Nonalcoholic steatohepatitis (NASH) is the progressive form of nonalcoholic fatty liver disease. Our aim was to estimate the total economic burden of NASH and advanced NASH in the United States. We ...constructed lifetime Markov models for all stages of NASH and a separate model to specifically identify the increased burden of advanced NASH (fibrosis stage >3). The models comprised patients aged 18+, who moved through seven different health states. We used a lifetime horizon with 1‐year cycles for each transition. Cohort size was estimated using US population data, and prevalence and incidence rates were obtained from the literature. Transition probabilities between states were derived from meta‐analyses. Costs included inpatient, outpatient, professional services, emergency department, and drug costs, which were obtained from the Center for Medicare and Medicaid Services Fee Schedule 2017 and published data. All future costs were discounted at an annual rate of 3%. Our models estimated that there are 6.65 million adults (18+ years old) with NASH in the United States and that there were 232,000 incident cases in 2017. Lifetime costs of all NASH patients in the United States in 2017 will be $222.6 billion, and the cost of the advanced NASH population will be $95.4 billion. Conclusion: NASH, especially advanced NASH, is associated with high lifetime economic burden; in the absence of treatment, the total direct costs of illness for these patients will continue to grow, and these costs would be even greater if the societal costs are included.
Premature drainage increases the amount of used saline water, increasing the transportation and purification costs of saline water. On the other hand, postmature drainage increases the salt ...concentration of the brine, which deteriorates the solar still performance and may cause salt perceptions. The present study aims to identify appropriate brine conditions for the drainage process and propose a layout for an automatic drainage process. Therefore, the effect of brine’s salt concentration and temperature on a pyramid solar still’s productivity is being investigated. Seven salt concentrations were investigated, and the brine and metrological conditions were measured. The results show that the higher the salt concentration, the lower the solar still productivity. The daily yield of solar still ranges 5778–4061 g/m
2
d for feedwater
salinity
0.15–134 ppt, respectively. Therefore, the novelty or recommendation of this study is that if the brine salinity reaches 127 ppt, the brine should be drained to avoid the precipitate, regardless of the stored thermal energy in the brine. Also, if the brine salinity reaches 118 ppt and the difference between its temperature and ambient temperature is about 1℃, the brine should be drained.
Abstract
Fuzzy techniques are approximations used to model phenomena or decisions for which mathematical precision is impractical or impossible. In this work, we have developed a new approach to ...modeling visual performance using fuzzy techniques. Fuzzy techniques allow us to include variables that are not included in the current visual performance model. We also introduce the term critical contrast, which we define as the contrast at which a change in the rating of visual performance occurs. The comparison between our fuzzy relative visual performance model and the relative visual performance model shows close agreement for most conditions. A digital tool was also developed and is available for use. This will make the proposed metric simple to use and implement.
The shear viscosity to entropy ratio (eta/s) is estimated for the hot and dense QCD matter created in Au+Au collisions at BNL Relativistic Heavy Ion Collider (square roots_{NN}=200 GeV). A very low ...value is found; eta/s approximately 0.1, which is close to the conjectured lower bound (1/4pi). It is argued that such a low value is indicative of thermodynamic trajectories for the decaying matter which lie close to the QCD critical end point.
In this work, a comparison between different potential natural ventilation strategies used in different climate zones are investigated. As an example of moderate summer climate zone, London city has ...been selected, while Dubai city has been selected as a warm winter climate zone. The influence of external wind speed and pressure was studied using Autodesk Flow Design Software. Then CFD simulations have been generated inside the building using IES Virtual Environment software to study the indoor ventilation (Micro-Flow analysis) and to demonstrate the success of the adopted potential strategies in enhancing the indoor climate conditions. Hourly Analysis Program (HAP) was used to calculate the cooling/heating load of the building and to check the energy savings. The results demonstrated that comfort conditions within the interior space of the building were met during certain months of the year using passive heating/cooling strategies alone (without the need of HVAC system). HAP energy modeling results showed that the annual space cooling for Dubai model dropped from almost 58,000 kW per year to almost 42,000 kW with a total energy savings of 18.6% (including all energy consumption parameters). On the other hand, London model results showed that the annual interior space heating dropped from almost 36,000 kW to almost 28,000 kW with a total energy savings of 16.4%.
This work is executed to predict the variation in global temperature and greenhouse gas (GHG) emissions resulting from climate change and global warming, taking into consideration the natural climate ...cycle. A mathematical model was developed using a Recurrent Neural Network (RNN) with Long–Short-Term Memory (LSTM) model. Data sets of global temperature were collected from 800,000 BC to 1950 AD from the National Oceanic and Atmospheric Administration (NOAA). Furthermore, another data set was obtained from The National Aeronautics and Space Administration (NASA) climate website. This contained records from 1880 to 2019 of global temperature and carbon dioxide levels. Curve fitting techniques, employing Sin, Exponential, and Fourier Series functions, were utilized to reconstruct both NOAA and NASA data sets, unifying them on a consistent time scale and expanding data size by representing the same information over smaller periods. The fitting quality, assessed using the R-squared measure, ensured a thorough process enhancing the model's accuracy and providing a more precise representation of historical climate data. Subsequently, the time-series data were converted into a supervised format for effective use with the LSTM model for prediction purposes. Augmented by the Mean Squared Error (MSE) as the analyzed loss function, normalization techniques, and refined data representation from curve fitting the LSTM model revealed a sharp increase in global temperature, reaching a temperature rise of 4.8 °C by 2100. Moreover, carbon dioxide concentrations will continue to boom, attaining a value of 713 ppm in 2100. In addition, the findings indicated that the RNN algorithm (LSTM model) provided higher accuracy and reliable forecasting results as the prediction outputs were closer to the international climate models and were found to be in good agreement. This study contributes valuable insights into the trajectory of global temperature and GHG emissions, emphasizing the potential of LSTM models in climate prediction.
Diffuse large B-cell lymphoma (DLBCL) is the most common adult non-Hodgkin lymphoma (NHL) and is highly invasive, with a poor prognosis. The main clinical treatment for DLBCL involves chemotherapy or ...a combination of chemotherapy and targeted drugs. CD56 expression is considered as an indicator of poor prognosis in patients with acute myeloid leukemia and anaplastic large cell lymphoma; however, its role in DLBCL remains unclear. We report on a patient with CD56-positive DLBCL/leukemia with BCL6/MYC double-hit, and DDX3X, LRP1B, SIN3A, and GNA13 gene mutations (stage IVA, prognostic index aaIPI = 2 points). The patient was treated with cyclophosphamide and prednisone pre-chemotherapy plus R-Hyper-CVAD AB and DA-EPOCH regimens. Lumbar puncture combined with intrathecal injection was performed to prevent central nervous system infiltration during hospitalization, and complete remission was confirmed. We also reviewed the literature to clarify the relevance of the unique clinical features associated with this case.
Background & Aims
Currently, standard of care (SOC) treatment for NASH is limited to lifestyle modifications. Drug regimens are being evaluated currently. We assessed the impact of a short‐term ...hypothetical treatment on clinical outcomes of NASH.
Methods
Markov models estimated differences in outcomes between SOC and 2 hypothetical NASH treatments (A and B). We modelled 10 000 50‐year‐old biopsy‐proven NASH patients over lifetime horizon. Health states included NASH with fibrosis (F1‐F3), cirrhosis, hepatocellular carcinoma, liver transplant and mortality. Fibrosis Regression Factor (FRF) variable modelled the probability of 1‐3 stage fibrosis improvement with treatment. Annual probability of treatment (ATP) ranged from 10%‐70%. Treatment success was defined as regression to fibrosis, whereas failure was defined as progression to stages beyond cirrhosis. In treatment‐A, successful treatment was followed by a maintenance regimen which stopped disease progression. After a successful treatment‐B, patients remained at risk of disease progression. Differences in outcomes were calculated between both treatments and SOC models. We conducted a probabilistic sensitivity analysis.
Results
At 10% to 70% ATP, treatment‐A averts 353 to 782 liver transplants and 1277 to 2381 liver‐related deaths relative to SOC. Treatment‐B averts 129 to 437 liver transplants and 386 to 1043 liver‐related deaths. Sensitivity analysis shows our model is robust in estimating liver‐related mortality and LTs averted, but is sensitive when estimating QALYs gained.
Conclusions
With a small annual probability of treatment and FRF = 1, a 2‐year treatment followed by maintenance of histologic improvement for patients would be highly beneficial relative to short‐term treatment alone.
Background
Abu Dhabi, a part of the United Arab Emirates, is situated in an arid region where water scarcity is a significant concern. The residential sector in Abu Dhabi consumes a large portion of ...the available water resources, leading to a critical need for effective water management strategies. This study aims to understand the relationship between water tariffs and water consumption in the residential sector in Abu Dhabi. It employs an integrated fuzzy logic model, a form of artificial intelligence, to assess the impact of water tariffs on water consumption. The model includes variables such as water tariffs, the level of water awareness, the level of water behavior, and the level of technology use. The objective of these variables is to evaluate their impact on the water-saving index, which represents the ratio of daily water consumption per capita in Abu Dhabi to the global average.
Results
The findings of this study, based on a survey measuring the level of water awareness, behavior, and technology use, revealed a potential strategy for reducing water consumption in Abu Dhabi’s residential sector. It was observed that increasing water tariffs, while maintaining current levels of water awareness, behavior, and technology use, could lead to a reduction in water consumption. However, it was also found that the impact of further tariff increases on water conservation diminishes after a certain threshold, indicating the necessity of a balanced approach in tariff adjustment. Interestingly, the study also highlights that Abu Dhabi residents demonstrate high levels of water behavior and technology use, indicating a positive trend toward water conservation.
Conclusions
This study emphasizes the importance of increasing water awareness among Abu Dhabi residents as a means to foster sustainable water consumption practices. While water tariffs can contribute to reductions in water consumption, the effects tend to decrease beyond a certain point. Therefore, a comprehensive approach involving water tariffs, increased water awareness, and the adoption of water-saving technologies may be the most effective strategy for water conservation. The insights from this study extend beyond Abu Dhabi and offer valuable guidance for addressing water conservation challenges worldwide. It highlights the importance of adopting a multi-faceted approach in water management, and the potential for such strategies to have international relevance in the pursuit of sustainable water consumption.
This work proposes implementation of a passive heat transfer enhancement technique in MEMS two-fluid parallel flow heat exchangers as well as model based investigation of the same; the technique ...involves embedding square in-line pin-fins in the microchannels of the heat exchanger. Model based study is conducted using MEMS two-fluid heat exchangers, with and without pin fins, for a wide range of Reynolds number and two heat capacity ratios. With increase in Reynolds number, the effectiveness of heat exchangers with pin fins increases in comparison with those without pin fins for all heat capacity ratios; moreover, at low Reynolds number the effectiveness of both types of heat exchangers are equal. The power consumption in heat exchangers with pin-fins is higher than in those without pin-fins; the difference in the power consumption increases with increase in Reynolds number irrespective of the heat capacity ratio. This enhancement technique allows MEMS two-fluid parallel flow heat exchangers operate at higher throughput without compromising the effectiveness. For purposes of simulation, microchannel dimensions are kept at 150 μm (width) by 150 μm (height) by 2 cm (length) and pin fin dimensions are held at 75 μm (width) by 500 μm (pitch) while the Reynolds number is varied between 50 and 1500 for heat capacity ratios of unity and 0.5. For the cases considered for simulation, the maximum increase in effectiveness, relative to the baseline case, achieved is 84% and 66% for balanced and unbalanced flow conditions, respectively.
Display omitted
•Square pin-fins embedded in microchannels for heat transfer enhancement of MEMS heat exchangers.•Simulations conducted for Reynolds number from 50 to 1500 and heat capacity ratios of 1 and 0.5.•High effectiveness possible without compromising flow rate and size and weight of heat exchanger.•Penalty of approach is increased pumping power.
PDF
