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Analysis by modelling production throughput is an efficient way to provide information for production decision-making. Observation and investigation based on a real-life tile production line revealed that the five main uncertain variables are demand rate, breakdown time, scrap rate, setup time, and lead time. The volatile nature of these random variables was observed over a specific period of 104 weeks. The processes were sequential and multi-stage. These five uncertain variables of production were modelled to reflect the performance of overall production by applying Bayesian inference using Gibbs sampling. The application of Bayesian inference for handling production uncertainties showed a robust model with 2.5 per cent mean absolute percentage error. It is recommended to consider the five main uncertain variables that are introduced in this study for production decision-making. The study proposes the use of Bayesian inference for superior accuracy in production decision-making.

Production throughput measures the performance and behaviour of a production system. Production throughput modelling is complex because of uncertainties in the production line. This study examined the potential application of the adaptive neuro-fuzzy inference system (ANFIS) to modelling the throughput of production under five significant production uncertainties: scrap, setup time, break time, demand, and lead time of manufacturing. The effects of these uncertainties on the production of floor tiles were studied by performing 104 observations on the production uncertainties over 104 weeks, based on a weekly production plan in a tile manufacturing industry. The results of the ANFIS model were compared with the multiple linear regression (MLR) model. The results showed that the ANFIS model was capable of forecasting production throughput under uncertainty with higher accuracy than was the MLR model, indicated by an R-squared of 98 per cent.

Abstract Background The field of health has been facing challenges with fraudulent practices and the prevalence of “quack medicine”. Many cases have given rise to this issue. Therefore, this study aims to comprehensively investigate and categorize the causes and consequences of quack medicine in the healthcare. Methods A scoping review, using the 5 stages of Arksey and O’Malley’s framework, was conducted to retrieve and analyze the literature. International databases including the PubMed, Scopus, Embase and Web of Science and also national Iranian databases were searched to find peer reviewed published literature in English and Persian languages. Grey literature was also included. Meta-Synthesis was applied to analyze the findings through an inductive approach. Results Out of 3794 initially identified studies, 30 were selected for this study. Based on the findings of this research, the causes of quackery in the health were divided into six categories: political, economic, socio-cultural, technical-organizational, legal and psychological. Additionally, the consequences of this issue were classified into three categories: health, economic and social. Economic and social factors were found to have a more significant impact on the prevalence of quackery in the health sector. Legal and technical-organizational factors played a crucial role in facilitating fraudulent practices, resulting in severe health consequences. Conclusion It is evident that governing bodies and health systems must prioritize addressing economic and social factors in combating quackery in the health sector. Special attention should be paid to the issue of cultural development and community education to strengthen the mechanisms that lead to the society access to standard affordable services. Efforts should be made also to improve the efficiency of legislation, implementation and evaluation systems to effectively tackle this issue.

This study systematically examines the behavior of multi-stacked long Josephson junctions (multi-sLJJs) under various magnetic inductances and a variety of drives. To investigate the localized modes in the multi-sLJJs, the tripled sine-Gordon equation (sGE) with a phase shift formation recognized as 0-π\pi -0 junction is analyzed. The amplitude equations are derived through asymptotic analysis. It is revealed that synchronized oscillations occur in the multi-sLJJs under both strong and weak couplings; however, the system experiences exponential decay in the absence of external drives. The stack naturally exhibits damping due to the energy produced by the oscillating mode through radiation, which arises from the higher harmonic excitation introduced into the system. It is observed that when an AC drive is present, the system exhibits synchronous oscillations for both strong and weak inductances but eventually becomes stable. However, for parametric drives under both coupling conditions, the system experiences exponential decay. Our findings suggest that weak coupling renders parametric drives ineffective. Nevertheless, numerical simulations demonstrate that a large driving amplitude induces oscillations in the system and causes it to approach a steady position under strong coupling.

Recently, nanoscience, especially metal–organic frameworks (MOFs), has been used to increase the effectiveness and properties of drugs. In this study, by using microwave irradiation; penicillin, which is a known antibiotic; and copper metal–organic frameworks (Cu-MOFs), a new penicillinoate@copper metal–organic framework (penicillinoate@Cu-MOF) was synthesized. The structure and characterization of the newly synthesized compound were determined using FT-IR spectrums, EDAX analysis, elemental analysis, XRD patterns, SEM images, nitrogen adsorption/desorption curves, and TGA curve. Then, its antimicrobial effects were evaluated on numerous Gram-positive and Gram-negative bacterial strains and were compared with those of penicillin and gentamicin. In continuation of the biological activities, antioxidant tests were performed on the compounds using the DPPH method. For biological activities, the synthesized penicillinoate@Cu-MOF is much more effective than penicillin and Cu-MOF. The loading of penicillin on the nanostructure and the presence of copper in the final composition can be attributed to the high antibiotic properties of the synthesized composition.

Introduction: Emergency department (ED) visits related to flare-ups of inflammatory bowel disease (IBD) are becoming more prevalent. There are many potentially dangerous complications and sequelae of uncontrolled IBD. Case Report: We report a case of a middle-aged woman who presented with a few hours of severe abdominal pain, nausea, and vomiting. Given her hemodynamic instability, she was sent urgently for computed tomography, which showed an incomplete small bowel malrotation, mesenteric volvulus, and high-grade small bowel obstruction with evolving ischemia. The patient underwent exploratory laparotomy to resect most of her small intestines. Biopsies later revealed active Crohn’s disease. Conclusion: Patients with flare-ups of IBD are common in the ED, but very few present with a midgut volvulus later in life. Our case is unique and adds to the literature due to the dramatic consequences of undiagnosed Crohn’s disease in a patient with intermittent symptoms and extensive workup spanning over two decades.

With the help of a hydrothermal approach in this study, we could provide flower-like nanostructures (NSs) of zinc oxide (ZnO) doped with Tb (FL-NS Tb3+/ZnO). Then, FL-NS Tb3+/ZnO morphology was investigated by energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), X-ray powder diffraction (XRD), and map analysis. The results revealed higher activity centers and porosity of this nanocomposite, which were followed by acceptable electrochemical function. Hence, it can be utilized for fabricating an electrochemical sensor with an appropriate response for the simultaneous determination of kynurenic acid (KYN) and tryptophan (TRP). However, as compared with the modified carbon paste electrode (FL-NS Tb3+/ZnO/CPE), the bare carbon paste electrode (BCPE) exhibited a weak response toward KYN and TRP but the modified electrode was followed by a high current response for KYN and TRP at a potential 0.35 and 0.809 V. Therefore, cyclic voltammetry (CV) was applied in optimal experimental conditions to study the electrochemical behaviors of KYN and TRP over the surface of the proposed modified electrode. Moreover, we used differential pulse voltammetry (DPV) for quantitative measurements. It was found that this new modified electrode linearly ranged from 0.001 to 700.0 μM, with detection limits of 0.34 nM and 0.22 nM for KYN and TRP, respectively. In addition, KYN and TRP in real samples can be analyzed by this sensor, with a recovery of 97.75%−103.6% for the spiked KYN and TRP in real samples.

The maintenance of functional independence is the top priority of patients with chronic kidney disease (CKD). Defects in mitochondrial energetics may compromise physical performance and independence. We investigated associations of the presence and severity of kidney disease with in vivo muscle energetics and the association of muscle energetics with physical performance. We performed measures of in vivo leg and hand muscle mitochondrial capacity (ATPmax) and resting ATP turnover (ATPflux) using 31phosphorus magnetic resonance spectroscopy and oxygen uptake (O2 uptake) by optical spectroscopy in 77 people (53 participants with CKD and 24 controls). We measured physical performance using the 6-minute walk test. Participants with CKD had a median estimated glomerular filtration rate (eGFR) of 33 ml/min per 1.73 m2. Participants with CKD had a -0.19 mM/s lower leg ATPmax compared with controls but no difference in hand ATPmax. Resting O2 uptake was higher in CKD compared with controls, despite no difference in ATPflux. ATPmax correlated with eGFR and serum bicarbonate among participants with GFR

Introduction: Most mortality in COVID-19 cases was due to the increased inflammatory cytokines and cytokine storm. As mesenchymal stem cells (MSCs) possess immunomodulatory properties, this study assessed the therapeutic effects of placental MSC-derived extracellular vesicles on the inflammation and pulmonary injury caused by COVID-19. Methods: The study was carried out in phases I (safety study, 101 patients) and II (efficacy study, 80 patients) in a randomized, double-blind study at four hospital centers from April 2021 to August 2021. In addition to standard treatments, 15 mL of normal saline solution containing 15×109 vesicles was injected intravenously for five consecutive days. Results: No reaction or adverse events were observed in any patients. In the intervention group, after 5 days of treatment, patients’ clinical status and oxygenation improved, and 75% of patients presented an increased SpO2 after 5 days. Besides, inflammatory parameters assessment indicated a 21% decrease in neutrophil-lymphocyte ratio and a 54% reduction in C-reactive protein after day five of the intervention. Conclusion: PMSC-derived extracellular vesicles were safe and well-tolerated, down-regulated cytokine storms, and restored oxygenation. Thus, they can be considered a promising therapeutic candidate for severe COVID-19.