Simulation based alternatives for overall process improvement at the cardiac catheterization lab

Cardiac catheterization is one of the critical procedures in patient care. It is pertinent for all process related issues in this department to be handled with due priority. This research is a cross-functional effort with a leading hospital that was in its planning stage to implement an overall process improvement at its cardiac catheterization lab department. It has been determined that significant process delays exist in this department. One of the identified key factors to process improvement was to reduce patient turnaround time. Process mapping was used to study the system and identify potential sources of delays in the system. A set of qualitative recommendations were put forward. These recommendations, include the reduction of wait time of outpatients and inpatients and the reduction of non-value-added times such as transfer time of patients, were evaluated using a discrete event simulation approach. The simulation study shows that the daily operating hours at the catheterization lab could be reduced, aiding to reallocate staff for discharging other duties, as the hospital may require.     

Effect of propranolol and nifedipine on maximal electroshock-induced seizures in mice: individually and in combination

To clarify the influence of the head-up position on cerebral oxygen metabolism during laparoscopy with CO2 insufflation in 12 patients who underwent laparoscopic cholecystectomy, changes in the concentrations of cerebral oxyhemoglobin (HbO2), deoxyhemoglobin (Hb), total hemoglobin (total Hb) and oxidized cytochrome aa3 (Cyt aa3) were measured by use of near-infrared laser spectroscopy. Anesthesia was maintained with nitrous oxide (66%), oxygen, and sevoflurane. Pneumoperitoneum was maintained at an intraabdominal pressure of 10-12 mm Hg by use of CO2. Minute ventilation was adjusted to maintain end-tidal CO2 tension (P(ET)CO2) between 35 and 40 mm Hg during the procedure. Patients were moved from supine to the head-up (20 degree) position before intraabdominal manipulation. The concentration of HbO2 decreased significantly when patients were moved to the head-up position and 30 min thereafter. It remained significantly low after they were returned to the supine position and at the end of surgery. The concentration of Hb was unchanged during the study. Therefore, the concentration of total Hb decreased significantly when patients were moved to the head-up position, as well as 30 min thereafter. It remained significantly low after they were returned to the supine position and at the end of surgery. The concentration of Cyt aa3, however, did not change significantly during the study. These results suggest that the head-up position during laparoscopic cholecystectomy decreases cerebral HbO2 and total Hb.     

Semantic Information Extraction from Multi-Corpora Using Deep Learning

Information extraction plays a vital role in natural language processing, to extract named entities and events from unstructured data. Due to the exponential data growth in the agricultural sector, extracting significant information has become a challenging task. Though existing deep learning-based techniques have been applied in smart agriculture for crop cultivation, crop disease detection, weed removal, and yield production, still it is difficult to find the semantics between extracted information due to unswerving effects of weather, soil, pest, and fertilizer data. This paper consists of two parts. An initial phase, which proposes a data preprocessing technique for removal of ambiguity in input corpora, and the second phase proposes a novel deep learning-based long short-term memory with rectification in Adam optimizer and multilayer perceptron to find agricultural-based named entity recognition, events, and relations between them. The proposed algorithm has been trained and tested on four input corpora i.e., agriculture, weather, soil, and pest & fertilizers. The experimental results have been compared with existing techniques and it was observed that the proposed algorithm outperforms Weighted-SOM, LSTM+RAO, PLR-DBN, KNN, and Naïve Bayes on standard parameters like accuracy, sensitivity, and specificity.     

Melting heat transfer analysis of electrically conducting nanofluid flow over an exponentially shrinking/stretching porous sheet with radiative heat flux under a magnetic field

Modern magnetic nanomaterial processing operations are progressing rapidly and require increasingly sophisticated mathematical models for their optimization. Stimulated by such developments, in this paper, a theoretical and computational study of a steady magnetohydrodynamic nanofluid over an exponentially stretching/shrinking permeable sheet with melting (phase change) and radiative heat transfer is presented. Besides, wall transpiration, that is, suction and blowing (injection), is included. This study deploys Buongiorno's nanofluid model, which simulates the effects of the Brownian motion and thermophoresis. The transport equations and boundary conditions are normalized via similarity transformations and appropriate variables, and the similarity solutions are shown to depend on the transpiration parameter. The emerging dimensionless nonlinear coupled ordinary differential boundary value problem is solved numerically with the Newton-Fehlberg iteration technique. Validation with special cases from the literature is included. The increase in the magnetic field, that is, the Hartmann number, is observed to elevate nanoparticle concentration and temperature, whereas it dampens the velocity. Higher values of the melting parameter consistently decelerate the boundary layer flow and suppress temperature and nanoparticle concentration. A higher radiative parameter strongly increases temperature (and thermal boundary layer thickness) and weakly accelerates the flow. The increase in the Brownian motion reduces nanoparticle concentrations, whereas a greater thermophoretic body force strongly enhances them. The Nusselt number and Sherwood number are observed to be decreased with an increasing Hartmann number, whereas they are elevated with a stronger wall suction and melting parameter.     

Nanocarrier-Based Delivery of SN22 as a Tocopheryl Oxamate Prodrug Achieves Rapid Tumor Regression and Extends Survival in High-Risk Neuroblastoma Models

Despite the use of intensive multimodality therapy, the majority of high-risk neuroblastoma (NB) patients do not survive. Without significant improvements in delivery strategies, anticancer agents used as a first-line treatment for high-risk tumors often fail to provide clinically meaningful results in the settings of disseminated, recurrent, or refractory disease. By enhancing pharmacological selectivity, favorably shifting biodistribution, strengthening tumor cell killing potency, and overcoming drug resistance, nanocarrier-mediated delivery of topoisomerase I inhibitors of the camptothecin family has the potential to dramatically improve treatment efficacy and minimize side effects. In this study, a structurally enhanced camptothecin analog, SN22, reversibly coupled with a redox-silent tocol derivative (tocopheryl oxamate) to allow its optimally stable encapsulation and controlled release from PEGylated sub-100 nm nanoparticles (NP), exhibited strong NB cell growth inhibitory activity, translating into rapid regression and durably suppressed regrowth of orthotopic, MYCN-amplified NB tumors. The robust antitumor effects and markedly extended survival achieved in preclinical models recapitulating different phases of high-risk disease (at diagnosis vs. at relapse with an acquired loss of p53 function after intensive multiagent chemotherapy) demonstrate remarkable potential of SN22 delivered in the form of a hydrolytically cleavable superhydrophobic prodrug encapsulated in biodegradable nanocarriers as an experimental strategy for treating refractory solid tumors in high-risk cancer patients.     

GENERATING A LAYOUT FROM A DESIGN SKELETON

In the past, researchers have proposed several types of design skeletons from which a human designer can generate good facilities layouts. Examples are flow graphs, SLP space relationships, bubble diagrams, planar adjacency graphs, matching based adjacency graphs, centroid locations, and cut trees. In this paper, we introduce a linear programming model which efficiently generates a layout from a graphical representation of any design skeleton. We demonstrate how the model can be used to enhance most design skeleton based layout approaches.     

Mixed convection flows of tangent hyperbolic fluid past an isothermal wedge with entropy: A mathematical study

The nonlinear, steady, and mixed convective boundary layer flow and heat transfer of an incompressible tangent hyperbolic non-Newtonian fluid over an isothermal wedge in the presence of magnetic field are analyzed numerically using the implicit Keller-Box finite-difference technique. The entropy analysis due to MHD flow of a tangent hyperbolic fluid past an isothermal wedge and viscous dissipation is also included. The numerical code is validated with previous Newtonian studies available in the literature. Graphical and tabulated results are analyzed to study the behavior of the fluid velocity, temperature, concentration, shear stress, heat transfer rate, entropy generation number, and Bejan number for various emerging thermophysical parameters, namely Weissenberg number (We), power-law index (n), mixed convection parameter (λ), pressure gradient parameter (m), Prandtl number (Pr), Biot number (γ), Hartmann number (Ha), Brinkmann number (Br), Reynolds number (Re), and temperature gradient (Π). It is observed that velocity, entropy, Bejan number, and surface heat transfer rate are reduced with the increase in the Weissenberg number, but temperature and local skin friction are increased. An increase in pressure gradient enhances velocity, entropy, local skin friction, and surface heat transfer rate, but reduces temperature and Bejan number. An increase in an isothermal power-law index (n) is observed to increase velocity, Bejan number, and surface heat transfer rate, but it decreases temperature, entropy, and local skin friction. An increase in the magnetic parameter (Ha) is found to decrease temperature, entropy, surface heat transfer rate, and local skin friction, and it increases velocity and Bejan number. The research is applicable for coating materials in chemical engineering, for instance, robust paints, production of aerosol deposition, and water-soluble solution thermal treatment.     

Rapamycin Alternatively Modifies Mitochondrial Dynamics in Dendritic Cells to Reduce Kidney Ischemic Reperfusion Injury

Dendritic cells (DCs) are unique immune cells that can link innate and adaptive immune responses and Immunometabolism greatly impacts their phenotype. Rapamycin is a macrolide compound that has immunosuppressant functions and is used to prevent graft loss in kidney transplantation. The current study evaluated the therapeutic potential of ex-vivo rapamycin treated DCs to protect kidneys in a mouse model of acute kidney injury (AKI). For the rapamycin single (S) treatment (Rapa-S-DC), Veh-DCs were treated with rapamycin (10 ng/mL) for 1 h before LPS. In contrast, rapamycin multiple (M) treatment (Rapa-M-DC) were exposed to 3 treatments over 7 days. Only multiple ex-vivo rapamycin treatments of DCs induced a persistent reprogramming of mitochondrial metabolism. These DCs had 18-fold more mitochondria, had almost 4-fold higher oxygen consumption rates, and produced more ATP compared to Veh-DCs (Veh treated control DCs). Pathway analysis showed IL10 signaling as a major contributing pathway to the altered immunophenotype after Rapamycin treatment compared to vehicle with significantly lower cytokines Tnfa, Il1b, and Il6, while regulators of mitochondrial content Pgc1a, Tfam, and Ho1 remained elevated. Critically, adoptive transfer of rapamycin-treated DCs to WT recipients 24 h before bilateral kidney ischemia significantly protected the kidneys from injury with a significant 3-fold improvement in kidney function. Last, the infusion of DCs containing higher mitochondria numbers (treated ex-vivo with healthy isolated mitochondria (10 µg/mL) one day before) also partially protected the kidneys from IRI. These studies demonstrate that pre-emptive infusion of ex-vivo reprogrammed DCs that have higher mitochondria content has therapeutic capacity to induce an anti-inflammatory regulatory phenotype to protect kidneys from injury.