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The cumulative incidence function (CIF) plays an important role in the comparison of competing risks in a competing risks model. Its value at time t is the probability of failure by time t from a particular type of risk in the presence of other risks. In this paper we consider the estimation of two CIFs, F 1 and F 2 , corresponding to two competing risks when the ratio R ( t ) ≡ F 1 ( t ) / F 2 ( t ) is nondecreasing in t > 0 . First, we derive their nonparametric maximum likelihood estimators (NPMLE) of these CIFs in the continuous case under this order constraint and show that they are inconsistent. We then develop projection-type estimators that are uniformly strongly consistent and study the weak convergence of the resulting processes. Through simulations, we compare the finite sample performance of the NPMLEs and our estimators and show that our estimators outperform them in general in terms of mean square error at all the scenarios that we consider. We also develop a test for the presence of this order constraint and extend all these results to the censored case. To illustrate the applicability of the theory we develop, we provide a real life example.

Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed weight-loss surgeries worldwide. Its common complications include bowel obstruction, anastomotic strictures, postoperative leak, dumping syndrome, nutritional complications, and venous thromboembolic events. Presentation of case This report presents a case of perforation at the jejuno-jejunal (j-j) anastomosis, an extremely rare complication after laparoscopic RYGB surgery (LRYGBS), with an incidence reported to be under 1% in the literature. Potential causes noted from previous reports include distal obstruction, abscess formation, patient comorbidities, technical factors, and microbiological factors. A morbidly obese female patient underwent LRYGBS with an uneventful recovery. The patient presented 15 weeks postoperatively with a 2-day history of acute abdominal pain, vomiting, constipation, and peritoneal signs. Discussion Following clinical and radiological evaluation, the patient underwent an exploratory laparoscopy for the diagnosis and treatment of complications. In this case, laparoscopy was shifted to the open technique due to technical difficulties. A 1.5-cm perforation was identified at the site of the anastomosis and was repaired with absorbable sutures and a graham patch. The patient recovered uneventfully. Conclusion Prompt recognition of symptoms and early intervention may reduce overall morbidity and mortality in similar cases. This report describes a case of a late perforation at the site of j-j anastomosis in an obese female. We also discuss the incidence, presentation, management, outcome, and possible causes of such complications.

(Ta2O5)1-x- (TiO2)x (TTOx) thin films, with x = 0, 0.03, 0.06, 0.08, and 0.11, were deposited using magnetron direct current (DC) sputtering method onto the P/boron-silicon (1 0 0) substrates by varying areas of Tantalum and Titanium metallic targets, in oxygen environment at ambient temperature. The as-deposited thin films were annealed at temperatures ranging from 500 to 800 °C. Generally, the formation of the Ta2O5 structure was observed from the X-ray diffraction measurements of the annealed films. The capacitance of prepared metal– oxide– semiconductor (MOS) structures of Ag/TTOx/p-Si was measured at 1 MHz. The dielectric constant of the deposited films was observed altering with varying composition and annealing temperature, showing the highest value 71, at 1 MHz, for the TTOx films, x = 0.06, annealed at 700 °C. With increasing annealing temperature, from 700 to 800 °C, the leakage current density was observed, generally decreasing, from 10−5 to 10−8 A cm−2, for the prepared compositions. Among the prepared compositions, films with x = 0.06, annealed at 800 °C, having the observed value of dielectric constant 48, at 1 MHz; and the leakage current density 2.7 × 10−8 A cm−2, at the electric field of 3.5 × 105 V cm−1, show preferred potential as a dielectric for high-density silicon memory devices.

Solar energy has the potential to meet the requirement of energy for the survival of human beings on the planet earth if used wisely. Some of the applications consist of electric power generation with the help of solar panel/thermoelectric generator/Rakine cycle based technology, water purification, dryer for agriculture product and refrigeration. Solar energy is pollution free and it can be utilized for irrigation with the help of solar energy based pump and some system for distribution of water. Many solar energy based pumping systems have been reported by researchers around the globe. In this work, a review on solar energy based pumping systems has been presented. Based on the study, conclusions have been drawn.

Current review deals with the design and analysis of a customized mechanisms for several real life problems. Several simple and complex kinematic mechanisms like 6 leg Robot mechanism, 5- Bar Spherical Mechanism, RP – Chain Mechanism, Flexure Joint Mechanism, Toggle Mechanism, Peaucellier’s – Lipkin Mechanism, flapping wing mechanism etc. are discussed. As the kinematics is concerned with the motion of parts without considering how the influencing factors (force and mass) affect the motion, also the load carrying mechanisms has been a big challenge over the last decades. So the review between several mechanisms is done to get the optimum output. Mathematical equations like Lagrangian equation are used to analyse the DOF of complex customized mechanisms. Major applications of customized mechanism are observed in almost all the fields to ease the existing working procedure. The emphasis is given to highlight the use of advance technologies, computer aided method etc. to enhance the working speed, flexibility, ease in modification and rework cost of any design. The analysis of mechanism is done to develop some innovative business plans according to the product along with the understandings of the current robotic applications. The main future prospective of the current review is to identify several easy methods to customize the existing designs as per the availability of resources like workspace, cost of project, materials, power requirement, level of automation, load bearing capacity, etc. In Future, new entrepreneur ideas can be developed based on the customized mechanism technology.

(Ta2O5)1-x-(TiO2)x (TTO) thin films, with x = 0.035, were deposited onto the P/boron-silicon (100) semiconducting substrates by reactive direct current (DC) magnetron sputtering of mosaic Ta and Ti metal targets, at ambient temperature. As-deposited films have been passed through the process of annealing at the temperatures, ranging from 500 to 800 °C. X-ray diffraction measurements, generally, show the formation of Ta2O5 structure of the annealed films. Metal–oxide–semiconductor (MOS) structure of Ag/(Ta2O5)1-x-(TiO2)x/p-Si (Ag/TTO/p-Si), with x = 0.035, was formed, and capacitance of the structure was measured, at room temperature and 1 MHz. Capacitance of prepared MOS structure was measured, and found generally, increasing with annealing temperature. Among the prepared films, maximum value of dielectric constant was found 45, at 1 MHz, for the films annealed at 700 °C. Frequency dependent behaviour of dielectric loss was observed, and was found minimum value of 0.022, at 200 kHz, for the films deposited at room temperature.

A self-microemulsifying drug delivery system (SMEDDS) was developed to enhance Paclitaxel (PTX) solubility and membrane permeability, thus improve its bioavailability. Pre-formulation studies were performed to optimize PTX-SMEDDS formulation. Then, in vitro characteristics of the formulation were determined and PTX oral absorption was investigated in rabbits. The optimized PTX-SMEDDS showed emulsification time of 31 ± 4 s, droplet size of 19.4 ± 0.5 nm, poly-dispersibility index of 0.35 ± 0.08, percentage transmittance after dilution of 99 ± 0.02%, zeta potential of 36.82 ± 1.8 mv, cloud point of 78 ± 0.5 °C and infinite dilution capability. The formulation maintained its physical and chemical stability during storage at 4 °C for three months. Oral administration of 10 mg/kg of 1.5% w/w PTX-loaded SMEDDS to rabbits increased PTX bioavailability by 4.5 fold in comparison to untreated PTX suspension. While when the rabbits received 1.5% w/w PTX-loaded SMEDDS after pretreated with 1 dose and 2 doses of cyclosporine A, PTX bioavailability increased by 4.4 and 7.8 fold, respectively. This indicates that the combined effect of the SMEDDS formulation in addition to pretreatment with P-gp and CYP3A4 inhibitor, can improve the oral bioavailability of poorly soluble and poorly permeable drugs such as PTX in rabbits.

Objective To screen 97 obese Arab adolescents for metabolic risk factors. Results Insulin resistance, metabolic syndrome and intermediate hyperglycaemia was found in 56.7 %, 14.4 % and 27.8 % (HbA1c) while fasting plasma glucose was impaired in 0–16.5 %, using different cut-offs. Interventions to prevent obesity and diabetes are needed.

An efficient energy management scheme for a standalone hybrid AC/DC microgrid (HMG) has been proposed in this paper. Energy management in a microgrid is a challenging task, because of the involvement of the distributed energy resources (DERs) which are intermittent in nature. The microgrid may therefore, undergo mismatch in demand and supply, when either the generation or load varies. This mismatch in power may result into DC bus voltage deviations and sometimes these deviations may be out of the permissible limits. A coordination control-based strategy (CCS) for DC bus voltage deviation mitigation and efficient energy management of the standalone microgrid is investigated here. The CCS is tested with the help of simulation studies on a test hybrid AC/DC microgrid in MATLAB covering all the scenarios which may arise. The test microgrid consists of a solar photovoltaic (PV) generation, a secondary source of generation, PEM fuel cell, a battery and a super capacitor. Coordination between the various sub-units and energy management of hybrid AC/DC microgrid is done using Fuzzy Logic Control (FLC) and the DC bus voltage deviations are also compared with PI based control system. It is found that the system with FLC has better performance than PI based control system.

Background and Aims Although people with type 1 diabetes are exempt from fasting the month of Ramadan due to the risk to their health, many wish to fast nonetheless. Little is known about the impact of structured education on the fasting experiences of people with type 1 diabetes. This study aimed to explore how the Dose Adjustment for Normal Eating (DAFNE) course affected people with type 1 diabetes’ fasting experiences to provide insight into the benefits of structured education for people wishing to fast while managing their diabetes. Methods Semi-structured interviews were conducted with 40 DAFNE graduates who fasted Ramadan. The purposive sample was selected from the DAFNE registry at Dasman Diabetes Institute in Kuwait. The interviews were transcribed verbatim and analysed thematically in an iterative process. Topics discussed included fasting experiences prior to attending the DAFNE course, fasting experiences this year, and how DAFNE affected their fasting. Results Five themes emerged; (1) Reduction in fluctuations and complications, (2) Improvement in confidence and self-reliance, (3) Tailored support for dose and pump programming adjustments, (4) Positive effect on wellbeing, and (5) Encouraging informed-decision making about fasting. Conclusions The findings have provided insight into the impact of DAFNE structured education on the fasting experiences of people with type 1 diabetes and has shown how overall, DAFNE had enhanced the quality of fasting. In addition, by assisting them in fulfilling their fasting wishes, DAFNE has had a positive effect on their wellbeing.