A robust variable-structure LQI controller for under-Actuated systems via flexible online adaptation of performance-index weights

This article presents flexible online adaptation strategies for the performance-index weights to constitute a variable structure Linear-Quadratic-Integral (LQI) controller for an underactuated rotary pendulum system. The proposed control procedure undertakes to improve the controller s adaptability, allowing it to flexibly manipulate the control stiffness which aids in efficiently rejecting the bounded exogenous disturbances while preserving the system s closed-loop stability and economizing the overall control energy expenditure. The proposed scheme is realized by augmenting the ubiquitous LQI controller with an innovative online weight adaptation law that adaptively modulates the state-weighting factors of the internal performance index. The weight adaptation law is formulated as a pre-calibrated function of dissipative terms, anti-dissipative terms, and model-reference tracking terms to achieve the desired flexibility in the controller design. The adjusted state weighting factors are used by the Riccati equation to yield the time-varying state-compensator gains

Determining the Role of Transformational Leadership on Firm Performance through Organizational Innovation and Technological Innovation Capabilities

This study aims to address the influential role of TL on FP through organizational innovation and technological capabilities innovation. The unit of analysis in study is individual employees working in software industry of Pakistan. The proposed research method for this study is Quantitative method. Research design of this study is administrative survey method. The current study is performed in the software marketplace which is incredibly energetic industry in Pakistan. Moreover, respondents are chosen randomly from different software companies for avoiding to any kind of biasness. A total of 395 survey questionnaire were collected from the software houses in Pakistan and 370 responses were completed. This study also uses statistically techniques such as reliability and structural equation model techniques for data analysis through AMOS and SPSS software. The empirical results show positive and significant influence of TL on FP. In addition, the findings of this study will help the firms to improve their business performance and improvements of new technological capabilities as well

Determining the Role of Transformational Leadership on Firm Performance through Organizational Innovation and Technological Innovation Capabilities

This study aims to address the influential role of TL on FP through organizational innovation and technological capabilities innovation. The unit of analysis in study is individual employees working in software industry of Pakistan. The proposed research method for this study is Quantitative method. Research design of this study is administrative survey method. The current study is performed in the software marketplace which is incredibly energetic industry in Pakistan. Moreover, respondents are chosen randomly from different software companies for avoiding to any kind of biasness. A total of 395 survey questionnaire were collected from the software houses in Pakistan and 370 responses were completed. This study also uses statistically techniques such as reliability and structural equation model techniques for data analysis through AMOS and SPSS software. The empirical results show positive and significant influence of TL on FP. In addition, the findings of this study will help the firms to improve their business performance and improvements of new technological capabilities as well

Blockchain based auditable access control for distributed business processes

The use of blockchain technology has been proposed to provide auditable access control for individual resources. However, when all resources are owned by a single organization, such expensive solutions may not be needed. In this work we focus on distributed applications such as business processes and distributed workflows. These applications are often composed of multiple resources/services that are subject to the security and access control policies of different organizational domains. Here, blockchains can provide an attractive decentralized solution to provide auditability. However, the underlying access control policies may be overlapping in terms of the component conditions/rules, and simply using existing solutions would result in repeated evaluation of user’s authorization separately for each resource, leading to significant overhead in terms of cost and computation time over the blockchain. To address this challenge, we propose an approach that formulates a constraint optimization problem to generate an optimal composite access control policy. This policy is in compliance with all the local access control policies and minimizes the policy evaluation cost over the blockchain. The developed smart contract(s) can then be deployed to the blockchain, and used for access control enforcement. We also discuss how the access control enforcement can be audited using a game-theoretic approach to minimize cost. We have implemented the initial prototype of our approach using Ethereum as the underlying blockchain and experimentally validated the effectiveness and efficiency of our approach

Coexistent Pseudogout and Mycobacterium avium-intracellulare

Pseudogout is a crystal-induced arthropathy characterized by the deposition of calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid, menisci, or articular cartilage. Although not very common, this entity can be seen in patients with chronic kidney disease (CKD). Septic arthritis due to Mycobacterium avium-intracellulare (MAI) is a rare entity that can affect immunocompromised patients such as those with acquired immunodeficiency syndrome (AIDS) or those who are on immunosuppressive drugs. Here, we describe a 51-year-old female who presented with fever, right knee pain, swelling, warmth, and decreased range of motion for several days. The initial assessment was consistent with pseudogout, with negative bacterial and fungal cultures. However, due to high white blood cell (WBC) count in the synovial fluid analysis, she was empirically started on intravenous (IV) vancomycin and piperacillin-tazobactam and discharged on IV vancomycin and cefepime, while acid-fast bacilli (AFB) culture was still in process. Seventeen days later, AFB culture grew Mycobacterium avium-intracellulare (MAI), and she was readmitted for relevant management. This case illustrates that septic arthritis due to MAI should be considered in the differential diagnosis of septic arthritis in immunocompromised patients

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED).Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health.Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses.Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk factor

Blockchain based auditable access control for business processes with event driven policies

The use of blockchain technology has been proposed to provide auditable access control for individual resources. Unlike the case where all resources are owned by a single organization, this work focuses on distributed applications such as business processes and distributed workflows. These applications are often composed of multiple resources/services that are subject to the security and access control policies of different organizational domains. Here, blockchains provide an attractive decentralized solution to provide auditability. However, the underlying access control policies may have event-driven constraints and can be overlapping in terms of the component conditions/rules as well as events. Existing work cannot handle event-driven constraints and does not sufficiently account for overlaps leading to significant overhead in terms of cost and computation time for evaluating authorizations over the blockchain. In this work, we propose an automata-theoretic approach for generating a cost-efficient composite access control policy. We reduce this composite policy generation problem to the standard weighted set cover problem. We show that the composite policy correctly captures all the local access control policies and reduces the policy evaluation cost over the blockchain. We have implemented the initial prototype of our approach using Ethereum as the underlying blockchain and empirically validated the effectiveness and efficiency of our approach. Ablation studies were conducted to determine the impact of changes in individual service policies on the overall cost

Metaplastic breast carcinoma: Clinicopathological parameters and prognostic profile

Introduction: Metaplastic breast carcinoma (MBC) is defined as breast cancer with a heterologous non-glandular component. MBC is considered a special type of breast cancer with a prognosis that is worse than invasive ductal carcinoma (IDC) of the breast. MBC is the most common breast cancer with a triple-negative profile. Therefore, in this study, we evaluated the clinicopathological parameters, recurrence and survival of MBC in our population.Methods: We conducted a retrospective observational study in the Department of Histopathology at Prince Faisal Oncology Centre, Buraidah, Saudi Arabia, over a period of five years. All cases diagnosed as MBC were included in the study. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) immunohistochemistry (IHC) was performed on representative tissue blocks.Results: Total 183 cases of MBCs were included in the study, out of which 120 cases were excision specimens. The mean age of the patients was 48.84±12.99 years, and the most common age group was between 36 and 50 years of age. Most of the cases were tumor (T) stage T3 (50%), and nodal metastasis was present in 40% of cases. Most cases were grade III (78.7%). ER, PR and HER2/neu positivity was noted in 15.8%, 13.1%, and 9.8% cases, respectively. Follow-up data were available for 70 cases, with a median follow-up period of 4 (1-7) years. Tumor recurrence was noted in 31.4% cases, with a survival rate of 71.4%. Squamous, chondroid, spindle cell differentiation, and matrix production were noted in 70.5%, 7.1%, 13.7%, and 2.2% cases, respectively. A significant association of squamous differentiation was noted with HER2/neu positivity. An inverse association of spindle cell differentiation was seen with axillary metastasis. Survival analysis by Kaplan-Meier revealed a significant association of survival with tumor recurrence.Conclusion: MBC is an important subtype of breast cancer, histopathological identification of which is challenging, owing to varied histological differentiation. We found squamous differentiation to be the most common in MBC, which was associated with HER2/neu positivity. A high recurrence rate of MBC was also observed in our study that was significantly associated with survival

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial