Search results for: clinical trial optimization

Authors: Naser Alajmi, Ali Alobaidly, Mubarak Alhajri, Salem Salamah, Muhammad Alsubaie

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Iterative Learning Control (ILC) known to be a controlling tool to overcome periodic disturbances for repetitive systems. This technique is required to let the error signal tends to zero as the number of operation increases. The learning process that lies within this context is strongly dependent on the initial input which if selected properly tends to let the learning process be more effective compared to the case where a system starts from blind. ILC uses previous recorded execution data to update the following execution/trial input such that a reference trajectory is followed to a high accuracy. Error convergence in ILC is generally highly dependent on the input applied to a plant for trial $1$, thus a good choice of initial starting input signal would make learning faster and as a consequence the error tends to zero faster as well. In the work presented within, an upper limit based on the Singular Values Principle (SV) is derived for the initial input signal applied at trial $1$ such that the system follow the reference in less number of trials without responding aggressively or exceeding the working envelope where a system is required to move within in a robot arm, for example. Simulation results presented illustrate the theory introduced within this paper.

Keywords: initial input, iterative learning control, maximum input, singular values

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Authors: Eva Queheille, Franck Taillandier, Nadia Saiyouri

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Waste management has become a major issue in demolition works, because of its environmental impact (energy consumption, resource consumption, pollution…). However, improving waste management requires to take also into account the overall demolition process and to consider demolition main objectives (e.g. cost, delay). Establishing a strategy with these conflicting objectives (economic and environment) remains complex. In order to provide a decision-support for demolition companies, a multi-objective optimization model was developed. In this model, a demolition strategy is computed from a set of 80 decision variables (worker team composition, machines, treatment for each type of waste, choice of treatment platform…), which impacts the demolition objectives. The model has experimented on a real-case study (demolition of several buildings in France). To process the optimization, different optimization algorithms (NSGA2, MOPSO, DBEA…) were tested. Results allow the engineer in charge of this case, to build a sustainable demolition strategy without affecting cost or delay.

Keywords: deconstruction, life cycle assessment, multi-objective optimization, waste management

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Authors: Ken Hampshire, Thomas Mazzuchi, Shahram Sarkani

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As a subset of metaheuristics, nature-inspired optimization algorithms such as particle swarm optimization (PSO) have shown promise both in solving intractable problems and in their extensibility to novel problem formulations due to their general approach requiring few assumptions. Unfortunately, single instantiations of algorithms require detailed tuning of parameters and cannot be proven to be best suited to a particular illustrative problem on account of the “no free lunch” (NFL) theorem. Using these algorithms in real-world problems requires exquisite knowledge of the many techniques and is not conducive to reconciling the various approaches to given classes of problems. This research aims to present a unified view of PSO-based approaches from the perspective of relevant systems engineering problems, with the express purpose of then eliciting the best solution for any problem formulation in an ensemble learning bucket of models approach. The central hypothesis of the research is that extending the PSO algorithms found in the literature to real-world optimization problems requires a general ensemble-based method for all problem formulations but a specific implementation and solution for any instance. The main results are a problem-based literature survey and a general method to find more globally optimal solutions for any systems engineering optimization problem.

Keywords: particle swarm optimization, nature-inspired optimization, metaheuristics, systems engineering, ensemble learning

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Authors: Benmoussa Dennai, H. Benslimane, A. Helmaoui

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Photovoltaic conversion is the direct conversion of electromagnetic energy into electrical energy continuously. This electromagnetic energy is the most solar radiation. In this work we performed a computer modelling using AMPS 1D optimization of hetero-junction solar cells GaInP / GaAs configuration for p / n. We studied the influence of the thickness the base layer in the cell offers on the open circuit voltage, the short circuit current and efficiency.

Keywords: optimization, photovoltaic cell, GaInP / GaAs AMPS-1D, hetetro-junction

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Authors: Benalia Nadia, Zerzouri Nora, Ben Si Ali Nadia

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Abstract: Among the many different modern heuristic optimization methods, genetic algorithms (GA) and the particle swarm optimization (PSO) technique have been attracting a lot of interest. The GA has gained popularity in academia and business mostly because to its simplicity, ability to solve highly nonlinear mixed integer optimization problems that are typical of complex engineering systems, and intuitiveness. The mechanics of the PSO methodology, a relatively recent heuristic search tool, are modeled after the swarming or cooperative behavior of biological groups. It is suitable to compare the performance of the two techniques since they both aim to solve a particular objective function but make use of distinct computing methods. In this article, PSO and GA optimization approaches are used for the parameter tuning of the power system stabilizer and Proportional integral derivative regulator. Load angle and rotor speed variations in the single machine infinite bus bar system is used to measure the performance of the suggested solution.

Keywords: SMIB, genetic algorithm, PSO, transient stability, power system stabilizer, PID

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Mahmoud Nadir, Adel Ghenaiet

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The main purpose of this study is the thermodynamic modeling, the parametric analysis, and the optimization of three pressure level reheat HRSG (Heat Recovery Steam Generator) using PSO method (Particle Swarm Optimization). In this paper, a parametric analysis followed by a thermodynamic optimization is presented. The chosen objective function is the specific work of the steam cycle that may be, in the case of combined cycle (CC), a good criterion of thermodynamic performance analysis, contrary to the conventional steam turbines in which the thermal efficiency could be also an important criterion. The technologic constraints such as maximal steam cycle temperature, minimal steam fraction at steam turbine outlet, maximal steam pressure, minimal stack temperature, minimal pinch point, and maximal superheater effectiveness are also considered. The parametric analyses permitted to understand the effect of design parameters and the constraints on steam cycle specific work variation. PSO algorithm was used successfully in HRSG optimization, knowing that the achieved results are in accordance with those of the previous studies in which genetic algorithms were used. Moreover, this method is easy to implement comparing with the other methods.

Keywords: combined cycle, HRSG thermodynamic modeling, optimization, PSO, steam cycle specific work

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Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Kenza Aida Amara, Bachir Djebbar

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We treat the two-dimensional bin packing problem which involves packing a given set of rectangles into a minimum number of larger identical rectangles called bins. This combinatorial problem is NP-hard. We propose a pretreatment for the oriented version of the problem that allows the valorization of the lost areas in the bins and the reduction of the size problem. A heuristic method based on the strategy first-fit adapted to this problem is presented. We present an approach of resolution by bee colony optimization. Computational results express a comparison of the number of bins used with and without pretreatment.

Keywords: bee colony optimization, bin packing, heuristic algorithm, pretreatment

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Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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Authors: Ju-Hong Lee, Ding-Chen Chung

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The paper deals with the optimal design of two-channel linear-phase (LP) quadrature mirror filter (QMF) banks using a metaheuristic based optimization technique. Based on the theory of two-channel QMF banks using two recursive digital all-pass filters (DAFs), the design problem is appropriately formulated to result in an objective function which is a weighted sum of the group delay error of the designed QMF bank and the magnitude response error of the designed low-pass analysis filter. Through a frequency sampling and a weighted least squares approach, the optimization problem of the objective function can be solved by utilizing a particle swarm optimization algorithm. The resulting two-channel QMF banks can possess approximately LP response without magnitude distortion. Simulation results are presented for illustration and comparison.

Keywords: quadrature mirror filter bank, digital all-pass filter, weighted least squares algorithm, particle swarm optimization

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Authors: Vincenzo Capalbo, Gianpaolo Ghiani, Emanuele Manni

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Global e-commerce sales have reached unprecedented levels in the past few years. As this trend is only predicted to go up as we continue into the ’20s, new challenges will be faced by companies when planning and controlling e-commerce logistics. In this paper, we survey the related literature on Optimization and Machine Learning as well as on combined methodologies. We also identify the distinctive features of next-generation planning algorithms - namely scalability, model-and-run features and learning capabilities - that will be fundamental to cope with the scale and complexity of logistics in the next decade.

Keywords: e-commerce, hardware acceleration, logistics, machine learning, mixed integer programming, optimization

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Authors: Liping Yang, Curran Crawford, Jr. Ren, Zhengyi Ren

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Considering the cost evaluation and the stress analysis, a fuzzy satisfactory optimization (FSO) method has been developed for a hybrid composite flywheel. To evaluate the cost, the cost coefficients of the flywheel components are obtained through calculating the weighted sum of the scores of the material manufacturability, the structure character, and the material price. To express the satisfactory degree of the energy, the cost, and the mass, the satisfactory functions are proposed by using the decline function and introducing a satisfactory coefficient. To imply the different significance of the objectives, the object weight coefficients are defined. Based on the stress analysis of composite material, the circumferential and radial stresses are considered into the optimization formulation. The simulations of the FSO method with different weight coefficients and storage energy density optimization (SEDO) method of a flywheel are contrasted. The analysis results show that the FSO method can satisfy different requirements of the designer and the FSO method with suitable weight coefficients can replace the SEDO method.

Keywords: flywheel energy storage, fuzzy, optimization, stress analysis

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Authors: Fábio A. S. Mota, Mauro A. S. S. Ravagnani, E. P. Carvalho

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In the present paper the design of plate heat exchangers is formulated as an optimization problem considering two mathematical modeling. The number of plates is the objective function to be minimized, considering implicitly some parameters configuration. Screening is the optimization method used to solve the problem. Thermal and hydraulic constraints are verified, not viable solutions are discarded and the method searches for the convergence to the optimum, case it exists. A case study is presented to test the applicability of the developed algorithm. Results show coherency with the literature.

Keywords: plate heat exchanger, optimization, modeling, simulation

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Authors: J. Satya Eswari, Ch. Venkateswarlu

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The formulation of a commercial pharmaceutical product involves several composition factors and response characteristics. When the formulation requires to satisfy multiple response characteristics which are conflicting, an optimal solution requires the need for an efficient multiobjective optimization technique. In this work, a regression is combined with a non-dominated sorting differential evolution (NSDE) involving Naïve & Slow and ε constraint techniques to derive different multiobjective optimization strategies, which are then evaluated by means of a trapidil pharmaceutical formulation. The analysis of the results show the effectiveness of the strategy that combines the regression model and NSDE with the integration of both Naïve & Slow and ε constraint techniques for Pareto optimization of trapidil formulation. With this strategy, the optimal formulation at pH=6.8 is obtained with the decision variables of micro crystalline cellulose, hydroxypropyl methylcellulose and compression pressure. The corresponding response characteristics of rate constant and release order are also noted down. The comparison of these results with the experimental data and with those of other multiple regression model based multiobjective evolutionary optimization strategies signify the better performance for optimal trapidil formulation.

Keywords: pharmaceutical formulation, multiple regression model, response surface method, radial basis function network, differential evolution, multiobjective optimization

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Authors: Abeer Alhazmi

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Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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Authors: Hassan Naseh, Javad Roozgard

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This paper represents the methodology based on Artificial Intelligent (AI) applied to Liquid Propellant Engine (LPE) optimization. The AI methodology utilized from Adaptive neural Fuzzy Inference System (ANFIS). In this methodology, the optimum objective function means to achieve maximum performance (specific impulse). The independent design variables in ANFIS modeling are combustion chamber pressure and temperature and oxidizer to fuel ratio and output of this modeling are specific impulse that can be applied with other objective functions in LPE design optimization. To this end, the LPE’s parameter has been modeled in ANFIS methodology based on generating fuzzy inference system structure by using grid partitioning, subtractive clustering and Fuzzy C-Means (FCM) clustering for both inferences (Mamdani and Sugeno) and various types of membership functions. The final comparing optimization results shown accuracy and processing run time of the Gaussian ANFIS Methodology between all methods.

Keywords: ANFIS methodology, artificial intelligent, liquid propellant engine, optimization

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Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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Authors: Guettal Djaouida, Ziadi Abdelkader

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In this paper, we study a coupling of the Alienor method with the algorithm of Piyavskii-Shubert. The classical multidimensional global optimization methods involves great difficulties for their implementation to high dimensions. The Alienor method allows to transform a multivariable function into a function of a single variable for which it is possible to use efficient and rapid method for calculating the the global optimum. This simplification is based on the using of a reducing transformation called Alienor.

Keywords: global optimization, reducing transformation, α-dense curves, Alienor method, Piyavskii-Shubert algorithm

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Authors: Mohamed Belhorma, Aboubakar S. Bouchikhi, Belkacem Bounab

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This paper addresses modeling a Double A-Arm suspension, a three-dimensional nonlinear model has been developed using the multibody systems formalism. Dynamical study of the different components responses was done, particularly for the wheel assembly. To validate those results, the system was constructed and simulated by RecurDyn, a professional multibody dynamics simulation software. The model has been used as the Objectif function in an optimization algorithm for ride quality improvement.

Keywords: double A-Arm suspension, multibody systems, ride quality optimization, dynamic simulation

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Authors: Akshay Paranjape, Nils Plettenberg, Robert Schmitt

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Traditional optimization methods like evolutionary algorithms are widely used in production processes to find an optimal or near-optimal solution of control parameters based on the simulated environment space of a process. These algorithms are computationally intensive and therefore do not provide the opportunity for real-time optimization. This paper utilizes the Deep Reinforcement Learning (DRL) framework to find an optimal or near-optimal solution for control parameters. A model based on maximum a posteriori policy optimization (Hybrid-MPO) that can handle both numerical and categorical parameters is used as a benchmark for comparison. A comparative study shows that DRL can find optimal solutions of similar quality as compared to evolutionary algorithms while requiring significantly less time making them preferable for real-time optimization. The results are confirmed in a large-scale validation study on datasets from production and other fields. A trained XGBoost model is used as a surrogate for process simulation. Finally, multiple ways to improve the model are discussed.

Keywords: reinforcement learning, evolutionary algorithms, production process optimization, real-time optimization, hybrid-MPO

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Authors: Ashraf Osman

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Effective deployable bridges that are characterized by an increased capacity to weight ratio are recently needed for post-disaster rapid mobility and military operations. In deployable bridging, replacing metals as the fabricating material with advanced composite laminates as lighter alternatives with higher strength is highly advantageous. This article presents a hierarchical optimization strategy of a composite bridge treadway considering maximum strength design and bridge weight minimization. Shape optimization of a generic deployable bridge beam cross-section is performed to achieve better stress distribution over the bridge treadway hull. The developed cross-section weight is minimized up to reserving the margins of safety of the deployable bridging code provisions. Hence, the strength of composite bridge plates is maximized through varying the plies orientation. Different loading cases are considered of a tracked vehicle patch load. The orthotropic plate properties of a composite sandwich core are used to simulate the bridge deck structural behavior. Whereas, the failure analysis is conducted using Tsai-Wu failure criterion. The naturally inspired particle swarm optimization technique is used in this study. The proposed technique efficiently reduced the weight to capacity ratio of the developed bridge beam.

Keywords: CFRP deployable bridges, disaster relief, military bridging, optimization of composites, particle swarm optimization

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Authors: Susan Ka Yee Chow

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Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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Authors: Rajesh Kumar G

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A challenging aspect of any clinical trial is to carefully plan the study design to meet the study objective in optimum way and to validate the assumptions made during protocol designing. And when it is a pediatric study, there is the added challenge of stringent guidelines and difficulty in recruiting the necessary subjects. Unlike adult trials, there is not much historical data available for pediatrics, which is required to validate assumptions for planning pediatric trials. Typically, pediatric studies are initiated as soon as approval is obtained for a drug to be marketed for adults, so with the adult study historical information and with the available pediatric pilot study data or simulated pediatric data, the pediatric study can be well planned. Generalizing the historical adult study for new pediatric study is a tedious task; however, it is possible by integrating various statistical techniques and utilizing the advantage of hybrid study design, which will help to achieve the study objective in a smoother way even with the presence of many constraints. This research paper will explain how well the hybrid study design can be planned along with integrated technique (SEV) to plan the pediatric study; In brief the SEV technique (Simulation, Estimation (using borrowed adult data and applying Bayesian methods)) incorporates the use of simulating the planned study data and getting the desired estimates to Validate the assumptions.This method of validation can be used to improve the accuracy of data analysis, ensuring that results are as valid and reliable as possible, which allow us to make informed decisions well ahead of study initiation. With professional precision, this technique based on the collected data allows to gain insight into best practices when using data from historical study and simulated data alike.

Keywords: adaptive design, simulation, borrowing data, bayesian model

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Authors: Dorota Witkowska, Paweł Gosek, Lukasz Swiecicki, Wojciech Jernajczyk, Bruce J. West, Miroslaw Latka

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In clinical practice, the selection of an antidepressant often degrades to lengthy trial-and-error. In this work we employ a normalized wavelet power of alpha waves as a biomarker of antidepressant treatment response. This novel EEG metric takes into account both non-stationarity and intersubject variability of alpha waves. We recorded resting, 19-channel EEG (closed eyes) in 22 inpatients suffering from unipolar (UD, n=10) or bipolar (BD, n=12) depression. The EEG measurement was done at the end of the short washout period which followed previously unsuccessful pharmacotherapy. The normalized alpha wavelet power of 11 responders was markedly different than that of 11 nonresponders at several, mostly temporoparietal sites. Using the prediction of treatment response based on the normalized alpha wavelet power, we achieved 81.8% sensitivity and 81.8% specificity for channel T4.

Keywords: alpha waves, antidepressant, treatment outcome, wavelet

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Saeed Ur Rahman, Naveed Ullah, Muhammad Irshad Khan, Quensheng Cao, Niaz Muhammad Khan

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In this paper the optimization performance of non-uniform linear antenna array is presented. The Particle Swarm Optimization (PSO) algorithm is presented to minimize Side Lobe Level (SLL) and Half Power Beamwidth (HPBW). The purpose of using the PSO algorithm is to get the optimum values for inter-element spacing and excitation amplitude of linear antenna array that provides a radiation pattern with minimum SLL and HPBW. Various design examples are considered and the obtain results using PSO are confirmed by comparing with results achieved using other nature inspired metaheuristic algorithms such as real coded genetic algorithm (RGA) and biogeography (BBO) algorithm. The comparative results show that optimization of linear antenna array using the PSO provides considerable enhancement in the SLL and HPBW.

Keywords: linear antenna array, minimum side lobe level, narrow half power beamwidth, particle swarm optimization

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Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

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Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

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Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre

Abstract:

New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.

Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination

Procedia PDF Downloads 126

Authors: K. K. Lee, H. W. Han, H. L. Kang, T. A. Kim, S. H. Han

Abstract:

For the robust optimization of the manufacturing product design, there are design objectives that must be achieved, such as a minimization of the mean and standard deviation in objective functions within the required sensitivity constraints. The authors utilized the sensitivity of objective functions and constraints with respect to the effective design variables to reduce the computational burden associated with the evaluation of the probabilities. The individual mean and sensitivity values could be estimated easily by using the 9 level orthogonal array based response surface models optimized by the stepwise regression. The present study evaluates a proposed procedure from the robust optimization of rubber domes that are commonly used for keyboard switching, by using the 9 level orthogonal array and stepwise regression along with a desirability function. In addition, a new robust optimization process, i.e., the I2GEO (Identify, Integrate, Generate, Explore and Optimize), was proposed on the basis of the robust optimization in rubber domes. The optimized results from the response surface models and the estimated results by using the finite element analysis were consistent within a small margin of error. The standard deviation of objective function is decreasing 54.17% with suggested sensitivity based robust optimization. (Business for Cooperative R&D between Industry, Academy, and Research Institute funded Korea Small and Medium Business Administration in 2017, S2455569)

Keywords: objective function, orthogonal array, response surface model, robust optimization, stepwise regression

Procedia PDF Downloads 288