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Cost-related medication non-adherence (CRN) can negatively impact health outcomes in older adults with asthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) by reducing access and adherence to essential medications. The objective of this study is to examine the association of ACO to any CRN and specific forms of CRN among a nationally representative sample of older (age ≥ 65 years) adults. We adopted a cross-sectional study design using data from pooled cross-sectional Medicare Current Beneficiary Surveys (MCBS) (2006–2013) and linked fee-for-service Medicare claims. Unadjusted and adjusted logistic regressions that accounted for the complex survey design examined the association of ACO to any CRN and specific forms of CRN. Among older adults with ACO, 16% reported any CRN. The most common form of CRN was "failing to get prescription". As compared to older adults with no asthma and no COPD, those with ACO were more likely to report any CRN (adjusted odds ratios [AOR] = 1.50, 95%CI = [1.14, 1.96]) and all forms of CRN. However, when the number of unique medications was added to the model, there were no statistically significant differences in CRN between the two groups. Older adults with ACO represent a vulnerable population with increased risk for CRN. Multiple factors can contribute to CRN including: a higher number of prescribed medications, multiple co-morbidities, and cost of therapies. Medication comprehensive review interventions have the potential of reducing the risk of CRN among the older Medicare beneficiaries with ACO. [ABSTRACT FROM AUTHOR]

Bridges play a critical role in the transportation system network; accordingly, assuring satisfaction with the service level of these structures is vital for bridge maintenance managers. Thus, it is vital to determine the optimum bridge maintenance plan (i.e., the optimum timing and type of repair activities applied to the bridge elements) considering the budget limitations. To optimize the bridge maintenance plan, some researchers have focused on developing optimization models, including the Genetic Algorithm (GA). However, a few studies have employed Bridge Information Modeling (BrIM) to enhance bridge maintenance management. This study focuses on developing an integrated framework based on BrIM and bridge maintenance optimization to utilize visualization capabilities of BrIM to assist maintenance managers in making decisions. The presented framework optimizes the bridge maintenance plan at the subelement level. The BrIM automatically feeds into the developed GA optimization system. The introduced framework is successfully verified using a real-world case study. [ABSTRACT FROM AUTHOR]

The popularity and demand for high-quality date palm fruits (Phoenix dactylifera L.) have been growing, and their quality largely depends on the type of handling, storage, and processing methods. The current methods of geometric evaluation and classification of date palm fruits are characterised by high labour intensity and are usually performed mechanically, which may cause additional damage and reduce the quality and value of the product. Therefore, non-contact methods are being sought based on image analysis, with digital solutions controlling the evaluation and classification processes. The main objective of this paper is to develop an automatic classification model for varieties of date palm fruits using a convolutional neural network (CNN) based on two fundamental criteria, i.e., colour difference and evaluation of geometric parameters of dates. A CNN with a fixed architecture was built, marked as DateNET, consisting of a system of five alternating Conv2D, MaxPooling2D, and Dropout classes. The validation accuracy of the model presented in this study depended on the selection of classification criteria. It was 85.24% for fruit colour-based classification and 87.62% for the geometric parameters only; however, it increased considerably to 93.41% when both the colour and geometry of dates were considered.

Recently a new inverse design algorithm has been developed for the design of ducts, called ball-spine (BS). In the BS algorithm, the duct walls are considered as a set of virtual balls that can freely move along some specified directions, called 'spines'. Initial geometry is guessed and the flow field is analyzed by a flow solver. Comparing the computed pressure distribution (CPD) with the target pressure distribution (TPD), new balls positions for the modified geometry are determined. This procedure is repeated until the target pressure is achieved. In the present work, the ball-spine algorithm is applied to three-dimensional design of axial compressor blades. The design procedure is tested on blades based on NACA65-410 and NACA65-610 profiles and the accuracy of the method is shown to be very good. As an application, the pressure distribution of the blade with NACA65-610 profiles is modified and the pressure gradient in the aft part of the blade is decreased and selected as target pressure distribution. The corresponding geometry which satisfies the target pressure is determined using the BS design algorithm. [ABSTRACT FROM AUTHOR]

Aims Educational involvement is one of the concepts employed by different investigators in education and training field and it is considered as learning attitude by recent researches. It has been shown that self-efficacy is associated with learning attitude components. The aim of this study was to investigate the correlation between emotional and cognitive attitude of learning and students self-efficacy. Methods This descriptive-correlational study was done In Isfahan in 2012. The study was done on 138 final term Bachelor of Science students of the Isfahan Shahid Rajai Higher Education Center of Farhangian University. The subjects were selected by census sampling method. Data collected via Motivated Strategies for Learning Questionnaire (MSLQ) containing self-efficacy, Endogenous values, the exam stress, cognitive strategies and selfregulative learning sub-scales. Data were analyzed using SPSS 16 by Pearson correlation coefficient, multivariate and simultaneous regression and One-way ANOVA tests. Findings There was no significant correlation between cognitive and emotional attitude and self-efficacy based on students educational field (p>0.001). There was a significant and positive difference between cognitive and emotional attitude and self-efficacy (p<0.001). Also, emotional attitude was a stronger predictor for self-efficacy compared with cognitive attitude. Conclusion There is a positive and significant correlation between learning emotional and cognitive attitude with teachers-students self-efficacy. Self-efficacy increases with emotional and cognitive attitude enhancement. Learning emotional attitude is stronger to predict self-efficacy. [ABSTRACT FROM AUTHOR]

Two patients with an intraluminal carcinoid tumour obstructing the right main bronchus in one, and the left main bronchus in the other, resulting in unilateral increased transradiancy from hypoperfusion of the lung, are described. Resection of the tumours and reconstruction of bronchial continuity was followed by return of perfusion to normal between three and 18 months after the operation. The patient in whom the diagnosis was delayed showed a much slower rate of return of perfusion and a small lung resulted. The finding of increased transradiancy of lung even in an asymptomatic patient should be an indication for bronchoscopy. [ABSTRACT FROM AUTHOR]

Background and Aims: Posterior palatal seal is one of the most important areas to support maxillary complete denture. The aims of this study was to evaluate the dimensional accuracy of both direct and indirect relining methods on the maxillary posterior palatal seal area. Materials and Methods: A maxillary edentulous model was selected. A 1.5 mm layer of wax was placed on the model to create a space for relining material and impression was done by the silicone material and 20 casts was prepared. By putting the wax on the casts and performed of flasking, 20 dentures were prepared. Direct reline method (as Chair side with GC reline) and indirect method (with Acrosoft-TC and firing with Acropars 100) were evaluated. The relined bases were put on the model and the spaces between them in five points (two points on the ridge , two points in the deepest part of palate and one point in the middle of palate) were calculated by the Stereo microscope and each calculations was repeated 5 times and the mean dimensional changes was measured. To compare the groups, data were analyzed using multivariate analysis. Results: The gap of P.P.S area was between 740.86 and 2356.49 . Direct method (1011.81±60.56) had a lesser gap in comparison with indirect (2056.8±13.13), and both method showed a significant statistic variance (P

Background: The aim of this study was to assess the role of consolidative intraperito-neal chemotherapy with carboplatin in decreasing relapse and increasing survival in advanced epithelial ovarian cancers, as well as evaluation of its toxicity. Methods: In this clinical trial 30 patients with epithelial ovarian cancer in stages II-IV who had complete surgery (optimal debulking surgery) received six standard cycles of intravenous carboplatin and paclitaxel. They were enrolled through non-random se-quential selection. The control patients were similar to case group in stage (II-IV) and pathology (epithelial ovarian cancer). The control group was evaluated retrospectively through hospital files. This clinical trial performed in Gynecology Oncology department in Tehran Valiasr University Hospital, during 2005-2010. They including 18 cases as the intervention group receiving intraperitoneal chemotherapy and 12 patients as the control group with only retrospective follow-up. The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Relapse of disease was diagnosed as increasing or even doubling CA125 serum titer during one month, or any CA125 above 100 IU, or an abdominal or pelvic mass in ul-trasound or physical exam. Mean survival of two and five years, progression-free inter-val (PFI), overall survival (OS), relapse, demographic parameters, drug toxicities, path-ologic types of cancers in two groups were coded and compared using SPSS 14. Any P0.05). The mean overall survival for cases and controls were 39±16.5 and 30.8±16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting. Conclusion: It seems that consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects. Since the mean survival in the intervention group was nine months more than controls, this difference may be clinically significant.