Linear Sensitivity Analysis Research Articles

Relationship between triglyceride-glucose index and endometriosis: a cross-sectional analysis

BackgroundThe link between insulin resistance and endometriosis is not well established. The triglyceride-glucose (TyG) index serves as a straightforward and economical indicator of insulin resistance. This study examines the link between the TyG index and the prevalence of endometriosis in a U.S. cohort.MethodsThis cross-sectional study analyzed data from the NHANES conducted between 1999 and 2006. Reproductive health was assessed through questionnaires, and the TyG index was derived from fasting triglyceride and glucose measurements. Weighted logistic regression models were used to analyze the relationship between the TyG index and endometriosis. Restricted cubic spline (RCS) curves explored the linear relationship, while stratified and sensitivity analyses assessed potential interactions and the robustness of the findings.ResultsThe study included 2,346 women, with 176 diagnosed with endometriosis and 2,170 without. Women with endometriosis exhibited an elevated TyG index compared to those without the condition. The weighted logistic regression analysis revealed that the TyG index is an independent risk factor for endometriosis (OR = 1.58, 95% CI 1.17–2.14, p = 0.004). RCS analysis indicated a significant positive linear association between the TyG index and endometriosis, with a turning point at 8.51. Subgroup analysis indicated a stronger association in certain populations. The post-propensity score matching analysis confirmed the robustness of these findings.ConclusionIn the U.S. population, a higher TyG index is positively and linearly associated with endometriosis prevalence. Effective management of blood glucose and lipid levels may reduce the prevalence of endometriosis.

Association between triglyceride glucose body mass index and cardiovascular disease in adults: evidence from NHANES 2011- 2020.

The association between insulin resistance and cardiovascular diseases (CVD) is of significant interest. However, there is limited published research on the relationship between CVD and the triglyceride glucose-body mass index (TyG-BMI). This study aims to examine the association between TyG-BMI and CVD in US adults. We analyzed data from 11016 adults collected through the 2011-2020 NHANES. Employing weighted generalized linear models, subgroup analysis, sensitivity analysis, and receiver operating characteristic curves, we examined the association between the TyG-BMI index and CVD. Nonlinear associations were investigated using restricted cubic splines. Higher TyG-BMI values were significantly associated with an increased prevalence of CVD (P<0.001). Weighted generalized linear models consistently demonstrated a positive association across all models. Specifically, individuals in the highest tertile of TyG-BMI had a 38% higher CVD prevalence than those in the lowest quartile (OR=1.380; 95% CI=1.080, 1.763). Unweighted logistic regression models further confirmed these findings. Sex, race, education, family income to poverty ratio, smoking, hypertension, and diabetes did not modify this positive association (P for interaction >0.05). Incorporating the TyG-BMI index into traditional risk factor models marginally improved the prediction of CVD prevalence (P for comparison <0.05). The TyG-BMI index, an indicator of insulin resistance, is significantly positive associated with a higher prevalence of CVD. These findings underscore the importance of managing insulin resistance to prevent CVD and highlight the need for further research into the underlying mechanisms of this association.

Vitamin D metabolism in critically ill patients with acute kidney injury: a prospective observational study

BackgroundVitamin D deficiency in critically ill patients is associated with poor outcomes, and vitamin D supplementation is recommended for patients with chronic kidney disease. Whether acute kidney injury (AKI) is associated with altered Vitamin D metabolism is unknown. We aimed to compare the longitudinal profiles of serum 25(OH)D and 1,25(OH)2D concentrations in critically ill patients with and without moderate to severe AKI and explore the impact of renal recovery and parathyroid hormone (PTH).MethodsIn this prospective, observational study in two centres in the UK, critically ill patients with and without AKI underwent serial measurement of serum 25(OH)D and 1,25(OH)2D and plasma PTH concentrations for 5 days. Linear mixed model analysis and sensitivity analyses were performed.ResultsSerial data of 137 patients were analysed. Seventy-one patients had AKI stage II/III of whom 23 recovered kidney function during the 5-day study period; 66 patients did not have AKI at enrolment of whom 14 developed new AKI. On day of enrolment, patients’ serum 25(OH)D concentrations were low (median 18 nmol/L) but there was no significant difference between patients with and without AKI. Median serum 1,25(OH)2D levels were significantly lower in patients with AKI II/III (41 pmol/L [IQR 26, 58]) compared to similarly unwell patients without AKI (54 pmol/L [IQR 33, 69]) during the 5-day period. Recovery of kidney function in patients with AKI was associated with a rise in 1,25(OH)2D concentrations. Plasma PTH results were impacted by serum calcium and magnesium levels but not associated with 1,25(OH)2D levels.ConclusionsCritically ill patients with moderate-to-severe AKI have significantly lower serum 1,25(OH)2D concentrations than similarly sick patients without AKI but there was no difference in serum 25(OH)D concentrations. Recovery of AKI was associated with a rise in serum 1,25(OH)2D concentrations. More research is needed to investigate the health benefits and safety of supplementation with active vitamin D in critically ill patients with moderate-to-severe AKI.Trial registration Clinicaltrials.gov (NCT02869919), registered on 16 May 2016.

A zero-net-mass-flux wake stabilization method for blunt bodies via global linear instability

A rectangular cylinder, with an aspect ratio of 5, is a widely used bluff body in engineering practice. It undergoes intricate dynamical behavior in response to minute alterations in the flow angle of attack (α). These modifications invariably precipitate the failure of wake control for classical flow control methods with various α values. In this study, global linear instability, adjoint method, and sensitivity analysis are employed to identify the optimal position for flow control. It is found that the sensitive region gradually transitions from the leeward side to the downwind side of the model as α and Reynolds number (Re) increase. So, we set up airflow orifices for flow control in both positions. Jet flow control on the leeward side effectively inhibits vortex shedding (α ≤ 2°). High-order dynamic mode decomposition is employed to reveal the inherent mechanism of control. Suction control on the downside effectively mitigates the shear layer separation phenomenon induced by the altered spatial structure associated with higher α. A novel zero-net-mass-flux wake control, bionics-based breathe-valve control (BVC), is proposed to optimize the control effect. BVC is applicable for various α and Re, with optimal effectiveness achievable through jet velocity adjustments. The prediction-control approach in this investigation provides a targeted method to mitigate flow-induced vibration.

Amplified PTSD Symptoms From Self-Attributed Moral Transgressions Are Linked to Internalized Moral Identity During Military Deployment.

Military personnel frequently experience stressful, morally challenging situations that can lead to posttraumatic stress disorder (PTSD). The relationships between moral identity, transgressive acts, and symptoms related to posttraumatic stress disorder (i.e., posttraumatic stress symptoms; PTSS) among U.S. Army Soldiers were assessed. A convenience cohort of 1,547 soldiers completed a survey assessing moral identity and PTSS before deployment. A subset of 505 soldiers completed another survey assessing transgressive acts and PTSS during deployment. Exploratory and confirmatory factor analyses were conducted to determine the underlying factor structure of the measures of moral identity and transgressive acts. Generalized linear modeling, robustness checks, and sensitivity analysis were used to evaluate the predictive relationships. Moral identity did not directly predict PTSS during deployment. However, self-attributed and betrayal-based transgressive acts were significant predictors. Specifically, self-attributed transgressive acts and PTSS were moderated by internalized moral identity; individuals with a higher internalized moral identity experienced more severe PTSS following self-attributed transgressive acts. These findings were consistent across various model checks, including covariate adjustments, data imputation, and the application of a data quality filter. The study highlights the significant role of self-attributed moral transgressions during deployment in the development of PTSS among military service members-especially in those with a strong internalized moral identity. This finding suggests a "target of opportunity" for the development of intervention strategies that mitigate PTSS by addressing the moral dimensions of military service.

Efficacy and safety of Buzhongyiqi decoction combined with acupoint application for functional constipation in elderly people: A systematic review and meta-analysis.

This study aimed to evaluate the efficacy and safety of Buzhongyiqi decoction combined with acupoint application in the treatment of functional constipation in elderly people. (1) Four Chinese databases (China National Knowledge Infrastructure, China Science Periodical Database, Chinese Citation Database, China Biology Medicine) and 4 foreign databases (PubMed, Web of Science, Cochrane Library, Embase) were searched, excluded, and included in randomized controlled trials of Buzhongyiqi decoction combined with acupoint application for the treatment of functional constipation in elderly people. (2) Systematic evaluation and meta-analysis using the RevMan 5.3 software. (3) Harbord linear regression and sensitivity analyses were conducted to evaluate publication bias using Stata 14.0. (4) Reliability of the conclusion assessment by sequential test analysis in TSA0.9 software. (5) Quality of evidence evaluation of outcome indicators was evaluated using Gradepro 3.6 software. Eight randomized controlled trials including 658 case sample sizes were included. Compared with the control group, the intervention group showed improved clinical cure rate and effective rate of functional constipation in elderly people, reduced recurrence rate, and efficacy regulated the levels of defecation-related indices and indices of gastrointestinal function. In addition, trial sequential analysis indicated that the total clinical efficacy rate was conclusive, which showed that the therapeutic efficacy of the intervention group was superior to that of the control group. However, the incidence of adverse effects in intervention group was comparable to that of control group, and trial sequential analysis suggests that this result needs to be supported by additional research. Buzhongyiqi decoction combined with acupoint application has potential value in the treatment of functional constipation in elderly people. Currently, there is insufficient clinical evidence to objectively evaluate safety grades for this combination therapy.

Effect of Platoon Configurations on the Anti-Disturbing Performance

&lt;div&gt;In order to promote the actual application of the vehicular platoon, this study investigates the effect of the specific platoon configurations including predecessor following (PF), predecessor–leader following (PLF), and bidirectional following (BD), on the anti-disturbing performance from the linear to nonlinear perspective. First, based on the method of sensitivity of error propagation to the disturbance, a linear platoon model is established by considering an individual vehicle as a lumped-mass point. Then, the transfer function matrix from disturbance to spacing error is derived for sensitivity analysis. Finally, especially considering the inherent vehicle dynamics, the Burckhardt tire force model is adopted to construct a nonlinear platoon dynamics model for the nonlinear dynamics analysis. The results reveal the characteristics of each platoon configuration, as well as the design of control gains in terms of the anti-disturbing performance. The nonlinear dynamics property in high-adhesion conditions are generally similar to those of the sensitivity analysis based on the linear platoon model. However, some particular and complex phenomena different from the linear sensitivity analysis especially in low-adhesion conditions are only observed by the nonlinear dynamics analysis.&lt;/div&gt;

The elusive crustal resistive boundary beneath the Deccan Volcanic Province and the western Dharwar craton, India

The electrical properties of the boundary beneath the Deccan Volcanic Province and the western Dharwar craton are imaged by using the magnetotelluric method. The magnetotelluric study was carried out along a 150km long WNW-ESE profile from Belgaum (in the Deccan Volcanic Province) to Haveri (in the western Dharwar craton).Data from 19 magnetotelluric stations spaced 10-15km apart were used. The dominant regional geo-electric strike direction obtained is N20ºE. Two-dimensional (2-D) inversion is done by using the non-linear conjugate gradient scheme for both apparent resistivity and phase. The 2-D resistivity model shows a high electrical resistivity character (&gt;10,000ohm-m) in the western Dharwar craton. Two conductive anomalies are mapped in the crustal region. In the WNW side of the profile, a conductive feature (~200ohm-m) is imaged in the mid-lower crust and, in the central part of the profile another conductive feature is mapped in the lower crust. The conductive features robustness is tested using linear and non-linear sensitivity analyses. The conductor mapped in the WNW part of the profile is considered as a deep seated fault representing a boundary or a rift related feature beneath the Deccan Volcanic Province and the western Dharwar craton. A zone of enhanced conductivity (&lt;50ohm-m) at an approximate depth of 10-30km may represent the presence of the rift in the region. This conducting feature on the Western side of the E-W trending Kaladgi Basin can be interpreted as the extension of the Kaladgi Basin further west. A well-correlated geological cross-section is also derived to interpret the resistive features mapped in this study. The electrical resistivity nature of the crust is compared with other regions of the world.

Impacts of Green Fraction Changes on Surface Temperature and Carbon Emissions: Comparison under Forestation and Urbanization Reshaping Scenarios

Global land cover dynamics alter energy, water, and greenhouse gas exchange between land and atmosphere, affecting local to global weather and climate change. Although reforestation can provide localized cooling, ongoing land use land cover (LULC) shifts are expected to exacerbate urban heat island impacts. In this study, we monitored spatiotemporal changes in green cover in response to land use transformation associated with the Khyber Pakhtunkhwa (KPK) provincial government’s Billion Tree Tsunami Project (BTTP) and the Ravi Urban Development Plan (RUDP) initiated by the provincial government of Punjab, both in Pakistan. The land change modeler (LCM) was used to assess the land cover changes and transformations between 2000 and 2020 across Punjab and KPK. Furthermore, a curve fit linear regression model (CFLRM) and sensitivity analysis were employed to analyze the impacts of land cover dynamics on land surface temperature (LST) and carbon emissions (CE). Results indicated a significant increase in green fraction of +5.35% under the BTTP, achieved by utilizing the bare land with an effective transition of 4375.87 km2. However, across the Punjab province, an alarming reduction in green fraction cover by −1.77% and increase in artificial surfaces by +1.26% was noted. A significant decrease in mean monthly LST by −4.3 °C was noted in response to the BTTP policy, while an increase of 5.3 °C was observed associated with the RUDP. A substantial increase in LST by 0.17 °C was observed associated with transformation of vegetation to artificial surfaces. An effective decrease in LST by −0.21 °C was observed over the opposite transition. Furthermore, sensitivity analysis suggested that LST fluctuations are affecting the % of CO2 emission. The current findings can assist policymakers in revisiting their policies to promote ecological conservation and sustainability in urban planning.

Association of systemic immune inflammatory index with all-cause and cause-specific mortality in hypertensive individuals: Results from NHANES.

The relationship between the systemic immune inflammatory index (SII) and the prognosis of hypertensive patients is unclear. This study aims to explore the association of SII with all-cause and cause-specific mortality in patients with hypertension. This study included 8524 adults with hypertension from the National Health and Nutritional Examination Surveys (NHANES) 2011-2018, and followed for survival through December 31, 2019. Cox proportional hazards models were used to investigate the associations between SII and mortality from all causes, cardiovascular disease (CVD), and cancer. Restricted cubic spline, piecewise linear regression, subgroup and sensitivity analyses were also used. During a median follow-up of 4.58 years, 872 all-cause deaths occurred. After adjusting for covariates, higher SII was significantly associated with an elevated risk of CVD mortality. There was a 102% increased risk of CVD mortality per one-unit increment in natural log-transformed SII (lnSII) (P < 0.001). Consistent results were also observed when SII was examined as categorical variable (quartiles). The associations of SII with all-cause and cancer mortality were detected as U-shaped with threshold values of 5.97 and 6.18 for lnSII respectively. Below thresholds, higher SII was significantly associated with lower all-cause mortality (HR=0.79, 95%CI=0.64-0.97) and cancer mortality (HR=0.73, 95%CI=0.53-1.00). Above thresholds, SII was significantly positive associated with all-cause mortality (HR=1.93, 95%CI=1.55-2.40) and cancer mortality (HR=1.93, 95%CI=1.22-3.05). The results were robust in subgroup and sensitivity analyses. Higher SII (either as a continuous or categorical variable) were significantly associated with a higher risk of CVD mortality. The U-shaped associations were observed between SII and all-cause and cancer mortality.

Optimization of Fatigue Performance of FDM ABS and Nylon Printed Parts

This research work aims to proceed with the optimization of Fused Deposition Modeling (FDM) printing parameters for acrylonitrile butadiene styrene (ABS) and polyamide (Nylon) to improve fatigue resistance. For that purpose, the methodology of the paper involves two main approaches: experimental study and finite element analysis. The experimental part of the paper used the Taguchi method to find the effects of printing internal geometry, printing speed, and nozzle diameter on the fatigue life of ABS and Nylon plastic materials. ANCOVA multiple linear regression and sensitivity analysis was used to investigate the effects of printing parameters on the fatigue life of materials. The analysis of the results revealed: Nylon performed better than ABS, but had a higher slope; the 'tri-hexagon' structure resulted in the highest fatigue life, but the effect was statistically significant only for ABS material; the fatigue life of both materials increased with decreasing the nozzle diameter; the printing speed had no statistically significant influence neither on ABS nor Nylon. The experimental results then were validated by numerical simulations and the difference between the values was within ±14% depending on the experiment. Such differences might occur due to numerical and experimental errors.

EMPLOYING A LINEAR PROGRAMMING METHOD AND SENSITIVITY ANALYSIS IN ORDER TO ESTIMATE THE OPTIMAL PRODUCTION VOLUME WITH APPLICATION

EMPLOYING A LINEAR PROGRAMMING METHOD AND SENSITIVITY ANALYSIS IN ORDER TO ESTIMATE THE OPTIMAL PRODUCTION VOLUME WITH APPLICATION

Structural modelling of 100% cotton single jersey fabrics for optimum UV protection

PurposeLightweight, open construction cotton knitted fabrics generally do not impart good protection from solar ultraviolet radiation (UVR). As lightweight 100% cotton single jersey is highly cherished for summerwear, it is sine qua non to understand the structural parameters that effectively strike a good balance between UV protection and thermophysiological comfort of the wearer. Relatively heavy fabrics protect from UVR, but comfort is compromised because of waning porosity, increase in thickness and thermal insulation. The purpose of this paper is to engineer knits that will bestow maximum UV protection while preserving the thermophysiological comfort of the wearer.Design/methodology/approachIn total, 27 cotton single jersey fabrics with different areal densities and yarn counts were selected. Ultraviolet protection factor (UPF) was calculated based on the work of Imrith (2022). To précis, the authors constructed a UV box to measure the UPF of fabrics, denoted as UPFB. UPFB data were correlated with AATCC 183-2004 and yielded high correlation, R2 0.977. It was concluded that UPF 50 corresponds to UPFB 94.3. Thermal comfort properties were measured on the Alambeta and water-vapour resistance on the Permetest. Linear programming (LP) was used to optimize UPFB and comfort. Linear optimization focused on maximizing UPFB while keeping the thermophysiological comfort and areal density as constraints.FindingsThe resulting linear geometrical and sensitivity analyses generated multiple technically feasible solutions of fabrics thickness and porosity that gave valid UPFB, thermal absorptivity and water-vapour and thermal resistance. Subsequently, an interactive optimization software was developed to predict the stitch length, tightness factor and yarn count for optimum UPFB from a given areal density. The predicted values were then used to knit seven 100% cotton single jersey fabrics and were tested for UV protection. All seven fabrics gave UPFB above the threshold, that is, higher than 94.3. The mathematical model demonstrated good correlations with the optimized parameters and experimental values.Originality/valueThe optimization software predicted the optimum UPFB reasonably well, starting from the fabric structural and constructional parameters. In addition, the models were developed as interactive user interfaces, which can be used by knitted fabric developers to engineer cotton knits for maximizing UV protection without compromising thermophysiological comfort. It has been demonstrated that LP is an efficient tool for the optimization and prediction of targeted knitted fabrics parameters.

Using the method of linear programming and sensitivity analysis to determine the optimal production volume for some of the products of the General Company for Electrical and Electronic Industries for the year 2016

Using the method of linear programming and sensitivity analysis to determine the optimal production volume for some of the products of the General Company for Electrical and Electronic Industries for the year 2016

Using the method of linear programming and sensitivity analysis to determine the optimal production volume for some of the products of the General Company for Electrical and Electronic Industries for the year 2016

The General company for electrical and industries in Iraq represents one of the most important companies that supply all economic sectors with the most important intermediate and consumer goods ,in addition to the needs of local demand, and the aim of the study is to find the optimum production volume for some products of the company by using the sensitivity analysis method in the linear programming model ,and to achieve the maximum possible profit for the company with the analysis and study of the reasons for the decline in the company’s low production in the previous years and to identify the most important of recommendations to advance the company’s factories, improve their industrial performance and meet the needs of local demand.

Patient-Specific Factors Associated with Dexmedetomidine Dose Requirements in Critically Ill Children

AbstractThe objective of this study was to evaluate patient-specific factors associated with dexmedetomidine dose requirements during continuous infusion. A retrospective cross-sectional analysis of electronic health record-derived data spanning 10 years for patients admitted with a primary respiratory diagnosis at a quaternary children's hospital and who received a dexmedetomidine continuous infusion (n = 346 patients) was conducted. Penalized regression was used to select demographic, clinical, and medication characteristics associated with a median daily dexmedetomidine dose. Identified characteristics were included in multivariable linear regression models and sensitivity analyses. Critically ill children had a median hourly dexmedetomidine dose of 0.5 mcg/kg/h (range: 0.1–1.8), median daily dose of 6.7 mcg/kg/d (range: 0.9–38.4), and median infusion duration of 1.6 days (range: 0.25–5.0). Of 26 variables tested, 15 were selected in the final model with days of dexmedetomidine infusion (β: 1.9; 95% confidence interval [CI]: 1.6, 2.3), median daily morphine milligram equivalents dosing (mg/kg/d) (β: 0.3; 95% CI: 0.1, 0.5), median daily ketamine dosing (mg/kg/d) (β: 0.2; 95% CI: 0.1, 0.3), male sex (β: −1.1; 95% CI: −2.0, −0.2), and non-Black reported race (β: −1.2; 95% CI: −2.3, −0.08) significantly associated with median daily dexmedetomidine dose. Approximately 56% of dose variability was explained by the model. Readily obtainable information such as demographics, concomitant medications, and duration of infusion accounts for over half the variability in dexmedetomidine dosing. Identified factors, as well as additional environmental and genetic factors, warrant investigation in future studies to inform precision dosing strategies.

The Association Between Grip Strength and Depression Among Adults Aged 60 Years and Older: A Large-Scaled Population-Based Study From the Longitudinal Aging Study in India.

BackgroundThe association between grip strength and depression in elderly individuals in low- and middle-income countries (LMICs) has rarely been studied. This study aims to explore the relevance of grip strength and depression in the elderly population using data from a national large-scale population.MethodsThis study was conducted using data from seniors over 60 years old in wave 1 of the Longitudinal Aging Study in India (LASI). Grip strength is the maximum of three measurements by the dynamometer. Depression symptoms were assessed using 10 items on the Center for Epidemiologic Studies Depression Scale (CESD-10) with a 10-point boundary. Multivariate linear regression analysis, non-linear analysis, subgroup analysis, interaction tests and sensitivity analysis were performed.ResultsThere were 27,343 participants in this study, including 19,861 participants with low grip strength and 7,482 participants with normal grip strength. The results revealed that grip strength and depression were negatively correlated in elderly individuals after adequate adjustment for confounding factors [odds ratio (OR) = 1.237, 95% confidence interval (CI) 1.172–1.305, p < 0.00001]. The results remained stable after adjusting for all confounding factors (OR = 1.090, 95% CI 1.030–1.155, p = 0.00307). Regression analysis showed that physical activity (PA), comorbidities and cognition may have an impact on the correlation between grip strength and depression symptoms. Smooth curve fit suggested that grip strength and depressive symptoms were linearly related. The interaction test results of gender in the relationship between grip strength and depression were significant (p for interaction < 0.05).ConclusionGrip strength and depression were negatively correlated in older Indians, and larger prospective studies are needed in the future to determine this association.

Design and Sensitive Analysis of Incremental Linear Actuator

Abstract:This paper presents a novel single-sided linear actuator design and sensitivity analysis of different geometric parameters on the performances of the actuator. A numerical model based on the finite element method is developed for that purpose. Thus, the electromagnetic behavior of the actuator is analyzed with 2D magneto-static analysis, and the electromagnetic characteristics were presented with the study of the effect of different geometric parameters on the thrust force. Indeed, the magnetic flux distribution and the force profile are presented and discussed. The analysis of different parameters on the actuator's performance allows the selection of the appropriate values of these parameters to obtain optimal performance of the actuator. The analysis shows the air gap and stack length has a powerful influence on the actuator's performance. Furthermore, the increase of supply current has a significant effect, but a high level of Ampere turns to bring the magnetic circuit to the saturation zone. It is important to determine the optimal geometrical dimensions to reduce the mass of the motor. It is critical to choose the optimum power values for the actuator to obtain optimum performance and avoid exceeding operating limits.Background:The linear switched reluctance motor is used in many industrial applications such as the linear motion of machine tools, sliding door applications, and conveyors.Objective:A new design approach for a linear switched reluctance motor is developed in order to determine the geometric parameters of the structure.Methods:Finite element method is used to predict the characteristics of the motor and the analysis its performances.Results:The simulation results obtained by finite element analysis make it possible to study the electromagnetic behavior of the motor and to validate the established geometric model.Conclusion:The study was carried out to choose the optimal parameters in order to obtain optimal performance and avoid exceeding the operating limits of the motor.

Effect of Abdominal Circumference on the Irradiated Bowel Volume in Pelvic Radiotherapy for Rectal Cancer Patients: Implications for the Radiotherapy-Related Intestinal Toxicity.

BackgroundTo effectively reduce the irradiated bowel volume so as to reduce intestinal toxicity from pelvic radiotherapy, treatment in the prone position with a full bladder on a belly board is widely used in pelvic radiotherapy for rectal cancer patients. However, the clinical applicable condition of this radiotherapy mode is unclear. The aim of this study was to preliminarily identify patients who were not eligible for this radiotherapy mode by analyzing the effect of abdominal circumference on the irradiated bowel volume.MethodsFrom May 2014 to September 2019, 179 patients with locally advanced rectal cancer were retrospectively reviewed in our center. All patients received pelvic radiotherapy. Weight, height, AC, and body mass index (BMI) were used as the research objects, and the irradiated bowel volume at different dose levels (V10, V20, V30, V40, V50) was selected as the outcome variable. Multivariate linear regression and sensitivity analyses were used to evaluate the correlation between AC and irradiated bowel volume. Generalized additive model (GAM) and piecewise linear regression were used to further analyze the possible nonlinear relationship between them.ResultsAmong the four body size indicators, AC showed a negative linear correlation with the irradiated bowel volume, which was the most significant and stable. In adjuvant radiotherapy patients, we further discovered the threshold effect between AC and irradiated bowel volume, as AC was greater than the inflection point (about 71 cm), irradiated bowel volume decreased rapidly with the increase in AC. t-test showed that in patients with small AC (<71 cm), the irradiated bowel volume was significantly higher than that of patients with medium-large AC (≥71 cm). Especially in patients with adjuvant radiotherapy, the mean irradiated bowel volume of patients with small AC was the highest in this study. Compared with adjuvant radiotherapy, in neoadjuvant radiotherapy, the mean difference of irradiated bowel volume between patients with medium-large AC and those with small AC was larger.ConclusionAC is an independent factor influencing the irradiated bowel volume and has a strong negative linear correlation with it. Patients with small AC may not benefit from this common mode of radiotherapy, especially in adjuvant radiotherapy.

Using a Product Life Cycle Cost Model to Solve Supplier Selection Problems in a Sustainable, Resilient Supply Chain

Supplier selection constitutes a crucial component of manufacturing procurement. We developed a product life cycle cost (PLCC) model to support Taiwanese light-emitting diode (LED) manufacturers in capacity planning for sustainable and resilient supply chain (SC) management. For firms, supply chain PLCC (SCPLCC) is a key consideration, but relevant evidence is scarce. We applied two types of goal programming, namely multiobjective linear programming and revised multichoice goal programming (RMCGP), to develop a PLCC-based model that minimizes net costs, rejections, and late deliveries. Moreover, we constructed a decision-making tool for application to a case of SC sustainable procurement management in a high-tech Taiwanese LED company. Managers can resolve relevant problems by employing the two approaches of the SCPLCC model with various parameters. The implementation of RMCGP with weighted linear goal programming sensitivity analysis produced sufficient findings, according to a study of five models for practical implications. The primary findings of the current model assist business decision-makers in minimizing PLCC, reducing PLCC cost, minimizing net cost, number of rejections, number of late deliveries, achieving PLCC goals, and selecting the best supplier in the context of sustainable SC development.