Assessing the Physiological, Psychological Stressors and Coping Strategies among Hemodialysis Patients in the Kingdom of Saudi Arabia

Chronic kidney disease became a global health problem worldwide. Therefore, in order to maintain a patient’s life and improve the survival rate, hemodialysis is essential to replace the function of their kidneys. However, those patients may complain about multiple physical and psychological stressors due to the nature of the disease and the need for frequent hemodialysis sessions. So, those patients use various strategies to cope with the stressors related to their disease and the treatment procedures. Cross-sectional, descriptive study was carried out to achieve the aim of the study. A convenient sample including all adult patients was recruited for this study. Hemodialysis Stressors Scale (HSS) and Jalowiec Coping Scale (JCS) were used to investigate the stressors and coping strategies of 89 hemodialysis patients, at a governmental hospital (King Khalid Hospital-Jeddah). Results of the study revealed that 50.7% experienced physiological stressors and 38% experienced psychosocial stressors. Also, optimistic, fatalistic, and supportive coping strategies were the most common coping strategies used by the patients with mean scores (2.88 + 0.75, 2.87 + 0.75, and 1.82 + 0.71), respectively. In conclusion, being familiar with the types of stressors and the effective coping strategies of hemodialysis patients and their families are important in order to enhance their adaptation with chronic kidney diseases.

Effect of Reynolds Number and Concentration of Biopolymer (Gum Arabic) on Drag Reduction of Turbulent Flow in Circular Pipe

Biopolymers are popular in many areas, like petrochemicals, food industry and agriculture due to their favorable properties like environment-friendly, availability, and cost. In this study, a biopolymer gum Arabic was used to find its effect on the pressure drop at various concentrations (100 ppm – 300 ppm) with various Reynolds numbers (10000 – 45000). A rheological study was also done by using the same concentrations to find the effect of the shear rate on the shear viscosity. Experiments were performed to find the effect of injection of gum Arabic directly near the boundary layer and to investigate its effect on the maximum possible drag reduction. Experiments were performed on a test section having i.d of 19.50 mm and length of 3045 mm. The polymer solution was injected from the top of the test section by using a peristaltic pump. The concentration of the polymer solution and the Reynolds number were used as parameters to get maximum possible drag reduction. Water was circulated through a centrifugal pump having a maximum 3000 rpm and the flow rate was measured by using rotameter. Results were validated by using Virk's maximum drag reduction asymptote. A maximum drag reduction of 62.15% was observed with the maximum concentration of gum Arabic, 300 ppm. The solution was circulated in the closed loop to find the effect of degradation of polymers with a number of cycles on the drag reduction percentage. It was observed that the injection of the polymer solution in the boundary layer was showing better results than premixed solutions.

Zinc Adsorption Determination of H2SO4 Activated Pomegranate Peel

Active carbon can be obtained from agricultural sources. Due to the high surface area, the production of activated carbon from cheap resources is very important. Since the surface area of 1 g activated carbon is approximately between 300 and 2000 m2, it can be used to remove both organic and inorganic impurities. In this study, the adsorption of Zn metal was studied with the product of activated carbon, which is obtained from pomegranate peel by microwave and chemical activation methods. The microwave process of pomegranate peel was carried out under constant microwave power of 800 W and 1 to 4 minutes. After the microwave process, samples were treated with H2SO4 for 3 h. Then prepared product was used in synthetic waste water including 40 ppm Zn metal. As a result, removal of waste Zn in waste water ranged from 91% to 93%.

Effect of Filler Metal Diameter on Weld Joint of Carbon Steel SA516 Gr 70 and Filler Metal SFA 5.17 in Submerged Arc Welding SAW

This work describes an investigation on the effect of filler metals diameter to weld joint, and low alloy carbon steel A516 Grade 70 is the base metal. Commercially SA516 Grade70 is frequently used for the manufacturing of pressure vessels, boilers and storage tank, etc. In fabrication industry, the hardness of the weld joint is between the important parameters to check, after heat treatment of the weld. Submerged arc welding (SAW) is used with two filler metal diameters, and this solid wire electrode is used for SAW non-alloy and for fine grain steels (SFA 5.17). The different diameters were selected (Ø = 2.4 mm and Ø = 4 mm) to weld two specimens. Both specimens were subjected to the same preparation conditions, heat treatment, macrograph, metallurgy micrograph, and micro-hardness test. Samples show almost similar structure with highest hardness. It is important to indicate that the thickness used in the base metal is 22 mm, and all specifications, preparation and controls were according to the ASME section IX. It was observed that two different filler metal diameters performed on two similar specimens demonstrated that the mechanical property (hardness) increases with decreasing diameter. It means that even the heat treatment has the same effect with the same conditions, the filler metal diameter insures a depth weld penetration and better homogenization. Hence, the SAW welding technique mentioned in the present study is favorable to implicate for the industry using the small filler metal diameter.

Numerical Modeling of Flow in USBR II Stilling Basin with End Adverse Slope

Hydraulic jump is one of the effective ways of energy dissipation in stilling basins that the ‎energy is highly dissipated by jumping. Adverse slope surface at the end stilling basin is ‎caused to increase energy dissipation and stability of the hydraulic jump. In this study, the adverse slope ‎has been added to end of United States Bureau of Reclamation (USBR) II stilling basin in hydraulic model of Nazloochay dam with scale 1:40, and flow simulated into stilling basin using Flow-3D ‎software. The numerical model is verified by experimental data of water depth in ‎stilling basin. Then, the parameters of water level profile, Froude Number, pressure, air ‎entrainment and turbulent dissipation investigated for discharging 300 m3/s using K-Ɛ and Re-Normalization Group (RNG) turbulence ‎models. The results showed a good agreement between numerical and experimental model‎ as ‎numerical model can be used to optimize of stilling basins.‎

Fatigue Behavior of Friction Stir Welded EN AW 5754 Aluminum Alloy Using Load Increase Procedure

Friction stir welding (FSW) is an advantageous method in the thermal joining processes, featuring the welding of various dissimilar and similar material combinations, joining temperatures below the melting point which prevents irregularities such as pores and hot cracks as well as high strengths mechanical joints near the base material. The FSW process consists of a rotating tool which is made of a shoulder and a probe. The welding process is based on a rotating tool which plunges in the workpiece under axial pressure. As a result, the material is plasticized by frictional heat which leads to a decrease in the flow stress. During the welding procedure, the material is continuously displaced by the tool, creating a firmly bonded weld seam behind the tool. However, the mechanical properties of the weld seam are affected by the design and geometry of the tool. These include in particular microstructural and surface properties which can favor crack initiation. Following investigation compares the dynamic properties of FSW weld seams with conventional and stationary shoulder geometry based on load increase test (LIT). Compared to classical Woehler tests, it is possible to determine the fatigue strength of the specimens after a short amount of time. The investigations were carried out on a robotized welding setup on 2 mm thick EN AW 5754 aluminum alloy sheets. It was shown that an increased tensile and fatigue strength can be achieved by using the stationary shoulder concept. Furthermore, it could be demonstrated that the LIT is a valid method to describe the fatigue behavior of FSW weld seams.

Effectiveness Evaluation of a Machine Design Process Based on the Computation of the Specific Output

In this paper, effectiveness of a machine design process is evaluated on the basis of the specific output calculus. Concretely, a screw-worm gear mechanical transmission is designed by using the classical and the 3D-CAD methods. Strength analysis and drawing of the designed parts is substantially aided by employing the SolidWorks software. Quality of the design process is assessed by manufacturing (printing) the parts, and by computing the efficiency, specific load, as well as the specific output (work) of the mechanical transmission. Influence of the stroke, travelling velocity and load on the mechanical output, is emphasized. Optimal design of the mechanical transmission becomes possible by the appropriate usage of the acquired results.

Functional and Efficient Query Interpreters: Principle, Application and Performances’ Comparison

This paper presents a general approach to implement efficient queries’ interpreters in a functional programming language. Indeed, most of the standard tools actually available use an imperative and/or object-oriented language for the implementation (e.g. Java for Jena-Fuseki) but other paradigms are possible with, maybe, better performances. To proceed, the paper first explains how to model data structures and queries in a functional point of view. Then, it proposes a general methodology to get performances (i.e. number of computation steps to answer a query) then it explains how to integrate some optimization techniques (short-cut fusion and, more important, data transformations). It then compares the functional server proposed to a standard tool (Fuseki) demonstrating that the first one can be twice to ten times faster to answer queries.

Multi-Scale Damage and Mechanical Behavior of Sheet Molding Compound Composites Subjected to Fatigue, Dynamic, and Post-Fatigue Dynamic Loadings

Sheet Molding Compounds (SMCs) with special microstructures are very attractive to use in automobile structures especially when they are accidentally subjected to collision type accidents because of their high energy absorption capacity. These are materials designated as standard SMC, Advanced Sheet Molding Compounds (A-SMC), Low-Density SMC (LD-SMC) and etc. In this study, testing methods have been performed to compare the mechanical responses and damage phenomena of SMC, LD-SMC, and A-SMC under quasi-static and high strain rate tensile tests. The paper also aims at investigating the effect of an initial pre-damage induced by fatigue on the tensile dynamic behavior of A-SMC. In the case of SMCs and A-SMCs, whatever the fibers orientation and applied strain rate are, the first observed phenomenon of damage corresponds to decohesion of the fiber-matrix interface which is followed by coalescence and multiplication of these micro-cracks and their propagations. For LD-SMCs, damage mechanisms depend on the presence of Hollow Glass Microspheres (HGM) and fibers orientation.

Sliding Mode Power System Stabilizer for Synchronous Generator Stability Improvement

Many modern synchronous generators in power systems are extremely weakly damped. The reasons are cost optimization of the machine building and introduction of the additional control equipment into power systems. Oscillations of the synchronous generators and related stability problems of the power systems are harmful and can lead to failures in operation and to damages. The only useful solution to increase damping of the unwanted oscillations represents the implementation of the power system stabilizers. Power system stabilizers generate the additional control signal which changes synchronous generator field excitation voltage. Modern power system stabilizers are integrated into static excitation systems of the synchronous generators. Available commercial power system stabilizers are based on linear control theory. Due to the nonlinear dynamics of the synchronous generator, current stabilizers do not assure optimal damping of the synchronous generator’s oscillations in the entire operating range. For that reason the use of the robust power system stabilizers which are convenient for the entire operating range is reasonable. There are numerous robust techniques applicable for the power system stabilizers. In this paper the use of sliding mode control for synchronous generator stability improvement is studied. On the basis of the sliding mode theory, the robust power system stabilizer was developed. The main advantages of the sliding mode controller are simple realization of the control algorithm, robustness to parameter variations and elimination of disturbances. The advantage of the proposed sliding mode controller against conventional linear controller was tested for damping of the synchronous generator oscillations in the entire operating range. Obtained results show the improved damping in the entire operating range of the synchronous generator and the increase of the power system stability. The proposed study contributes to the progress in the development of the advanced stabilizer, which will replace conventional linear stabilizers and improve damping of the synchronous generators.

Design of Identification Based Adaptive Control for Fermentation Process in Bioreactor

The biochemical technology has been developing extremely fast since the middle of the last century. The main reason for such development represents a requirement for large production of high-quality biologically manufactured products such as pharmaceuticals, foods, and beverages. The impact of the biochemical industry on the world economy is enormous. The great importance of this industry also results in intensive development in scientific disciplines relevant to the development of biochemical technology. In addition to developments in the fields of biology and chemistry, which enable to understand complex biochemical processes, development in the field of control theory and applications is also very important. In the paper, the control for the biochemical reactor for the milk fermentation was studied. During the fermentation process, the biophysical quantities must be precisely controlled to obtain the high-quality product. To control these quantities, the bioreactor’s stirring drive and/or heating system can be used. Available commercial biochemical reactors are equipped with open loop or conventional linear closed loop control system. Due to the outstanding parameters variations and the partial nonlinearity of the biochemical process, the results obtained with these control systems are not satisfactory. To improve the fermentation process, the self-tuning adaptive control system was proposed. The use of the self-tuning adaptive control is suggested because the parameters’ variations of the studied biochemical process are very slow in most cases. To determine the linearized mathematical model of the fermentation process, the recursive least square identification method was used. Based on the obtained mathematical model the linear quadratic regulator was tuned. The parameters’ identification and the controller’s synthesis are executed on-line and adapt the controller’s parameters to the fermentation process’ dynamics during the operation. The use of the proposed combination represents the original solution for the control of the milk fermentation process. The purpose of the paper is to contribute to the progress of the control systems for the biochemical reactors. The proposed adaptive control system was tested thoroughly. From the obtained results it is obvious that the proposed adaptive control system assures much better following of the reference signal as a conventional linear control system with fixed control parameters.

Water Resources Crisis in Saudi Arabia, Challenges and Possible Management Options: An Analytic Review

The Kingdom of Saudi Arabia (KSA) is heading towards a severe and rapidly expanding water crisis, which can have negative impacts on the country’s environment and economy. Of the total water consumption in KSA, the agricultural sector accounts for nearly 87% of the total water use and, therefore, any attempt that overlooks this sector will not help in improving the sustainability of the country’s water resources. KSA Vision 2030 gives priority of water use in the agriculture sector for the regions that have natural renewable water resources. It means that there is little concern for making reuse of municipal wastewater for irrigation purposes in any region in general and in water-scarce regions in particular. The use of treated wastewater is very limited in Saudi Arabia, but it has very considerable potential for future expansion due its numerous beneficial uses. This study reviews the current situation of water resources in Saudi Arabia, providing more highlights on agriculture and wastewater reuse. The reviewed study is proposing some corrective measures for development and better management of water resources in the Kingdom. Suggestions also include consideration of treated water as an alternative source for irrigation in some regions of the country. The study concluded that a sustainable solution for the water crisis in KSA requires implementation of multiple measures in an integrated manner. The integrated solution plan should focus on two main directions: first, improving the current management practices of the existing water resources; second, developing new water supplies from both conventional and non-conventional sources.

Principle Knowledge of Integrated Pest Management Adopting Cotton Cultivators in Irrigated and Rainfed Conditions: A Critical Analysis

In India cotton was the major commercial crop and cultivating all the states. In recent years, area of cotton declined due to pest and disease attack, drought, lower price for the produces etc. The first reason as pest and disease attack will be the challenges and it is of utmost importance that in future the insect problems would have to be tackled through Integrated Pest Management (IPM). The present study deals with principle knowledge of IPM adopting cotton cultivators in irrigated and rainfed conditions. Under irrigated conditions, among cultural practices, all respondents had principle knowledge about growing high yielding and pest resistant hybrids, sowing quality and certified seeds and avoiding cotton ratoon cropping. Regarding mechanical practices all respondents had principle knowledge about collecting and destroying egg, larvae and pupae of pests and removing and destroying pest and disease infected cotton squares, flowers and other shed materials. With regard to biological practices, 93% of them had principle knowledge about spraying neem oil, followed by 82% about tying Trichogramma eggcard. Among chemical practices, more than 90% of the respondents had principle knowledge about of spraying herbicide (96%), identifying ETL (Economic Threshold Level) for cotton pests (94%), and applying safe insecticides (90%). Under rainfed condition, among cultural practices, all respondents had principle knowledge about sowing quality and certified seeds and growing high yielding and pest resistant hybrids seeds. Regarding mechanical practices hundred percentage of the respondents had principle knowledge on the mechanical practices viz., collecting and destroying egg, larvae and pupae of pests and removing and destroying pest and disease infected cotton squares, flowers and other shed materials. With regard to biological practices, 96% of the respondents had correct in principle knowledge about spraying neem oil, followed by 89% about tying Trichogramma eggcard. With regard to chemical practices, more than 90% of the respondents had principle knowledge of applying safe insecticides (95%), avoiding repeated use of the same insecticides (95%), identifying ETL for cotton pests (94%) and applying granular insecticides (90%).

Path-Tracking Controller for Tracked Mobile Robot on Rough Terrain

Automation technologies for agriculture field are needed to promote labor-saving. One of the most relevant problems in automated agriculture is represented by controlling the robot along a predetermined path in presence of rough terrain or incline ground. Unfortunately, disturbances originating from interaction with the ground, such as slipping, make it quite difficult to achieve the required accuracy. In general, it is required to move within 5-10 cm accuracy with respect to the predetermined path. Moreover, lateral velocity caused by gravity on the incline field also affects slipping. In this paper, a path-tracking controller for tracked mobile robots moving on rough terrains of incline field such as vineyard is presented. The controller is composed of a disturbance observer and an adaptive controller based on the kinematic model of the robot. The disturbance observer measures the difference between the measured and the reference yaw rate and linear velocity in order to estimate slip. Then, the adaptive controller adapts “virtual” parameter of the kinematics model: Instantaneous Centers of Rotation (ICRs). Finally, target angular velocity reference is computed according to the adapted parameter. This solution allows estimating the effects of slip without making the model too complex. Finally, the effectiveness of the proposed solution is tested in a simulation environment.

Simulation of Concrete Wall Subjected to Airblast by Developing an Elastoplastic Spring Model in Modelica Modelling Language

To meet the civilizations future needs for safe living and low environmental footprint, the engineers designing the complex systems of tomorrow will need efficient ways to model and optimize these systems for their intended purpose. For example, a civil defence shelter and its subsystem components needs to withstand, e.g. airblast and ground shock from decided design level explosion which detonates with a certain distance from the structure. In addition, the complex civil defence shelter needs to have functioning air filter systems to protect from toxic gases and provide clean air, clean water, heat, and electricity needs to also be available through shock and vibration safe fixtures and connections. Similar complex building systems can be found in any concentrated living or office area. In this paper, the authors use a multidomain modelling language called Modelica to model a concrete wall as a single degree of freedom (SDOF) system with elastoplastic properties with the implemented option of plastic hardening. The elastoplastic model was developed and implemented in the open source tool OpenModelica. The simulation model was tested on the case with a transient equivalent reflected pressure time history representing an airblast from 100 kg TNT detonating 15 meters from the wall. The concrete wall is approximately regarded as a concrete strip of 1.0 m width. This load represents a realistic threat on any building in a city like area. The OpenModelica model results were compared with an Excel implementation of a SDOF model with an elastic-plastic spring using simple fixed timestep central difference solver. The structural displacement results agreed very well with each other when it comes to plastic displacement magnitude, elastic oscillation displacement, and response times.

Taguchi Robust Design for Optimal Setting of Process Wastes Parameters in an Automotive Parts Manufacturing Company

As a technique that reduces variation in a product by lessening the sensitivity of the design to sources of variation, rather than by controlling their sources, Taguchi Robust Design entails the designing of ideal goods, by developing a product that has minimal variance in its characteristics and also meets the desired exact performance. This paper examined the concept of the manufacturing approach and its application to brake pad product of an automotive parts manufacturing company. Although the firm claimed that only defects, excess inventory, and over-production were the few wastes that grossly affect their productivity and profitability, a careful study and analysis of their manufacturing processes with the application of Single Minute Exchange of Dies (SMED) tool showed that the waste of waiting is the fourth waste that bedevils the firm. The selection of the Taguchi L9 orthogonal array which is based on the four parameters and the three levels of variation for each parameter revealed that with a range of 2.17, that waiting is the major waste that the company must reduce in order to continue to be viable. Also, to enhance the company’s throughput and profitability, the wastes of over-production, excess inventory, and defects with ranges of 2.01, 1.46, and 0.82, ranking second, third, and fourth respectively must also be reduced to the barest minimum. After proposing -33.84 as the highest optimum Signal-to-Noise ratio to be maintained for the waste of waiting, the paper advocated for the adoption of all the tools and techniques of Lean Production System (LPS), and Continuous Improvement (CI), and concluded by recommending SMED in order to drastically reduce set up time which leads to unnecessary waiting.

Work-Related Shoulder Lesions and Labor Lawsuits in Brazil: Cross-Sectional Study on Worker Health Actions Developed by Employers

Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Using Business Intelligence Capabilities to Improve the Quality of Decision-Making: A Case Study of Mellat Bank

Today, business executives need to have useful information to make better decisions. Banks have also been using information tools so that they can direct the decision-making process in order to achieve their desired goals by rapidly extracting information from sources with the help of business intelligence. The research seeks to investigate whether there is a relationship between the quality of decision making and the business intelligence capabilities of Mellat Bank. Each of the factors studied is divided into several components, and these and their relationships are measured by a questionnaire. The statistical population of this study consists of all managers and experts of Mellat Bank's General Departments (including 190 people) who use commercial intelligence reports. The sample size of this study was 123 randomly determined by statistical method. In this research, relevant statistical inference has been used for data analysis and hypothesis testing. In the first stage, using the Kolmogorov-Smirnov test, the normalization of the data was investigated and in the next stage, the construct validity of both variables and their resulting indexes were verified using confirmatory factor analysis. Finally, using the structural equation modeling and Pearson's correlation coefficient, the research hypotheses were tested. The results confirmed the existence of a positive relationship between decision quality and business intelligence capabilities in Mellat Bank. Among the various capabilities, including data quality, correlation with other systems, user access, flexibility and risk management support, the flexibility of the business intelligence system was the most correlated with the dependent variable of the present research. This shows that it is necessary for Mellat Bank to pay more attention to choose the required business intelligence systems with high flexibility in terms of the ability to submit custom formatted reports. Subsequently, the quality of data on business intelligence systems showed the strongest relationship with quality of decision making. Therefore, improving the quality of data, including the source of data internally or externally, the type of data in quantitative or qualitative terms, the credibility of the data and perceptions of who uses the business intelligence system, improves the quality of decision making in Mellat Bank.

Compression Study on Velvet and Termeh in Iranian Brocade

From ancient times, in some cultures, the way of choosing the colour and pattern of the fabric, and its decoration, represents a message about their beliefs, traditions and ethnical origins. Due to the diversity of clothing in the Middle East, two special types of Iranian fabrics have been investigated. The process of knitting with a weaving-loom is always accompanied by passing the fibres of the warp in different ways. This study presented the historical investigation of brocades and explanation about traditional Iranian brocades in terms of fabric, shape, and patterns. Moreover, the compression results between characteristics of Termeh and velvet have been reported. The aim of the study was to focus on the history of fabric texture in Iran and general information about brocades and Termeh fabrics in expressions of their historical traditions. In conclusion, it is attempted to introduce knitting techniques and designed models which have been presented for this traditional and expensive Iranian fabric.

A Two-Stage Expert System for Diagnosis of Leukemia Based on Type-2 Fuzzy Logic

Diagnosis and deciding about diseases in medical fields is facing innate uncertainty which can affect the whole process of treatment. This decision is made based on expert knowledge and the way in which an expert interprets the patient's condition, and the interpretation of the various experts from the patient's condition may be different. Fuzzy logic can provide mathematical modeling for many concepts, variables, and systems that are unclear and ambiguous and also it can provide a framework for reasoning, inference, control, and decision making in conditions of uncertainty. In systems with high uncertainty and high complexity, fuzzy logic is a suitable method for modeling. In this paper, we use type-2 fuzzy logic for uncertainty modeling that is in diagnosis of leukemia. The proposed system uses an indirect-direct approach and consists of two stages: In the first stage, the inference of blood test state is determined. In this step, we use an indirect approach where the rules are extracted automatically by implementing a clustering approach. In the second stage, signs of leukemia, duration of disease until its progress and the output of the first stage are combined and the final diagnosis of the system is obtained. In this stage, the system uses a direct approach and final diagnosis is determined by the expert. The obtained results show that the type-2 fuzzy expert system can diagnose leukemia with the average accuracy about 97%.