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ABSTRACT Pseudomonas aeruginosa ST308 clone has been reported to carry carbapenemase genes such as blaIMP and blaVIM but has been rarely associated with blaNDM-1. A total of 199 P. aeruginosa ST308 clinical and environmental isolates obtained between April 2019 and November 2020 from a tertiary-care hospital in Singapore were characterized using whole-genome sequencing. In addition, 71 blaNDM-1-positive ST308 whole-genome sequences from two other local tertiary-care hospitals in Singapore and 83 global blaNDM-1-negative ST308 whole-genome sequences in public databases were included to assess phylogenetic relationships and perform genome analyses. Phylogenetic analysis and divergent time estimation revealed that blaNDM-1-positive P. aeruginosa ST308 was introduced into Singapore in 2005 (95 % highest posterior density: 2001 to 2008). Core genome, resistome, and analyses of all local blaNDM-1-positive ST308 isolates showed chromosomal integration of multiple antibiotic resistance genes (ARGs) [aac(3)-Id, aac(6′)-Il, aadA6, aadA11, dfrB5, msr(E), floR, sul2, and qnrVC1], which was absent in global blaNDM-1-negative ST308 sequences. Most ARGs and virulence genes were conserved across isolates originating from the three different local hospitals. Close genetic relatedness of the blaNDM-1-positive ST308 clinical and environmental isolates suggests cocirculation between the hospital environment and human hosts with the hospital environment as a potential reservoir. Core genome single nucleotide polymorphism analyses revealed possible clonal transmission of blaNDM-1-positive ST308 isolates between the three hospitals over 7 years. Bloodstream isolates accounted for six of 95 (6.3%) clinical isolates. This study reports the introduction of a pathogenic blaNDM-1-positive P. aeruginosa ST308 more than a decade ago in Singapore and warrants surveillance for wider dissemination. IMPORTANCE P. aeruginosa is a Gram-negative opportunistic pathogen ubiquitously found in the environment and a major cause of nosocomial infections. While the P. aeruginosa ST308 clone has been known to bear blaIMP and blaVIM among global isolates, reports of blaNDM-1-positive P. aeruginosa ST308 are rare. The local blaNDM-1-positive P. aeruginosa ST308 isolates detected in this study appear to be unique to this region, with evidence of chromosomal acquisition of multiple ARGs compared to global blaNDM-1-negative P. aeruginosa ST308 isolates. Surveillance in Singapore and beyond for dissemination is essential to determine whether existing measures are sufficient to control the spread of this ST308 clone.

Carbapenemase-producing Enterobacterales cause healthcare-associated infections but modes of transmission are not well understood. Here, the authors find evidence of transmission without direct patient contact, indicating presence of undetected environmental reservoirs, whilst half of the transmission events are likely due to plasmid-mediated transmission.

The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.

Here, the authors sample air and surfaces in hospital rooms of COVID-19 patients, detect SARS-CoV-2 RNA in air samples of two of three tested airborne infection isolation rooms, and find surface contamination in 66.7% of tested rooms during the first week of illness and 20% beyond the first week of illness.

The authors report the synthesis of an enantiomeric block co-beta-peptide that kills methicillin-resistant Staphylococcus aureus, including biofilm and persister bacterial cells, and disperses biofilms. The copolymer displays antibacterial activity in human ex vivo and mouse in vivo infection models without toxicity.

Abstract Background In May 2015, we noticed an increase in carbapenem-resistant Acinetobacter baumannii (CRAB) infections in the Medical Intensive Care Unit (MICU). To investigate this, we studied the extent of environmental contamination and subsequent onward clonal transmission of CRAB. Methods We conducted a one-day point prevalence screening (PPS) of the patients and environment in the MICU. We screened patients using endotracheal tube aspirates and swabs from nares, axillae, groin, rectum, wounds, and exit sites of drains. We collected environmental samples from patients’ rooms and environment outside the patients’ rooms. CRAB isolates from the PPS and clinical samples over the subsequent one month were studied for genetic relatedness by whole genome sequencing (WGS). Results We collected 34 samples from seven patients and 244 samples from the environment. On the day of PPS, we identified 8 CRAB carriers: 3 who screened positive and 5 previously known clinical infections. We detected environmental contamination in nearly two-thirds of the rooms housing patients with CRAB. WGS demonstrated genetic clustering of isolates within rooms but not across rooms. We analysed 4 CRAB isolates from clinical samples following the PPS. One genetically-related CRAB was identified in the respiratory sample of a patient with nosocomial pneumonia, who was admitted to the MICU five days after the PPS. Conclusion The extensive environmental colonization of CRAB by patients highlights the importance of environmental hygiene. The transmission dynamics of CRAB needs further investigation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The escalating incidence of depression has brought attention to the increasing concern regarding the mental well-being of university students in the current academic environment. Given the increasing mental health challenges faced by students, there is a critical need for efficient, scalable, and accurate screening methods. This study aims to address the issue by using the General Health Questionnaire-12 (GHQ-12), a well recognized tool for evaluating psychological discomfort, in combination with machine learning (ML) techniques. Firstly, for effective screening of depression, a comprehensive questionnaire has been created with the help of an expert psychiatrist. The questionnaire includes the GHQ-12, socio-demographic, and job and career-related inquiries. A total of 804 responses has been collected from various public and private universities across Bangladesh. The data has been then analyzed and preprocessed. It has been found that around 60% of the study population are suffering from depression. Lastly, 16 different ML models, including both traditional algorithms and ensemble methods has been applied to examine the data to identify trends and predictors of depression in this demographic. The models' performance has been rigorously evaluated in order to ascertain their effectiveness in precisely identifying individuals who are at risk. Among the ML models, Extremely Randomized Tree (ET) has achieved the highest accuracy of 90.26%, showcasing its classification effectiveness. A thorough investigation of the performance of the models compared, therefore clarifying their possible relevance in the early detection of depression among university students, has been presented in this paper. The findings shed light on the complex interplay among socio-demographic variables, stressors associated with one's profession, and mental well-being, which offer an original viewpoint on utilizing ML in psychological research.

Assessment of traffic safety is an essential study in transportation engineering. In a developing country like India, around 150,000 people die in road crashes every year. Furthermore, at uncontrolled median openings, the severity of road crashes is higher due to the presence of impatient U-turning road users who don't obey the rule of priority. Traditionally, road crash data have been used since long to analyze traffic safety. However, in developing countries, the main drawback of this conventional method is limited availability of accident data as very few accidents get reported. Moreover, the accuracy of these reported data is questionable. Therefore, now-a-days, various surrogate traffic safety measures like Post Encroachment Time (PET), and Time to Collision (TTC) are being used to examine the safety of road users. Among them, PET is regarded as the most consistent, and most widely used safety indicator. Therefore, in the present study, PET across different traffic volume levels has been determined. Videography data has been collected from selected median openings located on six-lane divided urban roads. PET values for different traffic volumes, and different category of vehicles have been analysed in detail. Further, the distribution of PET values across the full width of road has also been studied. Concept of critical speed is introduced which is compared with conflicting speed to assess unsafe conflicts and determine a critical PET. Finally, regression models have also been proposed with good levels of accuracy to determine the PET values for various category of vehicles travelling at different conflicting speeds.

Monkeypox is a zoonotic disease caused by the monkeypox virus (MPXV). It was an epidemic infection among African countries over the last few decades. In 2022, MPXV has been broke through in Africa, America, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific region. This widespread infection of MPXV has created panic across the nations, and the WHO has declared a global public health emergency due to the multi-country MPX outbreak. We prepared this brief report on the MPX outbreak 2022 by extracting data from Scopus, PubMed, and website databases. We manually read all the relevant articles from our target databases. The rapid spread of MPX infection in around a 100 countries has threatened the global healthcare systems. The available epidemiological data revealed that sexual orientations and encounters are potential contributing factors for monkeypox infections. However, it has not been categorized as a sexually transmitted infection. Also, MPXV can transfer from 1 individual to others in many ways. The empowerment of this old foe has created additional pressure and threat on the healthcare authorities during the ongoing Covid-19 pandemic. Effective preventive measures, social awareness, and therapeutic approaches can reduce this extra burden on the healthcare system across the countries. Focusing only on sexual orientations and encounters as risk factors for MPX infection might increase stigma that will be another barrier to controlling and preventing MPXV spread. Therefore, we should be careful in delivering messages about MPX infection to the general population. Also, we recommend repositioning the existing smallpox vaccines and antivirals in MPX infection until the development of specific antiviral agents against this infection.

Traffic safety assessment is an integral part of transportation engineering. In a developing country like India, it is observed that in every four second, one person gets injured in road crashes. Moreover, at median openings which are usually uncontrolled in India, the severity of road crashes increase many fold. This is due to the fact that neither lane discipline nor priority rule is followed at the median openings. Conventionally, road crash data reports were used to study and analyze traffic safety. However, the drawback of this traditional method is that a lot of accidents need to be recorded for analysis and to draw any conclusions and take necessary corrective measures. In developing countries like India, available accident data are based on reports submitted by the police department of respective state governments. The accuracy of these accident data details is highly questionable. Therefore, in the recent times surrogate traffic safety measures are being used to analyze traffic safety. Various surrogate traffic measures like Deceleration Time (DT), Time to Collision (TTC), Post Encroachment Time (PET), etc. are being used to examine road safety. These values are based on the temporal and spatial proximity between road-users during possible conflict situation. Among all the traffic safety measures, PET is regarded as the most reliable and most commonly used indicator. Therefore, in this study, PET across different traffic volume levels at median opening area is calculated. A critical safe ratio has been introduced to better analyze the traffic safety at median opening based on minimum stopping sight distance (SSD) as per IRC: 66–1976 and speed to PET ratio. Finally clustering technique has been used to define various severity indices for probable road crashes at median opening area. For this study, data has been collected from different median openings located on six-lane divided urban roads.

Background. Since 2010, the incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing in Singapore. We analyzed the clinical and molecular epidemiology of CRE among adult inpatients in Singapore. Methods. Quarterly incidence of unique subjects (per 100 000 patient-days) with positive clinical and surveillance cultures for CRE were estimated based on mandatory data submitted to the National Public Health Laboratory by public hospitals between 2010 and 2015. CRE-positive adult inpatients were prospectively recruited from 6 public sector hospitals between December 2013 and April 2015. Subjects answered a standardized epidemiologic questionnaire and provided samples for this study. Further clinical information was extracted from subjects' electronic medical records. Whole-genome sequencing was performed on study isolates to determine transmission clusters. Results. Incidence of CRE clinical cultures among adult inpatients plateaued from 2013 (range: 7.73 to 10.32 per 100 000 patient-days) following an initial increase between 2010 and end-2012. We prospectively recruited 249 subjects. Their median age was 65 years, 108 (43%) were female, and 161 (64.7%) had carbapenemase-producing Enterobacteriaceae (CPE). On multivariate analysis, prior carbapenem exposure (OR: 3.23; 95% CI: 1.67-6.25) and hematological malignancies (OR: 2.85; 95% CI: 1.10-7.41) were associated with non-carbapenemase-producing CRE (NCPE) (n = 88) compared with CPE (n = 161) subjects. Among 430 CRE isolates from the 249 subjects, 307(71.3%) were CPE, of which 154(50.2%) were blaKPC-positive, 97(31.6%) blaNDM-positive, and 42 (13.7%) blaOXA-positive. Klebsiella pneumoniae (n = 180, 41.9%), Escherichia coli (n = 129, 30.0%) and Enterobacter cloacae (n = 62, 14.4%) were the main Enterobacteriaceae species. WGS (n = 206) revealed diverse bacterial strain type (STs). The predominant blaKPC-positive plasmid was pHS102707 (n = 62, 55.4%) and the predominant blaNDM-positive plasmid was pNDM-ECS01 (n = 46, 48.9%). Five transmission clusters involving 13 subjects were detected. Conclusions. Clinical CRE trend among adult inpatients showed stabilization following a rapid rise since introduction in 2010 potentially due to infection prevention measures and antimicrobial stewardship. More work is needed on understanding CPE transmission dynamics. [ABSTRACT FROM AUTHOR]

Interstitial-free (IF) steel specimens were coated by hot-dip aluminizing process bearing bath composition as Al-6.9% Si-1.4% Mg and bath temperature at 800 °C. Dipping time varied for 0.5, 1, 3 and 6 min. The objective of the present study is to conduct a systematic investigation to identify and analyse the formation of various phases and compounds in the coating. Studies on aluminizing of steel had indicated the presence of an intermetallic layer adjacent to steel substrate. In this study, the morphological features obtained after hot dipping at 800 °C were investigated. For the application of aluminized steel sheets in industry for manufacture of tubes and pipes, the adherence of the aluminized coating must be ensured. This property of the coating is influenced by the morphological features of the coating. Aluminizing being thought of a possible substitution of galvanizing owing to its promise to evolve lesser volume fraction of intermetallic phases and consequently known to generate a ductile coating. The entire coating consists of an outer Al-Si topcoat and a thin intermetallic layer which composed of an outer θ-FeAl3 and inner η-Fe2Al5 layers. The thickness of intermetallic layers was found to increase with the increase of dipping time in a near parabolic manner.The phases formed on the IF steel substrates were characterized by scanning electron microscopy with EDS, X-ray diffraction, EPMA and EBSD techniques.Interesting findings from XRD include the presence of Al3FeSi2 (τ4) and Al2FeSi (τ3) phases, which normally appear after annealing of aluminised sheet. A distinct elemental Si peak was found in XRD study. Presence of Mg in the form of Mg2Si was also found in XRD and supported by EPMA investigation. Presence of several ternary Al-Fe-Si (τ3, τ4, τ5) and binary FeAl3 and Fe2Al5intermetallic phases were identified by composition profile analysis from SEM based EDS and GDOES and further confirmed by EBSD. Presence of Si humps in the top and intermetallic layer attributed by the presence of Si-bearing phases or elemental pro-eutectic Si in Al-Si alloy were also indicated in SEM-EDS and GDOES study. Variation of surface topographical features of the HDA steel substrates with increasing dipping durations were examined and reported for the first time by using AFM. Formability tests were conducted by bending the samples 180° over a mandrel. None of the specimens showed any tendency of flaking exhibiting excellent bonding of the coating with IF steel substrate.

In the paper, we propose an alternative strategy for multi-level linear programming (MLP) problem with neutrosophic numbers through goal programming strategy. Multi-level linear programming problem consists of k levels where there is an upper level at the first level and multiple lower levels at the second level with one objective function at every level. Here, the objective functions of the level decision makers and constraints are described by linear functions with neutrosophic numbers of the form [u + vI], where u, v are real numbers and I signifies the indeterminacy. At the beginning, the neutrosophic numbers are transformed into interval numbers and consequently, the original problem transforms into MLP problem with interval numbers. Then we compute the target interval of the objective functions via interval programming procedure and formulate the goal achieving functions. Due to potentially conflicting objectives of k decision makers, we consider a possible relaxation on the decision variables under the control of each level in order to avoid decision deadlock. Thereafter, we develop three new goal programming models for MLP problem with neutrosophic numbers. Finally, an example is solved to exhibit the applicability, feasibility and simplicity of the proposed strategy.

The cyclic plastic deformation of an archetypal microstructure dual phase steels has been examined via micromechanics modelling based on representative volume elements technique. The dual phase steel has soft ferrite – matrix with hard martensite – islands, which are distributed in a discrete manner. In the field of automobile industries, the suitable combination of strain hardening, strength and ductility, and their lean combination represent them as an economically desire option for huge multiple lightweight options. In this numerical approach, different microstructures for micromechanical modelling were constructed to detailed examination and analysis for the tensile and cyclic deformation response of dual phase steels. Due to the distinct difference in the stress–strain responses of ferrite and martensite phases, incompatibility of strain between matrix-softer ferrite and island-harder martensite phase arises during tensile straining. The effect of strain partitioning in cyclic plastic deformation response of dual phase steel has been studied in the present investigation. Apart from this, effect of martensite volume fraction on cyclic stress–strain response of dual phase steels, cyclic plastic deformation distribution in individual phases and cyclic deformation inhomogeneity at microstructural level have been systematically investigated. Keywords: Cyclic plastic deformation, Dual phase steel, Martensite volume fraction, Plastic strain localization, Stress triaxiality, Material inhomogeneity

The presence of U-turns at median openings affects the movement of approaching through vehicles in terms of either slowing down or lane changing. The approaching through vehicles change their lanes towards curb side to avoid possible conflict with the U-turns. The present study applies Markov's process to estimate lane changing patterns of approaching through vehicles due to the presence of U-turns. These vehicles generally start changing their lanes as they enter the slowdown section which is divided into equal parts of 10 m each. First, the probability matrices are obtained for the first 10 m of slowdown section and subsequently the transition matrices are defined for each lane. Finally, Markov procedure is applied to estimate the lane changing probabilities of the vehicles. These estimated probabilities by Markov's process are compared with the lane changing probabilities obtained from field data. The probability of lane changing is found to be more at low U-turning volumes whereas this probability decreases with an increase of U-turns.

Evolution of different phases formed on interstitial free (IF) steel after hot dipping in Al–Si–Mg alloy melt at 700 ​°C for 0.5, 1, 3 and 6 ​min were examined in the present research. Notable findings from XRD studies include presence of Al3FeSi2 (τ4) Al2FeSi (τ3) phases along with elemental Si and Mg in the form of Mg2Si. Composition profiles revealed by EDS and GDOES studies has been in line with the XRD results. Interestingly, EPMA study established presence of Si as isolated islands across the coating and up to the intermetallic layer apart from its association with Mg in the form of Mg2Si. The microstructure across the cross-section revealed by the EBSD technique showed three distinct layers consisting of Al–Si top coat, θ-FeAl3 and a major η-Fe2Al5 phase layer adjoining the steel substrate. This study also revealed ternary Fe–Al–Si intermetallic Al3FeSi2 (τ4) and Al2FeSi (τ3) phases scattered in the intermetallic layer. Texture measurement from EBSD revealed the presence of strong γ-fiber for 3 ​min hot dipped aluminized samples. Grain boundary characteristics distribution (GBCD) results indicated that the volume fractions of high angle grain boundaries were gradually increased with the advancement of dipping time.

The paper presents a novel strategy for solving bi-level linear programming problem based on goal programming in neutrosophic numbers environment. Bi-level linear programming problem comprises of two levels namely upper or first level and lower or second level with one objective at each level. The objective function of each level decision maker and the system constraints are considered as linear functions with neutrosophic numbers of the form [p + q I], where p, q are real numbers and I represents indeterminacy. In the decision making situation, we convert neutrosophic numbers into interval numbers and the original problem transforms into bi-level interval linear programming problem. Using interval programming technique, the target interval of the objective function of each level is identified and the goal achieving function is developed. Since, the objectives of upper and lower level decision makers are generally conflicting in nature, a possible relaxation on the decision variables under the control of each level is taken into account for avoiding decision deadlock. Then, three novel goal programming models are presented in neutrosophic numbers environment. Finally, a numerical problem is solved to demonstrate the feasibility, applicability and novelty of the proposed strategy.

Interval bipolar neutrosophic set is a significant extension of interval neutrosophic set where every element of the set comprises of three independent positive membership functions and three independent negative membership functions. In this study, we first define correlation coefficient, and weighted correlation coefficient measures of interval bipolar neutrosophic sets and prove their basic properties.

Purpose: Extracorporeal shock wave lithotripsy (ESWL) is an established modality for renal calculi. Its role for large stones is being questioned. A novel model of temporary double J (DJ) stenting followed by ESWL was devised and outcomes were assessed. Materials and Methods: The study included 95 patients with renal calculi sized 1 to 2 cm. Patients were randomized into 3 groups. Group 1 received ESWL only, whereas group 2 underwent stenting followed by ESWL. In group 3, a distinct model was applied in which the stent was kept for 1 week and then removed, followed by ESWL. Procedural details, analgesic requirements, and outcome were analyzed. Results: Eighty-eight patients (male, 47; female, 41) were available for analysis. The patients’ mean age was 37.9±10.9 years. Stone profile was similar among groups. Group 3 received fewer shocks (mean, 3,155) than did group 1 (mean, 3,859; p=0.05) or group 2 (mean, 3,872; p=0.04). The fragmentation rate was similar in group 3 (96.7%) and groups 1 (81.5%, p=0.12) and 2 (87.1%, p=0.16). Overall clearance in group 3 was significantly improved (83.3%) compared with that in groups 1 (63.0%, p=0.02) and 2 (64.5%, p=0.02) and was maintained even in lower pole stones. The percentage successful outcome in groups 1, 2, and 3 was 66.7%, 64.5%, and 83.3%, respectively (p=0.21). The analgesic requirement in group 2 was higher than in the other groups (p=0.00). Group 2 patients also had more grade IIIa (2/3) and IIIB (1/2) complications. Conclusions: Stenting adversely affects stone clearance and also makes the later course uncomfortable. Our model of brief stenting followed by ESWL provided better clearance, comfort, and a modest improvement in outcome with fewer sittings and steinstrasse in selected patients with large renal calculi.

Bipolar neutrosophic sets are the extension of neutrosophic sets and are based on the idea of positive and negative preferences of information. Projection measure is a useful apparatus for modelling real life decision making problems. In the paper, we define projection, bidirectional projection and hybrid projection measures between bipolar neutrosophic sets. Three new methods based on the proposed projection measures are developed for solving multi-attribute decision making problems. In the solution process, the ratings of performance values of the alternatives with respect to the attributes are expressed in terms of bipolar neutrosophic values.

This paper investigates an extended grey relational analysis method for multiple attribute decision making problems under interval neutrosophic uncertain linguistic environment. Interval neutrosophic uncertain linguistic variables are hybridization of uncertain linguistic variables and interval neutrosophic sets and they can easily express the imprecise, indeterminate and inconsistent information which normally exist in real life situations.

The present paper proposes neutrosophic soft multi-attribute decision making based on grey relational projection method. Neutrosophic soft sets is a combination of neutrosophic sets and soft sets and it is a new mathematical apparatus to deal with realistic problems in the fields of medical sciences, economics, engineering, etc.

In the paper, we propose Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) technique for solving single valued neutrosophic soft set expert based multi-attribute decision making problems. Single valued neutrosophic soft expert sets are combination of single valued neutrosophic sets and soft expert sets. In the decision making process, the ratings of alternatives with respect to the parameters are expressed in terms of single valued neutrosophic soft expert sets to deal with imprecise or vague information. The unknown weights of the parameters are derived from maximizing deviation method. Then, we determine the rank of the alternatives and choose the best one by using TOPSIS method. Finally, a numerical example for teacher selection is presented to demonstrate the applicability and effectiveness of the proposed approach.

The urachus is a tubular embryonic structure connecting the allantois at the umbilicus to the bladder during development of foetus. It gets obliterated at 12th week of gestation and remains as a fibrous cord like structure extending from the umbilicus to the dome of the bladder. Complete or partial failure of this process results in urachal anomalies. We are reporting a rare case of young lady presenting with features of dysuria and passage of jelly like material in urine which was subsequently diagnosed as vesicourachal diverticulum by cross sectional imaging, cystoscopy and managed with minimally invasive surgical excision.

At an uncontrolled median opening, the limited priority situation and the high degree of heterogeneity in traffic stream make the merging manoeuvre of U-turning vehicles very much complex. This study is an attempt to understand this merging manoeuvre. The different types of merging manoeuvres have been identified in the field and accordingly classified into different categories. Depending upon the number of vehicles that can merge all together into the opposing through traffic by accepting a single gap, the merging has been classified into two types: single entry merging and multiple entry merging. On the other hand, based on the situation of priority of movement, the merging process is divided into another two categories: ideal merging and forced merging. More explicitly, the ideal merging is split into free merging and Swift Merging (SM). In addition, the forced entry merging is categorized into Gradual Merging (GM) and Aggressive Merging (AM). Time distance diagrams for different types of merging are presented for their better understanding. Field data collected at seven median openings located on various 6-lane divided urban roads are used to analyse different types of merging in a mixed traffic situation. All vehicles plying on the road are divided into 5 categories such as car, motorized two-wheeler (2-W), motorized three-wheeler (3-W), Sports Utility Vehicle (SUV), and Light Commercial Vehicle (LCV) and the merging behaviour of these categories of vehicles have been studied. The effect of influencing parameters like opposing traffic volume and delay on merging are investigated. Mathematical relations are developed between Merging Time (MT) of a vehicle type and the opposing traffic volume. To address the effect of Service Delay (SD) on the MT of a vehicle, models are proposed between SD and MT for all the five categories of vehicles. The two types of merging; gradual and swift are prominently observed in field. The time required by different categories of vehicles for these two merging at various traffic volume levels are determined. Finally, two-tailed t-test is conducted to see if the MT for the two different types of merging is statistically different. First published online 26 October 2016

Introduction: Acute Urinary Retention (AUR) is an important feature of progression of Benign Prostatic Hyperplasia (BPH). The management of AUR is immediate urethral catheterisation followed by Trial without Catheter (TWOC). Aim: The aim of this study was to evaluate the factors predicting outcome of TWOC in patients with AUR due to BPH. Materials and Methods: Ninety patients with spontaneous AUR secondary to BPH were selected for the study. Various factors e.g., age, duration of Lower Urinary Tract Symptoms (LUTS), drained urinary volume, Digital Rectal Examination (DRE) prostate size, Ultrasonography (USG) prostate volume, thickened bladder wall, Intravesical Prostatic Protrusion (IPP) grade were recorded. Tamsulosin was administered for three days before trial. The TWOC was considered successful if patient voided within six hours with Qmax >5 mL/second and Post Void Residual (PVR) urine

The bipolar neutrosophic set is an important extension of the bipolar fuzzy set. The bipolar neutrosophic set is a hybridization of the bipolar fuzzy set and neutrosophic set. Every element of a bipolar neutrosophic set consists of three independent positive membership functions and three independent negative membership functions. In this paper, we develop cross entropy measures of bipolar neutrosophic sets and prove their basic properties. We also define cross entropy measures of interval bipolar neutrosophic sets and prove their basic properties. Thereafter, we develop two novel multi-attribute decision-making strategies based on the proposed cross entropy measures. In the decision-making framework, we calculate the weighted cross entropy measures between each alternative and the ideal alternative to rank the alternatives and choose the best one. We solve two illustrative examples of multi-attribute decision-making problems and compare the obtained result with the results of other existing strategies to show the applicability and effectiveness of the developed strategies. At the end, the main conclusion and future scope of research are summarized.