An analysis on the subject of “induced magnetic field effect on stagnation flow of a TiO2-Cu/water hybrid nanofluid over a stretching sheet” has been carried out in this paper. It should be noted ...that hybrid nanofluid consists of two or more types of nanoparticles along with a base fluid and it is used to increase the heat transfer. Furthermore, the non-linear differential equations modeling this issue are included in this article. In order to solve these equations numerically, Runge-Kutta Fehlberg method is used as a numerical method in this problem. The main objective of this paper is to investigate the effects of change in parameters of stretching ratio parameter (A∗), nanoparticles volumetric fractions (∅2), magnetic parameter (β) and reciprocal magnetic Prandtl number (λ) on the functions including velocity, induced magnetic field and temperature for both Cu-water nanofluid and TiO2-Cu/water hybrid nanofluid. Also Lorentz force which is derived from magnetic field is mentioned in this section. In addition, the impacts of (∅2), (β) and (λ) on the profiles of nanofluid and hybrid nanofluid temperature for three categories of nanoparticle shapes named brick, cylinders, and platelets are analyzed. At the end, the influences of (∅2), (β) and (λ) on skin friction coefficient (Cf) and Nusselt number (Nux) for Cu-water nanofluid and TiO2-Cu/water hybrid fluid for different nanoparticles shapes are discussed. In all of these studies it can be seen that applying platelets shaped nanoparticles is more effective.
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•TiO2‐Cu/H2O hybrid nanofluid is incorporated.•Analysis of thermal conductivity of hybrid nanofluid is highlighted.•Different shape factors for nanoparticles are addressed.•Nonlinear differential equations are solved numerically.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
This paper analyzed the boundary layer flow and heat transfer of an incompressible TiO2-water nanoparticle on micropolar fluid with homogeneously suspended dust particles in the presence of thermal ...radiation. Since the nanoparticles have high thermal conductivity coefficient compared to base fluids, so their distribution leads to an increase in the thermal conductivity of the fluids and they are considered to be the main parameters of heat transfer. In the following, nonlinear equations that can describe this problem are presented in this article. These nonlinear equations are numerically analyzed using the Runge-Kutta-Fehlberg method in MAPLE software. The main goal of this paper is to study and analyze the behavior of the velocity profile in two phases of liquid and dust for different values of parameters suction/injection (f0), mass concentration (L), Material (R), Penetrable (Kp), Magnetic (M), Solid volume fraction (φ), fluid particle interaction (β) and also temperature profile effectiveness from radiation parameter (Nr) changes, Eckert number (Ec), Prandtl number (Pr) in two PST and PHF cases for both fluid and dust phases, in which dual behavior of the velocity profile compared to the β changes in the fluid and dust phases and also Lorentz force generated by the magnetic field is also mentioned. Finally, the effect of changes of Kp and M in the presence of β on the coefficient of surface friction, the effect of Ec changes in the presence of Nr and Pr changes in the presence of β on the Nusselt number in two PST and PHF cases and also R changes in the presence of f0, β and M on couple stress has been investigated and analyzed.
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•TiO2 nanoparticle homogeneously suspended in Micropolar fluid•Magnetic field and thermal radiation effect on Micropolar dusty fluid are considered.•The Runge-Kutta-Fehlberg numerical method is employed to solving the nonlinear equations.•Increasing in the value of radiation parameter Nr make the thermal boundary layer thicker.•For increasing the values of Ec the Nusselt number increases for PHF case and decreases for PST.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
What do we know about happiness? What is the essence of happiness? What are the causes of happiness? Is there a difference between individual happiness and collective happiness? Can we measure ...happiness? Let us see if there is a correlation between suicide and happiness?
Andalusian music is the name of the classical music in Morocco. It grown in Andalucia, but we still find it just in Morocco and some other countries of North Africa. A music that related with ...soufisme and Marestans: hospitals at that era. A music which is also called “al-Ala” means the machine. It has 24 “Naoubas”: rythme as much the hours of the day and each Naoubas can be played in just an hour in the day.
It was played for patients in Marestans. This music was played by all the factions of the great Morocco (actual Morocco and Spain) society: including Muslims, Christians and Jews, with a variety of instruments this music did imposed itself, and still one of landmarks of Morocco.
We will talk about the specifities and also the particularities of this kind of chronomusicotherapy.
An analysis on the subject of "induced magnetic field effect on stagnation flow of a TiO2-Cu/water hybrid nanofluid over a stretching sheet" has been carried out in this paper. It should be noted ...that hybrid nanofluid consists of two or more types of nanoparticles along with a base fluid and it is used to increase the heat transfer. Furthermore, the non-linear differential equations modeling this issue are included in this article. In order to solve these equations numerically, Runge-Kutta Fehlberg method is used as a numerical method in this problem. The main objective of this paper is to investigate the effects of change in parameters of stretching ratio parameter (A*), nanoparticles volumetric fractions (Ø2), magnetic parameter (β) and reciprocal magnetic Prandtl number (λ) on the functions including velocity, induced magnetic field and temperature for both Cu-water nanofluid and TiO2-Cu/water hybrid nanofluid. Also Lorentz force which is derived from magnetic field is mentioned in this section. In addition, the impacts of (Ø2), (β) and (λ) on the profiles of nanofluid and hybrid nanofluid temperature for three categories of nanoparticle shapes named brick, cylinders, and platelets are analyzed. At the end, the influences of (Ø2), (β) and (λ) on skin friction coefficient (Cf) and Nusselt number (Nux) for Cu-water nanofluid and TiO2-Cu/water hybrid fluid for different nanoparticles shapes are discussed. In all of these studies it can be seen that applying platelets shaped nanoparticles is more effective.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Metastasis to the spinal column is a common complication of malignancy, potentially causing pain and neurologic injury. An automated system to identify and refer patients with spinal metastases can ...help overcome barriers to timely treatment. We describe the training, optimization and validation of a natural language processing algorithm to identify the presence of vertebral metastasis and metastatic epidural cord compression (MECC) from radiology reports of spinal MRIs.
Reports from patients with spine MRI studies performed between January 1, 2008 and April 14, 2019 were reviewed by a team of radiologists to assess for the presence of cancer and generate a labeled dataset for model training. Using regular expression, impression sections were extracted from the reports and converted to all lower-case letters with all nonalphabetic characters removed. The reports were then tokenized and vectorized using the doc2vec algorithm. These were then used to train a neural network to predict the likelihood of spinal tumor or MECC. For each report, the model provided a number from 0 to 1 corresponding to its impression. We then obtained 111 MRI reports from outside the test set, 92 manually labeled negative and 19 with MECC to test the model's performance.
About 37,579 radiology reports were reviewed. About 36,676 were labeled negative, and 903 with MECC. We chose a cutoff of 0.02 as a positive result to optimize for a low false negative rate. At this threshold we found a 100% sensitivity rate with a low false positive rate of 2.2%.
The NLP model described predicts the presence of spinal tumor and MECC in spine MRI reports with high accuracy. We plan to implement the algorithm into our EMR to allow for faster referral of these patients to appropriate specialists, allowing for reduced morbidity and increased survival.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Increasing evidence demonstrates disparities among patients with differing insurance statuses in the field of spine surgery. However, no pooled analyses have performed a robust review characterizing ...differences in postoperative outcomes among patients with varying insurance types.
A comprehensive literature search of the PUBMED, MEDLINE(R), ERIC, and EMBASE was performed for studies comparing postoperative outcomes in patients with private insurance versus government insurance. Pooled incidence rates and odds ratios were calculated for each outcome and meta-analyses were conducted for 3 perioperative events and 2 types of complications. In addition to pooled analysis, sub-analyses were performed for each outcome in specific government payer statuses.
Thirty-eight studies (5,018,165 total patients) were included. Compared with patients with private insurance, patients with government insurance experienced greater risk of 90-day re-admission (OR 1.84, p<.0001), non-routine discharge (OR 4.40, p<.0001), extended LOS (OR 1.82, p<.0001), any postoperative complication (OR 1.61, p<.0001), and any medical complication (OR 1.93, p<.0001). These differences persisted across outcomes in sub-analyses comparing Medicare or Medicaid to private insurance. Similarly, across all examined outcomes, Medicare patients had a higher risk of experiencing an adverse event compared with non-Medicare patients. Compared with Medicaid patients, Medicare patients were only more likely to experience non-routine discharge (OR 2.68, p=.0007).
Patients with government insurance experience greater likelihood of morbidity across several perioperative outcomes. Additionally, Medicare patients fare worse than non-Medicare patients across outcomes, potentially due to age-based discrimination. Based on these results, it is clear that directed measures should be taken to ensure that underinsured patients receive equal access to resources and quality care.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract Objective To investigate the postoperative morbidity and mortality rate of patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) undergoing elective anterior cervical ...fusion (ACF). Methods The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify adult patients who underwent elective ACF for degenerative spine disease. Major complication rates and in-hospital mortality was compared between three groups – no kidney disease, CKD, and ESRD (dialysis-dependent). A multiple logistic regression analysis was conducted to assess the independent effect of CKD and ESRD on outcome. Results There were 164,097 patients who met inclusion criteria. Among these, 1,047 had CKD (0.64%) and 270 had ESRD (0.16%). After multiple logistic regression analysis, patients with CKD (OR 1.51; 95% CI, 1.13 – 2.01; p=0.005) and ESRD (OR 1.96; 95% CI, 1.20 – 3.21; p=0.007) were significantly more likely to incur in a postoperative complication when compared to patients without kidney disease (the reference group). Compared to patients without kidney disease, patients with CKD did not have higher odds of postoperative mortality (OR 2.25; 95% CI, 0.83 – 6.06; p=0.108). However, in-hospital mortality was 15 times higher for patients with ESRD compared to patients without kidney disease (OR 15.2; 95% CI, 5.67 – 40.88; p<0.001). Conclusion Chronic and end-stage renal disease may significantly increase the risk of postoperative morbidity and mortality after ACF. Future research into preoperative optimization of these patients and on the potential benefits of undergoing surgery until after renal transplantation is warranted.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract Objective To investigate the impact of surgeon volume on inpatient morbidity after 1- and 2-level anterior cervical discectomy and fusion (ACDF). Methods Data from the Nationwide Inpatient ...Sample from 2009 were extracted. All adult patients who underwent an elective 1- or 2-level ACDF for degenerative cervical spine disease were identified. Surgeon volume was analyzed as a continuous and categorical variable (very-low (<12 procedures per year), low (12 – 23), medium (24 – 35), high (36 – 47), and very-high volume (48 or more)). A multivariate logistical regression analysis was performed to calculate the adjusted odds ratios of overall in-hospital and surgical complication occurrence in relation to surgeon volume. Results A total of 11,249 admissions were analyzed. The overall complication rate was 4.7% and the surgical complication rate was 1.2%. Following regression analysis, increasing surgeon volume (evaluated continuously) was independently associated with lower odds of overall complication (OR 0.99; 95% CI, 0.98 – 0.99; p<0.001) and surgical complication development (OR 0.98; 95% CI, 0.97 – 0.99; p=0.004). Very-high volume surgeons (performing 48 or more procedures per year; 4 or more per month) showed a significant decrease in overall complications (OR 0.58; 95% CI, 0.41 – 0.84; p=0.003) and surgical complications (OR 0.52; 95% CI, 0.25 – 0.99; p=0.041) when compared to very-low volume surgeons. Conclusion In this study, increasing surgeon volume was independently associated with significantly lower odds of perioperative complications following 1– and 2-level ACDF. Performing 4 or more procedures per month was associated with the lowest complication rate.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract Objective To investigate the impact of hospital teaching status on the timing of intervention and inpatient morbidity and mortality after surgery for acute spinal cord injury (SCI). Methods ...Data from the Nationwide Inpatient Sample (2002 – 2011) were reviewed. Patients were included if they had a diagnosis of closed vertebral column fracture with SCI, underwent spine surgery, and were admitted urgently or emergently. Early intervention (the day of or the day after admission), inpatient morbidity and mortality rates were compared between patients admitted to teaching versus nonteaching hospitals. Multivariable regression analyses were performed. Results A total of 9,236 patients were identified (mean age 43 years, 82.6% male gender), with 78.7% admitted to a teaching hospital (n=7,272) and 21.3% to a nonteaching hospital (n=1,964). The most common mechanism of injury was a motor vehicle collision (43.9%), while the most common fracture location was between C5 and C7 (35.3%), and 22% of cases were complete SCIs. Following multivariable analysis, teaching hospital status was significantly associated with early intervention (OR 1.12; 95% CI, 1.01 – 1.25), but not with complication development (OR 1.09; 95% CI, 0.98 – 1.23) or mortality (OR 1.19; 95% CI, 0.91 – 1.56). Conclusion In this nationwide study, patients with vertebral column fractures with SCI who were admitted to teaching hospitals were more likely to receive early intervention compared to patients admitted to nonteaching hospitals. Future studies into the long-term implications of admission to teaching versus nonteaching hospitals for patients with SCI are encouraged.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
