, Cox regression model, survival analysis, hazard ratio

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Authors: Saba Rahman, Arvind K. Jain, S. D. Bharti, T. K. Datta

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The present study compares the semi-empirical wake-oscillator models that are used to predict vortex-induced vibration of structures. These models include those proposed by Facchinetti, Farshidian, and Dolatabadi, and Skop and Griffin. These models combine a wake oscillator model resembling the Van der Pol oscillator model and a single degree of freedom oscillation model. In order to use these models for estimating the top displacement of chimneys, the first mode vibration of the chimneys is only considered. The modal equation of the chimney constitutes the single degree of freedom model (SDOF). The equations of the wake oscillator model and the SDOF are simultaneously solved using an iterative procedure. The empirical parameters used in the wake-oscillator models are estimated using a newly developed approach, and response is compared with experimental data, which appeared comparable. For carrying out the iterative solution, the ode solver of MATLAB is used. To carry out the comparative study, a tall concrete chimney of height 210m has been chosen with the base diameter as 28m, top diameter as 20m, and thickness as 0.3m. The responses of the chimney are also determined using the linear model proposed by E. Simiu and the deterministic model given in Eurocode. It is observed from the comparative study that the responses predicted by the Facchinetti model and the model proposed by Skop and Griffin are nearly the same, while the model proposed by Fashidian and Dolatabadi predicts a higher response. The linear model without considering the aero-elastic phenomenon provides a less response as compared to the non-linear models. Further, for large damping, the prediction of the response by the Euro code is relatively well compared to those of non-linear models.

Keywords: chimney, deterministic model, van der pol, vortex-induced vibration

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Authors: Egor Atan Obeten, Abong Augustine Agwul, Bissong A. Samson

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The position of the aquifer, its protective capability, and the quality of the groundwater beneath the dumpsite were all investigated. The techniques employed were laboratory, tritium tagging, electrical resistivity tomography (ERT), and vertical electrical sounding (VES). With a maximum electrode spacing of 500 meters, fifteen VES stations were used, and IPI2win software was used to analyze the data collected. The resistivity map of the dumpsite was determined by deploying six ERT stations for the 2 D survey. To ascertain the degree of soil infiltration beneath the dumpsite, the tritium tagging method was used. Using a conventional laboratory procedure, groundwater samples were taken from neighboring boreholes and examined. The findings showed that there were three to five geoelectric layers, with the aquifer position being inferred to be between 24.2 and 75.1 meters deep in the third, fourth, and fifth levels. Siemens with values in the range of 0.0235 to 0.1908 for the load protection capacity were deemed to be, at most, weakly and badly protected. The obtained porosity values ranged from 44.45 to 89.75. Strong calculated values for transmissivity and porosity indicate a permeable aquifer system with considerable storativity. The area has an infiltration value between 8 and 22 percent, according to the results of the tritium tagging technique, which was used to evaluate the level of infiltration from the dumpsite. Groundwater samples that have been analyzed reveal levels of NO2, DO, Pb2+, magnesium, and cadmium that are higher than what the NSDWQ has approved. Overall analysis of the results from the above-described methodologies shows that the study area's aquifer system is porous and that contaminants will circulate through it quickly if they are contaminated.

Keywords: aquifer, transmissivity, dumpsite, groundwater

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Authors: Chih Jou Hsiao, Chung Ming Lo, Li Chun Hsieh

Abstract:

Brain tumor is not the cancer having high incidence rate, but its high mortality rate and poor prognosis still make it as a big concern. On clinical examination, the grading of brain tumors depends on pathological features. However, there are some weak points of histopathological analysis which can cause misgrading. For example, the interpretations can be various without a well-known definition. Furthermore, the heterogeneity of malignant tumors is a challenge to extract meaningful tissues under surgical biopsy. With the development of magnetic resonance imaging (MRI), tumor grading can be accomplished by a noninvasive procedure. To improve the diagnostic accuracy further, this study proposed a computer-aided diagnosis (CAD) system based on MRI features to provide suggestions of tumor grading. Gliomas are the most common type of malignant brain tumors (about 70%). This study collected 34 glioblastomas (GBMs) and 73 lower-grade gliomas (LGGs) from The Cancer Imaging Archive. After defining the region-of-interests in MRI images, multiple quantitative morphological features such as region perimeter, region area, compactness, the mean and standard deviation of the normalized radial length, and moment features were extracted from the tumors for classification. As results, two of five morphological features and three of four image moment features achieved p values of <0.001, and the remaining moment feature had p value <0.05. Performance of the CAD system using the combination of all features achieved the accuracy of 83.18% in classifying the gliomas into LGG and GBM. The sensitivity is 70.59% and the specificity is 89.04%. The proposed system can become a second viewer on clinical examinations for radiologists.

Keywords: brain tumor, computer-aided diagnosis, gliomas, magnetic resonance imaging

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Authors: Jacob Green, Cecilia Cabrera, Maximilian Jakobs, Andrea Dimitracopoulos, Mark van der Wilk, Ryan Greenhalgh

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Predicting drug properties is key in drug discovery to enable de-risking of assets before expensive clinical trials and to find highly active compounds faster. Interest from the machine learning community has led to the release of a variety of benchmark datasets and proposed methods. However, it remains unclear for practitioners which method or approach is most suitable, as different papers benchmark on different datasets and methods, leading to varying conclusions that are not easily compared. Our large-scale empirical study links together numerous earlier works on different datasets and methods, thus offering a comprehensive overview of the existing property classes, datasets, and their interactions with different methods. We emphasise the importance of uncertainty quantification and the time and, therefore, cost of applying these methods in the drug development decision-making cycle. To the best of the author's knowledge, it has been observed that the optimal approach varies depending on the dataset and that engineered features with classical machine learning methods often outperform deep learning. Specifically, QSAR datasets are typically best analysed with classical methods such as Gaussian Processes, while ADMET datasets are sometimes better described by Trees or deep learning methods such as Graph Neural Networks or language models. Our work highlights that practitioners do not yet have a straightforward, black-box procedure to rely on and sets a precedent for creating practitioner-relevant benchmarks. Deep learning approaches must be proven on these benchmarks to become the practical method of choice in drug property prediction.

Keywords: activity (QSAR), ADMET, classical methods, drug property prediction, empirical study, machine learning

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Authors: Nicholas Bayfield, Mark Newman

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Case Presentation: A 48-year-old male was brought in by ambulance after an out-of-hospital cardiac arrest, with 20 minutes of good-quality cardiopulmonary resuscitation in the community. Return of spontaneous circulation was achieved with defibrillation, revealing an inferior ST-elevation myocardial infarction. He was revascularized emergently in the cath lab and stabilised. Following the procedure, he was noted to have paradoxical respiratory movements of the sternum and high oxygen requirements. CT imaging demonstrated a flail chest with bilateral anterior rib 1-7 fractures as well as a large left-sided extra-pleural haematoma and small haemopneumothorax, secondary to CPR. The patient’s ventilation was stabilised with oxygen via a high-flow humidifier. Pain relief was provided. The anatomy of his rib fractures was not easily amenable to operative fixation. In addition, he was considered to be a high-risk operative candidate due to his recent arrest. He was managed thus non-operatively with an external vacuum dressing applied to the anterior chest wall to minimise respiratory compromise and minimise pain from the motion around the rib fracture sites. Non-operative management was successful, and the patient was reviewed one month later. The paradoxical sternal movement had abated. Discussion: External vacuum dressing has been trialled for non-operative management of rib fractures with varying success. It provides an external brace to minimise fracture site movement during respiration and coughing, thus minimising pain. This modality should be considered a low-cost, high-reward adjunct to non-operative management of bony thoracic trauma.

Keywords: thoracic surgery, thoracic trauma, rib fractures, negative pressure dressing

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Authors: P. Hooshangitabrizi, I. Contreras, N. Bhuiyan

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This work presents an online scheduling problem which accommodates multiple requests of patients for chemotherapy treatments in a cancer center of a major metropolitan hospital in Canada. To solve the problem, an adaptive flexible approach is proposed which systematically combines two optimization models. The first model is intended to dynamically schedule arriving requests in the form of waiting lists whereas the second model is used to reschedule the already booked patients with the goal of finding better resource allocations when new information becomes available. Both models are created as mixed integer programming formulations. Various controllable and flexible parameters such as deviating the prescribed target dates by a pre-determined threshold, changing the start time of already booked appointments and the maximum number of appointments to move in the schedule are included in the proposed approach to have sufficient degrees of flexibility in handling arrival requests and unexpected changes. Several computational experiments are conducted to evaluate the performance of the proposed approach using historical data provided by the oncology clinic. Our approach achieves outstandingly better results as compared to those of the scheduling system being used in practice. Moreover, several analyses are conducted to evaluate the effect of considering different levels of flexibility on the obtained results and to assess the performance of the proposed approach in dealing with last-minute changes. We strongly believe that the proposed flexible adaptive approach is very well-suited for implementation at the clinic to provide better patient-care services and to utilize available resource more efficiently.

Keywords: chemotherapy scheduling, multi-appointment modeling, optimization of resources, satisfaction of patients, mixed integer programming

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Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

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Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

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Authors: Sajedeh Salehi, Marco Giacalone

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This paper examines the role of existing online dispute resolution (ODR) mechanisms and their effects on ameliorating access to justice – as a protected right by Art. 47 of the EU Charter of Fundamental Rights – for consumers in EU. The major focus of this study will be on evaluating ODR as the means of dispute resolution for Business-to-Consumer (B2C) cross-border small claims raised in e-commerce transactions. The authors will elaborate the consequences of implementing ODR methods in the context of recent developments in EU regulatory safeguards on promoting consumer protection. In this analysis, both non-judiciary and judiciary ODR redress mechanisms are considered, however, the significant consideration is given to – obligatory and non-obligatory – judiciary ODR methods. For that purpose, this paper will particularly investigate the impact of the EU ODR platform as well as the European Small Claims Procedure (ESCP) Regulation 861/2007 and their role on accelerating the access to justice for consumers in B2C e-disputes. Although, considerable volume of research has been carried out on ODR for consumer claims, rather less (or no-) attention has been paid to provide a combined doctrinal and empirical evaluation of ODR’s potential in resolving cross-border small e-disputes, in EU. Hence, the methodological approach taken in this study is a mixed methodology based on qualitative (interviews) and quantitative (surveys) research methods which will be mainly based on the data acquired through the findings of the Small Claims Analysis Net (SCAN) project. This project contributes towards examining the ESCP Regulation implementation and efficiency in providing consumers with a legal watershed through using the ODR for their transnational small claims. The outcomes of this research may benefit both academia and policymakers at national and international level.

Keywords: access to justice, consumers, e-commerce, small e-Disputes

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Authors: Sonal Sethi, Mukesh Yadav, Abhimanyu Gupta

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The upcoming field of radiogenomics has the potential to upgrade the role of imaging in lung cancer management by noninvasive characterization of tumor histology and genetic microenvironment. Receptor positivity like epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genotyping are critical in lung adenocarcinoma for treatment. As conventional identification of receptor positivity is an invasive procedure, we analyzed the features on non-invasive computed tomography (CT), which predicts the receptor positivity in lung adenocarcinoma. Retrospectively, we did a comprehensive study from 77 proven lung adenocarcinoma patients with CT images, EGFR and ALK receptor genotyping, and clinical information. Total 22/77 patients were receptor-positive (15 had only EGFR mutation, 6 had ALK mutation, and 1 had both EGFR and ALK mutation). Various morphological characteristics and metastatic distribution on CT were analyzed along with the clinical information. Univariate and multivariable logistic regression analyses were used. On multivariable logistic regression analysis, we found spiculated margin, lymphangitic spread, air bronchogram, pleural effusion, and distant metastasis had a significant predictive value for receptor mutation status. On univariate analysis, air bronchogram and pleural effusion had significant individual predictive value. Conclusions: Receptor positive lung cancer has characteristic imaging features compared with nonreceptor positive lung adenocarcinoma. Since CT is routinely used in lung cancer diagnosis, we can predict the receptor positivity by a noninvasive technique and would follow a more aggressive algorithm for evaluation of distant metastases as well as for the treatment.

Keywords: lung cancer, multidisciplinary cancer care, oncologic imaging, radiobiology

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Authors: Hu Zhenxing, Gao Jianxin

Abstract:

Stereo-based digital image correlation (also referred to as three-dimensional (3D) digital image correlation (DIC)) is a technique for both 3D shape and surface deformation measurement of a component, which has found increasing applications in academia and industries. The accuracy of the reconstructed coordinate depends on many factors such as configuration of the setup, stereo-matching, distortion, etc. Most of these factors have been investigated in literature. For instance, the configuration of a binocular vision system determines the systematic errors. The stereo-matching errors depend on the speckle quality and the matching algorithm, which can only be controlled in a limited range. And the distortion is non-linear particularly in a complex imaging acquisition system. Thus, the distortion correction should be carefully considered. Moreover, the distortion function is difficult to formulate in a complex imaging acquisition system using conventional models in such cases where microscopes and other complex lenses are involved. The errors of the distortion correction will propagate to the reconstructed 3D coordinates. To address the problem, an accurate mapping method based on 2D B-spline functions is proposed in this study. The mapping functions are used to convert the distorted coordinates into an ideal plane without distortions. This approach is suitable for any image acquisition distortion models. It is used as a prior process to convert the distorted coordinate to an ideal position, which enables the camera to conform to the pin-hole model. A procedure of this approach is presented for stereo-based DIC. Using 3D speckle image generation, numerical simulations were carried out to compare the accuracy of both the conventional method and the proposed approach.

Keywords: distortion, stereo-based digital image correlation, b-spline, 3D, 2D

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