Major Criteria Research Articles

Diagnostic Work-Up in Patients with Nonbacterial Thrombotic Endocarditis.

Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis that occurs in patients with predisposing conditions, including malignancies, autoimmune diseases (particularly antiphospholipid antibody syndrome, which accounts for the majority of lupus-associated cases), and coagulation disturbances for which the correlation with classical determinants is unclear. The condition is commonly referred to as "marantic", "verrucous", or Libman-Sacks endocarditis, although these are not synonymous, representing clinical-pathological nuances. The clinical presentation of NBTE involves embolic events, while local valvular complications, generally regurgitation, are typically less frequent and milder compared to infective forms of endocarditis. In the past, the diagnosis of NBTE relied on post mortem examinations, while at present, the diagnosis is primarily based on echocardiography, with the priority of excluding infective endocarditis through comprehensive microbiological and serological tests. As in other forms of endocarditis, besides pathology, transesophageal echocardiography remains the diagnostic standard, while other imaging techniques hold promise as adjunctive tools for early diagnosis and differentiation from infective vegetations. These include cardiac MRI and 18FDG-PET/CT, which already represents a major diagnostic criterion of infective endocarditis in specific settings. We will herein provide a comprehensive review of the current knowledge on the clinics and therapeutics of NBTE, with a specific focus on the diagnostic tools.

Location of Trigger Points in a Group of Police Working Dogs: A Preliminary Study.

This study examined the percentage and location of trigger points in police working dogs. Twelve dogs housed at a military police kennel were selected through convenience sampling. Only active dogs with no comorbidities or radiographic changes doing 6 hours of intense physical activity per day were included. After orthopedic and neurological examination, dogs were palpated for the detection of trigger points (TPs), carried out by two independent examiners, with criteria of palpations previously standardized. TPs were recorded using an anatomy reference image according to the corresponding anatomical location. The percentage of TPs was highest in the lumbar portion of the longissimus dorsi muscle (42%), followed by the latissimus dorsi, pectineus, quadriceps femoris, and sartorius (33%) muscles. Most TPs were located on the right side of the body. This study's percentage of TPs in police working dogs was higher in spinal and hind limb muscles, especially on the right side. The major criteria for identifying TPs in dogs were the pain responses to palpation and contractile local response. The findings of this study could be used to refine myofascial pain prevention to reduce early retirement due to musculoskeletal pain and draw attention to this kind of problem that can also affect dogs.

Economic Parameters vs Voting Behaviour in the Polish Presidential Election in 2020: Poviat level analysis

Abstract Voting behaviour is affected by various factors and the effect varies in individual countries. Economic and geographic factors are among the major criteria taken into account in electorate segmentation. The present study analyses them in the case of the Polish presidential election in 2020, held under the circumstances of strong polarisation within the society and controversies surrounding the rule-of-law and democratic standards. The present study analyses voter turnout and results of the second round of the election, focusing on the subregional level of poviats (counties). The analysis considers macroeconomic factors (such as GDP per capita, unemployment rate, average remuneration), financial condition of the local government (measured by budgetary revenues) and urbanisation (comparing the biggest cities to other counties). The findings confirm correlation between the macroeconomic parameters of the subregion and voter turnout. In the case of voting results, the hypotheses concerning macroeconomic parameters and the status of the biggest cities are confirmed, but there’s no evidence of correlation of the average remuneration on the poviat level and support for the centre-liberal candidate.

Assessing and Prioritizing Zoonotic Diseases in Punjab, India: A One Health Approach.

Zoonotic diseases have a significant impact on both human and animal health globally. The present study was planned to prioritize the zoonoses in Punjab state of India. To develop a zoonotic disease prioritization scoring system, a comprehensive approach has been taken, including literature review, key person interviews with animal health experts (n = 12) and medical professionals (n = 7), and nine focus group discussions (FGDs) with veterinary academicians, medical professionals, and field veterinary doctors. The scoring system comprises of seven major criteria, each assigned a weightage score (ws): prevalence/incidence of the disease (ws = 0.20), severity of illnesses in humans (ws = 0.18), epidemic potential (ws = 0.16), socio-economic burden (ws = 0.16), availability of effective control and prevention measures (ws = 0.15), inter-sectoral collaborations (ws = 0.1), and bioterrorism potential (ws = 0.05). The finalized scoring system, accompanied by a list of 15 selected zoonotic diseases, was implemented among a group of 23 professionals engaged in zoonoses research (n = 7), animal health (n = 10), and medical health (n = 6) to determine their prioritization. The zoonotic diseases prioritized for the Punjab (India) included, Brucellosis (0.70) > Rabies (0.69) > Anthrax (0.64) > Leptospirosis (0.62) = Toxoplasmosis (0.62) = Highly Pathogenic Avian Influenza (HPAI) (0.62) > Bovine tuberculosis (0.61) > Q fever (0.60) > Cysticercosis (0.59) > Listeriosis (0.58) > Crimean-Congo haemorrhagic fever (CCHF) (0.57) > Japanese encephalitis (0.56) = Echinococcosis (0.56) > Dermatophytosis (0.53) > and Scrub typhus (0.48), respectively. Higher priority is suggested for endemic zoonoses (e.g., brucellosis and rabies) as compared to those with epidemic potential (e.g., CCHF, HPAI etc.) in Punjab. Results of the current study will help in the development of targeted control and prevention strategies for zoonotic diseases in Punjab and other geographical regions facing similar challenges.

ECONOMIC INDICATORS USED IN THE DIAGNOSTIC ANALYSIS OF MULTINATIONAL COMPANIES: CASE STUDY FOR COMPANIES IN THE OIL AND BANKING FIELD

Purpose- The purpose of this research lies in the general objectives of the companies that determine the creation of added value. The efficiency in the use of the resources of the economic entity generates results. These can be analyzed and diagnosed in order to have an overview of the economic and financial state of the company. This scientific research aims to present the objective realities, the mechanism of formation and manifestation of economic and financial phenomena and processes, as well as the causal links between them in the case of ten multinational companies in the oil and banking sector. In the banking system, credibility is the essential element, the foundation of the relationship between the client and the bank when analyzing the granting of a loan. Gaining trust is achieved through a process of documentation and analysis of the client, which aims to evaluate as clearly as possible the patrimonial and financial situation, to recognize the quality of the services provided, the relationships with partners, the professionalism of the managers of companies. Methodology- This research was carried out having as documents the reports and information published by companies on their own web pages, as well as the annual reports published by each company on the Bucharest Stock Exchange website. 10 companies in the oil and banking field were selected, and the analysis period was between 2019-2022. The research methodology was both quantitative and qualitative. Findings- The results of the research highlighted the economic indicators used in the diagnostic analysis of multinational companies and how these entities evolved during the analyzed period. Conclusion- The importance of the diagnosed elements on a hierarchical scale may be different depending on the priority informational needs of the one who makes the diagnostic analysis. When this is done by a financial institution that makes an analysis of the creditworthiness of the client, in order to approve a credit, a solvency and liquidity diagnosis, the degree of indebtedness or cash flows, In the first place, the manager will pay attention to the efficiency of the use of the resources employed in the company’s economic circuit and to the results of the activity. An investor who wants to invest in a company will be particularly interested in the performance of the entity on the stock exchange and the profitability of the invested capital Value is the major criterion for assessing the company’s performance by shareholders. Classical performance indicators have the disadvantage of providing information about the company’s past performance, Without taking into account the cost of the invested capital, highlighting only the result of its use. If the one who makes the diagnosis is limited to studying only the classical indicators, he will be able to conclude that the entity achieves performance, but the results of the analysis will not present the actual reality because it does not create value and can even consume the existing one. Keywords: Diagnostic analysis, multinational companies, indebtedness degree, financial statements, cash flows JEL Codes: F23, G21, M41

A STUDY TO ASSESS THE PATTERN OF CONSUMPTION AND AWARENESS REGARDING USE OF CAFFEINE AND ENERGY DRINKS AMONG NURSING STUDENTS IN SELECTED NURSING COLLEGE AT DEHRADUN, UTTARAKHAND

A STUDY TO ASSESS THE PATTERN OF CONSUMPTION AND AWARENESS REGARDING USE OF CAFFEINE AND ENERGY DRINKS AMONG NURSING STUDENTS IN SELECTED NURSING COLLEGE AT DEHRADUN, UTTARAKHAND

Assessment of adherence to the national stress ulcer prophylaxis guidelines: A cross-sectional analysis

BackgroundClinical guidelines support the use of stress ulcer prophylaxis (SUP) in patients at risk of gastrointestinal (GI) bleeding such as those with coagulopathy, renal replacement therapy, and mechanical ventilation. Despite the observed benefits of SUP, its overuse has been highly associated with serious adverse effects. ObjectiveTo assess the adherence to the national SUP guidelines in a tertiary hospital in Saudi Arabia. MethodsA cross-sectional study was conducted using electronic health records at King Fahad Specialist Hospital (KFSH), Buraydah, Saudi Arabia. We collected the data from January 1st to December 31st, 2020. Adult patients aged 18 and older who received SUP prescriptions were included. Descriptive analysis was performed to assess the adherence to the guidelines and to explore the factors associated with SUP use in a hospital-based setting. ResultsA total of 424 patients were enrolled in this study. The median age of patients was 55.2 years old. Only 54% of patients were candidates for SUP. Internal medicine and surgery wards ranked the highest in prescribing SUP at 34.2% and 30.4%, respectively. The most common major criterion to start SUP was the concomitant use of two or more of these medications (anticoagulants, aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and antidepressants) followed by using NSAIDs or corticosteroids by older adult patients aged (≥65 years) or have GI bleeding history at 43.2% and 21.5%, respectively. ConclusionThe observed overuse of anti-ulcer drugs (AUD) indicates a need for greater adherence to SUP guidelines. Areas of improvement can be implemented to ensure appropriate adherence to SUP guidelines to control the costs and avoid unnecessary anti-ulcer-related adverse effects.

Diagnostic ability of Japanese version of high bleeding risk criteria for ischemic outcomes in patients with acute myocardial infarction.

The Japanese version of high bleeding risk (J-HBR) criteria was domestically proposed to identify patients at HBR after percutaneous coronary intervention (PCI). The applicability of J-HBR on bleeding events has been validated, while whether J-HBR predicts ischemic events is uncertain. This bi-center registry included 904 patients with acute myocardial infarction (MI) undergoing primary PCI. Patients were stratified by the J-HBR major (1 point) and minor (0.5 point) criteria. Patients with J-HBR ≥ 1 point were diagnosed as having HBR. The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiovascular death, recurrent MI, and ischemic stroke, after discharge. Of the 904 patients, 451 (49.9%) had the J-HBR. The primary endpoint more frequently occurred in patients with J-HBR than in those without (10.9% vs. 4.9%, p < 0.001) during the median follow-up period of 522days. Probability of MACE was progressively increased with the increase in the number of J-HBR major and minor criteria, in which severe anemia, severe chronic kidney disease, prior heart failure, peripheral artery disease, and prior ischemic stroke were identified as significant factors associated with MACE. In patients with acute MI undergoing PCI, the J-HBR criteria were predictive for ischemic outcomes after discharge, suggesting that the J-HBR criteria may be useful to identify patients at high bleeding and ischemic risks.

Sydenham chorea in the top end of Australia's Northern Territory: A 20-year retrospective case series.

Sydenham chorea is an immune-mediated neuropsychiatric condition, and a major criterion for diagnosis of acute rheumatic fever (ARF). Children in remote Northern Australia experience disproportionately high rates of ARF, yet studies looking at the epidemiology, clinical presentation and management of Sydenham chorea are limited in this population. We conducted a retrospective case series from January 2002 to April 2022 of all paediatric patients aged ≤18 years admitted to Royal Darwin Hospital with Sydenham chorea. Cases were identified using the hospital's clinical coding system (ICD10). Medical records were reviewed and data on demographics, clinical presentation, investigation results, treatment and outcome were extracted, deidentified and analysed. One hundred ten presentations of Sydenham chorea occurred between 2002 and 2022, 109 (99%) of these were in First Nations children, with 85% residing in very remote locations. Most commonly, chorea presented as a generalised movement disorder affecting all four limbs (49%). Neuropsychiatric symptoms were reported in 33 (30%), and there was evidence of rheumatic heart disease on echocardiogram in 86 (78%) at presentation. All patients received benzathine penicillin, but there was significant variation in management of chorea, ranging from supportive management, to symptomatic management with anticonvulsants, to immunomodulatory medications including corticosteroids. This case series highlights the significant burden of Sydenham chorea among First Nations children living in Northern Australia and demonstrates wide variation in treatment approaches. High-quality clinical trials are required to determine the best treatment for this disabling condition.

KLa based scale-up cultivation of the extremophilic archaeon Sulfolobus acidocaldarius: from benchtop to pilot scale.

The two major scale-up criteria in continuously stirred bioreactors are 1) constant aerated power input per volume (Pg/Vl), and 2) the volumetric O2 mass transfer coefficient (kla). However, Pg/Vl is only influenced by the stirrer geometry, stirrer speed, aeration and working volume, while the kla is additionally affected by physiochemical properties of the medium (temperature, pH, salt content, etc.), sparging of gas and also by the bioreactor design. The extremophilic archaeon Sulfolobus acidocaldarius, thriving at 75°C and pH 3.0, has the potential for many biotechnological applications. However, previous studies imply that the family Sulfolobaceae might be affected by higher oxygen concentration in the headspace (>26%). Hence, adequate oxygen supply without being toxic has to be ensured throughout the different scales. In this study, the scale-up criteria Pg/Vl and kla were analyzed and compared in a 2L chemostat cultivation of S. acidocaldarius on a defined growth medium at 75°C and a pH value of 3.0, using two different types of spargers at the same aerated power input. The scale-up criterion kLa, ensuring a high specific growth rate as well as viability, was then used for scaleup to 20L and 200L. By maintaining a constant kla comparable dry cell weight, specific growth rate, specific substrate uptake rates and viability were observed between all investigated scales. This procedure harbors the potential for further scale-up to industrial size bioreactors.

From Media Systems to Digital Journalisms: An Introduction to the Special Issue

Nearly half a century since the first calls for comparisons of national-level media-political relations, comparative studies of media systems – and even more so of digital journalism – are still an emergent research field. In this introduction to the special issue ‘Comparing Digital Journalisms across Nations and Cultures’, we draw links between media systems and digital journalism(s) in comparative studies. First, we suggest a ‘systemic turn’ in media systems studies, with various branches of systems theory applied to media studies in a sound way; directing comparative studies to seeking systemic stability of journalism along with assessing its democratic performance; dealing more with contexts; and finding new criteria for cross-country comparisons. Second, we argue that, for digital journalisms as multi-level research objects, the systemic perspective intertwines with the epistemic one of truth-seeking and cultures of media professionalism. Third, we show how this logic is supported by the articles in the special issue which assess the impact of de-industrialization upon media performance and compare journalistic roles across nations and media segments. They also draw attention to audience as a major new comparative criterion, rethink nation-state as the level of analysis, and highlight risk as a new dimension of comparing digital journalism(s).

Effects of susceptor thickness on microwave heating of raw meat

The susceptor and susceptor thickness significantly influence the microwave heating process. This work theoretically investigates the effects of two different susceptors with various thicknesses on microwave heating of raw meat. A susceptor with low dielectric loss (alumina) and a susceptor with high dielectric loss (SiC) are used for present study to investigate the effect of dielectric loss during microwave heating. The addition of the alumina susceptor either enhances or diminishes the heating rate of resonating samples depending on thickness, while the addition of the SiC susceptor improves the heating uniformity of resonating samples. The addition of susceptors on thick samples shows different characteristics from resonating samples. High heating rate and heating uniformity are the two major criteria for several microwave heating applications. Hence, the optimum susceptor thicknesses for specific sample dimensions are determined based on either high heating rate or heating uniformity.

Pharmacognostic and Preliminary Phytochemical Investigation of Clerodendrum thomsoniae Leaves

Clerodendrum thomsoniae (Lamiaceae) is an ornamental plant grown almost worldwide in humid environment. The phytocompounds present in plant protect the body from oxidative stress, brain disorders, skin rashes, sores and depression. Present study deals with to establish pharmacognostic, physiochemical and phytochemical standards of Clerodendrum thomsoniae leaves. Microscopical evaluation of Clerodendrum thomsoniae leaves showed the presence of covering trichomes, epidermis and other characteristics. Results of Clerodendrum thomsoniae leaves yielded 7.5% w/w total ash, alcohol extractive value not more than 23.33% w/w (Hot extraction), 21.66% w/w (Cold maceration) and water extractive value not more than 30.12% w/w (Hot extraction), 36.66% w/w (Cold maceration) and 8% w/w total moisture content by LOD. The Phytochemical investigation of extracts of Clerodendrum thomsoniae leaves shows the presence of sterols, triterpenes, alkaloids, flavonoids, tannins, glycosides, proteins and carbohydrate. Pharmacognostical and phytochemical parameters determined in the present work can serve as major criteria for identity, quality and purity of a crude drug and extracts.

TIPS-11 EFFICACY AND SAFETY OF STUPP REGIMEN WITH OR WITHOUT ANLOTINIB FOR NEWLY DIAGNOSED GLIOBLASTOMA: INTERIM RESULTS OF A MULTICENTER, DOUBLEBLIND, RANDOMIZED PHASE II TRIAL

Abstract BACKGROUND Postoperative radiotherapy with concomitant temozolomide (TMZ) followed by ≤ six cycles of adjuvant TMZ chemotherapy (STUPP regimen) is the standard treatment for newly diagnosed glioblastoma (GBM) with limited effectiveness. Anlotinib inhibits both tumor angiogenesis and tumor cell proliferation by targeting multiple kinases, and showing promising results in preclinical GBM models and phase I clinical trials. We designed a phase II trial to verify the efficacy and safety of the STUPP regimen plus anlotinib (NCT 04959500). METHODS This is a multicenter, double-blind, randomized, placebo-controlled trial with an expected 150 patients randomly assigned 1:1 ratio to receive TMZ-based radiochemotherapy with anlotinib or placebo. Major eligibility criteria include histologically confirmed newly diagnosed GBM and an ECOG performance score ≤2. Other criteria for inclusion include age ≥18 years and lack of significant comorbidity. The primary endpoint is the median progression-free survival (PFS). Secondary endpoints include 1-year overall survival rate, PFS at 6 months, overall response rate, duration of response, disease control rate, quality of life, and toxicity. RESULTS From July 2021 to February 8th 2023, 147 patients were enrolled. The results in this abstract were all obtained without exposing the blind state. The median PFS was 9.9 months (95% CI, 9.5-11.9) in the overall patient population, while the predicted mPFS of placebo group was 7 months according to the results of STUPP and AVAGlio trials. Grade 1 (72.82%) and grade 2 (24.27%) adverse events (AEs) were mainly observed, while grade 3 or worse AEs accounted for 2.9% among all AEs. The most frequent TRAEs were lymphocytopenia, decreased platelet count, decreased white blood cell count, decreased neutrophil count and hypertension. Two death cases occurred due to COVID-19 and severe pneumonia. CONCLUSIONS Under the condition of data blinding, these interim results suggest that the STUPP regimen with anlotinib demonstrate potential promising efficacy and a tolerable safety.

Abstract GS.12: A New Mouse Model To Investigate The Early Steps Of Arrhythmogenic Cardiomyopathy

Arrhythmogenic Cardiomyopathy (ACM) is characterized by progressive loss of cardiomyocytes with fibrosis, systolic dysfunction and life-threatening arrhythmias. Mutations in genes of the desmosomal adhesion complex such as desmoglein-2 (Dsg2) are the major cause, but the underlying mechanisms leading to the disease are not well understood. Accordingly, only symptomatic treatment is available. Here, we establish an inducible Dsg2-W2A knock-in mouse model with temporal control of disease onset as new approach to analyse the early processes underlying the ACM phenotype. We have previously characterized a constitutive Dsg2-W2A knock-in model which develops a cardiac phenotype bearing all major criteria of ACM directly after birth. To control the onset of disease, we now generated a mouse line bearing the Dsg2-W2A mutation and a loxP -flanked Dsg2 on separate alleles, leading to functional hemizygosity of the Dsg2-W2A mutation upon tamoxifen-induced Cre expression. Detailed characterization of this iDsg2-W2A model revealed early repolarization changes in ECG recordings starting directly after induction and progression to extensive impairment of electrical conduction over 10 weeks. These changes were paralleled with the appearance of ventricular and supraventricular arrhythmias. Starting two weeks after induction, reduced cardiac output function of the right and later of the left ventricle was detectable via echocardiography. Finally, these mice developed structural changes with loss of cardiomyocytes and ventricular fibrosis similar to ACM patients. This study gives detailed insight on the early steps of ACM showing a sequence from changes in conduction, occurrence of arrhythmia to functional impairment, starting in the right and progressing to the left ventricle, together with structural changes of the heart. We expect this model to be valuable to discern patho-mechanisms in detail and to identify and test novel treatment options for ACM.

Technological Advances and Evolution of Biowarfare: A Threat to Public Health and Security

Research in public health and medical sciences has always placed a high priority in managing disease outbreaks, effective treatment capacities, and overall human health and wellbeing. Despite the fact that advances in biology, biotechnology, and medical research have proven to have sufficient value in terms of lifesaving treatments, these have also presented major challenges in their effective utilization. Hence, potentially posing serious risks in the form of bioweapons, thereby, endangering governance frameworks that prioritize biosecurity and counter-biological warfare. In this review paper, a thorough literature review has been conducted to explore the critical aspects between advances in biology and their potential misuse, which could result in serious risks to public health and security. The history of biowarfare has been studied, and the results identify major criteria that have been used in deeming a biological agent fit for the use in mass destruction programs. Five historical biological warfare agents (Bacillus anthracis, smallpox, Yersinia pestis, Vibrio cholerae, and Francisella tularensis) have been studied critically to conclude that not all biological agents may act as bioweapons, but only those agents meeting these criteria may cause catastrophic damage. This paper examines key risks associated with bioweaponry posed by the convergence of biotechnology and artificial intelligence as evident in today’s world of innovation. Based on the situational analysis of the COVID-19 pandemic, the author also discusses some of the major shortcomings of the international framework and the healthcare system in handling future biological attacks having the potential of mass destruction. Through this paper, associations between different stakeholders, scientific communities, and research groups are highly recommended along with identifying the problem at its roots.&#x0D; Keywords: bioweapons, biological toxin, biotechnology, artificial intelligence

Early Diagnosis of Tuberous Sclerosis Complex: Prenatal Diagnosis.

Strong emphasis has been placed recently on early (4 postnatal months) detection of tuberous sclerosis complex and the introduction of antiepileptic treatment before seizure onset. This objective can be achieved prenatally: Cardiac rhabdomyomas and the major diagnostic tuberous sclerosis complex sign are detected during fetal ultrasound, and prenatal MR imaging allows detection of cerebral major manifestations: cortical tubers, subependymal nodules, and subependymal giant cell astrocytomas. We retrospectively reviewed 50 fetuses with ultrasound-detected cardiac tumors at 19-36 gestational weeks (median, 31 weeks). MR imaging with the use of 1.5T scanners was performed at 24-37 gestational weeks (median, 34 weeks). In 11 fetuses (22%), cardiac tumors remained the only criterion. In remaining 39 fetuses (78%), MR imaging revealed a prenatal diagnosis of tuberous sclerosis complex, having shown an additional 1-3 major criteria: subependymal nodules in all cases (39/39 = 100.0%), subependymal giant cell astrocytomas in 6 (6/39 = 15.4%), and cortical tubers in 24 (24/39 = 61.5%). Radial migration lines and cerebellar tuber, not published so far, were shown in 1 case each. A schedule of proper care of children with tuberous sclerosis complex can be established during the perinatal period due to education of women to report for mandatory ultrasound examinations during pregnancy, the good quality of ultrasound, and referral to MR imaging if a cardiac tumor is depicted on ultrasound. Gynecologists and pediatric cardiologists performing fetal ultrasound and radiologists performing prenatal MR imaging are a key to early diagnosis of tuberous sclerosis complex in many cases.

The relationship between metabolic syndrome criteria and pentraxin-3 levels in children.

While the positive correlation was shown in a few studies which investigated the relationship between obesity and pentraxin-3 (PTX-3) levels, different findings were obtained in other studies. We aimed to determine PTX-3 levels in obese and healthy children, and their relationship with Metabolic Syndrome (MetS) criteria. 105 children and adolescents were considered as the study population. Participants were divided into three groups; obese and MetS (OM+), obese and non-MetS (OM-) and the control group. Fasting glucose, blood lipids and PTX-3 levels were measured. Ultrasonography was performed to detect hepatic steatosis. MetS and hepatic steatosis were investigated by dividing the patients into two groups according to PTX-3 levels. The study population consisted of 37 patients with OM+; 35 patients with OM- and 33 healthy children. OM+ patients had higher fasting insulin (p<0.001), homeostatic model assessment for insulin resistance (p<0.001), triglyceride (p<0.001) and lower high-density lipoprotein (p=0.001). The PTX-3 level was higher in the OM+ group compared to both OM- group and the control group (p=0.002). When two groups were generated according to PTX-3 level, a higher frequency of MetS was detected in the high PTX 3 group than in all three major MetS diagnostic criteria groups. Moreover, there was more hepatic steatosis in the high PTX-3 group independent from obesity and MetS. Higher PTX-3 levels were present in children and adolescent obese patients with MetS.

Salience-based stakeholder selection to maintain stakeholder coverage in solving the next release problem

Stakeholders quantification plays a basic role in selecting the appropriate requirements because their judgement is a major criteria since not all of them have the same importance. Original proposals quantified stakeholders assigning them a weight. Nonetheless, actual projects manage a numerous stakeholders community hindering the inclusion of all their weights. This work proposes grouping strategies as means to reduce the number of stakeholders to manage in requirements selection keeping a proper coverage (i.e. howthe selection fulfils stakeholder demands). Our approach is based on stakeholders' salience, defined in terms of power, legitimacy and urgency attributes. Diverse strategies are applied selecting important stakeholders groups in a specific project. We use k-means}, k-medoids and hierarchical clustering, after deciding the number of cluster (4 and 3) based on validation indices. Either for all the stakeholders and each important group several requirements selection optimization problems have been solved. Tests find no significant differences for coverage when important stakeholders are filtered using clustering, regardless of the technique and number of groups, with a reduction between 66.32% to 87.75% in the number of stakeholders being considered. Applying clustering methods on data obtained from a real-world project is useful to identify the group of important stakeholders. The number of groups suggested matches the stakeholders theory and the coverage values in the requirements selection is kept.

Comparative analysis between Graphene and Carbon Nanotube reinforced epoxy composite

Composite structures are very high in demand because of their high strength-to-weight ratio and directional strength. The arrangement of fibers in the matrix is the major design criterion for the composites. Past studies prove that the fiber reinforcement of carbon nano allotropes such as Carbon Nanotubes (CNTs) and Graphene fibers develop reliable and durable structures for different applications. In this work, three different composite laminate sheets are designed and modeled using finite element analysis (FEA) software. Carbon nano allotropes, CNTs, Graphene, and CNT-Graphene fibers are used as reinforcements in the resin epoxy matrix. The modeled laminate sheets are analyzed for deformation and stress distribution using Hashin’s Failure criteria. The FEA results indicate that the CNTs fiber-reinforced laminate shows minimum deformation (0.000064 mm) and experiences minimum stress (3.81 MPa) compared to Graphene and CNT-Graphene reinforced laminates. The results of FEA can be used as a research basis for further study of composites in the future.