An Overview of Technology Availability to Support Remote Decentralized Clinical Trials

Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits, and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depending on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Performance Evaluation of Minimum Quantity Lubrication on EN3 Mild Steel Turning

Lubrication, cooling and chip removal are the desired functions of any cutting fluid. Conventional or flood lubrication requires high volume flow rate and cost associated with this is higher. In addition, flood lubrication possesses health risks to machine operator. To avoid these consequences, dry machining and minimum quantity are two alternatives. Dry machining cannot be a suited alternative as it can generate greater heat and poor surface finish. Here, turning work is carried out on a Lathe machine using EN3 Mild steel. Variable cutting speeds and depth of cuts are provided and corresponding temperatures and surface roughness values were recorded. Experimental results are analyzed by Minitab software. Regression analysis, main effect plot, and interaction plot conclusion are drawn by using ANOVA. There is a 95.83% reduction in the use of cutting fluid. MQL gives a 9.88% reduction in tool temperature, this will improve tool life. MQL produced a 17.64% improved surface finish. MQL appears to be an economical and environmentally compatible lubrication technique for sustainable manufacturing.

Sustainable Balanced Scorecard for Kaizen Evaluation: Comparative Study between Egypt and Japan

Continuous improvement activities are becoming a key organizational success factor; those improvement activities include but are not limited to kaizen, six sigma, lean production, and continuous improvement projects. Kaizen is a Japanese philosophy of continuous improvement by making small incremental changes to improve an organization’s performance, reduce costs, reduce delay time, reduce waste in production, etc. This research aims at proposing a measuring system for kaizen activities from a sustainable balanced scorecard perspective. A survey was developed and disseminated among kaizen experts in both Egypt and Japan with the purpose of allocating key performance indicators for both kaizen process (critical success factors) and result (kaizen benefits) into the five sustainable balanced scorecard perspectives. This research contributes to the extant literature by presenting a kaizen measurement of both kaizen process and results that will illuminate the benefits of using kaizen. Also, the presented measurement can help in the sustainability of kaizen implementation across various sectors and industries. Thus, grasping the full benefits of kaizen implementation will contribute to the spread of kaizen understanding and practice. Also, this research provides insights on the social and cultural differences that would influence the kaizen success. Determining the combination of the proper kaizen measures could be used by any industry, whether service or manufacturing for better kaizen activities measurement. The comparison between Japanese implementation of kaizen, as the pioneers of continuous improvement, and Egyptian implementation will help recommending better practices of kaizen in Egypt and contributing to the 2030 sustainable development goals. The study results reveal that there is no significant difference in allocating kaizen benefits between Egypt and Japan. However, with regard to the critical success factors some differences appeared reflecting the social differences and understanding between both countries, a single integrated measurement was reached between the Egyptian and Japanese allocation highlighting the Japanese experts’ opinion as the ultimate criterion for selection.

Additive Friction Stir Manufacturing Process: Interest in Understanding Thermal Phenomena and Numerical Modeling of the Temperature Rise Phase

Additive Friction Stir Manufacturing, or AFSM, is a new industrial process that follows the emergence of friction-based processes. The AFSM process is a solid-state additive process using the energy produced by the friction at the interface between a rotating non-consumable tool and a substrate. Friction depends on various parameters like axial force, rotation speed or friction coefficient. The feeder material is a metallic rod that flows through a hole in the tool. There is still a lack in understanding of the physical phenomena taking place during the process. This research aims at a better AFSM process understanding and implementation, thanks to numerical simulation and experimental validation performed on a prototype effector. Such an approach is considered a promising way for studying the influence of the process parameters and to finally identify a process window that seems relevant. The deposition of material through the AFSM process takes place in several phases. In chronological order these phases are the docking phase, the dwell time phase, the deposition phase, and the removal phase. The present work focuses on the dwell time phase that enables the temperature rise of the system due to pure friction. An analytic modeling of heat generation based on friction considers as main parameters the rotational speed and the contact pressure. Another parameter considered influential is the friction coefficient assumed to be variable, due to the self-lubrication of the system with the rise in temperature or the materials in contact roughness smoothing over time. This study proposes through a numerical modeling followed by an experimental validation to question the influence of the various input parameters on the dwell time phase. Rotation speed, temperature, spindle torque and axial force are the main monitored parameters during experimentations and serve as reference data for the calibration of the numerical model. This research shows that the geometry of the tool as well as fluctuations of the input parameters like axial force and rotational speed are very influential on the temperature reached and/or the time required to reach the targeted temperature. The main outcome is the prediction of a process window which is a key result for a more efficient process implementation.

Effect of Type of Pile and Its Installation Method on Pile Bearing Capacity by Physical Modeling in Frustum Confining Vessel

Various factors such as the method of installation, the pile type, the pile material and the pile shape, can affect the final bearing capacity of a pile executed in the soil; among them, the method of installation is of special importance. The physical modeling is among the best options in the laboratory study of the piles behavior. Therefore, the current paper first presents and reviews the frustum confining vessel (FCV) as a suitable tool for physical modeling of deep foundations. Then, by describing the loading tests of two open-ended and closed-end steel piles, each of which has been performed in two methods, “with displacement" and "without displacement", the effect of end conditions and installation method on the final bearing capacity of the pile is investigated. The soil used in the current paper is silty sand of Firuzkuh, Iran. The results of the experiments show that in general the without displacement installation method has a larger bearing capacity in both piles, and in a specific method of installation the closed ended pile shows a slightly higher bearing capacity.

Optimization of Hemp Fiber Reinforced Concrete for Mix Design Method

The purpose of this study is to evaluate the incorporation of hemp fibers (HF) in concrete. Hemp fiber reinforced concrete (HFRC) is becoming more popular as an alternative for regular mix designs. This study was done to evaluate the compressive strength of HFRC regarding mix procedure. HF were obtained from the manufacturer and hand processed to ensure uniformity in width and length. The fibers were added to concrete as both wet and dry mix to investigate and optimize the mix design process. Results indicated that the dry mix had a compressive strength of 1157 psi compared to the wet mix of 985 psi. This dry mix compressive strength was within range of the standard mix compressive strength of 1533 psi. The statistical analysis revealed that the mix design process needs further optimization and uniformity concerning the addition of HF. Regression analysis revealed that the standard mix design had a coefficient of 0.9 as compared to the dry mix of 0.375 indicating a variation in the mixing process. While completing the dry mix, the addition of plain HF caused them to intertwine creating lumps and inconsistency. However, during the wet mixing process, combining water and HF before incorporation allows the fibers to uniformly disperse within the mix hence the regression analysis indicated a better coefficient of 0.55. This study concludes that HRFC is a viable alternative to regular mixes however more research surrounding its characteristics needs to be conducted.

A Numerical Study of the Interaction between Residual Stress Profiles Induced by Quasi-Static Plastification

One of the most relevant phenomena in manufacturing is the residual stress state development through the manufacturing chain. In most cases, the residual stresses have their origin in the heterogenous plastification produced by the processes. Although a few manufacturing processes have been successfully approached by numerical modeling, there is still lack of understanding on how these processes' interactions will affect the final stress state. The objective of this work is to analyze the effect of the grinding procedure on the residual stress state generated by a quasi-static indentation. The model consists in a simplified approach of shot peening, modeling four cases with variations in indenter size and force. This model was validated through topography, measured by optical 3D focus-variation. The indentation model configured with two loads was then exposed to two grinding procedures and the result was analyzed. It was observed that the grinding procedure will have a significant effect on the stress state.

Physicochemical and Thermal Characterization of Starch from Three Different Plantain Cultivars in Puerto Rico

Plantain contains starch as the main component and represents a relevant source of this carbohydrate. Starches from different cultivars of plantain and bananas have been studied for industrialization purposes due to their morphological and thermal characteristics and their influence in food products. This study aimed to characterize the physical, chemical, and thermal properties of starch from three different plantain cultivated in Puerto Rico: Maricongo, Maiden and FHIA 20. Amylose and amylopectin content, color, granular size, morphology, and thermal properties were determined. According to the amylose content in starches, FHIA 20 presented lowest content of the three cultivars studied. In terms of color, Maiden and FHIA 20 starches exhibited significantly higher whiteness indexes compared to Maricongo starch. Starches of the three cultivars had an elongated-ovoid morphology, with a smooth surface and a non-porous appearance. Regardless of similarities in their morphology, FHIA 20 exhibited a lower aspect ratio since its granules tended to be more elongated. Comparison of the thermal properties of starches showed that initial starch gelatinization temperature was similar among cultivars. However, FHIA 20 starch presented a noticeably higher final gelatinization temperature (87.95°C) and transition enthalpy than Maricongo (79.69°C) and Maiden (77.40°C). Despite similarities, starches from plantain cultivars showed differences in their composition and thermal behavior. This represents an opportunity to diversify plantain starch use in food-related applications.

A 3D Numerical Environmental Modeling Approach for Assessing Transport of Spilled Oil in Porous Beach Conditions under a Meso-Scale Tank Design

Shorelines are vulnerable to significant environmental impacts from oil spills. Stranded oil can cause potential short- to long-term detrimental effects along beaches that include injuries to ecosystem, socio-economic and cultural resources. In this study, a three-dimensional (3D) numerical modeling approach is developed to evaluate the fate and transport of spilled oil for hypothetical oiled shoreline cases under various combinations of beach geomorphology and environmental conditions. The developed model estimates the spatial and temporal distribution of spilled oil for the various test conditions, using the finite volume method and considering the physical transport (dispersion and advection), sinks, and sorption processes. The model includes a user-friendly interface for data input on variables such as beach properties, environmental conditions, and physical-chemical properties of spilled oil. An experimental meso-scale tank design was used to test the developed model for dissolved petroleum hydrocarbon within shorelines. The simulated results for effects of different sediment substrates, oil types, and shoreline features for the transport of spilled oil are comparable to that obtained with a commercially available model. Results show that the properties of substrates and the oil removal by shoreline effects have significant impacts on oil transport in the beach area. Sensitivity analysis, through the application of the one-step-at-a-time method (OAT), for the 3D model identified hydraulic conductivity as the most sensitive parameter. The 3D numerical model allows users to examine the behavior of oil on and within beaches, assess potential environmental impacts, and provide technical support for decisions related to shoreline clean-up operations.

Technical, Environmental, and Financial Assessment for the Optimal Sizing of a Run-of-River Small Hydropower Project: A Case Study in Colombia

Run-of-river (RoR) hydropower projects represent a viable, clean, and cost-effective alternative to dam-based plants and provide decentralized power production. However, RoR schemes’ cost-effectiveness depends on the proper selection of site and design flow, which is a challenging task because it requires multivariate analysis. In this respect, this study presents the development of an investment decision support tool for assessing the optimal size of an RoR scheme considering the technical, environmental, and cost constraints. The net present value (NPV) from a project perspective is used as an objective function for supporting the investment decision. The tool has been tested by applying it to an actual RoR project recently proposed in Colombia. The obtained results show that the optimum point in financial terms does not match the flow that maximizes energy generation from exploiting the river's available flow. For the case study, the flow that maximizes energy corresponds to a value of 5.1 m3/s. In comparison, an amount of 2.1 m3/s maximizes the investors NPV. Finally, a sensitivity analysis is performed to determine the NPV as a function of the debt rate changes and the electricity prices and the CapEx. Even for the worst-case scenario, the optimal size represents a positive business case with an NPV of 2.2 USD million and an internal rate of return (IRR) 1.5 times higher than the discount rate. 

User’s Susceptibility Factors to Malware Attacks: A Systemic Literature Review

Users’ susceptibility to malware attacks have been noticed in the past few years. Investigating the factors that make a user vulnerable to those attacks is critical because they can be utilized to set up proactive strategies such as awareness and education to mitigate the impacts of those attacks. Demographic, behavioral, and cultural vulnerabilities are the main factors that make users susceptible to malware attacks. It is challenging, however, to draw more general conclusions based on those factors due to the varieties in the type of users and different types of malware. Therefore, we conducted a systematic literature review (SLR) of the existing research for user susceptibility factors to malware attacks. The results showed that all demographic factors are consistently associated with malware infection regardless of the users' type except for age and gender. Besides, the association of culture and personality factors with malware infection is consistent in most of the selected studies and for all types of users. Moreover, malware infection varies based on age, geographic location, and host types. We propose that future studies should carefully take into consideration the type of users because different users may be exposed to different threats or targeted based on their user domains’ characteristics. Additionally, as different types of malware use different tactics to trick users, taking the malware types into consideration is important.

Assessing the Theoretical Suitability of Sentinel-2 and WorldView-3 Data for Hydrocarbon Mapping of Spill Events, Using HYSS

Identification of hydrocarbon oil in remote sensing images is often the first step in monitoring oil during spill events. Most remote sensing methods adopt techniques for hydrocarbon identification to achieve detection in order to model an appropriate cleanup program. Identification on optical sensors does not only allow for detection but also for characterization and quantification. Until recently, in optical remote sensing, quantification and characterization were only potentially possible using high-resolution laboratory and airborne imaging spectrometers (hyperspectral data). Unlike multispectral, hyperspectral data are not freely available, as this data category is mainly obtained via airborne survey at present. In this research, two operational high-resolution multispectral satellites (WorldView-3 and Sentinel-2) are theoretically assessed for their suitability for hydrocarbon characterization, using the Hydrocarbon Spectra Slope model (HYSS). This method utilized the two most persistent hydrocarbon diagnostic/absorption features at 1.73 µm and 2.30 µm for hydrocarbon mapping on multispectral data. In this research, spectra measurement of seven different hydrocarbon oils (crude and refined oil) taken on 10 different substrates with the use of laboratory ASD Fieldspec were convolved to Sentinel-2 and WorldView-3 resolution, using their full width half maximum (FWHM) parameter. The resulting hydrocarbon slope values obtained from the studied samples enable clear qualitative discrimination of most hydrocarbons, despite the presence of different background substrates, particularly on WorldView-3. Due to close conformity of central wavelengths and narrow bandwidths to key hydrocarbon bands used in HYSS, the statistical significance for qualitative analysis on WorldView-3 sensors for all studied hydrocarbon oil returned with 95% confidence level (P-value ˂ 0.01), except for Diesel. Using multifactor analysis of variance (MANOVA), the discriminating power of HYSS is statistically significant for most hydrocarbon-substrate combinations on Sentinel-2 and WorldView-3 FWHM, revealing the potential of these two operational multispectral sensors as rapid response tools for hydrocarbon mapping. One notable exception is highly transmissive hydrocarbons on Sentinel-2 data due to the non-conformity of spectral bands with key hydrocarbon absorptions and the relatively coarse bandwidth (> 100 nm).

A Simulation Tool for Projection Mapping Based on Mapbox and Unity

A simulation tool is proposed for big-scale projection mapping events. The tool has four main functions based on Mapbox and Unity utilities. The first function is building three-dimensional models of real cities using Mapbox. The second function is movie projections to some buildings in real cities using Unity. The third is a movie sending function from a PC to a virtual projector. The fourth function is mapping movies with fitting buildings. The simulation tool was adapted to a real projection mapping event held in 2019. The event completed, but it faced a severe problem in the movie projection to the target building. Extra tents were set in front of the target building, and the tents became obstacles to the movie projection. The simulation tool developed herein could reconstruct the problems of the event. Therefore, if the simulation tool was developed before the 2019 projection mapping event, the problem of the tents being obstacles could have been avoided using the tool. Moreover, we confirmed that the simulation tool is useful for planning future projection mapping events to avoid various extra equipment obstacles, such as utility poles, planting trees, and monument towers.

Recycling of Sintered NdFeB Magnet Waste via Oxidative Roasting and Selective Leaching

Neodymium-iron-boron (NdFeB) magnets classified as high-power magnets are widely used in various applications such as automotive, electrical and medical devices. Because significant amounts of rare earth metals will be subjected to shortages in the future, therefore domestic NdFeB magnet waste recycling should therefore be developed in order to reduce social and environmental impacts towards a circular economy. Each type of wastes has different characteristics and compositions. As a result, these directly affect recycling efficiency as well as types and purity of the recyclable products. This research, therefore, focused on the recycling of manufacturing NdFeB magnet waste obtained from the sintering stage of magnet production and the waste contained 23.6% Nd, 60.3% Fe and 0.261% B in order to recover high purity neodymium oxide (Nd2O3) using hybrid metallurgical process via oxidative roasting and selective leaching techniques. The sintered NdFeB waste was first ground to under 70 mesh prior to oxidative roasting at 550–800 oC to enable selective leaching of neodymium in the subsequent leaching step using H2SO4 at 2.5 M over 24 h. The leachate was then subjected to drying and roasting at 700–800 oC prior to precipitation by oxalic acid and calcination to obtain Nd2O3 as the recycling product. According to XRD analyses, it was found that increasing oxidative roasting temperature led to an increasing amount of hematite (Fe2O3) as the main composition with a smaller amount of magnetite (Fe3O4) found. Peaks of Nd2O3 were also observed in a lesser amount. Furthermore, neodymium iron oxide (NdFeO3) was present and its XRD peaks were pronounced at higher oxidative roasting temperatures. When proceeded to acid leaching and drying, iron sulfate and neodymium sulfate were mainly obtained. After the roasting step prior to water leaching, iron sulfate was converted to form Fe2O3 as the main compound, while neodymium sulfate remained in the ingredient. However, a small amount of Fe3O4 was still detected by XRD. The higher roasting temperature at 800 oC resulted in a greater Fe2O3 to Nd2(SO4)3 ratio, indicating a more effective roasting temperature. Iron oxides were subsequently water leached and filtered out while the solution contained mainly neodymium sulfate. Therefore, low oxidative roasting temperature not exceeding 600 oC followed by acid leaching and roasting at 800 oC gave the optimum condition for further steps of precipitation and calcination to finally achieve Nd2O3.

OILU Tag: A Projective Invariant Fiducial System

This paper presents the development of a 2D visual marker, derived from a recent patented work in the field of numbering systems. The proposed fiducial uses a group of projective invariant straight-line patterns, easily detectable and remotely recognizable. Based on an efficient data coding scheme, the developed marker enables producing a large panel of unique real time identifiers with highly distinguishable patterns. The proposed marker Incorporates simultaneously decimal and binary information, making it readable by both humans and machines. This important feature opens up new opportunities for the development of efficient visual human-machine communication and monitoring protocols. Extensive experiment tests validate the robustness of the marker against acquisition and geometric distortions.

Influence of Laser Treatment on the Growth of Sprouts of Different Wheat Varieties

Cereals are considered as a strategic product in human life and their demand is increasing with the growth of world population. Increasing wheat production is important for the country. One of the ways to solve the problem is to develop and implement new, environmentally and economically acceptable technologies. Such technologies include pre-sowing treatment of seed with a laser and associative nitrogen-fixing bacteria - Azospirillum brasilense. In the region there are the wheat varieties - Dika and Lomtagora, which are among the most common in Georgia. Dika is a frost-resistant wheat, with a high ability to adapt to the environment, resistant to falling and it is sown in highlands. Lomtagora 126 differs with its winter and drought resistance, and it has a great ability to germinate. Lomtagora is characterized by a strong root system and a high budding capacity. It is an early variety, fall-resistant, easy to thresh and suitable for mechanized harvesting with large and red grains. This paper presents some preliminary experimental results where a continuous CO2 laser with a power of 25-40 W was used to radiate grains at a flow rate of 10 and 15 cm/sec. The treatment was carried out on grains of the Triticum aestivum L. var. Lutescens (local variety name - Lomtagora 126), and Triticum carthlicum Nevski (local variety name - Dika). Here the grains were treated with A. brasilense isolate (108-109 CFU/ml), which was isolated from the rhizosphere of wheat. It was observed that the germination of the wheat was not significantly influenced by either laser or bacteria treatment. The results of our research show that combined treatment with laser and A. brasilense significantly influenced the germination of wheat. In the case of the Lomtagora 126 variety, grains were exposed to the beam on a speed of 10 cm/sec, only slightly improved the growth for 38-day seedlings, in case of exposition of grains with a speed of 15 cm/sec - by 23%. Treatment of seeds with A. brasilense in both exposed and non-exposed variants led to an improvement in the growth of seedlings, with A. brasilense alone - by 22%, and with combined treatment of grains - by 29%. In the case of the Dika variety, only exposure led to growth by 8-9%, and the combined treatment - by 10-15%, in comparison with the control variant. Superior effect on growth of seedlings of different varieties was achieved with the combinations of laser treatment on grains in a beam of 15 cm/sec (radiation power 30-40 W) and in addition of A. brasilense - nitrogen fixing bacteria. Therefore, this is a promising application of A. brasilense as active agents of bacterial fertilizers due to their ability of molecular nitrogen fixation in cereals in combination with laser irradiation: choosing a proper strain gives a good ability to colonize roots of agricultural crops, providing a high nitrogen-fixing ability and the ability to mobilize soil phosphorus, and laser treatment stimulates natural processes occurring in plant cells, will increase the yield.

Scenario and Decision Analysis for Solar Energy in Egypt by 2035 Using Dynamic Bayesian Network

Bayesian networks are now considered to be a promising tool in the field of energy with different applications. In this study, the aim was to indicate the states of a previous constructed Bayesian network related to the solar energy in Egypt and the factors affecting its market share, depending on the followed data distribution type for each factor, and using either the Z-distribution approach or the Chebyshev’s inequality theorem. Later on, the separate and the conditional probabilities of the states of each factor in the Bayesian network were derived, either from the collected and scrapped historical data or from estimations and past studies. Results showed that we could use the constructed model for scenario and decision analysis concerning forecasting the total percentage of the market share of the solar energy in Egypt by 2035 and using it as a stable renewable source for generating any type of energy needed. Also, it proved that whenever the use of the solar energy increases, the total costs decreases. Furthermore, we have identified different scenarios, such as the best, worst, 50/50, and most likely one, in terms of the expected changes in the percentage of the solar energy market share. The best scenario showed an 85% probability that the market share of the solar energy in Egypt will exceed 10% of the total energy market, while the worst scenario showed only a 24% probability that the market share of the solar energy in Egypt will exceed 10% of the total energy market. Furthermore, we applied policy analysis to check the effect of changing the controllable (decision) variable’s states acting as different scenarios, to show how it would affect the target nodes in the model. Additionally, the best environmental and economical scenarios were developed to show how other factors are expected to be, in order to affect the model positively. Additional evidence and derived probabilities were added for the weather dynamic nodes whose states depend on time, during the process of converting the Bayesian network into a dynamic Bayesian network.

Supplementary Cementitious Materials as Sustainable Partial Replacement for Cement in the Building Industry

Cement is the most extensively used construction material due to its strength and versatility of use. However, the production of Portland cement has become unsustainable because of high energy usage, reduction of natural non-renewable resources and emissions of greenhouse gases. Production of cement contributes to anthropogenic greenhouse gases emissions annually. The growing concerns for the environment resulting from this constant and excessive use of cement has therefore raised the need for more green materials and technology. The use of supplementary cementitious materials (SCMs) is considered as one of the many alternatives suited to address this issue and serve as a sustainable partial replacement for cement in construction. This paper will examine the reuse of these waste materials to partially replace Portland cement. It provides a critical review of literature analysing various supplementary cementitious materials which are applicable in the building industry as either partial replacement for cement or aggregates. These materials have been grouped based on source into industrial wastes, domestic/general wastes, and agricultural wastes. The reuse of these waste materials could potentially reduce the negative effects of cement production and reduce landfills which constitute an environmental nuisance. This paper seeks to inform building industry professionals and researchers in the field on the applicability of these waste materials in construction.

Spexin and Fetuin A in Morbid Obese Children

Spexin, expressed in the central nervous system, has attracted much interest in feeding behavior, obesity, diabetes, energy metabolism and cardiovascular functions. Fetuin A is known as the negative acute phase reactant synthesized in the liver. Eosinophils are early indicators of cardiometabolic complications. Patients with elevated platelet count, associated with hypercoagulable state in the body, are also more liable to cardiovascular diseases (CVDs). In this study, the aim is to examine the profiles of spexin and fetuin A concomitant with the course of variations detected in eosinophil as well as platelet counts in morbid obese children. 34 children with normal-body mass index (N-BMI) and 51 morbid obese (MO) children participated in the study. Written-informed consent forms were obtained prior to the study. Institutional ethics committee approved the study protocol. Age- and sex-adjusted BMI percentile tables prepared by World Health Organization were used to classify healthy and obese children. Mean age ± SEM of the children were 9.3 ± 0.6 years and 10.7 ± 0.5 years in N-BMI and MO groups, respectively. Anthropometric measurements of the children were taken. BMI values were calculated from weight and height values. Blood samples were obtained after an overnight fasting. Routine hematologic and biochemical tests were performed. Within this context, fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein-cholesterol (HDL-C) concentrations were measured. Homeostatic model assessment for insulin resistance (HOMA-IR) values were calculated. Spexin and fetuin A levels were determined by enzyme-linked immunosorbent assay. Data were evaluated from the statistical point of view. Statistically significant differences were found between groups in terms of BMI, fat mass index, INS, HOMA-IR and HDL-C. In MO group, all parameters increased as HDL-C decreased. Elevated concentrations in MO group were detected in eosinophils (p < 0.05) and platelets (p > 0.05). Fetuin A levels decreased in MO group (p > 0.05). However, decrease was statistically significant in spexin levels for this group (p < 0.05). In conclusion, these results have suggested that increases in eosinophils and platelets exhibit behavior as cardiovascular risk factors. Decreased fetuin A behaved as a risk factor suitable to increased risk for cardiovascular problems associated with the severity of obesity. Along with increased eosinophils, increased platelets and decreased fetuin A, decreased spexin was the parameter, which reflects best its possible participation in the early development of CVD risk in MO children.

Fighter Aircraft Selection Using Technique for Order Preference by Similarity to Ideal Solution with Multiple Criteria Decision Making Analysis

This paper presents a multiple criteria decision making analysis technique for selecting fighter aircraft for the national air force. The selection of military aircraft is a process consisting of contradictory goals and objectives. When a modern air force needs to choose fighter aircraft to upgrade existing fleets, a multiple criteria decision making analysis and scenario planning for defense acquisition has been put forward. The selection of fighter aircraft for the air defense force is a strategic decision making process, since the purchase or lease of fighter jets, maintenance and operating costs and having a fleet is the biggest cost for the air force. Multiple criteria decision making analysis methods are effectively applied to facilitate decision making from various available options. The selection criteria were determined using the literature on the problem of fighter aircraft selection. The selection of fighter aircraft to be purchased for the air defense forces is handled using a multiple criteria decision making analysis technique that also determines a suitable methodological approach for the defense procurement and fleet upgrade planning process. The aim of this study is to originate an approach to evaluate fighter aircraft alternatives, Su-35, F-35, and TF-X (MMU), based on technique for order preference by similarity to ideal solution (TOPSIS).