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Microservices architecture is a functional software design methodology that promises the redefinition of the architectural style that aims to create a single application as a suite of tiny, loosely coupled services or components, each performing its own tasks and interacting with each other. The cloud services widely shifted from monoliths to microservices and gained the popularity for use in scalable cloud application. The usage of microservices involved intensive network communication to call number of interdependent microservices running inside the cloud nodes. It provides flexibility in the delivery of service but also increases energy usage and poor service efficiency which results in increased carbon emissions. To solve these issues, the prevailing technologies were designed for single unit monolithic cloud applications, and not tailored for the chain oriented service delivery. This study addresses the dynamic provisioning of containers and respective microservices in cloud computing environment by building rank-based profiles and using those profiles for allocation of web application’s microservices along with containers to the cloud data centers. The MicroRanker service is proposed to rank all of the participating microservices and distribute them across different nodes even before the execution of the cloud services. Further, the MicroRanker service is utilized to dynamically update the container placement due to continuous DevOps actions. The proposed solution was tested using custom built simulation environment. The achieved results showed that the distribution of containers along with respective microservices in accordance with MicroRanker service resulted in less energy consumption (i.e. between 81.6 kWh-87.7 kWh compared to 88.9 kWh-95.7 kWh) and significantly lowered the emission of carbon (i.e. between 5.92 kg-33.31 kg compared to 17.2 kg-47.35 kg) due to higher utilization of renewable energy. The use of rank-based microservices distribution also decreased response time (i.e. between 29 ms-142 ms compared to 106 ms-217 ms) due to the availability of the container along with microservice within the same data center region.

In patients with acute heart failure (AHF), hemoconcentration has been suggested as a surrogate for volume changes (AHF). However, literatures comparing the outcome of AHF patients that achieved hemoconcentration during hospitalization with those that do not are limited. The aim of this research is to see if achieving hemoconcentration prior to discharge is linked to a lower risk of re-admission in AHF patients. 124 patients hospitalized in the Cardiology Unit, University Malaya Medical Centre (UMMC) for AHF between November 2019 and November 2020 were enrolled. Information on patients’ clinical characteristics, laboratory values and in-hospital treatments were collected through electronic medical record. At admission and discharge, the change in hematocrit (HCT) levels was calculated, and patients were stratified based on two quantiles of delta HCT, either discharged with hemoconcentration (ΔHCT >1.5%) or without hemoconcentration (ΔHCT ≤1.5%). The study’s outcome was AHF readmission after a 90-day follow-up period. Readmission was significantly associated with ejection fraction (p = 0.032) and HCT change (p = 0.005). Consecutively, logistic regression performed revealed that patients with haemoconcentration were 78.3% less likely to be readmitted than those without haemoconcentration (OR = 0.217, p = 0.003, 95% CI = 0.078–0.605) and Patients with a lower ejection fraction have a threefold greater chance of being readmitted than those with a preserved ejection fraction (OR = 3.316, p = 0.022, 95% CI = 1.188–9.256). In conclusion, among patients hospitalized and discharged for AHF, those that (i) do not achieve haemoconcentration and (ii) patients with a reduced ejection fraction were more likely to be readmitted with acute heart failure. Therefore, optimising patients’ haematocrit levels prior to discharge may potentially reduce rehospitalizations among heart failure patients.

Interlocking Institutional Worlds (IWs) is a concept explaining the need to interoperate between institutions (or players), to solve problems of common interest in a given domain. Managing knowledge in the IWs domain is complex; however, promoting knowledge sharing based on standards and common terms agreeable to all players is essential and is something that must be established. In this context, ontologies, as a conceptual tool and a key component of knowledge-based systems, have been used by organizations for effective knowledge management, better decision-making, and interoperability among diverse institutions of an IWs domain. The development of ontology involves structural and logical complexity, and requires a well-designed, mature, and widely accepted methodology, to ensure its reliability. Many methodologies for ontology development have been proposed by several researchers; however, most of the developed methodologies have not included several important phases. Furthermore, several methodologies have not provided the complete details of the techniques and activities involved in the ontology construction process. Fewer details make it difficult to follow a methodology for designing ontologies. This study aims to compare existing methodologies based on sixteen important criteria and proposes an improved methodology for ontology development for IWs domains. The proposed methodology has included several important phases such as the Estimation of Human Resources, Re-engineering and Re-using of Resources, Collaborative Ontology Construction, the Conceptualization of both Endurants and Perdurants, Localization of an Ontology, Ontology Integration and Merging, Support for Interoperability, Versioning of an Ontology, and Ontology Population. The proposed methodology has been applied to design an OntoWM domain ontology for the Waste Management (WM) domain. The evaluation of the proposed methodology has been made by utilizing the designed OntoWM domain ontology in an ontology-based web application called SmartBinAnalytics. SmartBinAnalytics has been built using OntoWM, Java Server Pages (JSP), Jena Application Programming Interface (API), and MySQL. The proposed methodology can be used for the construction of domain ontologies in any IWs domain.

Objective The aim: To investigate the utility of testing for chlamydial heat shock protein 60 (CHSP60) antibodies in the diagnosis of tubal infertility. Patients and methods Materials and methods: All the collected samples were assayed for IgM and IgG antibodies to chlamydia trachomatis and chlamydial heat shock protein 60 (CHSP60) by using immunofluorescence and enzyme-linked immunosorbent assay (ELISA) techniques, respectively. Results Results: There were no substantial differences between antibodies to C. trachomatis in females with tubal infertility (67%) and non-tubal infertility (48%). However, women with tubal infertility (45%) have more anti-CHSP60 antibodies than non-tubal infertility (9%). Antibody screening for C. trachomatis has only (63%) sensitivity and (54%) specificity for detecting tubal infertility. On the other hand, the CHSP60 antibody testing has (44%) sensitivity and 92% specificity for diagnosing tubal infertility. A positive microimmunofluorescence (MIF) titer was observed in 12 of 18 (67%) females with the tubal problem, 31 of 64 (48%) with non-tubal infertility (P=0.3, OR=2.2, 95% CI=0.71 to 8.01). The CHSP60 antibodies were found in 8 of 18 (45%) females with tubal problem & 6 of 64 (9%) women with non-tubal infertility, power factor alpha α P=0.004, OR=9.3, 95% CI=2.1 to 43.2, power= 1.002 for n= 0.05). Incorporating CHSP60 and C. trachomatis antibodies testing gives an excellent positive probability proportion of 10 to diagnose C. trachomatis associated tubal infertility. Conclusion Conclusions: CHSP60 antibody testing is a more specific evaluation than antibody testing for C. trachomatis for predicting chlamydia-associated tubal infertility. Using these tests at the first infertility examination may help the immediate diagnosis for non-interceptive tubal infertility.

he acoustic emission technique has been applied successfully for the identification, characterization, and localization of deformations in civil engineering structures. Numerous localization techniques, such as Modal Acoustic Emission, Neural Networks, Beamforming, and Triangulation methods with or without prior knowledge of wave velocity, have been presented. Several authors have conducted in-depth research in the localization of AE sources. However, existing review papers do not focus on the performance evaluation of existing source localization techniques. This paper discusses these techniques based on the number of sensors used and the geometry of the structures of interest. Furthermore, it evaluates them on the basis of their performance. At the end of this paper, a comparative analysis of existing methods has been presented based on their basic principles, key strengths, and limitations. A deep learning circular sensor cluster-based solution has the potential to provide a low-cost reliable localization solution for acoustic emission sources.

Objective The aim: This review was aimed to understand the role of different types of autoantibodies like antiphospholipid, antithyroid, antisperm, antinuclear, anti-ovarian autoantibodiesand heat shock protein HSP 60 in the process of implantation in the normal way of conceiving and IVF and also to estimate that how the presence of these autoantibodies affect the normal pregnancy outcome. Patients and methods Materials and methods: This review process performed in the obstetrics and gynaecology postgraduate department, Bogomolets national medical university, Kyiv, Ukraine. It was a review of already published papers not to need the ethical board committee's approval. By following the literature review guidelines, this paper was written and searched for relevant studies regarding autoantibodies and implantation, published in medical literature till 2020 were included in this review process. The search is done for studies published till 2020 in the English language from the Medline database, including Google Scholar, PubMed, Web of Science and Cochrane library database. Conclusion Conclusions: Our recent work found that the involvement of APA, ANA and/or ATA in recipients of oocyte donations did not affect their pregnancy outcomes. Some researchers did not give any clear conclusion about these risks, and some stated that the use of some immunodepressant agents could be useful to reduce the harmful effects of these autoantibodies associated with implantation failure. Each autoantibody has a different mechanism of action to create the pathological state, some have direct effect, and some indirectly impact implantation. In future, further high-quality studies need to be performed for better understanding.

Cardiovascular disease (CVD) is the number one killer among women in Malaysia and globally, with over two million deaths each year. In this study, two modelling approaches namely Bayesian approach and frequentist approach were considered to identify associated risk factors in CVD among female patients presenting with ST Elevation Myocardial Infarction (STEMI) and to obtain feasible model to fit the data. Comparisons were made to find the best model. A total of 874 STEMI female patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate and multivariate analysis were performed for both Bayesian and frequentist approaches. Six variables namely smoking, dyslipidaemia, myocardial infarction (MI), renal disease, Killip class and age group were found to be significant at the multivariate analysis. The standard errors obtained from the Bayesian approach were much smaller than the frequentist approach. Also, the model fit using Bayesian approach was much better than the frequentist as the deviance value produced by the Bayesian approach was smaller. The Bayesian analysis provides a better alternative to the frequentist approach in the analysis of the risk factors associated with mortality among female CVD patients.

Steel plate devices are commonly used for the seismic energy dissipation and damage mitigation of structures. Particularly, butterfly-shaped steel plate fuses are essential components in controlled rocking frames, which have been shown as promising self-centering systems for minimizing financial losses due to repair costs and downtime in strong earthquakes. The cyclic behavior of a steel plate fuse varies depending on design factors related to its geometry and material. This paper aims at assessing the effect of seven factors on the cyclic response of steel plate fuses. These factors include the fuse length, mid-width, end-width, thickness, band zone length, fuse yield strength, and modulus of elasticity. Detailed finite element models are first developed and validated against past experimental test results. A design of experiment method is used to statistically evaluate the effects of the design factors and their interactions on the cyclic response characteristics of steel plate fuses in terms of initial stiffness, yield strength, ultimate stiffness, effective damping, maximum strength, and ductility. The results show that the most significant effects are the fuse end-width, thickness, and length.

Agile software development is successful due to self-organizing teams, adaptive planning, a cooperative environment with respect to communication with clients and team members, small development cycles, continuous design improvements, continuous delivery and feedback of clients. Cloud computing helps to reduce cost, enables scalability and enhances communication through its services. A generic framework with the conjunction of Agile Development and Cloud Computing (ADCC) proposed in an earlier study is evaluated in this study. The Malaysia Research and education network (MyRen) cloud is utilized to implement the framework. A case study is conducted to evaluate the framework. Before conducting the case study, the participants are educated on the ADCC framework. The results of the case study show that the performance of agile methods is improved with the usage of the ADCC framework. The improvement is measured in terms of local and distributed agile development environments.

The influence of Molybdenum diselenide (MoSe2) as an interfacial layer between Cu(In,Ga)Se2 (CIGS) absorber layer and Molybdenum (Mo) back contact in a conventional CIGS thin-film solar cell was investigated numerically using SCAPS-1D (a Solar Cell Capacitance Simulator). Using graded bandgap profile of the absorber layer that consist of both back grading (BG) and front grading (FG), which is defined as double grading (DG), attribution to the variation in Ga content was studied. The key focus of this study is to explore the combinatorial effects of MoSe2 contact layer and Ga grading of the absorber to suppress carrier losses due to back contact recombination and resistance that usually occur in case of standard Mo thin films. Thickness, bandgap energy, electron affinity and carrier concentration of the MoSe2 layer were all varied to determine the best configuration for incorporating into the CIGS solar cell structure. A bandgap grading profile that offers optimum functionality in the proposed configuration with additional MoSe2 layer has also been investigated. From the overall results, CIGS solar cells with thin MoSe2 layer and high acceptor doping concentration have been found to outperform the devices without MoSe2 layer, with an increase in efficiency from 20.19% to 23.30%. The introduction of bandgap grading in the front and back interfaces of the absorber layer further improves both open-circuit voltage (VOC) and short-circuit current density (JSC), most likely due to the additional quasi-electric field beneficial for carrier collection and reduced back surface and bulk recombination. A maximum power conversion efficiency (PCE) of 28.06%, fill factor (FF) of 81.89%, JSC of 39.45 mA/cm2, and VOC of 0.868 V were achieved by optimizing the properties of MoSe2 layer and bandgap grading configuration of the absorber layer. This study provides an insight into the different possibilities for designing higher efficiency CIGS solar cell structure through the manipulation of naturally formed MoSe2 layer and absorber bandgap engineering that can be experimentally replicated.

Structural degradation takes place in pipelines with the passage of time. Hence. The restoration of proper functioning of these pipelines requires these defects to be identified and localized. Acoustic emission (AE) is a powerful non-destructive evaluation (NDE) technique for the detection of defects. Acoustic emission signals contain a significant amount of noise. In this paper, machine learning technique has been used to accurately classify and localize the corrosion defect. Experiments were performed on a 10’’ steel pipeline to show the relationship between the location of the corrosion defect and the acoustic emission signal. The results show that by using SVR, corrosion defect can identified and localized. This method is capable of providing a reference value for the real-time pipeline monitoring being operational in status, with broad application prospects.

Share buyback is a strategy for companies to repurchase their outstanding shares to reduce the number of shares from the open markets. With buyback, it indirectly increases the shares proportion and earning per shares (EPS) of a company. The aim of this study is to investigate the trend of share buyback strategy, and to design a simple prediction model for stock market price movement before initiating any buyback action. This study finds the use of Long Short-Term Memory (LSTM) as prediction algorithm has demonstrated that stock market price movement can be predicted using associated stock indicators, namely MACD and RSI which have an impact to the stock market price movement. The study also finds that the "Open" parameter based on the MAE, MSE and RMSE have been found to be the lowest value as compared to "High", "Low" and "Close" parameters.

Cloud computing is a paradigm that has already evolved. Cloud computing moved widely to microservices from monoliths. The modular cloud application has gained attention for Microservices. Intensive network communication is required to call the interdependent microservices operating inside the cloud nodes. This research focuses on container-based microservices pre-distribution techniques and proposes two distribution strategies i.e. design pattern distribution and random distribution. The microservices are arbitrarily distributed to the available data centers in the random allocation method. While the microservices are clustered in the pattern distribution based on behavioral design patterns, which identify common contact patterns between entities. A custom-built modeling environment has been used to evaluate the proposed method. The findings revealed that the pre-distribution of microservices in accordance with the application architecture trend led to substantial less response time for the calls made to services hosted at geographically dispersed data centers.

Background: Little is known regarding the impact of socioeconomic factors on the use of evidence-based therapies and outcomes in patients with heart failure with reduced ejection fraction across Asia. Methods: We investigated the association of both patient-level (household income, education levels) and country-level (regional income level by World Bank classification, income disparity by Gini index) socioeconomic indicators on use of guideline-directed therapy and clinical outcomes (composite of 1-year mortality or HF hospitalization, quality of life) in the prospective multinational ASIAN-HF study (Asian Sudden Cardiac Death in Heart Failure). Results: Among 4540 patients (mean age: 60±13 years, 23% women) with heart failure with reduced ejection fraction, 39% lived in low-income regions; 34% in regions with high-income disparity (Gini ≥42.8%); 64.4% had low monthly household income (P interaction Conclusions: These findings highlight the importance of socioeconomic determinants among patients with heart failure in Asia and suggest that attention should be paid to address disparities in access to care among the poor and less educated, including those from wealthy regions. Registration: URL: https://clinicaltrials.gov ; Unique Identifier: NCT01633398.

A search of peer-reviewed articles regarding heat shock proteins (HSP’s) especially HSP 60 and 70 was conducted in this review to understand its role in the development of various complications like miscarriage, preterm birth, tubal infertility and spontaneous abortion associated with chlamydial HSP 60 in IVF, male infertility, preeclampsia, cancer, immune system activation, autoimmune diseases, coronary heart disease, dysregulation of steroidal hormone from the endometrium and its up-regulation in stress response. ELISA, western blotting, immunofluorescence, and affinity chromatography were the most common methods researchers used to determine and separate HSP 60 and antibodies related to it. Heat shock proteins are responsible for normal folding of other proteins and prevent its abnormal folding and cause degradation of abnormally folded proteins, mitochondrial protein transport, DNA metabolism, regulation of apoptosis are their significant functions. HSP 60 is a homologue of bacterial HSP 60 (GroEL) and needs co-chaperonin HSP 10 for its proper functioning. Gynaecological and obstetrical complications were more prevalent in most studies. Pregnant women were mostly affected subjects. Abnormal HSP 60 leads to a high level of unfolded or misfolded proteins, which in turn activate other body systems to produce the clinical outcome. Some researchers stated that there is no association between preterm birth and HSP 60&70, chlamydial HSP 60 antibodies trigger tubal infertility, preeclamptic pregnancies has detectable HSP60 as compared to control, GroEL leads to tubal infertility and IVF failure, chlamydial (CHSP 60) activates autoimmunity. HSP60 seropositivity reduces the opportunities of ectopic pregnancy, levels of HSP 60 does not stay constant throughout the menstrual cycle in reference to control, while other opposed these conclusions in their research works. According to some researchers, HSP 60 is a risk factor for pregnancy-related pathologies development, and some other opposed this theory and considered HSP 60 as a safety factor for normal pregnancy outcome, according to this review harmful effect of HSP 60 dominate, in future further high-quality studies need to be done for better understanding.

Support is one of the most important elements for a disabled entrepreneur to grow a business. However, this support is not only financial in nature but consists of various other needs. In fact, the support medium is not only the government but also NGO and others. The main purpose of this article is to discuss the objective of the study, which is to explore the support received by entrepreneurs with disability to grow the business. The second objective is to understand the situation experienced by people with disabilities in start business. Therefore, this study was conducted through qualitative methods using a semi-structured interview approach involving 8 informants consisting of disabled entrepreneurs to obtain research information.

This study was developed using Arduino Nano that act as main brain of this system. Together with the android application that was developed use to allowed user to unlock and lock their bicycle easily by tapping the green and red button inside the application. A high security should be applied because this bicycle lock can be hack or stolen by anyone. Therefore, this project has an addition of vibration sensor and alarm to prevent theft from happening. To compare this study with top keyless bicycle company maker is far way to achieved but it is something that is not impossible to do. In this study, the objective that had to develop a keyless way to secure the bicycle lock. The software development of the keyless bicycle lock is to be based on simple yet powerful programming languages such as Arduino coding or Raspberry Pi 3 processor coding. The Bluetooth in the lock system are to be connected with the mobile phone Bluetooth software for the locking mechanism.

An improved hybrid bidirectional DC-DC converter is proposed in this paper which is suitable to be deployed in energy storage applications interfacing the DC bus of a microgrid. The converter utilizes voltage boosting techniques such as a switched-capacitor network and coupled inductor to achieve a large voltage conversion ratio. Furthermore, the converter requires a small number of components and a simple PWM controller. The steady-state analysis of the converter is presented and derived. The performance of the converter is also compared with other similar converters. Simulation is carried out using Matlab Simulink which verifies the theoretical analysis of the converter.

Energy supply industries play a vital role in a country. Inefficiencies in the energy supply chain regarding tricky contest and the lack of management instantly change energy tariff calculation. This work proposes the Ethereum blockchain platform with existing traditional infrastructure to track and investigate energy supply chain activities using a unique identity with smart contracts. It maintains the records of the organization’s activities that are protected and available to stakeholders according to the recognized collection of procedures and practices without requiring any centralized administration. This paper focuses entirely on analyzing and developing a simplified, low-cost economical solution to quickly connect the present energy supply industry at various geological locations to track and trace the linked data in the energy market.

An outbreak of coronavirus caused by a novel virus called SARS-CoV-2 occurred at the end of 2019. The unexpected outbreak and unchecked global spread of COVID19 indicate that the current global healthcare networks have limitations in addressing the crises for public safety. The detection of infected or tested patients globally is challenging when patients travel abroad. As such, innovative technology such as blockchain has emerged as a potential approach for addressing coronavirus patient tracking. Blockchain technology can tackle pandemics by allowing early detection of outbreaks, protecting individual privacy while maintaining data security by using smart contracts. Motivated by these facts, we propose a novel blockchain-based framework that integrates intercountry for COVID-19 to track infected or tested patients globally using the methodology of design science research. The proposed framework could help governments, aviation industries, health authorities, and residents make essential decisions on infection identification, infection prediction, and infection prevention.

Introduction The objective of this study was to compare the accumulated clinical outcomes of two Malaysian all-comers populations, each treated with different polymer-free sirolimus-eluting stents (PF-SES) of similar stent design. Methods The Malaysian subpopulation of two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined and compared to a Malaysian-only cohort which was treated with a later-generation PF-SES. The PF-SES’s used differed only in their bare-metal backbone architecture, with otherwise identical sirolimus coating. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 12 months. The rates of major adverse cardiac events (MACE), stent thrombosis (ST) and myocardial infarction (MI) were part of the secondary endpoints. Results A total of 643 patients were treated with either the first-generation PF-SES (413 patients) or second-generation PF-SES (230 patients). Patient demographics were similar in terms of age (p = 0.744), male gender (0.987), diabetes mellitus (p = 0.293), hypertension (p = 0.905) and acute coronary syndrome (ACS, 44.8% vs. 46.1%, p = 0.752) between groups. There were no differences between treatment groups in terms of lesion length (20.8 ± 7.3 mm vs. 22.9 ± 7.9, p = 0.111) or vessel diameter (2.87 ± 0.39 vs. 2.93 ± 0.40, p = 0.052) despite numerically smaller diameters in the first-generation PF-SES group. The second-generation PF-SES tended to have more complex lesions as characterized by calcification (10.3% vs. 16.2%, p = 0.022), severe tortuosity (3.5% vs. 6.9%, p = 0.041) and B2/C lesions (49.2% vs. 62.8%, p

Background: Identifying risk factors associated with mortality is important in providing better prognosis to patients. Consistent with that, Bayesian approach offers a great advantage where it rests on the assumption that all model parameters are random quantities and hence can incorporate prior knowledge. Therefore, we aimed to develop a reliable model to identify risk factors associated with mortality among ST-Elevation Myocardial Infarction (STEMI) male patients using Bayesian approach. Methods: A total of 7180 STEMI male patients from the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry for the years 2006-2013 were enrolled. In the development of univariate and multivariate logistic regression model for the STEMI patients, Bayesian Markov Chain Monte Carlo (MCMC) simulation approach was applied. The performance of the model was assessed through convergence diagnostics, overall model fit, model calibration and discrimination. Results: A set of six risk factors for cardiovascular death among STEMI male patients were identified from the Bayesian multivariate logistic model namely age, diabetes mellitus, family history of CVD, Killip class, chronic lung disease and renal disease respectively. Overall model fit, model calibration and discrimination were considered good for the proposed model. Conclusion: Bayesian risk prediction model for CVD male patients identified six risk factors associated with mortality. Among the highest risks were Killip class (OR=18.0), renal disease (2.46) and age group (OR=2.43) respectively.

INTRODUCTION Clinical depression is a known consequence of acute coronary syndrome (ACS) and is associated with an adverse outcome among these patients, although this is often under-recognised. Through this study, we investigated the incidence of depression in post-ACS patients and its associated factors. METHODS We conducted a prospective cohort study in 95 patients with ACS admitted to University Malaya Medical Centre, Malaysia. Clinical depression was assessed during the index admission and at 30 days after discharge, using the Patient Health Questionnaire-9 (PHQ-9). Data was analysed using IBM SPSS Statistics, and binary logistic regression was used to determine the independent factors associated with depression, after adjusting for significant demographic variables and clinical characteristics. The strength of this association was presented as odds ratio and 95% confidence interval, and the significance level was set at 0.05. RESULTS The mean age of the study population was about 60 years, and 72.6% of the patients were male. Symptoms of depression were present in 88.4% of the patients at baseline. Depression at 30 days was more likely in female patients, patients with diabetes mellitus and patients on dialysis (p = 0.024, p < 0.001, p = 0.008, respectively). Patients with baseline moderate to severe depression were more likely to have moderate to severe depression at 30 days (p < 0.001). Baseline depression was the strongest predictor of depression at 30 days. An increment of one unit in PHQ-9 baseline score increased the risk of developing severe depression at 30 days by 31%. CONCLUSION Depression was prevalent in our post-ACS patients. The associated factors were female gender, diabetes mellitus and dialysis treatment.

Copper-based cables have limitation of distributing power safely and efficiently for Internet of Things (IoTs) application as well as during emergency conditions. This research paper aims to demonstrate the power over fiber (PoF) distribution system network in the short-haul distance, as an alternative to copper-based cable. The maximum efficiency obtained for the full system was 12% at 450 mA of laser driving current. The obtained results clearly demonstrated that as the laser driving current increases from 50 mA to 450 mA, overall efficiency of the system increases. The prototype was designed with a low power output where the main parameter that affects the overall efficiency system is the optical to electrical conversion module. Prototype results demonstrated the potential of PoF for low power distribution system.

Background Data comparing outcomes in heart failure ( HF ) across Asia are limited. We examined regional variation in mortality among patients with HF enrolled in the ASIAN ‐HF (Asian Sudden Cardiac Death in Heart Failure) registry with separate analyses for those with reduced ejection fraction ( EF ; Methods and Results The ASIAN ‐ HF registry is a prospective longitudinal study. Participants with symptomatic HF were recruited from 46 secondary care centers in 3 Asian regions: South Asia (India), Southeast Asia (Thailand, Malaysia, Philippines, Indonesia, Singapore), and Northeast Asia (South Korea, Japan, Taiwan, Hong Kong, China). Overall, 6480 patients aged >18 years with symptomatic HF were recruited (mean age: 61.6±13.3 years; 27% women; 81% with HF and reduced r EF ). The primary outcome was 1‐year all‐cause mortality. Striking regional variations in baseline characteristics and outcomes were observed. Regardless of HF type, Southeast Asians had the highest burden of comorbidities, particularly diabetes mellitus and chronic kidney disease, despite being younger than Northeast Asian participants. One‐year, crude, all‐cause mortality for the whole population was 9.6%, higher in patients with HF and reduced EF (10.6%) than in those with HF and preserved EF (5.4%). One‐year, all‐cause mortality was significantly higher in Southeast Asian patients (13.0%), compared with South Asian (7.5%) and Northeast Asian patients (7.4%; P Conclusions This first multinational prospective study shows that the outcomes in Asian patients with both HF and reduced or preserved EF are poor overall and worst in Southeast Asian patients. Region‐specific risk factors and gaps in guideline‐directed therapy should be addressed to potentially improve outcomes. Clinical Trial Registration URL : https://www.clinicaltrials.gov/ . Unique identifier: NCT 01633398.

The lack of control in voltage overshoot, transient response, and steady state error are major issues that are frequently encountered in a grid-connected photovoltaic (PV) system, resulting in poor power quality performance and damages to the overall power system. This paper presents the performance of a control strategy for an inverter in a three-phase grid-connected PV system. The system consists of a PV panel, a boost converter, a DC link, an inverter, and a resistor-inductor (RL) filter and is connected to the utility grid through a voltage source inverter. The main objective of the proposed strategy is to improve the power quality performance of the three-phase grid-connected inverter system by optimising the proportional-integral (PI) controller. Such a strategy aims to reduce the DC link input voltage fluctuation, decrease the harmonics, and stabilise the output current, voltage, frequency, and power flow. The particle swarm optimisation (PSO) technique was implemented to tune the PI controller parameters by minimising the error of the voltage regulator and current controller schemes in the inverter system. The system model and control strategies were implemented using MATLAB/Simulink environment (Version 2020A) Simscape-Power system toolbox. Results show that the proposed strategy outperformed other reported research works with total harmonic distortion (THD) at a grid voltage and current of 0.29% and 2.72%, respectively, and a transient response time of 0.1853s. Compared to conventional systems, the PI controller with PSO-based optimization provides less voltage overshoot by 11.1% while reducing the time to reach equilibrium state by 32.6%. The consideration of additional input parameters and the optimization of input parameters were identified to be the two main factors that contribute to the significant improvements in power quality control. Therefore, the proposed strategy effectively enhances the power quality of the utility grid, and such an enhancement contributes to the efficient and smooth integration of the PV system.

BACKGROUND: Coronary artery disease (CAD) is one of the leading causes of death in Malaysia. However, the prevalence of CAD in males is higher than in females and mortality rates are also different between the two genders. This suggest that risk factors associated with mortality between males and females are different, so we compared the clinical characteristics and outcome between male and female STEMI patients. OBJECTIVES: To identify the risk factors associated with mortality for each gender and compare differences, if any, among ST-elevation myocardial infarction (STEMI) patients. DESIGN: Retrospective analysis. SETTINGS: Hospitals across Malaysia. PATIENTS AND METHODS: We analyzed data on all STEMI patients in the National Cardiovascular Database-Acute coronary syndrome (NCVD-ACS) registry for the years 2006 to 2013 (8 years). We collected demographic and risk factor data (diabetes mellitus, hypertension, smoking status, dyslipidaemia and family history of CAD). Significant variables from the univariate analysis were further analysed by a multivariate logistic analysis to identify risk factors and compare by gender. MAIN OUTCOME MEASURES: Differential risk factors for each gender. RESULTS: For the 19 484 patients included in the analysis, the mortality rate over the 8 years was significantly higher in females (15.4%) than males (7.5%) (P

Coronary artery disease (CAD) continues to be one of the leading causes of morbidity and mortality globally. Of particular relevance for this issue is that major efforts should be focused on understanding the risk factor involved. In this study, three types of Bayesian models, each with different prior distribution were considered to identify associated risk factors in CAD among Malaysian male patients presenting with ST-Elevation Myocardial Infarction (STEMI) and to obtain a feasible model to fit the data. The results of the three models were compared to find the best model. A total of 7180 STEMI male patients from the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate and multivariate analyses for the three models were performed using one of the Bayesian Markov Chain Monte Carlo (MCMC) simulation approach known as Gibbs sampling. Models’ performances are evaluated through overall model fit. Bayesian model C which used both Beta and Dirichlet prior distributions, consisted of six significant variables namely diabetes mellitus, family history of cardiovascular disease, chronic lung disease, renal disease, Killip class and age group was considered as the best model. The same set of variables that were observed to be significant in the Bayesian model C was also found to be significant in models A and B which used single prior distribution, respectively. Model C has a better fit than models A and B as the deviance value produced was the smallest. This study showed that posterior estimation was mostly influenced by the existing prior knowledge. Though applying the non-informative prior which were both Beta and Dirichlet distribution priors, model C can minimise uncertainty in making effective clinical decisions and provides better parameters estimates of the posterior distribution.

ObjectiveYoung women form a minority but an important group of patients with acute myocardial infarction (MI) as it can potentially cause devastating physical and socioeconomic impact. This study was aimed to investigate the characteristics and outcomes of young women with MI in Malaysia.DesignThis is a retrospective analysis of women with ST-elevation MI (STEMI) and non-STEMI (NSTEMI) from 18 hospitals across Malaysia using the Malaysian National Cardiovascular Database registry–acute coronary syndrome (NCVD-ACS).ParticipantsWomen patients diagnosed with acute MI from year 2006 to 2013 were identified and divided into young (age ≤ 45, n=292) and older women (age >45, n=5580).Primary outcome measureComparison of demographics, clinical characteristics and in-hospital management was performed between young and older women. In-hospital and 30-day all-cause mortality were examined.ResultsYoung women (mean age 39±4.68) made up 5% of women with MI and were predominantly of Malay ethnicities (53.8%). They have a higher tendency to present as STEMI compared with older women. Young women have significantly higher rates of family history of premature coronary artery disease (CAD) (20.5% vs 7.8% p80% prescribed statins and aspirin. The all-cause mortality rates of young women were lower for both in-hospital and 30 days, especially in those with STEMI with adjusted mortality ratio to the older group, was 1:9.84.ConclusionYoung women with MI were over-represented by Malays and those with a family history of premature CAD. Preventive measures are needed to reduce cardiovascular risks in young women. Although in-hospital management was similar, short-term mortality outcomes favoured young compared with older women.

PURPOSE Older women with breast cancer remain under-represented in clinical trials. The Cancer and Leukemia Group B 49907 trial focused on women age 65 years and older. We previously reported the primary analysis after a median follow-up of 2.4 years. Standard adjuvant chemotherapy showed significant improvements in recurrence-free survival (RFS) and overall survival compared with capecitabine. We now update results at a median follow-up of 11.4 years. PATIENTS AND METHODS Patients age 65 years or older with early breast cancer were randomly assigned to either standard adjuvant chemotherapy (physician’s choice of either cyclophosphamide, methotrexate, and fluorouracil or cyclophosphamide and doxorubicin) or capecitabine. An adaptive Bayesian design was used to determine sample size and test noninferiority of capecitabine. The primary end point was RFS. RESULTS The design stopped accrual with 633 patients at its first sample size assessment. RFS remains significantly longer for patients treated with standard chemotherapy. At 10 years, in patients treated with standard chemotherapy versus capecitabine, the RFS rates were 56% and 50%, respectively (hazard ratio [HR], 0.80; P = .03); breast cancer–specific survival rates were 88% and 82%, respectively (HR, 0.62; P = .03); and overall survival rates were 62% and 56%, respectively (HR, 0.84; P = .16). With longer follow-up, standard chemotherapy remains superior to capecitabine among hormone receptor–negative patients (HR, 0.66; P = .02), but not among hormone receptor–positive patients (HR, 0.89; P = .43). Overall, 43.9% of patients have died (13.1% from breast cancer, 16.4% from causes other than breast cancer, and 14.1% from unknown causes). Second nonbreast cancers occurred in 14.1% of patients. CONCLUSION With longer follow-up, RFS remains superior for standard adjuvant chemotherapy versus capecitabine, especially in patients with hormone receptor–negative disease. Competing risks in this older population dilute overall survival benefits.

Recent clinical trials have raised concerns about the safety and efficacy of ABSORB™ bioresorbable vascular scaffolds (BVS). The difference in the vascular healing process between SYNERGY™ bioabsorbable polymer-coated everolimus-eluting stents (BP-EES) and BVS remains unclear. The aim of the ENHANCE study was to compare vascular healing on BP-EES versus BVS by optical coherence tomography (OCT) and coronary angioscopy (CAS) at 4- and 12-month follow-ups. This is a prospective, non-randomized, single center clinical trial. Thirteen eligible patients with multivessel disease were enrolled. BP-EES and BVS were simultaneously implanted in the same patients, but in different coronary vessels. Imaging follow-up with both OCT and CAS was completed in 11 patients at 12 months. Neointimal coverage rates were similar between the two groups based on OCT measurements. The neointimal thickness of BP-EES was significantly thicker at the 12th month than at the 4th month, whereas the neointimal thickness of BVS did not change between the measurements taken at the 4th and 12th month. Existence of intra-stent thrombus was significantly higher in the BVS group, compared to the BP-EES group. On the other hand, CAS revealed that red-thrombi and yellow-plaque were more frequently observed in BVS at 4 months and up to 12-month follow-ups than in BP-EES. These findings suggested that the evidence of instability remained up to 12 months in the vascular healing with BVS, compared to that with BP-EES. Vascular healing of the stented wall was recognized at the very early phase after BP-EES implantation. However, vascular healing with BVS was still incomplete after 12 months.

ObjectivesCardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population.DesignA retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006–2013.Participants16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013.Primary outcome measuresIn-hospital and 30 day post-discharge mortality.ResultsCS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality.ConclusionMortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients.

Cardiovascular disease is the leading cause of death in Malaysia and globally. This study aimed to identify associated risk factors in cardiovascular disease among ST elevation myocardial infarction (STEMI) male patients and obtain a feasible model to describe the data. A total of 16,673 STEMI male patients from 18 participating hospitals across Malaysia in the National Cardiovascular Disease Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013 were analysed. Univariate analysis was conducted. Significant variables from the univariate analysis were further analysed by a multivariate logistic analysis to identify the prognostic factors. The most prevalent risk factor for male patients was smoking (79.3%), followed by hypertension (54.9%) and diabetes mellitus (40.4%). At univariate level, this study is consistent with the findings from the Malaysian National Health and Morbidity Survey (NHMS) where smoking is a significant risk factor. After adjustment in multivariate logistic model, the risk factors for cardiovascular death among male patients are related to age, premorbid condition such as diabetes mellitus, hypertension, family history of CVD, Killip class, type of treatment such as percutaneous coronary intervention (PCI) and relevant comorbidity such as renal disease. Drastic efforts in the management of all risk factors in males is needed to improve adherence outcomes.

We simulated the effect of band gap grading in the CIGS absorber layer; in terms of performance parameters of the cell and the electric field across the absorber layer. Band gap grading can be accomplished through variation of Ga composition as a function of thickness across the absorber layer. Based on analysis on four different band gap profiles, it is shown that cell with double graded band gap structure reaches the highest efficiency of 22.52%.

Treated water is an improved water quality and very essential for aquaculture or for domestic usage at remote area. One of the process to treat water is by filtration. A solar powered water treatment device (SWAD) prototype was built to cater this demand. SWAD is basically a floating water filter which operates in a self-sustainable way on calm water body such as lake or pond. Solar panel is used to generates electricity to power the pumps to suck water into the filter. This paper discusses the filtering performance of the prototype by taking UNITEN Lake as the venue for the test. The tests show significant results on the activated carbon filter where the contaminants are removed effectively. The activated carbon is able to filter water in an effective and efficient way.

BACKGROUND: The administration of evidence-based pharmacotherapy and timely primary percutaneous coronary intervention have been shown to improve outcome in ST elevation myocardial infarction (STEMI). However, implementation remains a challenge due to the limitations in facilities, expertise and funding. OBJECTIVES: To investigate adherence to guideline-based management and mortality of STEMI patients in Malaysia. DESIGN: Retrospective analysis. SETTINGS: STEMI patients from 18 participating hospital across Malaysia included in the National Cardiovascular Database-Acute coronary syndrome (NCVD-ACS) registry year 2006 to 2013. PATIENTS AND METHODS: Patients were categorized into four subgroups based on the year of admission (2006 to 2007, 2008 to 2009, 2010 to 2011 and 2012 to 2013). Baseline characteristics and clinical presentation, in-hospital pharmacotherapy, invasive revascularization and in-hospital/30-day mortality were analysed and compared between the subgroups. MAIN OUTCOME MEASURE(S): Rate of in-hospital catheterization/percutaneous coronary intervention. RESULTS: The registry contained data on 19 483 patients. Intravenous thrombolysis was the main reperfusion therapy. Although the overall rate of in-hospital catheterisation/PCI more than doubled over the study period, while the use of primary PCI only slowly increased from 7.6% in 2006/2007 to 13.6% in 2012/2013. The use of evidence-based oral therapies increased steadily over the years except for ACE-inhibitors and angiotensin-receptor blockers. The adjusted risk ratios (RR) for in-hospital mortality for the four sub-groups have not shown any significant improvement. The 30-day adjusted risk ratios however showed a significant albeit gradual risk reduction (RR 0.773 95% CI 0.679-0.881, P

As the Education industry becoming more competitive these days, the institutions of higher education is competing to attract students by providing better e-Services Quality (e-SQ) which can improve their relationship and enhance their satisfaction. However, measuring e-SQ and satisfaction is a complex process because they relate to users feelings which cannot be predicted and measured easily. This study aims to develop a measurement scale for hypothesized conceptual model of e-service quality and user satisfaction relationship in Malaysian universities. The hypothesized conceptual model utilises Expectancy Disconfirmation Theory model (EDT), which is based on expected outcome and perceived performance of e-services quality. Nine dimensions of e-SQ are proposed for this model based on reviewing and analysing the related literature, especially the common e-SQ measures. The dimensions include efficiency, availability, privacy/security, fulfilment, reliability, web design, interactivity, information and ease of use. A structured questionnaire is conducted in five Malaysian universities to achieve the first stage of the hypothesized model related to evaluating the dimensions and defining the significant ones suitable for evaluating the expected outcome and perceived performance of e-Service Quality (e-SQ). These dimensions represent a core of a proper scale for the quality of e-services in higher education in Malaysia and will help to measure the students’ satisfactions in the target domain.

The current research aims to identify the role of strategic prowess in strengthening the management of high commitment and the practice of the Iraqi media network of strategic ingenuity, and management of high commitment, and given the scarcity of studies that attempted to identify and recognize the nature of the relationships between the three research variables in their direct and indirect form in the Iraqi environment, in addition, the researcher’s attempt to study and address a real and realistic problem that directly affects the Iraqi media network.However, the research adopted the intentional stratified sampling method for a population of network managers 250 individuals. The researcher used the Thompson equation and Mascheran’s table for small samples and the size of the research sample was 160, And for this purpose, statistical tools and methods were utilized in analyzing the practical side of the search (arithmetic mean, standard deviation, Pearson correlation coefficient, simple and multiple regression methods, path analysis, Sobel test), and they were analyzed by the statistical program (SPSS V.26 & AMOS V 26), in addition to the descriptive and analytical approach through polling opinions and interviews, and it was the main tool in collecting data (the questionnaire). The theoretical part in an attempt to bridge the knowledge gap in explaining the variables.

Background Patients with renal impairment often left out from most major clinical trials assessing the optimal treatment for ST-elevation myocardial infarction (STEMI). Large body of evidence from various cardiovascular registries reflecting more ‘real-world’ experience might contribute to the knowledge on how best to treat this special cohort. We aim to analyze the outcomes of Malaysian STEMI patients with renal impairment treated with coronary angioplasty. Methods Utilizing the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014, STEMI patients treated with percutaneous coronary intervention (PCI) were stratified into presence (GFR

Objectives The aim of this randomized controlled trial was to investigate a novel sirolimus-coated balloon (SCB) compared with the best investigated paclitaxel-coated balloon (PCB). Background Treatment of coronary in-stent restenosis (ISR) remains challenging. PCBs are an established treatment option outside the United States with a Class I, Level of Evidence: A recommendation in the European guidelines. However, their efficacy is better in bare-metal stent (BMS) ISR compared with drug-eluting stent (DES) ISR. Methods Fifty patients with DES ISR were enrolled in a randomized, multicenter trial to compare a novel SCB (SeQuent SCB, 4 μg/mm2) with a clinically proven PCB (SeQuent Please Neo, 3 μg/mm2) in coronary DES ISR. The primary endpoint was angiographic late lumen loss at 6 months. Secondary endpoints included procedural success, major adverse cardiovascular events, and individual clinical endpoints such as stent thrombosis, cardiac death, target lesion myocardial infarction, clinically driven target lesion revascularization, and binary restenosis. Results Quantitative coronary angiography revealed no differences in baseline parameters. After 6 months, in-segment late lumen loss was 0.21 ± 0.54 mm in the PCB group versus 0.17 ± 0.55 mm in the SCB group (p = NS; per-protocol analysis). Clinical events up to 12 months also did not differ between the groups. Conclusions This first-in-man comparison of a novel SCB with a crystalline coating shows similar angiographic outcomes in the treatment of coronary DES ISR compared with a clinically proven PCB. (Treatment of Coronary In-Stent Restenosis by a Sirolimus [Rapamycin] Coated Balloon or a Paclitaxel Coated Balloon [FIM LIMUS DCB]; NCT02996318)

Background:Cardiovascular diseases are the main cause of death globally. Individuals with evidence of coronary artery disease are at increased risk of further cardiovascular events. However, with good secondary prevention, which consists broadly of lifestyle changes, medical therapy and revascularisation, this risk can be reduced. The true extent of secondary prevention in individuals who are re-admitted with a myocardial infarction in such a high-risk cohort has never been explored in Malaysia.Methods:We performed a retrospective, observational study in a tertiary hospital in 100 individuals with previously diagnosed coronary artery disease admitted with a myocardial infarction from August 2016 to February 2017.Results:Twenty-nine per cent of patients were still smoking; 15% and 47% were not taking antiplatelet or beta-blocker therapy, respectively. A further 45% and 20% of patients were not on any renin–angiotensin–aldosterone inhibition or lipid-lowering therapy, respectively.Conclusion:In our high-risk cohort, secondary prevention practices were sub-optimal. Poor physician–patient communication was frequently listed as a major factor. Simple strategies taken at various levels of care should be implemented and audited to improve these practices.

Number of existing signal processing methods can be used for extracting useful information. However, the problem of signal processing method, essential to highlight the wanted information and attenuate the undesired signal is trivial. Several signal processing methods have been implemented to solve this issue. Research using Empirical Mode Decomposition (EMD) algorithm shows promising results in comparison to other signal processing methods, especially in the accuracy showing the relationship between signal energy and time – frequency distribution by represents series of the stationary signals with different amplitudes and frequency bands. However, this EMD algorithm will still have noise contamination that may compromise the accuracy of the signal processing to highlight the wanted information. It is because the mode mixing phenomenon in the Intrinsic Mode Function’s (IMF) due to the undesirable signal with the mix of additional noise. There is still room for the improvement in the selective accuracy of the sensitive IMF after decomposition that can influence the correctness of feature extraction of the oxidized carbon steel. Using four datasets, analysis parameters of the Ensemble Empirical Mode Decomposition (EEMD) algorithm has been conducted.

This paper presents challenges in cyber security implementation at organisational level. This research is based on a case study on government sector in Malaysia deploying qualitative approach using semi-structured interviews with key officers in the organization. The data were analysed using Grounded Theory. The findings clustered under three pillars of success namely People, Process and Technology. Under the pillar of People, the challenges are lack of skills, cyber security is everyone’s responsibilities and human error, whilst under Process, challenges identified are lack of implementation plan, wrongly placed human resource and lack of budget. The challenge in Technology is that it moves too fast. The findings are useful for the cyber security policy makers and implementers.

In this paper, a modelling approach for a photovoltaic solar cell has been proposed which begins with the development of a solar cell up to enabling the solar cell to be implemented at circuit level simulations. This modelling approach is useful in the photovoltaic field to have an initial or overall observation on the effects toward the photovoltaic system. The modelling approach begins with modelling a thin film Cu(In, Ga)Se 2 (CIGS) solar cell using Silvaco TCAD (Technology Computer-Aided Design) software with a predefined baseline parameters. The electrical parameters as well as the I-V curve of the TCAD model are obtained and the data is exported to be post-processed in Matlab software. Key parameters of the TCAD model are used to develop an equivalent electrical model. The Single-diode model topology is implemented for simplicity. In order to test the validity of the single-diode model, the 1-V curve is compared to the 1-V curve of the TCAD model. As an extension, the 1-V curves are also presented across different temperatures in order to test the accuracy of the single-diode model

Number of existing signal processing methods can be used for extracting useful information. However, receiving desired and eliminating undesired information is yet a significant problem of these methods. Empirical Mode Decomposition (EMD) algorithm shows promising results in comparison to other signal processing methods especially in terms of accuracy. For example, it shows an efficient relationship between signal energy and time frequency distribution. Though, EMD algorithm still has a noise contamination which may compromise the accuracy of the signal processing. It is due to the mode mixing phenomenon in the Intrinsic Mode Function’s (IMF) which causes the undesirable signal with the mix of additional noise. Therefore, it has still a room for the improvements in the selective accuracy of the sensitive IMF after decomposition that can influence the correctness of feature extraction of the oxidized carbon steel. This study has used two datasets to compare the parameters analysis of the Ensemble Empirical Mode Decomposition (EEMD) algorithm for constructing the signal signature.

this paper focuses on the influence of technological factors on students' academic performance (SAP) in blended and traditional learning domains. Its purpose is to identify the most important and significant factors of technology that influence SAP. The method used is a survey study with a total sample size of 216 participants of experimental group and control group. The results have shown that the influence of use of technology on SAP is significant. These predictors of technological factors contribute by 65% and 98% of explained variance in improving SAP in blended learning compared to traditional learning respectively.

Objective. Coronary revascularization in chronic total occlusion (CTO) is associated with improved clinical outcomes. The choice of the coronary stent is crucial in maintaining long-term vessel patency after CTO revascularization. We investigated the efficacy and safety of polymer-free ultrathin strut sirolimus-probucol coated drug-eluting stents (PF-SES) for CTO lesions. Methods. Patients with CTO lesions treated with PF-SES were identified from the prospective multicenter international ISAR 2000 registry. The primary endpoint was clinically driven target lesion revascularization (TLR) at 9 months. Secondary endpoints were 9-month major adverse cardiac events (death, myocardial infarction, or TLR) (MACE) and the occurrence of stent thrombosis. Results. A total of 111 patients with CTO lesions (n=127) were available for analysis. The 9-month clinical follow-up rate was 91%. The mean reference vessel diameter and lesion length were 2.76 mm ± 0.40 and 26.8 mm ± 13.1, respectively. The overall DAPT duration was 9.7 ± 2.8 months. Only one (1%) in-hospital MI was reported. The TLR and MACE rates at 9 months were 2% (2/101) and 5.9% (6/101), respectively. The 9-month accumulated rates of definite or probable stent thrombosis was 0% (0/101). Conclusion. Revascularizations for CTO with PF-SES are associated with low rates of TLR and MACE at 9 months with no stent thrombosis. These initial findings need to be compared with results of other new generation DES of larger studies.

In the Infrastructure as a Service (IaaS) industry, the decision-making to choose the prioritized trust improvement actions is significant as to ensure the trustworthiness and service continuity of the IaaS cloud providers. This is done by checking the trust control elements (TCEs) of IaaS cloud regularly so as to put together an efficient and effective improvement plan. However, it is very difficult to put such improvement plan unless it is based on the results of a preparatory evaluation. This paper, present rigorous and reliable evaluation framework based evaluation theory called trust evaluation of IaaS cloud framework. The main goal of this evaluation framework is to help IaaS cloud providers to identify the unimproved gaps according to particular TCEs. Diagrammatic trust tree and hybrid evaluation and ranking technique combining fuzzy set, simple additive weight, and important performance analysis (IPA) are the main components of this novel framework. The proposed framework is applied to evaluate the IaaS cloud of two providers. The results show that each provider has several different unimproved gaps that need urgent improvement actions. Moreover, based on the analysis results of IPA, several recommendations have been suggested to fill these gaps.

Displays based on microsized gallium nitride light-emitting diodes possess extraordinary brightness. It is demonstrated here both theoretically and experimentally that the layout of the n-contact in these devices is important for the best device performance. We highlight, in particular, the significance of a nonthermal increase of differential resistance upon multipixel operation. These findings underpin the realization of a blue microdisplay with a luminance of $10^{6}$ cd/ $\text{m}^{2}$ .