Bali Tour Object Visualization Using Multimedia Asymetrix Toolbook 4.0

Multimedia is a concept and new technology in the field of information technology. Where text, images, sound, animation and video incorporated into the computer to be stored, processed and presented on a linear or interactive.The Birth of Multimedia technology is a result of the advancement of electronic technology, computers and software. So with this multimedia technology will change the human task becomes easier

An enhancement to the Bees Algorithm with slope angle computation and Hill Climbing Algorithm and its applications on scheduling and continuous-type optimisation problem

This paper focuses on improvements to the Bees Algorithm (BA) with slope angle computation and Hill Climbing Algorithm (SACHCA) during the local search process. First, the SAC was employed to determine the inclination of the current sites. Second, according to the slope angle, the HCA was utilised to guide the algorithm to converge to the local optima. This enabled the global optimum of the given problem to be found faster and more precisely by focusing on finding the available local optima first before turning the attention on the global optimum. The proposed enhancements to the BA have been tested on continuous-type benchmark functions and compared with other optimisation techniques. The results show that the proposed algorithm performed better than other algorithms on most of the benchmark functions. The enhanced BA performs better than the basic BA, in particular on higher dimensional and complex optimisation problems. Finally, the proposed algorithm has been used to solve the single machine scheduling problem and the results show that the proposed SAC and HCA-BA outperformed the basic BA in almost all the considered instances, in particular when the complexity of the problem increases

Insights into mantle-type volatiles contribution from dissolved gases in artesian waters of the Great Artesian Basin, Australia

The geochemical features of the volatiles dissolved in artesian thermal waters discharged over three basins (Millungera, Galilee and Cooper basin) of the Australian Great Artesian Basin (GAB) consistently indicate the presence of fluids from multiple gas sources located in the crust (e.g. sediments, oil reservoirs, granites) as well as minor but detectable contributions of mantle/magma-derived fluids. The gases extracted from 19 water samples and analyzed for their chemical and isotopic composition exhibit amounts of CO up to about 340mlSTP/L marked by a δC (Total Dissolved Carbon) ranging from -16.9 to +0.18‰ vs PDB, while CH concentrations vary from 4.4×10 to 4.9mlSTP/L. Helium contents were between 9 and >2800 times higher than equilibrium with Air Saturated Water (ASW), with a maximum value of 0.12mlSTP/L. Helium isotopic composition was in the 0.02-0.21 Ra range (Ra = air-normalized He/He ratio). The three investigated basins differ from each other in terms of both chemical composition and isotopic signatures of the dissolved gases whose origin is attributed to both mantle and crustal volatiles. Mantle He is present in the west-central and hottest part of the GAB despite no evidence of recent volcanism. We found that the partial pressure of helium, significantly higher in crustal fluids than in mantle-type volatiles, enhances the crustal He signature in the dissolved gases, thus masking the original mantle contribution. Neotectonic activity involving deep lithospheric structures and magma intrusions, highlighted by recent geophysical investigations, is considered to be the drivers of mantle/magmatic volatiles towards the surface. The results, although pertaining to artesian waters from a vast area of >542,000km, provide new constraints on volatile injection, and show that fluids' geochemistry can provide additional and independent information on the geo-tectonic settings of the Great Artesian Basin and its geothermal potential

Equivalence between free quantum particles and those in harmonic potentials and its application to instantaneous changes

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedIn quantum physics the free particle and the harmonically trapped particle are arguably the most important systems a physicist needs to know about. It is little known that, mathematically, they are one and the same. This knowledge helps us to understand either from the viewpoint of the other. Here we show that all general time-dependent solutions of the free-particle Schrodinger equation can be mapped to solutions of the Schrodinger equation for harmonic potentials, both the trapping oscillator and the inverted `oscillator'. This map is fully invertible and therefore induces an isomorphism between both types of system, they are equivalent. A composition of the map and its inverse allows us to map from one harmonic oscillator to another with a different spring constant and different center position. The map is independent of the state of the system, consisting only of a coordinate transformation and multiplication by a form factor, and can be chosen such that the state is identical in both systems at one point in time. This transition point in time can be chosen freely, the wave function of the particle evolving in time in one system before the transition point can therefore be linked up smoothly with the wave function for the other system and its future evolution after the transition point. Such a cut-and-paste procedure allows us to describe the instantaneous changes of the environment a particle finds itself in. Transitions from free to trapped systems, between harmonic traps of different spring constants or center positions, or, from harmonic binding to repulsive harmonic potentials are straightforwardly modelled. This includes some time dependent harmonic potentials. The mappings introduced here are computationally more efficient than either state-projection or harmonic oscillator propagator techniques conventionally employed when describing instantaneous (non-adiabatic) changes of a quantum particle's environmentPeer reviewe

Vortices and chirality of magnetostatic modes in quasi-2D ferrite disk particles

In this paper we show that the vortex states can be created not only in magnetically soft "small" (with the dipolar and exchange energy competition) cylindrical dots, but also in magnetically saturated "big" (when the exchange is neglected) cylindrical dots. A property associated with a vortex structure becomes evident from an analysis of confinement phenomena of magnetic oscillations in a ferrite disk with a dominating role of magnetic-dipolar (non-exchange-interaction) spectra. In this case the scalar (magnetostatic-potential) wave functions may have a phase singularity in a center of a dot. A non-zero azimuth component of the flow velocity demonstrates the vortex structure. The vortices are guaranteed by the chiral edge states of magnetic-dipolar modes in a quasi-2D ferrite disk

Massive right atrial myxoma presenting as syncope and exertional dyspnea: case report

Primary heart neoplasms are rare occurring with an estimated incidence of 0.0017-0.19%. Myxoma is the most prevalent primary heart tumor. The right atrium is an unusual localization, occurring only in 15-20% of myxoma cases. We report a rare case of a massive right atrial myxoma causing tricuspid valve obstruction and presenting as syncope and exertional dyspnea. This case illustrates the influence of myxoma's size, position and mobility as well as patient's body posture and respiration to the development of signs and symptoms. Three-dimensional echocardiography proved useful in surgery planning, allowing a better definition of the tumor outline and attachment

Risk Levels and Adverse Clinical Outcomes Among Patients With Nonvalvular Atrial Fibrillation Receiving Oral Anticoagulants

IMPORTANCE: The CHA(2)DS(2)-VASc score (calculated as congestive heart failure, hypertension, age 75 years and older, diabetes, stroke or TIA, vascular disease, age 65 to 74 years, and sex category) is the standard for assessing risk of stroke and systemic embolism and includes age and thromboembolic history. To our knowledge, no studies have comprehensively evaluated safety and effectiveness outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants according to independent, categorical risk strata. OBJECTIVE: To evaluate the incidence of key adverse outcomes among patients with nonvalvular atrial fibrillation receiving oral anticoagulants by CHA(2)DS(2)-VASc risk score range, thromboembolic event history, and age group. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a retrospective claims data analysis using combined data sets from 5 large health claims databases. Eligible participants were adult patients with nonvalvular atrial fibrillation who initiated oral anticoagulants. Data were analyzed between January 2012 and June 2019. EXPOSURE: Initiation of oral anticoagulants. MAIN OUTCOMES AND MEASURES: We observed clinical outcomes (including stroke or systemic embolism, major bleeding, and a composite outcome) on treatment through study end, censoring for discontinuation of oral anticoagulants, death, and insurance disenrollment. The population was stratified by CHA(2)DS(2)-VASc risk score; history of stroke, systemic embolism, or transient ischemic attack; and age groups. We calculated time to event, incidence rates, and cumulative incidence for outcomes. RESULTS: We identified 1 141 097 patients with nonvalvular atrial fibrillation; the mean (SD) age was 75.0 (10.5) years, 608 127 patients (53.3%) were men, and over 1 million were placed in the 2 highest risk categories (high risk 1, 327 766 participants; high risk 2, 688 449 participants). Deyo-Charlson Comorbidity Index scores ranged progressively alongside CHA(2)DS(2)-VASc risk score strata (mean [SD] scores: low risk, 0.4 [1.0]; high risk 2, 4.1 [2.9]). The crude incidence of stroke and systemic embolism generally progressed alongside risk score strata (low risk, 0.25 events per 100 person-years [95% CI, 0.18-0.34 events]; high risk 2, 3.43 events per 100 person-years [95% CI, 3.06-4.20 events]); patients at the second-highest risk strata with thromboembolic event history had higher stroke incidence vs patients at the highest risk score strata without event history (2.06 events per 100 person-years [95% CI, 2.00-3.12 events] vs 1.18 events per 100 person-years [95% CI, 1.14-1.30 events]). Major bleeding and composite incidence also increased progressively alongside risk score strata (major bleeding: low risk, 0.68 events per 100 person-years [95% CI, 0.56-0.82 events]; high risk 2, 6.29 events per 100 person-years [95% CI, 6.21-6.62 events]; composite incidence: 1.22 events per 100 person-years [95% CI, 1.06-1.41 events]; high risk 2, 10.67 events per 100 person-years [95% CI, 10.26-11.48 events]). The 12-month cumulative incidence proportions for stroke and systemic embolism, major bleeding, and composite outcomes progressed alongside risk score strata (stroke or systemic embolism, 0.30%-1.85%; major bleeding, 0.55%-5.55%; composite, 1.05%-8.23%). Age subgroup analysis followed similar trends. CONCLUSIONS AND RELEVANCE: The observed incidence of stroke or systemic embolism and major bleeding events generally conformed to an expected increasing incidence by risk score, adding insight into the importance of specific risk score range, thromboembolic event history, and age group strata. These results can help inform clinical decision-making, research, and policy

Lymph node metastasis in grossly apparent clinical stage Ia epithelial ovarian cancer: Hacettepe experience and review of literature

Background Lymphadenectomy is an integral part of the staging system of epithelial ovarian cancer. However, the extent of lymphadenectomy in the early stages of ovarian cancer is controversial. The objective of this study was to identify the lymph node involvement in unilateral epithelial ovarian cancer apparently confined to the one ovary (clinical stage Ia). Methods A prospective study of clinical stage I ovarian cancer patients is presented. Patient's characteristics and tumor histopathology were the variables evaluated. Results Thirty three ovarian cancer patients with intact ovarian capsule were evaluated. Intraoperatively, neither of the patients had surface involvement, adhesions, ascites or palpable lymph nodes (supposed to be clinical stage Ia). The mean age of the study group was 55.3 ± 11.8. All patients were surgically staged and have undergone a systematic pelvic and paraaortic lymphadenectomy. Final surgicopathologic reports revealed capsular involvement in seven patients (21.2%), contralateral ovarian involvement in two (6%) and omental metastasis in one (3%) patient. There were two patients (6%) with lymph node involvement. One of the two lymph node metastasis was solely in paraaortic node and the other metastasis was in ipsilateral pelvic lymph node. Ovarian capsule was intact in all of the patients with lymph node involvement and the tumor was grade 3. Conclusion In clinical stage Ia ovarian cancer patients, there may be a risk of paraaortic and pelvic lymph node metastasis. Further studies with larger sample size are needed for an exact conclusion.PubMedWoSScopu

Effectiveness and Safety of Apixaban Versus Warfarin Among Older Patients with Venous Thromboembolism with Different Demographics and Socioeconomic Status

Introduction Impact of demographics and socioeconomic status (SES) on anticoagulant treatment outcomes among patients with venous thromboembolism (VTE) is not well understood. This study evaluated risks of recurrent VTE, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB) among older patients with VTE initiating apixaban or warfarin stratified by demographics and SES. Methods Adult patients (≥ 65 years) who initiated apixaban or warfarin after a VTE event were selected from the US CMS Medicare database (September 2014–December 2017). Stabilized inverse probability treatment weighting (IPTW) was used to balance patient characteristics between treatment cohorts. Patients were stratified by age, gender, race, and SES. For each subgroup, Cox proportional hazard models were used to evaluate if there was a significant interaction (p \u3c 0.10) between treatment and subgroup for recurrent VTE, MB, and CRNMB. Results In total, 22,135 apixaban and 45,840 warfarin patients with VTE were included. Post-IPTW, patient characteristics were balanced between treatment cohorts. In older patients, apixaban treatment was associated with significantly lower risks of recurrent VTE (hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.52–0.79), MB (HR 0.65; 95% CI 0.57–0.75), and CRNMB (HR 0.79; 95% CI 0.75–0.85) versus warfarin. When stratified by demographics and SES, higher incidence rates of recurrent VTE, MB, and CRNMB were observed for black vs white patients and patients with lower vs higher SES. Comparison of apixaban with warfarin by different demographic and SES subgroups showed generally consistent results as the overall analysis. For most subgroups, no significant interaction was observed between treatment and subgroup strata for recurrent VTE, MB, and CRNMB. Conclusion Among older patients with VTE initiating apixaban or warfarin, higher rates of recurrent VTE and bleeding were observed in black patients and patients with lower SES. Apixaban had a lower risk of recurrent VTE, MB, and CRNMB compared to warfarin. Analyses of demographic and SES subgroups showed consistent findings

Effectiveness and Safety of Apixaban vs Warfarin in Patients with Venous Thromboembolism with Risk Factors for Bleeding or for Recurrences

Introduction Patients at increased risk of bleeding and recurrent VTE who develop venous thromboembolism (VTE) present challenges for clinical management. This study evaluated the effectiveness and safety of apixaban vs warfarin in patients with VTE who have risk factors for bleeding or recurrences. Methods Adult patients with VTE initiating apixaban or warfarin were identified from five claims databases. Stabilized inverse probability treatment weighting (IPTW) was used to balance characteristics between cohorts for the main analysis. Subgroup interaction analyses were conducted to evaluate treatment effects among patients with and without each of the conditions that increased the risk of bleeding (thrombocytopenia and history of bleed) or recurrent VTE (thrombophilia, chronic liver disease, and immune-mediated disorders). Results A total of 94,333 warfarin and 60,786 apixaban patients with VTE met selection criteria. After IPTW, all patient characteristics were balanced between cohorts. Apixaban (vs warfarin) patients were at lower risk of recurrent VTE (HR [95% confidence interval (CI) 0.72 [0.67–0.78]), major bleeding (MB) (HR [95% CI] 0.70 [0.64–0.76]), and clinically relevant non-major (CRNM) bleeding (HR [95% CI] 0.83 [0.80–0.86]). Subgroup analyses showed generally consistent findings with the overall analysis. For most subgroup analyses, there were no significant interactions between treatment and subgroup strata on VTE, MB and CRNM bleeding. Conclusion Patients with prescription fills for apixaban had lower risk of recurrent VTE, MB, and CRNM bleeding compared with warfarin patients. Treatment effects of apixaban vs warfarin were generally consistent across subgroups of patients at increased risk of bleeding/recurrences