Flowchart Research Articles

Future perspective and clinical applicability of the combined use of plasma phosphorylated tau 181 and neurofilament light chain in Subjective Cognitive Decline and Mild Cognitive Impairment

We aimed to assess diagnostic accuracy of plasma p-tau181 and NfL separately and in combination in discriminating Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) patients carrying Alzheimer’s Disease (AD) pathology from non-carriers; to propose a flowchart for the interpretation of the results of plasma p-tau181 and NfL. We included 43 SCD, 41 MCI and 21 AD-demented (AD-d) patients, who underwent plasma p-tau181 and NfL analysis. Twenty-eight SCD, 41 MCI and 21 AD-d patients underwent CSF biomarkers analysis (Aβ1-42, Aβ1-42/1–40, p-tau, t-tau) and were classified as carriers of AD pathology (AP+) it they were A+/T+ , or non-carriers (AP−) when they were A−, A+/T−/N−, or A+/T−/N+ according to the A/T(N) system. Plasma p-tau181 and NfL separately showed a good accuracy (AUC = 0.88), while the combined model (NfL + p-tau181) showed an excellent accuracy (AUC = 0.92) in discriminating AP+ from AP− patients. Plasma p-tau181 and NfL results were moderately concordant (Coehn’s k = 0.50, p < 0.001). Based on a logistic regression model, we estimated the risk of AD pathology considering the two biomarkers: 10.91% if both p-tau181 and NfL were negative; 41.10 and 76.49% if only one biomarker was positive (respectively p-tau18 and NfL); 94.88% if both p-tau181 and NfL were positive. Considering the moderate concordance and the risk of presenting an underlying AD pathology according to the positivity of plasma p-tau181 and NfL, we proposed a flow chart to guide the combined use of plasma p-tau181 and NfL and the interpretation of biomarker results to detect AD pathology.

ROLE OF THE MOLECULAR TESTS FOR PATIENTS WITH INFECTIVE ENDOCARDITIS UNDERGOING CARDIAC SURGERY: AN EXPANDING HORIZON

Abstract Background Molecular tests have been proven to be a highly sensible tool to identify the pathogen of infective endocarditis (IE). However, their usefulness in the management of both blood culture positive and valve culture negative IE remains unclear. Methods We prospectively enrolled 100 consecutive patients with IE who underwent cardiac surgery between April 2020 and June 2023. Molecular testing (broad–range PCR 16S rRNA) was systematically performed and results were collected together with those of preoperative blood culture, valve culture and histopathological analysis of the specimen. Results Blood culture, valve culture and molecular testing were positive in 83%, 47% and 76% of patients, respectively. Both the sensitivity of valve culture and 16S rRNA PCR decreased significantly with increasing duration of preoperative antibiotic therapy. In 7% of cases, molecular test was the only positive test, allowing an etiological diagnosis. In 33% of cases, valve culture was negative but molecular test was positive. In the majority of these patients, histopathological analysis documented acute inflammation. Finally, molecular test clarified discrepancies between the results of blood cultures and those of valve cultures in 12.5% of patients. Conclusions The molecular tests showed high sensitivity. Although it decreased as the duration of preoperative antibiotic therapy increased, it was still higher than that of valve culture 28 days after the start of treatment. In addition to patients without an etiological diagnosis, the molecular test proved useful in other circumstances: 1) when the valve culture was negative because, together to the results of the histopathological analysis, it allowed to identify those patients who could benefit from a prolongation of antibiotic treatment; 2) in cases of discordance between the results of blood cultures and those of valve cultures, because it allowed the type of antibiotic treatment to be directed. Figure 1: Usefulness of molecular tests (PCR) according to the results of blood and valve cultures. Figure 2: Valve cultures are of paramount importance in the management of antibiotic therapy (ABT). However, their sensibility is low and the risk of under–treatment exists. Molecular tests may help targeting the duration of ABT but they could be persistently positive leading to an over–treatment. Figure 3: Flow–chart showing the possible role of molecular test in the management of patients with infective endocarditis.

Use of corticosteroids in non-infectious uveitis – expert consensus in Taiwan

Purpose To offer consensus on the utilization of corticosteroids (CS) for treating non-infectious uveitis in the context of clinical practice in Taiwan. This entails examining the different administration methods, their advantages and disadvantages, and considering alternative treatments according to the prevailing evidence and health policies. Methods Ten ophthalmologists and one rheumatologist convened on December 11, 2022, to review and discuss literature on the topic. The databases explored were the Central Cochrane library, EMBASE, Medline, PUBMED, and Web of Science using relevant keywords. The search spanned from January 1996 to June 2023. After the initial results of the literature review were presented, open voting determined the final statements, with a statement being accepted if it secured more than 70% agreement. This consensus was then presented at significant meetings for further discussions before the final version was established. Results A flow chart and nine statements emerged from the deliberations. They address the importance of CS in uveitis management, guidelines for using topical CS, indications for both periocular or intravitreal and systemic therapies, and tapering and discontinuation methods for both topical and systemic CS. Conclusion While CS are a cornerstone for non-infectious uveitis treatment, their administration requires careful consideration, depending on the clinical situation and the specific type of uveitis. The consensus generated from this article provides a guideline for practitioners in Taiwan, taking into account local health policies and the latest research on the subject. It emphasizes the significance of strategic tapering, the potential for alternative therapies, and the importance of patient-centric care.

Sorption Characteristics and Chromatographic Separation of 90Y3+ from 90Sr2+ from Aqueous Media by Chelex-100 (Anion Ion Exchange) Packed Column.

There is growing demand for separation of 90Y carrier free from 90Sr coexisting to produce high purity 90Y essential for radiopharmaceutical uses. Thus, in this context the sorption profiles of Y3+ and Sr2+ from aqueous solutions containing diethylenetriaminepenta acetic acid (DTPA), ethylenediaminetetra-acetic acid (EDTA), acetic acid, citric acid, or NaCl onto Chelex-100 (anion ion exchange) solid sorbent were critically studied for developing an efficient and low-cost methodology for selective separation of Y3+ from Sr2+ ions (1.0 × 10-5 M). Batch experiments displayed relative chemical extraction percentage (98 ± 5.4%) of Y3+ from aqueous acetic acid solution onto Chelex-100 (anion ion exchanger), whereas Sr2+ species showed no sorption. Hence, a selective separation of Y3+ from its parent 90Sr2+ has been established based upon percolation of the aqueous solution of Y3+ and Sr2+ ions containing acetic acid at pH 1-2 through Chelex-100 sorbent packed column at a 2 mL min-1 flow rate. Y3+ species were retained quantitatively while Sr2+ ions were not sorbed and passed through the sorbent packed column without extraction. The sorbed Y3+ species were then recovered from the sorbent packed column with HNO3 (1.0 M) at a 1.0 mL min-1 flow rate. A dual extraction mechanism comprising absorption associated to "weak-base anion exchanger" and "solvent extraction" of Y3+ as (YCl6)3- and an extra part for "surface adsorption" of Y3+ by the sorbent is proposed. The established method was validated by measuring the radiochemical (99.2 ± 2 1%), radionuclide purity and retardation factor (Rf = 10.0 ± 0.1 cm) of 90Y3+ recovered in the eluate. Ultimately, the sorbent packed column also presented high stability for reusing 2-3 cycles without drop in its efficiency (±5%) towards Y3+ uptake and relative chemical recovery. A proposed flow sheet describing the analytical procedures for the separation of 90Y3+ from 90Sr2+ using chelating Chelex 100 (anion exchange) packed column is also included.

A Research on Determining the Importance Levels of Criteria Effective in Forest Road Network Planning through GIS-Based Methods

This study investigated the importance levels of criteria effective in forest road network planning using Geopraphic Information System (GIS)- based Multi- Criteria Evaluation (MCE) method. It is crucial to determine the criteria to be considered in forest road construction and planning for a standardized application nationwide. The research was conducted within the boundaries of the Yaylacık Forest Management Directorate (YFMD) under the Tokat Forest Management. Firstly, the existing road network was identified in the research. After the identification of the existing road network, a GIS database was created. In this study, criteria to be used, in Forest Road Network Planning (terrain slope, aspect, road density, distance to road, land use, distance to main stream) were determined. Each criterion was classified and scored internally. Information from road and road network planning studies and previous works were utilized in determining the criteria to be used in Forest Road Network Planning. Five different degrees and suitability values are defined for the determined criteria. In this context, it was created to reach 5 fundamental road network planning functions to determine their positional statuses as Absence (Ab), Very Suitable Areas for road planning (VS), Suitable Areas for road planning (S), Less Suitable Areas for road planning (LS), and Very Less Suitable Areas for road planning (VLS). As a result, Terrain Slope and Road Density were determined as the most effective criteria in Road Network Planning, while Distance to Main Stream was identified as the least effective criterion. As a result of the study, a flow chart was created to determine the criteria and impact values that are effective in forest road network planning in order to ensure integrity and convenience in application throughout the country.

PYTHON-МОДЕЛЬ ПРОТОКОЛУ УЗГОДЖЕННЯ СЕКРЕТНОГО КЛЮЧА У ГРУПІ З ДОВІЛЬНОЇ КІЛЬКОСТІ УЧАСНИКІВ

The article is devoted to the problem of common secret key agreement in a group of an arbitrary number of participants. Data is exchanged between participants through open data channels. The problem of sharing a secret key over open data channels arose due to the need for a secure exchange of information between two or more parties that may be remote from each other and do not have a common confidential communication channel. Reliable methods of secret key exchange, such as transferring the key in person or using a secure channel, are not practical in remote or scalable scenarios. In the process of developing and modelling cryptographic systems, in which there is a need of cryptographic keys agreement in a group of two or more participants, it is very convenient to have a model that implements these algorithms. The agreement protocol is based on the Diffie-Hellman protocol on elliptic curves (ECDH). The paper contains theoretical justifications, a flow chart of the algorithm, and a Python implementation of the algorithm that performs the secret key agreement in a group of an arbitrary number of participants. To implement cryptographic operations on elliptic curves, the Python library Cryptography is used, in particular, the X25519 algorithms that use the elliptic curve Curve25519. The results of the work are shown on an example for a group of four participants, which demonstrate the correct operation of the model and the same secret key obtained as a result of agreement process. The paper also contains the link to a GitHub repository with the full program. The multi_participant_ecdh.py file contains a secret key agreement program for N participants written in Python. The file two_participant_ecdh.py demonstrates a typical two-participant Diffie-Hellman protocol. Both programs use the X25519 algorithm implemented in the Cryptography Python library. Thus, this work makes it possible to better understand the principles of secret key exchange algorithms between two and an arbitrary number of participants, to compare the results with other implementations, to apply the developed model for educational and demonstration purposes, and may be useful for a number of other scientific and engineering tasks.

Power Flow Calculation for AC/DC Power Systems with Line-Commutated Converter–Modular Multilevel Converter (LCC-MMC) Hybrid High-Voltage Direct Current (HVDC) Based on the Holomorphic Embedding Method

To harness the strengths and mitigate the limitations of line-commutated converter (LCC) and modular multilevel converter (MMC) HVDC systems, the LCC-MMC hybrid HVDC system has been developed. This paper proposes a holomorphic embedding (HE)-based power flow calculation method for AC/DC power systems with the LCC-MMC hybrid HVDC system. Firstly, the methodology involves establishing the mathematical model of the LCC-MMC hybrid HVDC system and its control modes. Subsequently, the HE formulation for the constructed LCC-MMC model is derived using the HE method. The proposed method simplifies the HE formulation using substitute variables, making it adaptable to various control modes. The designed HE formulation facilitates the derivation of the germ solution and the calculation of high-order power series coefficients. A sequential solution flow chart compatible with AC power flow algorithms is constructed to enhance the practicality of the HE method for real-world large-scale systems. The accuracy and effectiveness of the proposed method are verified through numerical tests on the modified IEEE 14-bus, IEEE 57-bus, and large 2383-bus system. The proposed method provides a reliable and efficient solution for power flow analysis in hybrid HVDC systems.

Determining line-crossing sequences between laser printing and black ink using digital microscopy: The influence of writing tool and toner

One of the recurring issues in forensic document analysis is determining the chronological order of line-crossing sequences. This seemingly simple but tricky task allows forensic laboratories to demonstrate the real order of events. The aim of this work is to analyse black ink/toner intersections using the digital microscope Hirox RH-2000. Five types of pens (ballpoint, gel, rollerball, fountain and fineliner) as well as five different laser printers were used to create the samples. Forensic examiners were tasked with assessing toner fractures, the bronzing effect, and gaps. The findings were analysed to determine the importance of each characteristic for each type of pen. Results indicate that observing the bronzing effect at high magnification (700x) is crucial for establishing the sequence order of application. In this regard, the fineliner pen is considered the most challenging type of pen to analyse in a black ink/toner intersection. The method was validated through a blind test. Based on this, a flow chart has been developed to assist the Forensic Document Examiners (FDEs) in their evaluations. The flow chart emphasises the significance of combining multiple observations and enables a more objective analysis for trained FDEs.

Low irisin levels predict acutely decompensated heart failure in type 2 diabetes mellitus patients

Abstract Funding Acknowledgements None. Background Acutely decompensated heart failure (ADHF) continues to be associated with unacceptably increasing in-hospital mortality rates and one-year mortality rates. Distinct scenarios of the natural course of ADHF relate to clinical heterogeneity among patients admitted to hospitals, cardiac dysfunction etiology, precipitating factors contributing to heart failure (HF) decompensation including type 2 diabetes mellitus (T2DM). The aim of this study was to determine the discriminative value of irisin for ADHF in T2DM patients with hemodynamically stable chronic HF. Methods A total of 738 patients with T2DM were prescreened using the local database of "Vita Center" (Ukraine). Using criteria of inclusion (male/female with age of ≥18 years, established T2DM with hemodynamically stable chronic HF, glycosylated hemoglobin &amp;lt; 6.9%, informed consent to participate in the study), we enrolled 489 patients with T2DM with concomitant chronic HF I-IV New York Heart Association (NYHA) functional classes. We enrolled 480 T2DM patients with any phenotype of HF and followed them for 52 weeks. Hemodynamic performances and the serum levels of biomarkers were detected at the study entry. The primary clinical end-point was ADHF that led to urgent hospitalization. Results We found that the serum levels of N-terminal natriuretic pro-peptide (NT-proBNP) were higher (1719 [980-2457] pmol/mL vs. 1057 [570-2607] pmol/mL, respectively) and the levels of irisin were lower (4.96 [3.14-6.85] ng/mL vs. 7.95 [5.73-9.16] ng/mL) in ADHF patients than in those without ADHF. The ROC curve analysis showed that the estimated cut-off point for serum irisin levels (ADHF versus non-ADHF) was 7.85 ng/mL (area under curve [AUC] = 0.869 (95% CI = 0.800-0.937), sensitivity = 82.7%, specificity = 73.5%; p = 0.0001). The multivariate logistic regression yielded that the serum levels of irisin &amp;lt; 7.85 ng/mL (OR = 1.20; p = 0.001) and NT-proBNP &amp;gt; 1215 pmol/mL (OR = 1.18; p = 0.001) retained the predictors for ADHF. Kaplan-Meier plots (Figure) showed a significant difference of clinical end-point accumulations in patients with HF depending on irisin levels (&amp;lt;7.85 ng/mL versus ≥7.85 ng/mL). The intra-class correlation coefficient for inter-observer reproducibility of LV dimensions was 0.88 (95% CI = 0.83–0.92), of LVEF was 0.93 (95% CI = 0.90–0.97), of LAVI was 0.92 (95% CI = 0.89–0.94), and of E/e’ was 0.90 (95% CI = 0.87–0.94). Along with it, the intra-class correlation coefficient for the intra-observer reproducibility of LV dimensions was 0.91 (95% CI = 0.88–0.95), of LVEF was 0.94 (95% CI = 0.90–0.98), of LAVI was 0.95 (95% CI = 0.93–0.97), and of E/e’ was 0.92 (95% CI = 0.90–0.95). In conclusion, we established that decreased levels of irisin were associated with ADHF presentation in chronic HF patients with T2DM independently from NT-proBNP.Flow chart of the study designThe Kaplan–Meier analysis of ADHF

Research Status of New Energy Vehicle Thermal Management

Thermal management of new energy vehicles, as a way to break through the driving range of new energy vehicles and one of the guarantees of safety performance, has been paid more and more attention to. In order to improve the thermal management efficiency of new energy vehicles, the thermal management mode of the whole vehicle should be optimized, so that different parts can work at a suitable temperature, so as to ensure the functional safety and service life of the vehicle. Based on this, this paper analyzes the passenger cabin thermal management system through Positive Temperature Coefficient (PTC) heating air conditioning, heat pump air conditioning and other technologies. This paper introduces the new energy vehicle battery thermal management system from the aspects of direct cooling mode and heating mode, introduces the battery thermal management system through the analysis of flow charts, and introduces the cooling mode of electric control and motor, and pays attention to some cutting-edge research progress, and summarizes the automobile thermal management technology theory.

Novel Separation Processes and Their Applications

Separation processes are an integral part of any process flow sheet. Various techniques can beused to separatethe mixture depending on the raw mix. Sometimes, two or more methods must be used to get the desiredproduct. Differences in chemical and physical properties also help decide the separation technique that mustbe used. An external agent, any form of energyor matter, can act as the driving force for the separation. Someof these techniques are conventional processes like distillation, filtration, adsorption, and absorption, whichhave already been well-studied and extensively used. These days newer separation processes called novelseparation processes, such as membrane separation, gas separation, supercritical fluid extraction, use ofultrasonics, chromatographic separation, magnetic projection, and liquid- liquid extraction, among manyothers, are gaining importance in the area of research and implementation. Novel processes were firstimplemented as analytical tools in laboratories. However, they developed rapidly to become significant commercially and technically. The development in gas separation techniques has led to using Liquified Natural Gas in Air Separation Units to produce high-purity nitrogen and oxygen4. Novel separation methods also include ultrasound to enhance separation processes like extraction, demulsification, and crystallisation. Pressure-driven processes are a subset of membrane separation techniques where pressure is utilised as a driving force for separation, with asemipermeable membrane acting as a barrier. This method has various applications ranging from wastewater treatment to dairy processing. Chiral chromatography is used for enantiomeric separations by the use ofHPLC. A new magnetic separation process proposes the separation of plastics by submerging them in a paramagnetic medium and attaching a magnet. This results in moving the particles inside the medium with different trajectories, thereby separating them. This article will scrutinise and briefly describe the essential aspects and developments of novelseparation processes and their applications.

Kidney Doppler ultrasonography in critical care nephrology.

Color pulsed-wave Doppler ultrasound (CPWD-US) emerges as a pivotal tool in intensive care units (ICUs) for diagnosing acute kidney injury (AKI) swiftly and non-invasively. Its bedside accessibility allows for rapid assessments, making it a primary imaging modality for AKI characterization. Furthermore, CPWD-US serves as a guiding instrument for key diagnostic-interventional procedures such as renal needle biopsy and percutaneous nephrostomy, while also facilitating therapy response monitoring and AKI progression tracking. This review shifts focus towards the integration of renal ultrasound into ICU workflows, offering contemporary insights into its utilization through a diagnostic standard-oriented approach. By presenting a flow chart, this review aims to provide practical guidance on the appropriate use of point-of-care ultrasound in critical care scenarios, enhancing diagnostic precision, patient management and safety, albeit amidst a backdrop of limited evidence regarding long-term outcomes.

Swallowed topical steroid therapy for eosinophilic oesophagitis in children: practical, evidence-based guidance by the BSPGHAN Eosinophilic Oesophagitis Working Group

ObjectiveTo develop evidence-based guidance for topical steroid use in paediatric eosinophilic oesophagitis (pEoE) in the UK for both induction and maintenance treatment.MethodsA systematic literature review using Cochrane guidance was carried...

Research on pinch analysis of union station a subsystem

To realize the cascade utilization of energy from the subsystem of Union Station A and improve the extraction of residual heat from sewage in the oilfield, this paper presents a process flow chart based on the Union Station A subsystem and analyses the energy flow of the entire Union Station A subsystem through the method of pinch analysis. In this study, we examine the energy flow distribution across the temperature spectrum within the system, identify the system’s energy consumption “bottleneck”, and optimize the system. The optimization findings reveal that the appropriate range for the pinch point temperature difference in the distributed energy system of the station is 8 to 14°C, with an associated energy-saving potential of 2.73%.

Optimization and Techno-Economic analysis of catalytic gasification of wheat straw biomass using ASPEN PLUS model

Biomass gasification efficiently produces heat, electricity, and power. However, removing harmful contaminants from raw syngas is crucial. Tar production is a challenge due to blockage, plugging, and corrosion. Tar steam reforming (TSR) is the most promising technique, converting high molecular weight hydrocarbons into CO, CO2, H2, and CH4. In this study, a model of biomass gasification using wheat straw as biomass feedstock has been developed using Aspen Plus. The gasification flow sheet encompasses gasification, catalytic filter candle, gas cleaning, impurity removal reactor, separator, and subsequent sorbent reactors. Ni-based catalysts with Ni ratios (5%, 10%, and 15%) are used to simulate TSR reactions. Results show that the 15% Ni-Co-Al2O3 catalyst outperforms the 10% and 5% Ni-Co-Al2O3 catalysts. This study explores the impact of temperature, catalyst loadings, and steam-to-carbon (S/C) ratios on toluene conversion and hydrogen yield in catalytic steam reforming, along with temperature, steam-to-biomass ratios, and equivalence ratio on syngas fraction in gasification. It includes a techno-economic analysis of wheat straw gasification to improve syngas energy through efficient tar conversion.

Guideline for diagnosis and treatment of recurrent spontaneous abortion with integrated traditional Chinese and western medicine

Recurrent spontaneous abortion is one of the most common pregnancy complications in obstetrics and gynecology. The normative diagnosis and treatment of recurrent spontaneous abortion has become an important problem to be solved urgently in the field of reproductive health. The integrated traditional Chinese and western medicine provides a safe and effective treatment method for recurrent spontaneous abortion, but there is no guideline for diagnosis and treatment of recurrent spontaneous abortion with integrated traditional Chinese and western medicine. The guideline is based on the requirements of World Health Organization(WHO) handbook for guideline development and follows the principles of evidence-based medicine. Through literature pre-search, expert interviews, clinical research, and conference consensus, 16 clinical problems are identified in this guideline. PICO principles are used for evidence retrieval, screening, and synthesis. The evidence quality is evaluated for the included evidence bodies. Recommendation opinions and consensus suggestions are formed through three rounds of the Delphi expert questionnaire survey. An expert meeting is held to finalize the draft. The opinions of experts in traditional Chinese medicine, western medicine, integrated traditional Chinese and western medicine, methodology and pharmacy are widely solicited. The guideline contains five parts: scope, term and definition, diagnosis, treatment, and diagnosis and treatment flow chart of integrated traditional Chinese and western medicine. There are corresponding recommendations and summaries of evidence for clinical problems related to the diagnosis and treatment of integrated traditional Chinese and western medicine. This guideline is guided by clinical problems, combining disease differentiation and syndrome differentiation and integrating pre-pregnancy regulation and treatment and post-pregnancy preservation, highlighting the therapeutic advantages of integrated traditional Chinese and western medicine, so as to further standardize the clinical diagnosis and treatment of recurrent spontaneous abortion and promote the diagnosis and treatment level of integrated traditional Chinese and western medicine for recurrent spontaneous abortion.

Aging with and into disability: An introductory review with clarification of basic terms

Aging involves the progression of becoming older, encompassing physical, mental, and social changes that take place in individuals over time. The longer lifespan and decreasing fertility rates have brought attention to the difficulties experienced by elderly people with disabilities. A survey method was used to collect titles of articles from different electronic databases, both online and offline, in national and international journals, as well as chapters or full-length books in the fields of gerontology and disability studies. The resulting list of 95 entries up to March 2024 was examined using the SANRA guidelines (Scale for the Assessment of Narrative Review Articles: Baethge, Goldbeck-Wood, &amp; Mertens, 2019), aided by a flow chart and harvest plot to visually present the findings. The main focus was on clarifying fundamental terms related to aging with and into disability, successful aging, atypical aging, psychological aging, premature aging, and others. This type of clarification, which is not yet available from a single source, is considered necessary for aspiring researchers in this field to choose specific topics or themes for further study. The findings provide valuable insights for future considerations and opportunities for additional research.

DEVELOPMENT OF STANDARD OPERATING PROCEDURES FOR OPERATING REFRIGERATION MACHINERY ON FISHING VESSELS

Refrigeration machines in fishery companies are widely used to maintain the quality of seafood products to keep them fresh. These machines are quite complex, so operating them correctly is crucial, as fatal operational errors can lead to the damage of the refrigeration equipment. The absence of written SOPs has the potential for non-standardized operations. Therefore, this article aims to develop Standard Operating Procedures (SOPs) for operating refrigeration machines on fishing vessels. To achieve this goal, data from the refrigeration system is used, and competent machine crew members are involved to obtain valid data. The data obtained is analyzed using a quantitative descriptive method. A proposed design of Standard Operating Procedure (SOP) with a cross-functional flow chart diagram has been produced as a guideline for operating refrigeration machines on fishing vessels. Based on the analysis, this SOP Draft has met the eligibility criteria for use. The SOP this machinery are highly significant in assisting the machine crew in ensuring that the machines are operated in a controlled manner following the correct procedures.

Effectiveness of Methotrexate Versus Cyclosporine in the Management of Moderate to Severe Atopic Dermatitis- Meta-Analysis of Randomised Controlled Trials

Objective: To compare the effectiveness of Methotrexate (MTX) versus Cyclosporine (CyA) in the patients of moderate to severe atopic dermatitis (AD) Study Design: Systematic review and Meta-analysis. Methodology: After formulating our research team and PICO question rationally, a search strategy and literature search were carried out as per Cochrane guidelines. Full-text articles were retrieved after title and abstract screening per our inclusion criteria. The whole search process was documented in the form of a PRISMA flow chart. Team members made and filed data extraction sheets, and qualitative data synthesis was performed. Afterwards, a meta-analysis was carried out, involving a total of 03 randomized controlled trials. Revman was used to process the continuous and dichotomous data collected for our outcomes. RoB 2 was used to assess the risk of bias in the included studies. Grade pro-GDT was used to summarize the findings in the table. Results: Pooled results from 3 RCTs showed that CyA in a 2.5mg/kg dose is better than MTX @0.4 mg/kg/week at 12 weeks in AD. At follow-up, MTX maintains better disease control, i.e., until 24 weeks post-treatment. MTX has a better safety profile than CyA. Conclusion: MTX and CyA are both effective drugs for moderate to severe AD, but they have their pros and cons.

Proposals for the Use of Thermoelectric Modules for Pasteurization and Cooling of Milk on the Farms

The process flow sheets of environmentally friendly thermoelectric pasteurizers-coolers of milk are proposed. The methodology for thermal calculation of the power of thermoelectric modules of the milk pasteurizer-cooler for the farms with robotic milking and the basic variants of using thermoelectric modules for the primary processing of livestock products are presented. It has been shown that thermoelectric modules are promising option for the farms with milking robots where low cooling capacity, the heat for the pasteurization and the possibility of reversed process are needed. Furthermore these modules can be effectively used in combination with natural cold and heat recovery.