Ideal Time Research Articles

Diagnosis and treatment in a series of patients with cardiac corrected transposition of the great arteries (double discordance)

The atrio-ventricular and ventricle-arterial double discordance (DD) or corrected transposition of the great arteries is a rare heart disease, it occurs in 0.02-0.07 of every 1,000 live newborns. The objective of the study is to describe the diagnosis, treatment and evolution of a series of patients with DD. A retrospective and descriptive study was carried out, reviewing the records of patients diagnosed with DD in the last 22 years. Descriptive statistics were performed. Numerical variables were obtained using means and standard deviation and categorical variables using frequencies and percentages. Thirty patients were studied in 22 years with a ratio of 1.5:1 for men, with a mean age of 20 months. The situs was solitus in 24/29 patients (82.7%). Ventricular septal defect was the most frequent lesion in 25/29 (86.2%) Tricuspid insufficiency in 70%. Four patients diagnosed with pulmonary atrial hypertension. With atrio-ventricular block 20%. One with Wolff-Parkinson-White syndrome. Surgical treatment was carried out in 70% of patients. Eight with Glenn procedure (26.6%) and 4 with Fontan surgery (13.3%). Follow-up ranged from 1 month to 17 years. Five died (16.6%). Of the 25 patients in follow-up, 18 patients (72%) had normal ventricular function, 5 with Grade II Ross classification (20%) and 2 in Grade III (8%). The quality of life of these patients is improving and there is still controversy in the literature about the ideal time to perform the most appropriate surgical procedure.

The effect of oral motor intervention with different initiation times to improve feeding outcomes in preterm infants: protocol for a single-blind, randomized controlled trial

BackgroundPremature infants commonly encounter difficulties with oral feeding, a complication that extends hospital stays, affects infants’ quality of life, and imposes substantial burdens on families and society. Enhancing preterm infants’ oral feeding skills and facilitating their transition from parenteral or nasal feeding to full oral feeding pose challenges for neonatal intensive care unit (NICU) healthcare professionals. Research indicates that oral motor interventions (OMIs) can enhance preterm infants’ oral feeding capabilities and expedite the transition from feeding initiation to full oral feeding. Nonetheless, the most suitable timing for commencing these interventions remains uncertain.MethodsThis is a single-blind, randomized controlled trial. Preterm with a gestational age between 29+0 to 34+6 weeks will be eligible for the study. These infants will be randomized and allocated to one of two groups, both of which will receive the OMIs. The intervention commences once the infant begins milk intake during the early OMIs. Additionally, in the late OMIs group, the intervention will initiate 48 h after discontinuing nasal continuous positive airway pressure.DiscussionOMIs encompass non-nutritive sucking and artificial oral stimulation techniques. These techniques target the lips, jaw, muscles, or tongue of premature infants, aiming to facilitate the shift from tube feeding to oral feeding. The primary objective is to determine the ideal intervention timing that fosters the development of oral feeding skills and ensures a seamless transition from parenteral or nasal feeding to full oral feeding among preterm infants. Furthermore, this study might yield insights into the long-term effects of OMIs on the growth and neurodevelopmental outcomes of preterm infants. Such insights could bear substantial significance for the quality of survival among preterm infants and the societal burden imposed by preterm birth.Trial registrationchictr.org.cn ChiCTR2300076721. Registered on October 17, 2023.

Culture time to optimize embryo cell-free DNA analysis for frozen-thawed blastocysts undergoing noninvasive preimplantation genetic testing for aneuploidy

To investigate the ideal time in culture to optimize embryo cell-free deoxyribonucleic acid (cfDNA) analysis in frozen-thawed blastocysts undergoing noninvasive preimplantation genetic testing for aneuploidy (PGT-A). Cell-free DNA is released into the spent blastocyst media (spent media) by the embryo. However, the optimal timing to determine maximal cfDNA in the case of frozen-thawed blastocysts undergoing noninvasive PGT-A remains to be elucidated. In this prospective observational study, 135 spent media and corresponding whole blastocysts were collected from January 2021 through March2022. Private fertility clinics. Day-5 frozen-thawed blastocysts were cultured for 8 hours (Day-5 Short) or 24 hours (Day-5 Long), whereas day-6 frozen-thawed blastocysts were cultured for 8 hours (Day-6 Short). The spent media and whole blastocysts were then collected for further analysis. Spent media and whole blastocysts were amplified using whole genome amplification and sequenced using next-generation sequencing. Informativity and concordance rates between cfDNA in spent media and whole blastocyst DNA were compared according to the different times in culture. When comparing time in culture, informativity rates for spent media were significantly higher for Day-5 Long and Day-6 Short (>91%) compared with the Day-5 Short group (<60%). A similar trend was observed for cases with and without a previous PGT-A. Regarding blastocyst expansion grade, informativity rates were lower on Day-5 Short compared with Day-5 Long and Day-6 Short, regardless of expansion degree. This decrease was significant for Gardner-grade expansion grades 3, 4, and 5-6. In addition, for a similar time in culture, the grade of expansion did not have an impact on the informativity rates. For concordance rates, no significant differences were observed among the 3 groups. In all cases, concordance rates were 90.5% for Day-5 Short, 93.6% for Day-5 Long, and 92.3% for Day-6 Short. No impact of the expansion grade was observed on concordance rates. Noninvasive PGT-A in frozen-thawed blastocysts yields very high concordance rates with whole blastocysts, possibly limiting the need for invasive PGT-A and making it available for a wider range of patients.

Timing-accurate scheduling and allocation for parallel I/O operations in real-time systems

In industrial real-time systems, the I/O operations are often required to be both timing predictable, i.e., finish before the deadline to ensure safety, and timing accurate, i.e., start at or close to an ideal time instant for optimal I/O performance. However, for I/O-extensive systems, such strict timing requirements raise significant challenges for the scheduling of I/O operations, where execution conflicts widely exist if the I/O operations are scheduled at their ideal time instants. Existing methods mainly focus on one I/O device and apply simple heuristics to schedule I/O operations, which cannot effectively resolve execution conflicts, hence, undermining both timing predictability and accuracy. This paper proposes novel scheduling and allocation methods to maximize the timing accuracy while guaranteeing the predictability of the system. First, on one I/O device, a fine-grained schedule using Mixed Integer Linear Programming (MILP) is constructed that optimizes the timing accuracy of the I/O operations. Then, for systems containing multiple I/O devices of the same type, two novel allocations are proposed to realize parallel timing-accurate I/O control. The first utilizes MILP to further improve the timing accuracy of the system, whereas the second is a heuristic that provides competitive results with low overheads. Experimental results show the proposed methods outperform the state-of-the-art in terms of both timing predictability and accuracy by 37% and 25% on average (up to 5.56x and 33%), respectively.

Study of CO Gas Dilution in Forcing Ventilation System at Ramp Down KKRB 4 Utama, Pongkor, West Java

CO is a hazardous gas formed from the reaction of explosives that lack oxygen balance. These explosives have the potential to generate toxic gases, including CO. It is crucial to minimize CO concentration at the work site by ensuring proper air circulation. This study aims to examine the impact of varying ducting distances on CO gas dilution, using the gas diffusion coefficient value as a basis. The research method employed is observational, involving the assessment of CO gas dilution in the tested tunnel at varying distances from the working front to the sensor. The research was conducted on the Ramp Down KKRB 4 Utama. Result of the research is the most ideal carbon monoxide reduction time at RD KKRB 4 Utama is shown at sensor placement distance 1 using the blow system, where A Sensor takes 2.21 hours and B Sensor takes 1.06 hours to reach a concentration level below the TLV (Threshold Limit Value) 50 ppm.

Personalized Timing for Allogeneic Stem-Cell Transplantation in Hematologic Neoplasms: A Target Trial Emulation Approach Using Multistate Modeling and Microsimulation.

Decision about the optimal timing of a treatment procedure in patients with hematologic neoplasms is critical, especially for cellular therapies (most including allogeneic hematopoietic stem-cell transplantation [HSCT]). In the absence of evidence from randomized trials, real-world observational data become beneficial to study the effect of the treatment timing. In this study, a framework to estimate the expected outcome after an intervention in a time-to-event scenario is developed, with the aim of optimizing the timing in a personalized manner. Retrospective real-world data are leveraged to emulate a target trial for treatment timing using multistate modeling and microsimulation. This case study focuses on myelodysplastic syndromes, serving as a prototype for rare cancers characterized by a heterogeneous clinical course and complex genomic background. A cohort of 7,118 patients treated according to conventional available treatments/evidence across Europe and United States is analyzed. The primary clinical objective is to determine the ideal timing for HSCT, the only curative option for these patients. This analysis enabled us to identify the most appropriate time frames for HSCT on the basis of each patient's unique profile, defined by a combination relevant patients' characteristics. The developed methodology offers a structured framework to address a relevant clinical issue in the field of hematology. It makes several valuable contributions: (1) novel insights into how to develop decision models to identify the most favorable HSCT timing, (2) evidence to inform clinical decisions in a real-world context, and (3) the incorporation of complex information into decision making. This framework can be applied to provide medical insights for clinical issues that cannot be adequately addressed through randomized clinical trials.

Trajectory planning and simulation of upper limb rehabilitation robot based on NSGA2

In order to increase the stability and comfort of hemiplegic rehabilitation training, this paper integrates B-spline curves with a non-dominated sorting genetic algorithm (NSGA2) for trajectory planning of a 5-DOF upper limb exoskeleton rehabilitation robot, the structural characteristics of the robot are analyzed. Subsequently, the forward kinematics equation is derived by the D-H method, and its correctness is verified by Adams simulation. Subsequently, the robot workspace is calculated, and the outcomes show that it satisfies the patient’s demand for activity. Finally, the trajectory curve is constructed using the 5th-order B-splines. Under kinematic constraints, the NAGA2 is used to discover the ideal time interval sequence for time, impact and energy, and then complete the trajectory planning. The simulation findings demonstrate the suggested trajectory planning method produces continuous, smooth, and high-performance motion trajectories, providing good rehabilitation training for patients.

The mammalian sperm factor phospholipase C zeta is critical for early embryo division and pregnancy in humans and mice.

The mammalian sperm factor phospholipase C zeta is critical for early embryo division and pregnancy in humans and mice.

Preoperative Optimization of Crohn's Patients before Abdominopelvic Surgery

AbstractIn this article, we review and identify modifiable risk factors associated with postoperative complications of Crohn's disease. We highlight the importance of factors such as nutrition, corticosteroids, immunomodulators, abscesses, ideal timing of surgery, and biologic and small-molecule therapy on surgical outcomes. Herein, we discuss the strategies for attenuating these risk factors. Special consideration is given to venous thromboembolism prophylaxis in this patient population.

Safety of catheter ablation in patients with recently implanted cardiac implantable electronic device: A 5-year experience.

Catheter ablation (CA) can interfere with cardiac implantable electronic device (CIED) function. The safety of CA in the 1st year after CIED implantation/lead revision is uncertain. This single center, retrospective cohort included patients who underwent CA between 2012 and 2017 and had a CIED implant/lead revision within the preceding year. We assessed the frequency of device/lead malfunctions in this population. We identified 1810 CAs in patients between 2012 and 2017, with 170 CAs in 163 patients within a year of a CIED implant/lead revision. Mean age 68±12 years (68% men). Time between the CIED procedure and CA was 158±99 days. The CA procedures included AF ablation (n=57, 34%), AV node ablation (n=40, 24%), SVT ablation (n=37, 22%), and PVC/VT ablations (n=36, 21%). The cumulative frequency of lead dislodgement, significant CIED dysfunction, and/or CIED-related infection following CA was (n=1/170, 0.6%). There was a single atrial lead dislodgement (0.6%). There were no instances of power-on-reset or CIED-related infection. Following CA, there was no significant difference in RA or RV lead sensing (p=0.52 and 0.84 respectively) or thresholds (p=0.94 and 0.17 respectively). The RA impedance slightly decreased post-CA from 474±80 Ohms to 460±73 Ohms (p=0.002), as did the RV impedance (from 515±111 Ohms to 497±98 Ohms, p<0.0001). CA can be performed within 1 year following CIED implantation/lead revision with a low risk of CIED/lead malfunction or lead dislodgement. The ideal time to perform CA after a CIED remains uncertain.

Carcass characteristics and meat quality of goat kids according to the Colomer – Rocher carcass fatness and conformation classes

Classifying kid carcasses according to their fatness and conformation scores guides producers toward higher quality and income-generating production methods and determines the ideal slaughter time. This study aimed to determine the effects of Colomer–Rocher fatness and conformation classes on carcass and meat quality characteristics in goat kids. A total of 102 male kid carcasses were used in the study. Carcasses were divided into fatness (1-, 1, 1+, 2-) and conformation (P-, P, P+; O-) classes according to the Colomer–Rocher classification, and these groups were accepted as the experimental group. Hierarchical clustering analysis divided the kid carcasses into 5 clusters using certain carcass characteristics. Differences between clusters in most of the carcass characteristics were significant. The difference between the cluster groups in terms of meat colour and sensory characteristics was also significant. Fatness and conformation classes significantly affected most characteristics except kidney knob and channel fat (KKCF) percentages and carcass joints percentages. The Colomer-Rocher conformation classification was found to be more discriminatory in terms of meat quality than the fatness classification.

Strategi Pemasaran dan Inovasi Produk dalam Keberlanjutan Bisnis: Studi Kasus UMKM di Masa Pandemi

Marketing and innovation strategies are the key to success inining a business, success determined by victory in the face of competition using established strategies to innovate with their business. Innovation in UMKM can be seen through three dimensions: process innovation, product innovation, and management system innovation. In this case product innovation becomes the most important part to improve UMKM performance. In its implementation, paying attention to the ideal time and how to innovate is an important thing when the entrepreneur will implement the necessary marketing strategy. Marketing startups and product innovations are the key to success inining a business, success is determined by victory in the face of competition using established strategies to innovate with the business. In the implementation of marketing strategies as well as product innovation should pay attention to the ideal time and how things innovate is important when the entrepreneur will implement the necessary marketing strategy. keywords : strategy UMKM, marketing, inovation

Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review.

The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

Predicting Airline Ticket Prices Using Machine Learning Predicting Airline Ticket Prices Using Machine Learning

Airfare prices are constantly changing due to various factors like the time of flight, destination, and length of the trip. To help people figure out the best time to buy tickets, we are working on a system that will use machine learning to predict prices. By studying past flight data in India, we want to uncover pricing patterns and suggest the ideal time to purchase tickets. This project aims to confirm or dispel common beliefs about airlines by comparing prediction models and finding ways to save money on ticket purchases. Price trends can vary significantly based on various factors such as the route, month, day, time of departure, holidays, and the airline carrier. Competitive routes like major business destinations (Mumbai-Delhi) tend to see price increases closer to the departure date. On the other hand, routes like tier 1 to tier 2 cities (Delhi-Guwahati) have specific time frames when prices are lower. The data also shows that there are two main categories of airline carriers in India: economical and luxurious. Generally, the lowest-priced flights fall under the economical group. Moreover, the data confirms that specific times of the day tend to have higher prices. By including different routes in this project, there is a potential for substantial savings when buying domestic flight tickets in India. Key Words: Airline Ticket, Pricing strategies, Fare fluctuations, Competitor analysis, Market trends

An Example of Parallel Merkle Tree Traversal: Post-Quantum Leighton-Micali Signature on the GPU

The hash-based signature (HBS) is the most conservative and time-consuming among many post-quantum cryptography (PQC) algorithms. Two HBSs, LMS and XMSS, are the only PQC algorithms standardised by the National Institute of Standards and Technology (NIST) now. Existing HBSs are designed based on serial Merkle tree traversal, which is not conducive to taking full advantage of the computing power of parallel architectures such as CPUs and GPUs. We propose a parallel Merkle tree traversal (PMTT), which is tested by implementing LMS on the GPU. This is the first work accelerating LMS on the GPU, which performs well even with over 10,000 cores. Considering different scenarios of algorithmic parallelism and data parallelism, we implement corresponding variants for PMTT. The design of PMTT for algorithmic parallelism mainly considers the execution efficiency of a single task, while that for data parallelism starts with the full utilisation of GPU performance. In addition, we are the first to design a CPU-GPU collaborative processing solution for traversal algorithms to reduce the communication overhead between CPU and GPU. For algorithmic parallelism, our implementation is still 4.48 × faster than the ideal time of the state-of-the-art traversal algorithm. For data parallelism, when the number of cores increases from 1 to 8192, the parallel efficiency is 78.39%. In comparison, our LMS implementation outperforms most existing LMS and XMSS implementations.

Augmented Kalman Estimator and Equivalent Replacement Based Taylor Series-LQG Control for a Magnetorheological Semi-Active Suspension

This research presents an augmented Kalman estimator and an equivalent replacement-based Taylor series (ERBTS)-linear quadratic Gaussian (LQG) control strategy to cope with the control accuracy and response delay of magnetorheological (MR) dampers for vehicle semi-active suspensions. The parameters in the MR model are identified from experimental measurements. Then, two main sources of control error, namely, modelling error and real-time variety of the MR damper output force, are defined as an integrated compound real-time variety. Subsequently, they are written into a differential equation with characteristics of the minimum system to augment the state equation of the semi-active suspension system. The augmented Kalman estimator is constructed to estimate the abovementioned compound real-time variety. To calculate an acceptable time-delay compensation predictive control force, an equivalent operation is implemented beforehand in the suspension comprehensive performance index by replacing a part of the squared time-delay control force with the corresponding predictive control force. Simulation results verify the effectiveness of the proposed augmented Kalman estimator, and the newly developed ERBTS-LQG controller almost achieves control effectiveness of the ideal time delay free semi-active suspension.

Seroconversion and Kinetics of Vibriocidal Antibodies during the First 90 Days of Re-Vaccination with Oral Cholera Vaccine in an Endemic Population.

Despite the successful introduction of oral cholera vaccines, Zambia continues to experience multiple, sporadic, and protracted cholera outbreaks in various parts of the country. While vaccines have been useful in staying the cholera outbreaks, the ideal window for re-vaccinating individuals resident in cholera hotspot areas remains unclear. Using a prospective cohort study design, 225 individuals were enrolled and re-vaccinated with two doses of Shanchol™, regardless of previous vaccination, and followed-up for 90 days. Bloods were collected at baseline before re-vaccination, at day 14 prior to second dosing, and subsequently on days 28, 60, and 90. Vibriocidal assay was performed on samples collected at all five time points. Our results showed that anti-LPS and vibriocidal antibody titers increased at day 14 after re-vaccination and decreased gradually at 28, 60, and 90 days across all the groups. Seroconversion rates were generally comparable in all treatment arms. We therefore conclude that vibriocidal antibody titers generated in response to re-vaccination still wane quickly, irrespective of previous vaccination status. However, despite the observed decline, the levels of vibriocidal antibodies remained elevated over baseline values across all groups, an important aspect for Zambia where there is no empirical evidence as to the ideal time for re-vaccination.

Process intensification in flow chemistry using micro and millidevices: Numerical simulations of the syntheses of three different intermediate API compounds for diabetes mellitus drug production

Microreactor Technology (MRT) appears as an interesting alternative for process intensification, including the development of continuous synthesis of fine chemicals and Active Pharmaceutical Ingredients (API). The inherent proposal of MRT is to reduce the scale-up time by simply increasing the number of microreactors in parallel, the numbering-up concept using optimal designed micro or millidevices. Among the API, rosiglitazone and lobeglitazone are derivatives of thiazolidine-2,4-dione (TZD), which is used as a building block, for molecules with biological activity, sensitive to insulin and, thus, with its administration the body makes better use of the insulin it produces, being an important structural element in medicinal chemistry, especially for type 2 diabetes mellitus, one of the biggest concerns in the health area worldwide, affecting nowadays more than 180 million people. The numerical assessment of MRT for various API synthesis related to type 2 diabetes mellitus drugs indicates its comparable or superior performance compared to traditional batch process. Specifically, proposed micromixer designs facilitate successful scale-up to milliscale while maintaining microscale performance, with significantly lower pressure drops than commercial Asia microreactors. The proposed flow distributors offer good performance in ensuring uniform distribution across outlets due to their conical shape design and laminar flow regime, with low pressure drops. The flow distributor with eights outlet is preferred for higher flow rates due to its superior performance, minimizing the pressure drops. Efficient flow rate and molar concentration control at each reactor unit can be ensured by using one distributor for each reactant's feed stream. This approach guarantees accurate concentration, flow rate control and ideal residence time, ultimately facilitating higher total throughput for scale-up. The potential use of micromixer actuators lies in its ability to maintain or enhance performance while transitioning from micro to milli-scale, offering promising alternatives for process intensification and scale-up in pharmaceutical synthesis, particularly for medications targeting type 2 diabetes mellitus.

Proposing an Innovative Method for Predicting Optimum Wind Generator Output

Renewable energy sources offer environmental benefits and a more consistent supply, making them essential for integrating into energy fusions. Network operators have challenges with intermittent and stochastic power sources like wind power owing to their fluctuating production. This study presents an innovative method for predicting wind turbine power output, from any location in a vast region with high efficiency. To ensure a representative sample of geographical locations, the research region is divided into a grid and sampled accordingly. The ideal production times for each sub-area are discovered and utilized to anticipate electricity output. It uses the LSTM model to predict meteorological data and the linear model to approximate wind turbine power curves. The sub-area showed one-day wind speed, direction, and power projections clustering scores. Wind and directional predictions yielded RMSE (0.35m\sec, 7.9rad) and R2 (94%, 71%) scores.

The equation for medical multiple-choice question testing time estimation.

Multiple-choice questions (MCQs) offer a suitable means to assess the cognitive domain of learners with a high degree of objectivity. The study's objective is to formulate an equation for determining the ideal timing for MCQ examinations, thereby inspiring the development of a model to estimate the duration of these examinations. The authors generated a specific computer program that integrated with the operating system of the examination. Technical-specific features included the ability to calculate the speed of students taking examinations with images or videos in the questions or options. This bespoke computer program was designed specifically for assessing individual students' MCQ test-taking pace and generating a proctor report in a computer-readable format. Subsequently, data derived from this program underwent regression analysis to determine the speed at which students completed MCQ examinations. The data were collected from a total of 1035 examinees, all of whom were non-native English speakers. The average reading rate was 62.38±20.4 words/min. It was found that the rate decreased significantly in difficult (50.65±6.9 words/min) items compared to easy (82.29±21.3 words/min) and intermediate (60.56±19.1 words/min) items (p<0.001), respectively. The linear regression analysis predicted option selection (words/min) as; 33.92+1.93(%tables/figures)+0.14(%recall)-0.37(%application), r2=0.45, p<0.001. It is not advisable to base the decision solely on reading time or time allocation. Examination administrators are advised to proactively plan ahead, with particular emphasis on establishing a well-defined taxonomy, as it constitutes a fundamental cornerstone in the utilization of the estimation equation.