Optimal cardiopulmonary resuscitation duration for favorable neurological outcomes after out-of-hospital cardiac arrest

Background A favorable neurological outcome is closely related to patient characteristics and total cardiopulmonary resuscitation (CPR) duration. The total CPR duration consists of pre-hospital and in-hospital durations. To date, consensus is lacking on the optimal total CPR duration. Therefore, this study aimed to determine the upper limit of total CPR duration, the optimal cut-off time at the pre-hospital level, and the time to switch from conventional CPR to alternative CPR such as extracorporeal CPR. Methods We conducted a retrospective observational study using prospective, multi-center registry of out-of-hospital cardiac arrest (OHCA) patients between October 2015 and June 2019. Emergency medical service–assessed adult patients (aged ≥ 18 years) with non-traumatic OHCA were included. The primary endpoint was a favorable neurological outcome at hospital discharge. Results Among 7914 patients with OHCA, 577 had favorable neurological outcomes. The optimal cut-off for pre-hospital CPR duration in patients with OHCA was 12 min regardless of the initial rhythm. The optimal cut-offs for total CPR duration that transitioned from conventional CPR to an alternative CPR method were 25 and 21 min in patients with initial shockable and non-shockable rhythms, respectively. In the two groups, the upper limits of total CPR duration for achieving a probability of favorable neurological outcomes < 1% were 55–62 and 24–34 min, respectively, while those for a cumulative proportion of favorable neurological outcome > 99% were 43–53 and 45–71 min, respectively. Conclusions Herein, we identified the optimal cut-off time for transitioning from pre-hospital to in-hospital settings and from conventional CPR to alternative resuscitation. Although there is an upper limit of CPR duration, favorable neurological outcomes can be expected according to each patient’s resuscitation-related factors, despite prolonged CPR duration.

Response Surface Grey Relational Analysis On The Manufacturing of High Grade Biomedical Ti-13Zr-13Nb

Optimization of the manufacturing conditions with more than one performance characteristics have been a thing of concern, especially for Response Surface Method (RSM) optimization. Hence, this study addressed this challenge by reanalyzing a data presented in a previous study using grey relational analysis (GRA) and regression analysis. Central Composite Design (CCD) of RSM with high and low values of manufacturing conditions; voltage (50, 70) V, current (8, 16) A, pulse ON time (6, 10) μs, and pulse OFF time (7, 11) μs. The manufacturing conditions for optimal biomedical Ti-13Zr-13Nb alloy were obtained to be 50V voltage, 8A current, 6 μs pulse ON time, and 11 μs pulse OFF time. It was also revealed that the mathematical model was very efficient because the modeled GRG was in consonant with the experimental one. In addition, it was also established that current was the most significant manufacturing condition with a contribution of 47.27%. Voltage, factors interactions and residual error were insignificant on the GRG value of the titanium alloy. In conclusion, it can be deduced that the a small value of voltage within the considered settings could be used to manufacture better grade Ti-13Zr-13Nb alloy and also the small value of residual error showed the high manufacturability of the material.

Optimization techniques for p-GTO thyristor design

A new type of semiconductor power device was devised in the early ’90s as an alternative to the classic Gate Turn-Off (GTO) thyristor. Because the low-doped n-base was replaced by a low-doped p-base, it was called the p-GTO. Its main advantage is a higher possible control voltage when the device is switched off, leading to the possibility of a higher blocking anode current (IATO) and a lower turn-off time. The studies and techniques employed with the help of SILVACO-TCAD simulation software Athena and Atlas show that the p-GTO has higher breakdown voltages compared with its classic counterpart and similar on-state voltage (VT) and switching characteristics when replacing the GTO in the same circuit. Specific circuit improvements, like an affordable higher turn-off gate voltage, will drive the p-GTO into even faster switching operation.

Identification of Optimal Process Parameters in Electro-Discharge Machining Using ANN and PSO

Electrical Discharge Machining (EDM) process is a widely used machining process in several fabrication, construction and repair work applications. Considering Pulse-On Time, Pulse OFF time, Peak-Current and Gap voltage as the inputs and among all possible outputs, in the present work Material Removal Rate and Surface Roughness are considered as outputs. In order to reduce the number of experiments Design of Experiments (DOE) was undertaken using Orthogonal Array and later on the outputs were optimized using ANN and PSO. It was found that the results obtained from both the techniques were tallying with each other.

FlexFashion: E-Commerce with Advance Features

The aim of this website is to enhance the shopping experience for customers using an advance feature of recommending matching outfits using the colorgram module. Flex Fashion is an interactive e-commerce solution providing users with an excellent fashion platform. The e - commerce platform displays an order cut-off time and a delivery window for the products selected by the consumer. The e - commerce platform does not settle with the user's credit supplier until the item chosen by the consumer is picked from inventory but before it is delivered. As a result, the buyer can make adjustments to the purchase online. There are different categories on the home page available to filter the products based on your style and needs. In addition to the apparels for both men and women one will find flexible variety of accessories and daily essential products. The e - commerce platform does not settle with the user's credit supplier until the item chosen by the consumer is picked from inventory but before it is delivered. As a result, the buyer can make adjustments to the purchase online. Once the customer decides to submit a purchase order, there is a track us page where just by adding ordered and email the user can track there order. This is to facilitate all people who are busy with their work and have no time to get their desired apparels. We are here to provide user with all the best and suitable clothing for sale. If once register into our site, then anyone can avail the benefit with our latest updates of the sale. Keywords: Colorgram, Tracker

Outcomes Impacting Quality of Life in Advanced Parkinson’s Disease Patients Treated with Levodopa-Carbidopa Intestinal Gel

Background: It is believed that motor symptoms, including dyskinesia, and non-motor symptoms impact health-related quality of life (HRQoL) in patients with Parkinson’s disease (PD), and that improvements in these metrics are correlated. Objective: Investigate the relationship between HRQoL and measures of PD severity and treatment efficacy, including motor and nonmotor symptoms. Methods: This was a planned investigation of an international, prospective, single-arm, post-marketing observational study of the long-term effectiveness of levodopa-carbidopa intestinal gel (LCIG) in patients with advanced PD. Pearson correlation coefficients (PCC) were calculated for baseline and change from baseline at 12 months between HRQoL, and motor and nonmotor symptoms. Results: A total of 195 patients were included. At baseline, HRQoL was moderately positively correlated with Activities of Daily Living (UPDRS II, PCC = 0.44), non-motor symptoms (0.48), and measures of sleep (0.50 and 0.40); all p < 0.001. After 12 months of treatment with LCIG, improvements in HRQoL were moderately positively correlated with improvement from baseline in non-motor symptoms (PCC = 0.42), sleep (0.54), and daytime sleepiness (0.40; all p < 0.001), and weakly correlated with improvement in dyskinesia signs and symptoms (PCC = 0.23; p = 0.011). Improvement in HRQoL was not correlated with improvements in OFF time or dyskinesia time. Conclusion: Both at baseline and for change from baseline at 12 months, HRQoL was correlated with baseline and change from baseline in dyskinesia, Activities of Daily Living, and non-motor symptoms, including sleep; but not with baseline or change in OFF time.

PENGARUH PARAMETER PROSES TERHADAP DIMENSI CASING GEAR DENGAN PRODUKSI MENGGUNAKAN TEKNOLOGI 3D PRINTER DLP (DIGITAL LIGHT PROCESS)

Teknologi 3D Printer DLP (Digital Light Process) adalah mesin pencetak 3 dimensi yang berbahan resin dengan system penyinaran menggunakan proyektor cahaya dengan proses pencetakan lapis demi lapis. Pada penelitian ini penulis akan membuat objek yaitu salah satu komponen permesinan yaitu casing gearbox. Dalam penelitian ini penulis akan menganalisa pengaruh parameter proses (exposre time, off time, dan interkasi keduanya) terhadap dimensi hasil cetak dan mendapatkan parameter paling optimal guna diaplikasikan ke komponen atau objek pencetakan. Dalam melakukan pengujian pengukuran dimensi penguji menggunakan alat ukur jangka sorong Krisbow KW06-422. Kemudian data hasil pengukuran diolah dengan metode Anova dengan bantuan software design expert version 10. Setelah dilakukan proses penelitian didapatkanlah hasil yaitu parameter yang paling berpengaruh adalah factor interaksi antara parameter exposure time dan parameter off time terhadap dimensi pada benda yang dicetak, dan kombinasi parameter yang paling optimal terdapat pada parameter exposure time 10 second dan off time 1 second dengan tingkat ketelitian sebesar 95%.

Wire Electrical Discharge Machining (WEDM) of Hybrid Composites (Al-Si12/B4C/Fly Ash)

The present study looks into the effect of WEDM process parameters on the material removal rate (MRR) and surface roughness (SR) responses when machining hybrid composites (Al-Si12/boron carbide/fly ash) using the Taguchi technique. Fly ash and boron carbide (B4C) particles were used for reinforcement (3%, 6%, and 9% by weight), and aluminium alloy (Al-Si12) was used as a matrix material. ANOVA was used to find out the importance of machining factors that affect the quality features of the WEDM process, as well as the relative role of input parameters in determining the WEDM process’ responses. The greatest impact on the response is finalised by the signal-to-noise (S/N) ratio response analysis. However, as a last step, a confirmation experiment with the best combination was carried out to predict and validate the accuracy of the observed values. As the pulse on time and reinforcement increases, MRR also increases. As the gap voltage, wire feed, and pulse off time decrease, it increases. SR is increased by increasing the gap voltage, pulse on time, and pulse off time, wire feed, and reinforcement. The maximum MRR of 38.01 mm3/min and the minimum SR of 3.24 μm were obtained using optimal machining conditions.

CFRP composite drilling through electrical discharge machining using aluminum as fixture plate

Recent developments in manufacturing require holes on composite materials, especially on the carbon fiber reinforced polymer (CFRP) with smooth hole periphery, low delamination, burr formation, taper, better circularity, and a high processing speed. Its non-conductive surface (epoxy layering) limits its machining through electrical discharge machining (EDM). To overcome this limitation, an aluminum fixture has been designed to guide the copper electrode of EDM for producing holes on a CFRP sheet of 1 mm thickness at low machining complexity, cost, time, delamination, burr in hole periphery and without affecting the material’s surface quality and performance. Even components with high geometrical complexity can also be drilled through this approach. Here, a multi-quality analysis called grey relational analysis is developed for examining the hole quality attributes, considering peak current, pulse on and off time, and flushing pressure as input parameters. This approach points out the optimum factor level setting and critical parameters (pulse-on time and peak current) that regulate the hole attributes (entrance and exit diameter, circularity, taper, material removal, and tool wear rate). An artificial neural network model has been designed and trained through experimental data sets. This model can also be adopted during the determination of hole quality attributes when the parameter settings are beyond a defined boundary, as the regression analysis value is very close to 1, and model performance is 4.99e-10. Peak current = 4 A, pulse-on time = 25 µs, pulse-off time=25 µs, and flushing pressure = 0.6 MPa were the optimum drilling parameters. In the initial hole, average burr length is 391.75 μm, and delamination of 539.3 μm is noticed. But burr formation is very negligible with delamination of 350.7 μm being observed with uniform circularity (0.979), low taper angle (−0.81354°), and TWR (0.000069 g/min) under optimum drilling conditions through this drilling approach.