Two-Echelon Supply Chain Design for Spare Parts with Time Constraints

We consider a single-part, two-echelon supply chain problem for spare parts. The network consists of a single manufacturing plant, a set of service centers (SCs) and a set of customers. Both echelons keep spare parts using the base-stock replenishment policy. The plant behaves as an M/M/1 queueing system and has limited production and storage capacity. Demand faced by each SC follows an independent Poisson process. The problem is to determine optimal location-allocation and optimal base-stock levels at both echelons while satisfying the target service levels and customer preferences of SCs. We develop a mixed integer non-linear programming model and use cutting-plane method to optimize the inventory-location decisions. We present an exact solution procedure for the inventory stocking problem and demonstrate the limitations of using traditional inventory models like METRIC-like and Approximate in case of high utilization rates. We show the effectiveness of our proposed cutting-plane algorithm and provide important managerial insights for spare parts management

Complications In The Management Of High-Energy Closed Fractures Of Proximal Tibial Plateau. A Retrospective Study

Objective: To analyze the management of high-energy Schatzker type V and VI tibial plateau fractures which are associated with infectious and noninfectious complications. Methods: This study was carried out in the Department of Orthopedic Surgery, Rawalpindi Medical University from July 1, 2018, to June 30, 2021. This is a retrospective study which is done in three years. Patients had to be between the ages of 18 and 60, have no history of arthritis, have a closed fracture of the proximal tibia (Schatzker type V and VI), or have AO type 41-C1, C2 or C3 involvement of the lower limb. Each patient received treatment using techniques such as internal fixation with locking plates and open reduction which are minimally invasive. Results: This study involved a total of 132 patients.Mean age was 35.15±10.59.115(87%) were men and 17(13%) were women out of 132. A total of 39 out of 132 patients experienced complications (29.54%). Infectious complications (18.93%) were found in (25/132) patients 16 out of 25 patients had superficial infections. Routine dressing changes and antibiotic treatment were carried out in patients who had superficial infections.9 out of 25 patients who had faced a deep-seated infection underwent repeated implant removal, debridements, amputation, and flap covering depending on the reaction of the host. Noninfectious complications had been reported in 14 patients(10.6%). Six patients had hardware-related issues and four of them required a secondary treatment.08 individuals had malalignment, with five of them having it in their immediate postoperative radiographs and three others having it in their late postoperative radiographs. Conclusion: In closed wounds, substantial soft tissue destruction is linked to the fractures of the proximal tibial plateau, particularly Shatzker type V and VI. By selecting the right patients and minimising soft tissue dissection, the problems related to the management of these fractures can be reduced.

Agronomic biofortification of fodder sorghum with zinc under different levels of nitrogen

Zinc (Zn) deficient soil prevails throughout the world and it has become the bottleneck in achieving production potential and quality of crops. The negligible use of micronutrients along with irregular use of macronutrients is practised for fodder production in Pakistan. Varying levels of zinc (0, 5, 10 and 15 kg ha-1) and nitrogen (0, 60, 120 and 180 kg ha-1) were evaluated for their effect on yield, quality and zinc uptake on fodder sorghum (variety Hegari) in a field experiment for two consecutive years (2014 and 2015). Data were analysed by using Fishers’ analysis of variance (at p<0.05) and response surface methodology (RSM). Correlation between different parameters was also studied. Application of zinc and nitrogen improved the plant height, leaf area plant-1, green fodder yield, dry matter yield, crude protein percentage and zinc content of plant but decreased the neutral detergent fiber, acid detergent fiber and ash percentage. Values for different parameters recorded at second and third levels of zinc and nitrogen were remained at par with each other. Application of 10 kg ha-1 zinc and 120 kg ha-1 nitrogen showed an average increase of 7.3 and 18.6% in green fodder yield while 12.1 and 15.8% in dry matter yield, respectively. Similarly 6.1 and 7.5% increase in crude protein was noted over control. Correlation between NDF and ADF was negative with rest of the studied parameters. In conclusion, Zn2 and N2 gave the best results in term of yield and quality of fodder sorghum

Accuracy of Uterine Artery Doppler in Second Trimester in Determining Pre-Eclampsia

Background: To determine the accuracy of uterine artery doppler in the second trimester (18-24 weeks) in determining preeclampsia.Methods: In this descriptive study, a total of 89 women with singleton pregnancy attending routine second-trimester anomaly scan were included. Uterine artery doppler sonography was conducted in the women coming for routine anomaly scan. Flow velocity waveforms of right and left uterine artery were imaged with the patient in the semi-recumbent position and the uterine artery was identified in the longitudinal scan, lateral to the uterus. Resistive index, pulsatility index and presence and absence of early diastolic notch and its depth in terms of notch index were calculated.Results: Uterine artery doppler finding in second trimester in determining preeclampsia showed abnormal findings in 41.57% women in which 24.32% had type I (Resistive index &gt;0.58), 45.95% (17/37) type II (Mild notching of uterine artery at beginning of diastole) and 29.73% had type III [(Severe notching + abnormal Resistive index (&gt;0.58)]. After the follow-up of each patient, we found that pre-eclampsia was developed in 28.09% (25/89) cases. The accuracy, sensitivity, specificity, positive and negative predictive values of uterine artery doppler were 75.28%, 80%, 73.44%, 54.05% and 90.38% respectivelyConclusion: By detecting abnormal uterine artery Doppler indices (high RI) between 18-24 weeks of pregnancy can identify those women who are at risk for development of preeclampsia

4 x 4 Massive MIMO antennas for 39 GHz millimeter-wave applications

This paper shows a compacted design of 4x4 Massive Multiple Input Multiple Output (mMIMO) antennas that will be used for future 39 GHz millimeter-wave (mm-Wave) effective communications required for 5th Generation (5G) networks. The 5G networks not only support a high data rate but also accommodate excessive internet traffic. The proposed single element antenna is designed on Rogers RT5880 (lossy) with a maximum dimension of 10x8.

Linear Diophantine Fuzzy Rough Sets: A New Rough Set Approach with Decision Making

In this article, a new hybrid model named linear Diophantine fuzzy rough set (LDFRS) is proposed to magnify the notion of rough set (RS) and linear Diophantine fuzzy set (LDFS). Concerning the proposed model of LDFRS, it is more efficient to discuss the fuzziness and roughness in terms of linear Diophantine fuzzy approximation spaces (LDFA spaces); it plays a vital role in information analysis, data analysis, and computational intelligence. The concept of (,)-indiscernibility of a linear Diophantine fuzzy relation (LDF relation) is used for the construction of an LDFRS. Certain properties of LDFA spaces are explored and related results are developed. Moreover, a decision-making technique is developed for modeling uncertainties in decision-making (DM) problems and a practical application of fuzziness and roughness of the proposed model is established for medical diagnosis

Early versus delayed flow diversion for ruptured intracranial aneurysms: A meta-analysis

Objective: The use and timing of flow diversion for aneurysmal subarachnoid hemorrhage is controversial. The objective of this study is to perform a meta-analysis and systematic review to compare overall complication rate between early versus delayed flow diversion for ruptured aneurysms.Methods: A literature search for all eligible articles was performed using PubMed, Cochrane, and Web of Science databases. The primary outcome was the overall complication rate (any complication in the perioperative period), and secondary outcomes were 1) hemorrhage and 2) stroke/death (all hemorrhagic/ischemic strokes and/or death).Results: Thirteen articles including 142 patients met inclusion criteria. Eighty-nine (62.7%) patients underwent early deployment of flow diverters (i.e., 2 days or less). The odds ratio for overall complication rate with early versus delayed flow diversion was 0.95 (95% confidence interval [CI] 0.36-2.49, P = 0.42). The odds ratio for the secondary outcome of hemorrhagic complication for early versus delayed flow diversion was 1.44 (95% CI 0.45-4.52, P = 0.87) and of stroke/death was 1.67 (95% CI 0.5-4.9, P = 0.69). The odds ratio of early versus delayed flow diversion for blister/dissecting/fusiform aneurysms was 0.82 (95% CI 0.29-2.30) and for saccular/giant aneurysms was 2.23 (95% CI 0.17-29.4). At last follow-up, 71.6% of patients had good performance status (modified Rankin Scale score 0-2), and the rate of angiographic aneurysm occlusion was 90.2%.Conclusions: This meta-analysis did not show a difference in overall complication rate between early versus delayed flow diversion for ruptured aneurysms. Early flow diversion for ruptured blister/fusiform/dissecting aneurysms carries a lower risk of aneurysm rerupture and overall complications as compared with that for ruptured saccular/giant aneurysms

Probiotics: mechanism of action, health benefits and their application in food industries

Probiotics, like lactic acid bacteria, are non-pathogenic microbes that exert health benefits to the host when administered in adequate quantity. Currently, research is being conducted on the molecular events and applications of probiotics. The suggested mechanisms by which probiotics exert their action include; competitive exclusion of pathogens for adhesion sites, improvement of the intestinal mucosal barrier, gut immunomodulation, and neurotransmitter synthesis. This review emphasizes the recent advances in the health benefits of probiotics and the emerging applications of probiotics in the food industry. Due to their capability to modulate gut microbiota and attenuate the immune system, probiotics could be used as an adjuvant in hypertension, hypercholesterolemia, cancer, and gastrointestinal diseases. Considering the functional properties, probiotics are being used in the dairy, beverage, and baking industries. After developing the latest techniques by researchers, probiotics can now survive within harsh processing conditions and withstand GI stresses quite effectively. Thus, the potential of probiotics can efficiently be utilized on a commercial scale in food processing industries

Probiotics: mechanism of action, health benefits and their application in food industries

Probiotics, like lactic acid bacteria, are non-pathogenic microbes that exert health benefits to the host when administered in adequate quantity. Currently, research is being conducted on the molecular events and applications of probiotics. The suggested mechanisms by which probiotics exert their action include; competitive exclusion of pathogens for adhesion sites, improvement of the intestinal mucosal barrier, gut immunomodulation, and neurotransmitter synthesis. This review emphasizes the recent advances in the health benefits of probiotics and the emerging applications of probiotics in the food industry. Due to their capability to modulate gut microbiota and attenuate the immune system, probiotics could be used as an adjuvant in hypertension, hypercholesterolemia, cancer, and gastrointestinal diseases. Considering the functional properties, probiotics are being used in the dairy, beverage, and baking industries. After developing the latest techniques by researchers, probiotics can now survive within harsh processing conditions and withstand GI stresses quite effectively. Thus, the potential of probiotics can efficiently be utilized on a commercial scale in food processing industries