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Summary In this paper, a communication‐based selective protective scheme using the combined adaptive cumulative sum algorithm (CACUSUM) is proposed, which can be used in wide‐area protection of multi‐terminal high voltage direct current (MT‐HVDC) transmission lines. The proposed algorithm works in the time domain and uses the variation pattern of the magnitude of line currents and bus voltages for fault detection. Simulation is done in MATLAB program using a test four terminals meshed HVDC transmission system. As a robust fault detector, the proposed approach detects fault occurrence as well as determining faulty zone, either faults on the DC line or AC part of the HVDC system; the whole in less than 2 ms. Simulation results confirm the robustness of CACUSUM performance against different fault resistances and different fault locations as well as the presence of noise in the signals. Appropriate speed, adaptivity, independence from system parameters, low sampling rate, low computational burden, simplicity, no need for any complicated hardware, and ability to detect cross faults are the significant benefits of this method in comparison with other ones. [ABSTRACT FROM AUTHOR]

Background: It is conjectured that providing feedback on physicians' prescribing behavior improves quality of drug prescriptions. However, the effectiveness of feedback provision and mode of feedback delivery is not well understood. The objective of this study was to assess and compare the effect of traditional paper letters (TPL) and short text message (STM) feedback on general practitioners' prescribing behavior of parenteral steroids (PSs).Methods: In a single-blind randomized controlled trial, 906 general practitioners (GPs) having at least 10 monthly prescriptions were randomly recruited into two interventions and one control study arms with 1:1 allocation, stratified by percentage of prescriptions. The intervention was the provision of 3 feedback messages containing prescribing indices in TPL and STM (in the first two arms) versus the control arm (CG) with an interval of 3 months between these messages. We calculated the PS Defined Daily Dose (DDD) for every GP, every month, and compared between the 3 arms, before and after the interventions. The expected primary outcome was to reduce prescription of parenteral steroids by participants. The study was performed in the Kerman Social Security Organization in Iran.Results: A total of 906 GPs were selected for the trial, but only 721 of them (TPL=191, STM=228, CG=302) were recruited for the 1st feedback. The mean age of GPs was 44 and 59% of them were male. The prescribed parenteral steroid DDDs at baseline were similar (TPL=121.62, STM=127.49, CG=115.68, P>0.5). At the end of the study, DDDs in the TPL and STM arms were similar (TPL=104.38, STM=101.90, P>0.9) but DDDs in each intervention arm was statistically significantly lower than in CG (CG=156.17, P<0.0001). Being in TPL and STM arms resulted in 36.1 and 41.7 units of decrease in DDD respectively, compared to the control arm (P<0.02 and P<0.005) after the one-year duration of the study.Conclusion: Feedback by TPLs and STMs on prescribing performance effectively reduced prescribing PSs by GPs. STM, being a cheap and fast tool, is potentially powerful and efficient for drug prescription rationalization. [ABSTRACT FROM AUTHOR]

Body packers are people who illegally carry drugs, mostly cocaine as well as opium and/or heroin, concealed within their bodies. The packets are inserted in the mouth, rectum, or vagina in order to get across borders without being detected. In this presentation we report a case of an opium body packer and review the available scientific literature by focusing on mechanisms of toxicity and treatment approach. The patient was a 35-year-old man who had lethargy, respiratory depression, tachycardia, normal blood pressure, hyperthermia, and pinpoint pupils on presentation. No past medical history was obtained and the only positive history was his travel from Afghanistan 2 days earlier, which he had given to emergency personnel before arriving at our hospital. Complete blood cells and kidney and liver tests were all in normal range. In the emergency department, the patient was treated with oxygen, naloxone, and hypertonic glucose. One dose of activated charcoal (1 g/kg) was administered orally. After intravenous injection of naloxone (4 mg), the lethargy, respiratory depression, and miosis were resolved. The patient was admitted to the intensive care unit and 90 min after admission, the patient redeveloped respiratory distress and lost consciousness. He was intubated and mechanically ventilated due to the suspicious of body packing. Plain abdominal x-ray showed multiple packets throughout the gastrointestinal tract; 81 packets were removed by surgery and three of them were left due to leaking. After removing the packets, the patient was treated conservatively. He suffered a pulmonary infection (aspiration pneumonia) and he regained consciousness after 4 days. Upon recovery the patient was seen by a psychiatrist prior to going to prison. Surgery is recommended for body packers who have significant signs or symptoms. [ABSTRACT FROM AUTHOR]

A single step anodizing process is used to produce micro-nano structures on Aluminum (1050) substrates with sulfuric acid as electrolyte. Therefore, surface energy of the anodized layer is reduced using stearic acid modification. Undoubtedly, effects of different parameters including anodizing time, electrical current, and type and concentration of electrolyte on the final contact angle are systemically studied and optimized. Results show that anodizing current of 0.41 A, electrolyte (sulfuric acid) concentration of 15 wt.% and anodizing time of 90 min are optimal conditions which give contact angle as high as 159.2° and sliding angle lower than 5°. Moreover, the study reveals that adding oxalic acid to the sulfuric acid cannot enhance superhydrophobicity of the samples. Also, scanning electron microscopy images of samples show that irregular (bird's nest) structures present on the surface instead of high-ordered honeycomb structures expecting from normal anodizing process. Additionally, X-ray diffraction analysis of the samples shows that only amorphous structures present on the surface. The Brunauer–Emmett–Teller (BET) specific surface area of the anodized layer is 2.55 m 2  g −1 in optimal condition. Ultimately, the surface keeps its hydrophobicity in air and deionized water (DIW) after one week and 12 weeks, respectively. [ABSTRACT FROM AUTHOR]