Co-Administration of Clomiphene Citrate and Letrozole in Mild Ovarian Stimulation Versus Conventional Controlled Ovarian Stimulation Among POSEIDON Group 4 Patients

This retrospective study assessed the effect of the co-administration of clomiphene citrate (CC) and letrozole in mild ovarian stimulation, compared to conventional regimens, among Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) Group 4 patients. There were 114 POSEIDON Group 4 patients undergoing in vitro fertilization treatments with 216 stimulation cycles recruited from a Taiwan’s reproductive center during 2016-2020. Main outcomes were the numbers, quality of retrieved oocytes and embryo development. Pregnancy outcomes were assessed after embryo transfers. Per stimulation cycle, patients receiving mild stimulation with a combination of CC and letrozole (study group) versus those with COS (control group) had lower numbers of pre-ovulatory follicles (2.00 ± 1.23 vs. 2.37 ± 1.23, p=0.0066) and oocytes retrieved (1.83 ± 1.17 vs. 2.37 ± 1.23, p=0.0017), and lower follicular output rate (58.6% vs. 68.38%, p=0.0093) and mature oocyte output rate (44.29% vs. 52.88%, p=0.0386) but a higher top-quality metaphase II oocyte ratio (66.7% vs. 54.59%, p=0.0444) and a similar fertilization rate (91.67% vs. 89.04%, p=0.4660). With adjustment for significant between-group baseline differences using multivariable logistic generalized estimating equation model analyses, there was no statistical difference in oocytes retrieved and embryo development between the study and control groups, and insignificant increases in successful pregnancies in the study group were found compared to the control group (i.e., odds ratios [95% CIs]: 1.13 [0.55, 232] and 1.50 [0.65, 3.49] for ongoing pregnancy and live birth, respectively). For POSEIDON Group 4 patients, cotreatment of CC and letrozole in mild stimulation may increase the high-quality oocyte ratio and yield comparable fertilization rate and pregnancy outcomes.

Effect of combined glucocorticoid therapy on bronchial asthma dynamics

This work is aimed to compare the effectiveness of parenteral and inhalation bronchial asthma treatment in combination with glucocorticosteroids and bronchodilators. The study was conducted in 2020 in Botkin City Clinical Hospital (Moscow, the Russian Federation). Case histories of 106 patients diagnosed with bronchial asthma exacerbation of moderate severity were analyzed. Patients were divided into two equal groups based on the therapy method: (1) Group 1 received systemic glucocorticosteroids parenterally in combination with inhalation glucocorticosteroids; (2) Group 2 received systemic glucocorticosteroids parenterally, but inhalation therapy was performed with a nebulizer. Clinical manifestations of bronchial asthma have been recorded. During hospital admission, the breath rate was 22.0 for Group 1 and 21.5 for Group 2, P ≥ 0.05, and heart rates were 93.0 and 92.5, respectively (P ≥ 0.05). All indices (blood saturation, breath rate, peak output rate) in Group 1 remained unchanged 4 h after the start of the therapy, while in Group 2, peak flow rate changed to 53.5% with a median increase of 72.0 ml over 4 h, P ≤ 0.05. On Day 3, patients of Group 1 demonstrated a peak flow rate of 59.5%, P ≤ 0.05, and on Day 10, patients of Group 2 had a peak output rate of 53.0 and 59.5%, respectively (P ≤ 0.05). Systemic glucocorticoids were eliminated in 47 patients of Group 1 and in all patients of Group 2. The treatment tactics applied in Group 2 resulted in faster and more significant improvement in patients diagnosed with bronchial asthma exacerbation. Both treatment regimens showed high results.

Testing and Validation of Reciprocating Positive Displacement Pump for Benchtop Pulsating Flow Model of Cerebrospinal Fluid Production and Other Physiologic Systems

Background: The flow of physiologic fluids through organs and organs systems is an integral component of their function. The complex fluid dynamics in many organ systems are still not completely understood, and in-vivo measurements of flow rates and pressure provide a testament to the complexity of each flow system. Variability in in-vivo measurements and the lack of control over flow characteristics leave a lot to be desired for testing and evaluation of current modes of treatments as well as future innovations. In-vitro models are particularly ideal for studying neurological conditions such as hydrocephalus due to their complex pathophysiology and interactions with therapeutic measures. The following aims to present the reciprocating positive displacement pump, capable of inducing pulsating flow of a defined volume at a controlled beat rate and amplitude. While the other fluidic applications of the pump are currently under investigation, this study was focused on simulating the pulsating cerebrospinal fluid production across profiles with varying parameters. Methods: Pumps were manufactured using 3D printed and injection molded parts. The pumps were powered by an Arduino-based board and proprietary software that controls the linear motion of the pumps to achieve the specified output rate at the desired pulsation rate and amplitude. A range of 0.01 to 0.7 was tested to evaluate the versatility of the pumps. The accuracy and precision of the pumps’ output were evaluated by obtaining a total of 150 one-minute weight measurements of degassed deionized water per output rate across 15 pump channels. In addition, nine experiments were performed to evaluate the pumps’ control over pulsation rate and amplitude. Results: volumetric analysis of a total of 1200 readings determined that the pumps achieved the target output volume rate with a mean absolute error of -0.001034283 across the specified domain. It was also determined that the pumps can maintain pulsatile flow at a user-specified beat rate and amplitude. Conclusion: The validation of this reciprocating positive displacement pump system allows for the future validation of novel designs to components used to treat hydrocephalus and other physiologic models involving pulsatile flow. Based on the promising results of these experiments at simulating pulsatile CSF flow, a benchtop model of human CSF production and distribution could be achieved through the incorporation of a chamber system and a compliance component

Process simulation of modelled reverse osmosis for desalination of seawater

Model equations for prediction of process parameters of reverse osmosis for desalination of seawater were developed via mathematical derivation from basic equations for reverse osmosis process. A model equation relating the interfacial solute concentration () with the process pressure difference () was developed. Taking the of a reverse osmosis as the basic independent variable, further model equations relating other process parameters such as the solute concentration polarity , water flux , osmotic pressure , water output rate (q), power density (Pd) and specific energy consumption (SEC) were developed. Simulation of a hypothetical reverse osmosis data using Microsoft Excel Worksheet and a Microsoft Windows 10 on a 64-bit operating system was carried out. Simulation results showed that the optimum fluid bulk concentration was = 0.0004 mole/cm3. The optimum rate of increase in the solute rejection factor per unit rise in ΔP was 0.45%. The optimum solute rejection factor was 97.6%. The optimum water output rate, specific energy consumption and power density were 103.2 L/h, 3.65 kWh/m3 and 6.09 W/m2, respectively.

An Algorithm for Arranging Operators to Balance Assembly Lines and Reduce Operator Training Time

Industry 4.0 is transforming how costs, including labor costs, are managed in manufacturing and remanufacturing systems. Managers must balance assembly lines and reduce the training time of workstation operators to achieve sustainable operations. This study’s originality lies in its use of an algorithm to balance an assembly line by matching operators to workstations so that the line’s workstations achieve the same targeted output rates. First, the maximum output rate of the assembly line is found, and then the number of operators needed at each workstation is determined. Training time is reduced by matching operators’ training and skills to workstations’ skill requirements. The study obtains a robust, cluster algorithm based on the concept of group technology, then forms operator skill cells and determines operator families. Four numerical examples are presented to demonstrate the algorithm’s implementation. The proposed algorithm can solve the problem of arranging operators to balance assembly lines. Managers can also solve the problem of worker absences by assigning more than one operator with the required skillset to each workstation and rearranging them as needed.

Women in Advanced Reproductive Age: Are the Follicular Output Rate, the Follicle-oocyte Index and the Ovarian Sensitivity Index Predictors of Live Birth in an IVF Cycle?

BackgroundSeveral researches have investigated alternative markers related to ovarian responsiveness in order to better predict IVF outcomes, particularly in advanced reproductive aged women. The follicular output rate (FORT), the follicle-oocyte index (FOI) and the ovarian sensitivity index (OSI) are among the most promising. However, these three metrics have not been investigated as independent predictors of live birth in women of advanced reproductive age, neither have been compared to the two ‘component’ characteristics that were used to calculate them.MethodsA logistic regression model containing all relevant predictors of ovarian reserve or response was used to evaluate the potential of FORT, FOI and OSI as predictors of live birth. After, the non-linear associations between FORT, FOI and OSI and the probability of live birth was evaluated. Finally, we fitted multiple logistic regression models to compare whether FORT, FOI and OSI were more informative predictors than the two ‘components’ used to calculate them. Results590 couples received a total of 740 IVF cycles, after which 127 (17.5%) obtained a live birth. None of FORT, FOI and OSI showed a strength of association or a p-value even close to female age (Odds ratio for live birth (95% Confidence Interval) 1.00 (0.99-1.01), 1.00 (0.99-1.01), 0.98 (0.88-1.11) and 0.58 (0.48-0.72), respectively). The three models comparing FORT, FOI and OSI with the two ‘components’ used to calculate them were not more informative.Conclusion(s)In a population of women of advanced age with unexplained infertility, none of FORT, FOI and OSI were predictive of live birth and more predictive than the two ‘components’ characteristics that were used to calculate them. We suggest clinicians and researchers still to use female age as the most reliable predictor of an IVF treatment.Trial registrationretrospectively registered

Multi-System Urban Waste-Energy Self-Circulation: Design of Urban Self-Circulation System Based on Emergy Analysis

The current worldwide state of energy scarcity and low waste utilization has led to a decrease in the supply of ecological services, something that seriously affects the development of cities. In this study, we propose an urban self-circulation design based on multiple systems within the traditional biogas, wetland, rainwater, solar power, and urban farm systems framework to achieve effective improvements in urban waste utilization and the optimization of the urban waste–energy flow cycle. Emergy conversion is used to evaluate system optimization, and the simulation results show that the novel proposed system can effectively improve urban waste utilization with an energy output rate of 3.18 × 10, an environmental load of 4.27 × 10−2, and a sustainability index of 7.45 × 102 in the core system; additionally, it can improve resource utilization of small-scale cities with an energy output rate of 1.85 × 100, an environmental load of 1.20 × 100, and a sustainability index of 1.54 × 100 in the total system. The inter-system energy flow model can significantly optimize urban energy systems based on ecological models with low-emergy resource input, including biogas systems and urban farm systems. This model can reduce the environmental load and effectively compensate for the reduced supply capacity of ecosystem services caused by urbanization, making it suitable for extension to other small-scale built environments that are relatively independent and rich in natural resources.

A Comparison of the Application of the SMED Methodology in Two Different Cutting Lines

Purpose: This study was carried out in a cork company and its purpose was to observe and analyze the practices and methods used during the tools/series change moments and to propose improvements and alternatives to these same procedures so that the time needed to carry out the setup is reduced by 15% in both lines. Methodology/Approach:The methodology included the following phases: 1st - historical data collection and setup video recording, 2nd - footage analysis and conduction of informal interviews with employees, 3rd - flow, Gantt, and spaghetti charts creation and making of an action plan based on the waste and improvement opportunities identified in video analysis, 4th - validation with the line workers of the new operating mode created with the Single Minute Exchange of Dies (SMED) tool and communication to the Maintenance department about their role in this project, 5th - making and placement of plasticized cards on the cutting lines to ensure that new operating mode is followed and carrying out the actions identified in the action plan. Findings: Throughout this project using observations, video recording and its subsequent analysis, as well as interviews to the workers operating in the line, it was found the existence of several actions carried out by them during the setups which did not add value to the product, lack of adequate tools for the work to be performed and lack of work tools in general Research Limitation/implication: The study was limited by the lines and products under study and by the duration of the curricular internship, which was about five months. Originality/Value of paper: The article demonstrates the added value in terms of product quality and production output rate that SMED methodology can bring to companies that adopt the lean philosophy and in particular this continuous improvement tool.

Effects of Driving Frequency and Voltage on the Performances of Vibrating Mesh Nebulizers

The functional components of vibrating mesh nebulizers are a piezoelectric ceramic with a mesh mounted on one side, a reservoir, and a driving circuit. The piezoelectric material vibrates at a specific intrinsic frequency, and when the mechanical resonance frequency of the piezoelectric ceramic and the frequency of the applied electrical signal match, the vibration amplitude of the ceramic is greatest. In the present study, nebulizing performances were tested with respect to driving voltage amplitude after automatic resonance frequency tuning (ARFT) and/or impedance matching (IM) for salbutamol and glycerol solutions. A 1% mismatch of resonance frequency reduced the output rate by 11.0~30.1% and increased particle size by 1.6~7.7% and power consumption increased by 6.6~13.6%. Driving at 30 Vpp after ARFT and IM increased output rate by 45% and decreased power consumption by 31% compared with operation at nominal resonance frequency without IM at 50 Vpp. Nebulization of viscous solutions was also enhanced by applying ARFT with IM. The study shows the application of ARFT with IM improves vibrating mesh nebulizer performance and reduces power consumption.