Two-stage Procedure Research Articles

Smoking-informed methylation and expression QTLs in human brain and colocalization with smoking-associated genetic loci

Smoking is a leading cause of preventable morbidity and mortality. Smoking is heritable, and genome-wide association studies (GWASs) of smoking behaviors have identified hundreds of significant loci. Most GWAS-identified variants are noncoding with unknown neurobiological effects. We used genome-wide genotype, DNA methylation, and RNA sequencing data in postmortem human nucleus accumbens (NAc) to identify cis-methylation/expression quantitative trait loci (meQTLs/eQTLs), investigate variant-by-cigarette smoking interactions across the genome, and overlay QTL evidence at smoking GWAS-identified loci to evaluate their regulatory potential. Active smokers (N = 52) and nonsmokers (N = 171) were defined based on cotinine biomarker levels and next-of-kin reporting. We simultaneously tested variant and variant-by-smoking interaction effects on methylation and expression, separately, adjusting for biological and technical covariates and correcting for multiple testing using a two-stage procedure. We found >2 million significant meQTL variants (padj < 0.05) corresponding to 41,695 unique CpGs. Results were largely driven by main effects, and five meQTLs, mapping to NUDT12, FAM53B, RNF39, and ADRA1B, showed a significant interaction with smoking. We found 57,683 significant eQTL variants for 958 unique eGenes (padj < 0.05) and no smoking interactions. Colocalization analyses identified loci with smoking-associated GWAS variants that overlapped meQTLs/eQTLs, suggesting that these heritable factors may influence smoking behaviors through functional effects on methylation/expression. One locus containing MUSTN1 and ITIH4 colocalized across all data types (GWAS, meQTL, and eQTL). In this first genome-wide meQTL map in the human NAc, the enriched overlap with smoking GWAS-identified genetic loci provides evidence that gene regulation in the brain helps explain the neurobiology of smoking behaviors.

Evaluation of chronic perilunate dislocations: A comparative study of single-stage, two-stage ORIF, and salvage procedures

ObjectiveThis study aims to evaluate the outcomes of open reduction and internal fixation (ORIF) for chronic perilunate dislocations using single-stage, two-stage, and salvage procedures. The study also compares these approaches with each other and with results from existing literature. MethodsA total of 15 patients with chronic perilunate injuries from 2013 to 2019 were included in the study. Pre-operative and post-operative assessments were conducted using plain radiographs, with CT scans performed selectively for detailed morphology and fracture pattern analysis. Among the patients, 13 underwent ORIF, while 2 underwent salvage procedures. Among the ORIF cases, single-stage procedures were performed in 4 patients, and two-stage procedures in 9 patients. External fixators, including unilateral uniplanar external fixators (UUEF) and bilateral uniplanar external fixators (BUEF), were applied in 5 and 4 patients, respectively. Our methodology of treating chronic perilunate injuries has evolved over the years. We started with single stage ORIF then graduated to a two staged procedure initially using a external fixator as a carpal distractor applied only on the radial side and finally settling down with bilateral carpal distraction using external fixators both on the radial and ulnar sides. ResultsAmong the 15 patients, 3 were lost to follow-up. Of these, one underwent four-corner fusion, while the remaining two had UUEF. The mean time interval between injury and surgery was 3.60 months. The post-operative mean scapholunate angle measured 52.46°, with a negative radio-lunate angle (indicating flexion) observed in two patients, while others showed a positive angle (indicating extension). Two cases exhibited nonunion and avascular necrosis (AVN) of the scaphoid, while one case presented with lunate AVN. Mid-carpal and radio-carpal arthritis was observed in 4 and 2 patients, respectively. Functional outcomes were evaluated using Mayo's wrist score categorized as good for two-stage BUEF cases and satisfactory for UUEF and single-stage procedures. ConclusionStaged reduction utilizing the BUEF followed by open reduction has demonstrated superior outcomes when compared to UUEF, single-stage open reduction and salvage procedures. Level of evidence: 4

Carbon Trading and Its Role in Shaping Indonesia’s Environmental Resilience to Climate Change

Abstract In Indonesia, considerable environmental issues originate from industrial and agricultural activity, peatland fires, and deforestation. The government of Indonesia is legally required to adopt efforts to address these challenges. One feasible alternative under discussion is the formation of a carbon market, whereby firms are issued permits to release particular amounts of greenhouse gases. This notion has attracted support from both the European Union (EU) and numerous Asian nations. This paper investigates the function and importance of carbon emission trading systems in attaining carbon reduction targets. Leveraging global data envelope analysis (DEA), it formulates performance indicators for energy consumption and carbon emissions via a two-stage procedure. Furthermore, the study assesses the policy effect of carbon trading by developing counterfactual trajectories using the synthetic control technique. The study presents the notion of carbon markets and analyzes its potential to become a vital aspect of Indonesia’s climate mitigation plans. It indicates that carbon markets contain the ability to dramatically boost carbon and energy-carbon performance, mostly owing to technical restrictions and stakeholder participation.

Comparison of outcomes of percutaneous deep venous arterialization in multiple practice settings

ObjectiveWe compared the efficacy of percutaneous deep venous arterialization (pDVA) in patients with no-option chronic limb-threatening ischemia in the hospital vs in office-based laboratory (OBL) settings. MethodsA retrospective chart review was performed of all patients who underwent pDVA using off-the-shelf devices from January 2018 to March 2023 in a hospital and an OBL. We identified 73 eligible patients, 41 from a hospital setting (59% male; median age, 72 years; interquartile range, 18 years) and 32 from an OBL setting (59% males; 67 years; interquartile range, 16 years). All eligible patients were deemed to have no-option critical limb ischemia, had at least one patent proximal tibial artery available for the creation of an arteriovenous anastomosis, and were classified as having Rutherford classification IV or higher peripheral arterial disease. Patients were ineligible if classified as Rutherford classification III or lower, had active infection, did not have at least one appropriate venous target, and/or had rapidly progressing wounds requiring immediate major amputation. The primary outcome was major amputation-free survival (AFS). Secondary outcomes included technical success, limb salvage, survival, primary patency, reintervention rate, adverse events, and partial and complete wound healing. Outcomes were evaluated using Kaplan-Meier method, log-rank, and two-stage procedure tests. ResultsTechnical success was achieved in 70 patients (96%) with 1 hospital (2.4%) and 2 OBL (6.3%) patients lost to follow-up. Major AFS estimates at 6 months, 1 year, and 2 years were 51.4%, 40.4%, and 30.2% in the hospital group and 69.4%, 54.0%, and 49.5% in the OBL group, respectively. Partial wound healing estimates at 6 months, 1 year, and 2 years were 27.5%, 71.7%, and 81.2% in the hospital group and 62.7% at all time points in the OBL group. Complete wound healing estimates at 6 months, 1 year, and 2 years were 6.7%, 33.3%, and 33.3% in the hospital group and 5.3%, 37.7%, and 41.6% in the OBL group, respectively. There was no significant difference in major AFS (P = .13), limb salvage (P = .07), survival (P = .69), primary patency (P = .53), partial (P = .08), or complete wound healing (P = .79) between groups. Reintervention was performed in 8 hospital (20.5%) and 14 OBL (45.2%) patients. ConclusionspDVA is a feasible and safe procedure for no-option critical limb ischemia in the hospital and OBL setting without significant differences in outcomes at ≤2 years.

Surgical approach on combined chronic patellar tendon and bicruciate knee ligament injury

A combined injury of the patellar tendon and both the anterior and posterior cruciate ligaments is disabling. It directly affects knee kinematics and biomechanics, presenting a considerable surgical challenge. In this complex and uncommon injury, decision-making should take into account the surgeon’s experience and consider one- or two-stage surgery, tendon graft, graft fixation, and rehabilitation protocol. This manuscript discusses the surgical approach based on a comprehensive understanding of the patellar tendon and bicruciate biomechanics to guide which structures should be reconstructed first, especially when a two-stage procedure is chosen.

Estimation of riverbank erosion by combining channel morphological models with AI techniques

Simulating riverbank erosion involves modeling the complex interactions between water flow, sediment transport, and bank stability. The present study employs a novel approach, combining the Self Organizing Map (SOM) algorithm and the Long Short-Term Memory (LSTM) network, to capture the behavior of riverbank erosion. A two-stage training procedure is promoted to enhance predictive accuracy and emphasize the need for preprocessing input data related to hydrological conditions, geomorphological features, and soil properties. Pivotal variables that can characterize changes in channel geometry are designed as the output targets, such as the vertical displacement of the riverbed, the horizontal displacement of the riverbank, and the channel width. The goal of this study is to create an alternative to addressing challenges associated with predicting riverbank erosion by utilizing new training methods of artificial intelligence (AI) models. The proposed method performs well in assessing three output variables, showing low mean relative errors, less than 0.081, and high correlation coefficients above 0.981, along with R-squared values over 0.963. These results highlight the effectiveness of this method in accurately describing cross-sectional changes. The proposed method is designed with practical applications in mind, satisfying the need for methods that are not only accurate but also operationally efficient.

Ensemble technique of intrusion detection for IoT-edge platform

Internet of Things (IoT) technology has revolutionized modern industrial sectors. Moreover, IoT technology has been incorporated within several vital domains of applicability. However, security is overlooked due to the limited resources of IoT devices. Intrusion detection methods are crucial for detecting attacks and responding adequately to every IoT attack. Conspicuously, the current study outlines a two-stage procedure for the determination and identification of intrusions. In the first stage, a binary classifier termed an Extra Tree (E-Tree) is used to analyze the flow of IoT data traffic within the network. In the second stage, an Ensemble Technique (ET) comprising of E-Tree, Deep Neural Network (DNN), and Random Forest (RF) examines the invasive events that have been identified. The proposed approach is validated for performance analysis. Specifically, Bot-IoT, CICIDS2018, NSL-KDD, and IoTID20 dataset were used for an in-depth performance assessment. Experimental results showed that the suggested strategy was more effective than existing machine learning methods. Specifically, the proposed technique registered enhanced statistical measures of accuracy, normalized accuracy, recall measure, and stability.

Modified and alternative bone cements can improve the induced membrane: Critical size bone defect model in rat femur

BackgroundAs a two-stage surgical procedure, Masquelet's technique has been used to care for critical-size bone defects (CSD). We aimed to determine the effects of modified and altered bone cement with biological or chemical enriching agents on the progression of Masquelet's induced membrane (IM) applied to a rat femur CSD model, and to compare the histopathological, biochemical, and immunohistochemical findings of these cements to enhance IM capacity. MethodsThirty-five male rats were included in five groups: plain polymethyl methacrylate (PMMA), estrogen-impregnated PMMA (E+PMMA), bone chip added PMMA (BC+PMMA), hydroxyapatite-coated PMMA (HA) and calcium phosphate cement (CPC). The levels of bone alkaline phosphatase (BALP), osteocalcin (OC), and tumor necrosis factor-alpha (TNF-α) were analyzed in intracardiac blood samples collected at the end of 4 weeks of the right femur CSD intervention. All IMs collected were fixed and prepared for histopathological scoring. The tissue levels of rat-specific Transforming Growth Factor-Beta (TGF-β), Runt-related Transcription Factor 2 (Runx2), and Vascular Endothelial Growth Factor (VEGF) were analyzed immunohistochemically. ResultsSerum levels of BALP and OC were significantly higher in E+PMMA and BC+PMMA groups than those of other groups (P = 0.0061 and 0.0019, respectively). In contrast, TNF-α levels of all groups with alternative bone cement significantly decreased compared to bare PMMA (P = 0.0116). Histopathological scores of E+PMMA, BC+PMMA, and CPC groups were 6.86 ± 1.57, 4.71 ± 0.76, and 6.57 ± 1.51, respectively, which were considerably higher than those of PMMA and HA groups (3.14 ± 0.70 and 1.86 ± 0.69, respectively) (P < 0.0001). Significant increases in TGF-β and VEGF expressions were observed in E+PMMA and CPC groups (P = 0.0001 and <0.0001, respectively) whereas Runx2 expression significantly increased only in the HA group compared to other groups (P < 0.0001). ConclusionsThe modified PMMA with E and BC, and CPC as an alternative spacer resulted in a well-differentiated IM and increased IM progression by elevating BALP and OC levels in serum and by mediating expressions of TGF-β and VEGF at the tissue level. Estrogen-supplemented cement spacer has yielded promising findings between modified and alternative bone cement.

Total Endoscopic or Endoscope-Assisted Excision of Non-embolized Advanced Juvenile Nasopharyngeal Angiofibroma: A Clinical Case Series.

Background Surgical excision is the primary treatment for juvenile nasopharyngeal angiofibroma (JNA), but this procedure is challenging due to its high vascularity and local aggressiveness. Moreover, preoperative embolization is a subject of debate. Objective The objective of this study is to assess the efficacy, safety, and feasibility of endoscope-assisted excision as a surgical intervention for non-embolized advanced JNA. Materials and methods This case series involved six male patients (mean age: 16 years) with JNA, classified as stages Ⅱc to Ⅲb according to the Radkowski classification. None underwent preoperative embolization. Results Two stage Ⅱc cases underwent total endoscopic endonasal excision. One patient with stage Ⅲa and another with stage Ⅲb underwent surgery via an endoscope-assisted sublabial approach. Two patients, one with stage Ⅱc JNA and another with Ⅲb, underwent a two-stage procedure. Postoperative CT scans showed no residual disease at the six-month mark. On average, each procedure required 1.5 units of blood transfusion. One patient experienced intraoperative bleeding, whereas the remaining patients were free of any major complications. The mean operation duration was 175 minutes per procedure. The mean length of stay at the hospital was 3.75 days per procedure. Conclusion Endoscope-assisted or purely endoscopic approaches can be safely and effectively employed for the complete excision of non-embolized advanced JNAs.

An Improved DeNSE Methodology for Optimal Sectorization of Water Distribution Networks

Sectorization of a water distribution network (WDN) into district meter areas (DMAs) is considered a key strategy for an efficient management of WDNs. Typically, it involves a two-stage procedure: a clustering stage, in which the division of the WDN into clusters is performed, and a dividing stage, which involves the placement of valves and flow meters on the cluster’s boundary pipes to define the DMAs. While recently published methods attempt to enhance both the clustering and dividing stages, they fail to provide decision-making flexibility. They also neglect to consider the presence of existing valves in the WDN, which can significantly affect the evaluated implementation cost, often considered the primary decision-driving factor. This paper presents improvements to the previously introduced DeNSE method for sectorization of WDNs, aiming to address these deficiencies. The methodology consists of a clustering stage, based on the network uniformity index, and a dividing stage, in which the originally used heuristic procedure is replaced with Genetic Algorithm (GA) optimization, minimizing implementation cost. Consideration of existing valves in WDN and criteria for water supply security are also included in the dividing stage to offer a better estimate of implementation costs and post-sectorized operational efficiency of the WDN. Finally, GIS visualization is implemented, and a hydraulic model of the sectorized WDN (EPANET file) is generated, providing practitioners with valuable insights and decision-making flexibility. The methodology is tested on a part of the Amsterdam WDN in the Netherlands, serving as a pilot for methodology evaluation. A range of feasible sectorization solutions is generated and compared based on implementation cost and three performance indicators (PIs). The paper provides an in-depth discussion on the selection of preferable sectorization solution. The reported results demonstrate the method’s efficiency in optimizing sectorization solutions with minimum implementation cost whilst preserving the WDN operational efficiency and meeting the local design criteria.

Improving the efficiency of research proposals evaluation: A two-stage procedure

Abstract An important share of research funding is allocated via competitive programs, which entail considerable direct and indirect costs, such as to develop and evaluate the proposals. The goal of this article is to explore whether adopting a two-stage evaluation procedure could improve the efficiency of the process. For this purpose, we study the evaluation system designed by the Foundation Dam (Stiftelsen Dam), one of the largest foundations in Norway supporting health research. In 2020, Foundation Dam adopted a new evaluation procedure consisting in a short proposal for a first stage of selection and, for those selected, a second-stage evaluation of a long proposal. We explore whether such a procedure reduces the evaluation costs and how the evaluation procedures compare in terms of reliability. Survey responses from 94 of the 594 applicants in the one-stage procedure (2018–19) and all the 668 applicants in the two-stage procedure (2020–21) show that the two-stage procedure reduced the average time that applicants spent in drafting the proposal(s) by 38%. According to the reviewers’ estimate, the two-stage procedure also reduced by 28% the time they spent on average to evaluate an applicant’s proposal(s). The analysis of the evaluation data of 594 long proposals in the one-stage procedure and 668 short proposals in the two-stage procedure shows that reviewers’ scores of short proposals display greater reliability and agreement than the reviewers’ scores of long proposals in the old one-stage procedure. Our findings suggest that a two-stage procedure can substantially improve the efficiency of grant writing and review, without harming the reliability of the evaluation.

Anatomical Insights on the Cervical Nerve for Contemporary Face and Neck Lifting: A Cadaveric Study.

Despite the significant roles it plays in the functions of the platysma and lower lip, the cervical branch of the facial nerve is often overlooked compared to other branches, but its consideration is critical for ensuring the safety of neck surgeries. The aim of this study was to clarify the anatomical discrepancies associated with the cervical branch of the facial nerve to enhance surgical safety. The study utilized 20 fresh-frozen hemiheads. A 2-stage surgical procedure was employed, beginning with an initial deep-plane facelift including extensive neck dissection, followed by a superficial parotidectomy on fresh-frozen cadavers. This approach allowed for a thorough exploration and mapping of the cervical nerve in relation to its surrounding anatomical structures. Upon exiting the parotid gland, the cervical nerve consistently traveled beneath the investing layer of the deep cervical fascia for a brief distance, traversing the deep fascia to travel within the areolar connective tissue before terminating anteriorly in the platysma muscle. A single branch was observed in 2 cases, while 2 branches were noted in 18 cases. The cervical nerve's relatively deeper position below the mandible's angle facilitates a safer subplatysmal dissection via a lateral approach for the release of the cervical retaining ligaments. Due to the absence of a protective barrier, the nerve is more susceptible to injuries from direct trauma or thermal damage caused by electrocautery, especially during median approaches.

Radiological and Pulmonary Results of Surgical Treatment of Severe Idiopathic Scoliosis Using Preoperative Halo Gravity Traction Compared with Less Invasive Temporary Internal Distraction in Staged Surgery in Adolescents.

Background: Severe and rigid scoliosis represents a type of spinal deformity characterized by a Cobb angle exceeding 90° and a flexibility of less than 30%. Halo spinal traction remains the established standard for managing severe scoliosis, although alternative approaches such as temporary internal distraction rods and staged surgical correction exist. The primary objective of this investigation was to compare two cohorts of patients treated using these distinct methods to ascertain any divergences in terms of surgical and radiological outcomes, pulmonary function (PF), and quality of life (QoL). Methods: This study encompassed a total of 62 pediatric patients meeting the specified criteria, which included severe idiopathic scoliosis (major Cobb curve >90) and flexibility <30%. Group 1 (G1) underwent surgical intervention involving preoperative Halo gravity traction (HGT) succeeded by posterior spinal fusion (PSF). On the other hand, Group 2 (G2) underwent a two-stage procedure starting with a less invasive temporary internal distraction technique (LITID) prior to PSF. The radiological outcomes, PF, and QoL were documented and assessed over a monitoring period ranging from 2 to 5 years. Results: The average preoperative major curves (MCs) measured 124° and 122° in G1 and G2, respectively (p < 0.426). Initial flexibility, as observed in preoperative bending films, ranged from 18% in G1 to 21% in G2 (p < 0.001). Following the ultimate surgical intervention, the MCs were corrected to 45° and 37.4° in G1 and G2, respectively (p < 0.001). The percentage correction of the MCs was higher in G2 (63% vs. 70% in G1 and G2, respectively), with significant between-group disparities (p < 0.001). The mean preoperative thoracic kyphoses (TKs) were 96.5° in G1 and 92° in G2 (p = 0.782), which were rectified to 45.8° in G1 and 36.2° in G2 (p < 0.001), equating to correction rates of 55% and 60% in the respective groups. Initially, G2 exhibited lower values for the percentage of predicted lung volume (FVC) and predicted FEV1 compared with G1 (49% and 58% vs. 54.5% and 60.8%; N.S.). Nonetheless, both groups demonstrated enhancements in their FVC and FEV1 values over the follow-up period. Conclusions: The surgical management of severe and untreated spinal curvatures in the pediatric and adolescent population can be considered safe, with a tolerable incidence of minor complications. LITID emerges as a method offering improved QoL and pulmonary function, achieving notably substantial average corrections in deformity by 70% in the coronal plane and 60% in the sagittal plane, alongside a mean increase in trunk height of 10.8 cm. Furthermore, a typical reduction of 76% in rib humps and enhancements in respiratory function, as indicated by improvements in 1 s predicted forced expiratory volume (by 25-56%) and forced vital capacity (by 35-65%), were achieved, leading to a clinically and statistically significant enhancement in QoL when evaluated using SRS-22r, without resorting to more radical, high-risk procedures.

Consistent two-stage estimation in heterogeneous network autoregressive model

Obtaining consistent estimates of network effects in the heterogeneous network autoregressive model presents significant challenges. These challenges arise from the large number of target parameters, potential endogeneity, and non-identifiability issues. To overcome these challenges, we reformulate the model into a higher-order version. Our proposed two-stage estimation procedure first reduces parameter complexity by screening out nodes with negligible network effects. Then, we employ the ordinary least squares method and the instrumental variables technique for effective post-screening estimation. We further investigate the consistency and asymptotic normality of the estimators under appropriate assumptions and explore the cases of heteroscedasticity. The finite sample performance of the two-stage method is evaluated by simulation studies and an empirical analysis.

Single stage management of suspected gallbladder cancer guided by intraoperative frozen section analysis: A retrospective cohort study.

The management of radiologically suspected gallbladder cancers (GBC) that lack definitive radiological features usually involves performing a first-stage routine laparoscopic cholecystectomy, followed by an open second-stage liver resection (segments IVB and V) and hilar lymphadenectomy (extended cholecystectomy) if subsequent formal histology confirms a malignancy. Performing a cholecystectomy with an intraoperative frozen section to guide the need for conversion to an extended cholecystectomy as a single-stage procedure has multiple benefits compared to a two-stage approach. However, the safety and efficacy of this approach have not yet been evaluated in a tertiary setting. A retrospective cohort study was performed using a database of all consecutive patients with suspected GBC who had been referred to our tertiary unit. Following routine cholecystectomy, depending on the operative findings, the gallbladder specimen was removed and sent for frozen-section analysis. If malignancy was confirmed, the depth of tumour invasion was evaluated, followed by simultaneous extended cholecystectomy, when appropriate. The sensitivity and specificity of frozen section analysis for the diagnosis of GBC were measured using formal histopathology as a reference standard. A total of 37 consecutive cholecystectomies were performed. In nine cases, GBC was confirmed by intraoperative frozen section analysis, three of which had standard cholecystectomy only as their frozen section showed adenocarcinoma to be T1a or below (n=2) or were undetermined (n=1). In the remaining six cases, malignant invasion beyond the muscularis propria (T1b or above) was confirmed; thus, a synchronous extended cholecystectomy was performed. The sensitivity (95% CI 66.4%-100%) and specificity (95% CI 87.7%-100%) for identifying GBC using frozen section analysis were both 100%. The net cost of the single-stage pathway in comparison to the two-stage pathway resulted in overall savings of £3894. Intraoperative frozen section analysis is a reliable tool for guiding the use of a safe, single-stage approach for the management of GBC in radiologically equivocal cases. In addition to its lower costs compared to a conventional two-stage procedure, intraoperative analysis also affords the benefit of a single hospital admission and single administration of general anaesthesia, thus greatly enhancing the patient's experience and relieving the burden on waiting lists.

Wall-modeled large eddy simulation of a tandem wing configuration in transonic flow

In this study, the interaction between a turbulent wake and the boundary layer of a horizontal tail plane (HTP) in the transonic flow regime is investigated. The setup considered corresponds to a generic tandem wing configuration with an OAT15A airfoil as the main wing and a National Advisory Committee for Aeronautics (NACA) 64A-110 as an HTP. Due to the transonic flow, the suction side of the OAT15A exhibits buffet. The numerical approach consists of a two-stage procedure in which a detached eddy simulation (DES) provides unsteady inflow conditions for a subsequent zonal high-fidelity large eddy simulation (LES) performed for the HTP region only; the turbulent boundary layer is modeled using scale-resolved wall-modeled LES (WMLES). The study mainly pursues two objectives: first, to discuss the influence of wake turbulence on the flow characteristics of the NACA airfoil; and second, to evaluate the capability of WMLES as a low-cost but high-resolution numerical approach in challenging flow conditions. Essentially, the study confirms the expected result that the outer part of the HTP's boundary layer is dominated by the wake of the main wing. Mainly based on a discussion of turbulence spectra, the study further demonstrates the advantage of WMLES over DES, proving that WMLES is able to capture the effects of wake turbulence on boundary layer dynamics, and thus validates the WMLES approach as a cost-effective, high-resolution turbulence modeling approach. On a superordinate level, the study further sketches a possible way on how a flow problem with such a strongly unsteady behavior could be systematically evaluated.

Гибридная интеллектуальная система машинного обучения для моделирования процессов обработки фосфатного рудного сырья

The results of a study are presented, the purpose of which was to create an intelligent machine learning system for modeling the processes of charge agglomeration during processing of phosphate ore raw materials. The relevance of the study is justified by the need to improve the information support of technological systems management processes in the context of the digital transformation of the production environment, carried out within the framework of the Fourth Industrial Revolution and characterized by the massive introduction of the industrial Internet of things, which leads to an avalanche-like increase in the volume of technological data. Their processing using modern analysis methods, including artificial intelligence methods, can improve the quality of decisions made and provide competitive advantages. The scientific novelty of the research results is the structure of the proposed hybrid intelligent machine learning system for modeling phosphate ore processing processes, which is based on the joint use of a dynamic model of the sintering process in the Simulink environment and a deep neural network. The architecture of the neural network was developed taking into account the specifics of the mathematical description of the agglomeration process and includes input fully connected layers that receive measurement results of process variables, as well as a recurrent layer that processes the combined sequence from the outputs of fully connected layers. The integration of a Simulink model and a deep neural network makes it possible to quickly adapt an intelligent system to a specific sintering machine through the use of a two-stage machine learning procedure – first on a Simulink simulation model, and then on a real object. Taking into account the significant inertia of the processes accompanying agglomeration, this approach ensures prompt changes in the settings of the hybrid intelligent machine learning system for the new composition of raw materials and technological parameters. A program has been developed that provides a convenient graphical interface for preparing and using an intelligent system, and simulation experiments have shown that the process of additional training for new technological parameters is much faster than initial training while maintaining high accuracy of the obtained modeling results.

Multilevel analysis of anemia and associated factors among women of reproductive age (15-49 years) in Liberia: Evidence from the 2019/20 Liberia demographic and health survey data.

Anemia is a global public health problem, principally affecting young children and reproductive-age mothers. Although anemia is a main public health concern in low-income countries, there is no evidence about its prevalence and associated factors among women of reproductive age in Liberia. Thus, the purpose of this study was to identify the prevalence and associated factors of anemia among women of reproductive age in Liberia. We used the data extracted from the fifth Liberia Demographic and Health Survey (LDHS-V) that were carried out between October 2019 and February 2020. The sample was chosen using a stratified two-stage cluster sampling procedure. Overall weighted samples of 4027 women of reproductive age were used in the analysis. Data weighting was carried out to obtain reliable estimates and standard errors as well as to restore the representativeness of the data. Stata version 14 software was used for data extraction, coding, and analysis. We used multilevel analysis to identify the significant factors associated with anemia among women of reproductive age. The prevalence of anemia among women of reproductive age in Liberia was 44.51 (95% CI: 42.97-46.04). From these, about 23.10% of women of reproductive age were mildly anemic, 20.63% were moderately anemic and 0.78% was severely anemic. In multivariable analysis; women with the groups of 20-24 years (adjusted odds ratio (AOR) = 0.72, 95% CI: 0.56, 0.92), 25-29 years (AOR = 0.57, 95% CI: 0.43, 0.77), 30-34 years (AOR = 0.59, 95% CI: 0.43, 0.83), 35-39 years (AOR = 0.56, 95% CI: 0.41, 0.79), 40-44 years (AOR = 0.61, 95% CI: 0.43,0.87), 45-49 years (AOR = 0.57, 95% CI: 0.39,0.82), overweight (AOR = 0.83; 95% CI: 0.70, 0.98), obese (AOR = 0.72; 95% CI: 0.58, 0.88), using modern contraceptive methods (AOR = 0.61; 95% CI: 0.52, 0.72), and being from the Northcentral region (AOR = 0.55; 95% CI: 0.43, 0.72) were significantly associated with lower odds of anemia. However, being pregnant (AOR = 1.34; 95% CI: 1.04, 1.73) and having higher parity (3 children or more) (AOR = 1.40; 95% CI: 1.03, 1.93) were significantly associated with higher odds of anemia. In the present study, the prevalence of anemia in women of reproductive age was relatively high. Therefore, it is better to provide special emphasis on high-risk groups such as pregnant and multiparous women.

Comparison of MOEAs in an Optimization-Decision Methodology for a Joint Order Batching and Picking System

This paper investigates the performance of a two-stage multi-criteria decision-making procedure for order scheduling problems. These problems are represented by a novel nonlinear mixed integer program. Hybridizations of three Multi-Objective Evolutionary Algorithms (MOEAs) based on dominance relations are studied and compared to solve small, medium, and large instances of the joint order batching and picking problem in storage systems with multiple blocks of two and three dimensions. The performance of these methods is compared using a set of well-known metrics and running an extensive battery of simulations based on a methodology widely used in the literature. The main contributions of this paper are (1) the hybridization of MOEAs to deal efficiently with the combination of orders in one or several picking tours, scheduling them for each picker, and (2) a multi-criteria approach to scheduling multiple picking teams for each wave of orders. Based on the experimental results obtained, it can be stated that, in environments with a large number of different items and orders with high variability in volume, the proposed approach can significantly reduce operating costs while allowing the decision-maker to anticipate the positioning of orders in the dispatch area.

A firm-specific Malmquist productivity index model for stochastic data envelopment analysis: an application to commercial banks

In the data envelopment analysis (DEA) literature, productivity change captured by the Malmquist productivity index, especially in terms of a deterministic environment and stochastic variability in inputs and outputs, has been somewhat ignored. Therefore, this study developed a firm-specific, DEA-based Malmquist index model to examine the efficiency and productivity change of banks in a stochastic environment. First, in order to estimate bank-specific efficiency, we employed a two-stage double bootstrap DEA procedure. Specifically, in the first stage, the technical efficiency scores of banks were calculated by the classic DEA model, while in the second stage, the double bootstrap DEA model was applied to determine the effect of the contextual variables on bank efficiency. Second, we applied a two-stage procedure for measuring productivity change in which the first stage included the estimation of stochastic technical efficiency and the second stage included the regression of the estimated efficiency scores on a set of explanatory variables that influence relative performance. Finally, an empirical investigation of the Iranian banking sector, consisting of 120 bank-year observations of 15 banks from 2014 to 2021, was performed to measure their efficiency and productivity change. Based on the findings, the explanatory variables (i.e., the nonperforming loan ratio and the number of branches) indicated an inverse relationship with stochastic technical efficiency and productivity change. The implication of the findings is that, in order to improve the efficiency and productivity of banks, it is important to optimize these factors.