Free convection of hybrid nanofluids in a C-shaped chamber under variable heat flux and magnetic field: simulation, sensitivity analysis, and artificial neural networks

In the present investigation, the free convection energFree convection of hybrid nanofluids in a C-shaped chamber under variable heat flux and magnetic field: simulation, sensitivity analysis, and artificial neural networksy transport was studied in a C-shaped tilted chamber with the inclination angle α that was filled with the MWCNT (MultiWall Carbon Nanotubes)-Fe3O4-H2O hybrid nanofluid and it is affected by the magnetic field and thermal flux. The control equations were numerically resolved by the finite element method (FEM). Then, using the artificial neural network (ANN) combined with the particles swarm optimization algorithm (PSO), the Nusselt number was predicted, followed by investigating the effect of parameters including the Rayleigh number (Ra), the Hartmann number (Ha), the nanoparticles concentration (ϕ), the inclination angle of the chamber (α), and the aspect ratio (AR) on the heat transfer rate. The results showed the high accuracy of the ANN optimized by the PSO algorithm in the prediction of the Nusselt number such that the mean squared error in the ANN model is 0.35, while in the ANN model, it was optimized using the PSO algorithm (ANN-PSO) is 0.22, suggesting the higher accuracy of the latter. It was also found that, among the studied parameters with an effect on the heat transfer rate, the Rayleigh number and aspect ratio have the greatest impact on the thermal transmission intensification. The obtained data also showed that a growth of the Hartmann number illustrates a reduction of the Nusselt number for high Rayleigh numbers and the heat transfer rate is almost constant for low Rayleigh number values

Exploration and Explanation of the Rationale of Project-Based Curriculum

Background and Objective:Reflecting on different societies and despite the claim of progress in the fields of education, technology, society, etc., there are still many problems in human relations, civil relations and inefficiency of individuals. With this explanation, the question arises as to whether various advances have not been able to be used in practice. Has the development of education and technology not been in the public and real interests of human beings? Is education not adapted to the needs of society? Have various developments not found operational ground? And perhaps there are many other questions that can be asked about this. But with a little care it can be seen that each of these factors is rooted in a major cause, and that is the type of education and educational goals. The widespread objection of educational theorists is that learners in traditional systems seldom have the opportunity to learn something in-depth through the transfer of subject matter. At the present time, however, efforts should be made to lay the foundation for children's intellectual skills in the very early years of childhood and to shape their personalities so that they can look to their future with an open, independent and selective attitude. To this end, all available potentials and facilities such as teachers, students, parents, peers, learning environment and community around the school should be used to provide the desired indicators as much as possible. The goal of this article is about explain and analysis of project based curriculum. This study has considered rationale of project based learning in different aspects. Methods: In attention to the main goal of research and also rational of curriculum that is defined based on its basics, principles, and messages, so the fivefold questions of research include how defined the philosophical, psychological, and social basics of project based learning and the same time it considered its message and principles. In order to reach to analyze and explain of above aim applied research syntheses in which selected, contextualized, and categorized researches related to project based learning with a regular method. In the next step selected 101 researches which had objective criteria, then based on syntheses principles, rethinking, data rearrangement presented combination of their findings. Findings:Researcher with the help of research and with identifying of philosophical, psychological, and social basics of project based learning and drawing of message and principles of this kind of learning tried to analysis and explain rationale of project based curriculum. Conclusion: A study of previous research has shown that a direct study of project-based learning has not been conducted in the form of a curriculum. Most project-based research has been in the fields of agriculture, architecture, or project management. Although it has been considered in a few cases in formal education, it has been studied more as a teaching method and has dealt with only one element and not the whole curriculum   ===================================================================================== COPYRIGHTS  ©2019 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.  ====================================================================================

The impact of post-operative sepsis on mortality after hospital discharge among elective surgical patients: a population-based cohort study

Our aim in the present study was to assess the mortality impact of hospital-acquired post-operative sepsis up to 1 year after hospital discharge among adult non-short-stay elective surgical patients.We conducted a population-based, retrospective cohort study of all elective surgical patients admitted to 82 public acute hospitals between 1 January 2007 and 31 December 2012 in New South Wales, Australia. All adult elective surgical admission patients who stayed in hospital for ≥4 days and survived to discharge after post-operative sepsis were identified using the Admitted Patient Data Collection records linked with the Registry of Births, Deaths, and Marriages. We assessed post-discharge mortality rates at 30 days, 60 days, 90 days and 1 year and compared them with those of patients without post-operative sepsis.We studied 144,503 survivors to discharge. Of these, 1857 (1.3%) had experienced post-operative sepsis. Their post-discharge mortality rates at 30 days, 60 days, 90 days and 1 year were 4.6%, 6.7%, 8.1% and 13.5% (vs 0.7%, 1.2%, 1.5% and 3.8% in the non-sepsis cohort), respectively (P < 0.0001 for all). After adjustment for patient and hospital characteristics, post-operative sepsis remained independently associated with a higher mortality risk (30-day mortality HR 2.75, 95% CI 2.14-3.53; 60-day mortality HR 2.45, 95% CI 1.94-3.10; 90-day mortality HR 2.31, 95% CI 1.85-2.87; 1-year mortality HR 1.71, 95% CI 1.46-2.00). Being older than 75 years of age (HR 3.50, 95% CI 1.56-7.87) and presence of severe/very severe co-morbidities as defined by Charlson co-morbidity index (severe vs normal HR 2.05, 95% CI 1.45-2.89; very severe vs normal HR 2.17, 95% CI 1.49-3.17) were the only other significant independent predictors of increased 1-year mortality.Among elective surgical patients, post-operative sepsis is independently associated with increased post-discharge mortality up to 1 year after hospital discharge. This risk is particularly high in the first month, in older age patients and in the presence of severe/very severe co-morbidities. This high-risk population can be targeted for interventions.Lixin Ou, Jack Chen, Ken Hillman, Arthas Flabouris, Michael Parr, Hassan Assareh and Rinaldo Bellom

Pathology of the new curriculum of electrotechnical field of the technical and vocational education branch (Case study:Yazd province)

Background and Objective:  One of the most important parts of the educational system of any country is its technical and vocational education, and this type of education is one of the basic policies of countries to train skilled and semi-skilled efficient manpower. Training of human resources in order to develop efficient and effective human resources is one of its important tasks. The role of technical and vocational education in comparison with theoretical education is very vital in the sense that it provides the manpower needed by countries at the pre-university level. Because the main core of technical and vocational education and skills training is the relationship between these trainings and the labor market. Since there is an increasing possibility of development in the sectors of industry, agriculture and services in the country, education and training of human resources in the technical and professional fields is one of the basic requirements of the country's development. As stated in the report of the United Nations Educational, Scientific and Cultural Organization (UNESCO) for sustainable development, human-centered development and the key to it is technical and vocational education. The purpose of this study was to pathology of the new curriculum of electrotechnical field of the technical and vocational education branch. Methods:  This research is practical in purpose and is done using the mixed-research method. The statistical population includes all of the educational managers, electrotechnical teachers and 11th grade students of electrotechnical field in Yazd province at the academic year 96-97. A census method was used to select the quantitative part sample and the qualitative part sample selected with a purposive sampling method. In order to gather data, three researcher-made questionnaires, observation and semi-structured interview was used. The questionnaires’s validity was confirmed by 4 professors. Theirs reliability was obtained by Cronbach’s alpha method and confirmed. data was analyzed using descriptive and inferential statistics. Findings:The results showed that the electrotechnical new curriculum was estimated relatively desirable from the viewpoint of educational managers and students and relatively undesirable from the viewpoint of teachers. But the workshop equipment and educational facilities, the teachers’ awareness of the upper documents and guidances and in-service course educations was estimated relatively undesirable. Also the instructional time, students’learning activities and students’ readiness from the viewpoint of the teachers was estimated relatively undesirable. Conclusion: In the present study, the new curriculum of technical and vocational education of secondary school in the field of electrotechnics in Yazd province was studied both in terms of Klein curriculum elements and other influential elements. Then, based on qualitative observations and interviews, the current situation of each component was described and some of the most important causes of injury in each component were mentioned.   ===================================================================================== COPYRIGHTS  ©2019 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.  ====================================================================================

Change Point Estimation in Monitoring Survival Time

Precise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in a Bayesian framework. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the mean survival time of patients who underwent cardiac surgery. The data are right censored since the monitoring is conducted over a limited follow-up period. We capture the effect of risk factors prior to the surgery using a Weibull accelerated failure time regression model. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted survival time CUSUM control charts for different magnitude scenarios. The proposed estimator shows a better performance where a longer follow-up period, censoring time, is applied. In comparison with the alternative built-in CUSUM estimator, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities are enhanced when probability quantification, flexibility and generalizability of the Bayesian change point detection model are also considered

Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

Background: Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia. Methods: A population-based study using all admitted patients (aged 18–90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002–2009. Poisson mixed models were used to derive adjusted rate ratios (IRR) in presence of patient and hospital characteristics. Results: Amongst, 3,331,677 patients, the incidence of HA-VTE was 11.45 per 1000 patients and one in ten who developed HA-VTE died in hospital. HA-VTE incidence, initially rose, but subsequently declined, whereas case fatality rate consistently declined by 22 % over the study period. Surgical patients were 128 % (IRR = 2.28, 95 % CI: 2.19–2.38) more likely to develop HA-VTE, but had similar case fatality rates compared to medical patients. Private hospitals, in comparison to public hospitals had a higher incidence of HA-VTE (IRR = 1.76; 95 % CI: 1.42–2.18) for medical patients. However, they had a similar incidence (IRR = 0.91; 95 % CI: 0.75–1.11), but a lower mortality (IRR = 0.59; 95 % CI: 0.47–0.75) amongst surgical patients. Smaller public hospitals had a lower HA-VTE incidence rate compared to larger hospitals (IRR 1.71). Hospitals with a lower reported HA-VTE incidence tended to have a higher HA-VTE case fatality rate. Conclusion: Despite the decline in HA-VTE incidence and case fatality, there were large variations in incidents between medical and surgical patients, public and private hospitals, and different hospital groups. The causes of such differences warrant further investigation and may provide potential for targeted interventions and quality improvement initiatives.Hassan Assareh, Jack Chen, Lixin Ou, Ken Hillman and Arthas Flabouri

Rate of venous thromboembolism among surgical patients in Australian hospitals: a multicentre retrospective cohort study

OBJECTIVES: Despite the burden of venous thromboembolism (VTE) among surgical patients on health systems in Australia, data on VTE incidence and its variation within Australia are lacking. We aim to explore VTE and subsequent mortality rates, trends and variations across Australian acute public hospitals. SETTING: A large retrospective cohort study using all elective surgical patients in 82 acute public hospitals during 2002-2009 in New South Wales, Australia. PARTICIPANTS: Patients underwent elective surgery within 2 days of admission, aged between 18 and 90 years, and who were not transferred to another acute care facility; 4 362 624 patients were included. OUTCOME MEASURES: VTE incidents were identified by secondary diagnostic codes. Poisson mixed models were used to derive adjusted incidence rates and rate ratios (IRR). RESULTS: 2/1000 patients developed postoperative VTE. VTE increased by 30% (IRR=1.30, CI 1.19 to 1.42) over the study period. Differences in the VTE rates, trends between hospital peer groups and between hospitals with the highest and those with the lowest rates were significant (between-hospital variation). Smaller hospitals, accommodated in two peer groups, had the lowest overall VTE rates (IRR=0.56:0.33 to 0.95; IRR=0.37:0.23 to 0.61) and exhibited a greater increase (64% and 237% vs 19%) overtime and greater between-hospital variations compared to larger hospitals (IRR=8.64:6.23 to 11.98; IRR=8.92:5.49 to 14.49 vs IRR=3.70:3.32 to 4.12). Mortality among patients with postoperative VTE was 8% and remained stable overtime. No differences in post-VTE death rates and trends were seen between hospital groups; however, larger hospitals exhibited less between-hospital variations (IRR=1.78:1.30 to 2.44) compared to small hospitals (IRR>23). Hospitals performed differently in prevention versus treatment of postoperative VTE. CONCLUSIONS: VTE incidence is increasing and there is large variation between-hospital and within-hospital peer groups suggesting a varied compliance with VTE preventative strategies and the potential for targeted interventions and quality improvement opportunities.Hassan Assareh, Jack Chen, Lixin Ou, Stephanie J Hollis, Kenneth Hillman, Arthas Flabouri

Geographic variation of Failure-to-Rescue in public acute hospitals in New South Wales, Australia

Despite the wide acceptance of Failure-to-Rescue (FTR) as a patient safety indicator (defined as the deaths among surgical patients with treatable complications), no study has explored the geographic variation of FTR in a large health jurisdiction. Our study aimed to explore the spatiotemporal variations of FTR rates across New South Wales (NSW), Australia. We conducted a population-based study using all admitted surgical patients in public acute hospitals during 2002-2009 in NSW, Australia. We developed a spatiotemporal Poisson model using Integrated Nested Laplace Approximation (INLA) methods in a Bayesian framework to obtain area-specific adjusted relative risk. Local Government Area (LGA) was chosen as the areal unit. LGA-aggregated covariates included age, gender, socio-economic and remoteness index scores, distance between patient residential postcode and the treating hospital, and a quadratic time trend. We studied 4,285,494 elective surgical admissions in 82 acute public hospitals over eight years in NSW. Around 14% of patients who developed at least one of the six FTR-related complications (58,590) died during hospitalization. Of 153 LGAs, patients who lived in 31 LGAs, accommodating 48% of NSW patients at risk, were exposed to an excessive adjusted FTR risk (10% to 50%) compared to the state-average. They were mostly located in state's centre and western Sydney. Thirty LGAs with a lower adjusted FTR risk (10% to 30%), accommodating 8% of patients at risk, were mostly found in the southern parts of NSW and Sydney east and south. There were significant spatiotemporal variations of FTR rates across NSW over an eight-year span. Areas identified with significantly high and low FTR risks provide potential opportunities for policy-makers, clinicians and researchers to learn from the success or failure of adopting the best care for surgical patients and build a self-learning organisation and health system.Hassan Assareh, Lixin Ou, Jack Chen, Kenneth Hillman, Arthas Flabouris, Stephanie J. Holli

Comparison of Allelopathic Effect of Zataria Multiflora on the Germination and Growth Features of Cymbopogen Olivieri and Stipa Arabica Seedlings 1

Abstract: Application of native and genetically modified species is one of the main approaches to revival and modification of ranches. But in the mean time, it should be noted that those species that are compatible to each other should be used in vegetation expansion projects. Shiraz oregano (Zataria Multiflora) is from among those plants which could cause allelopathic effects due to their various chemical compositions. Hence, due to profusion of this plant throughout the Khalil Beig ranch of Arsanjan, and the considerable amount of Stipa Arabica and Cymbopogen Olivieri in the adjacent areas to this ranch that are consumed by the livestock, it was decided to study the possibility of applying the aforesaid species for expansion of vegetation throughout the Khalil Beig ranch. To this end, an investigation was conducted in the greenhouse environment using the soil taken from the habitat of Shiraz oregano. Underground and aerial parts of this plant were collected and extracts of 25, 50, 75 and 100 percent as well as 50 and 100 % densities were obtained from aerial and underground parts, respectively. Also, a bittern was considered as the prototype (distilled water). Seeds of Sarabica and C.olivieri were cultivated in flower pots containing the soils of oregano habitat and were irrigated using the abovementioned bitterns throughout the entire study. The investigations lasted for 5 weeks and the germination and growth rates of seedlings were recorded on a daily basis. In the end, characteristics of both species such as percentage of germination, length of stem, length of root, wet weight of stem, wet weight of root, dry weight of stem and dry weight of root affected by different density percentages of Shiraz oregano extract were analyzed through variance analysis. The Duncan test was applied for comparison of means. The results represented the preventive effect of compositions existing in Shiraz oregano on the studied features and the less vulnerability of S.arabica as compared with the C.olivieri