Search results for: clinical simulation

Authors: Asaf Toker

Abstract:

Matricelf developed a technology that enables the production of autologous engineered tissue composed of matrix and cells derived from patients Omentum biopsy. The platform showed remarkable pre-clinical results for several medical conditions. The company recently licensed the technology that enabled scientist at Tel Aviv university that 3D printed a human heart from human cells and matrix for the first time in human history. The company plans to conduct its first human clinical trial for Acute Spinal Cord Injury (SCI) early in 2023.

Keywords: tissue engineering, regenerative medicine, spinal Cord Injury, autologous implants, iPSC

Procedia PDF Downloads 127

Authors: M. Iommi, G. Losco

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Current building sector is focused on reduction of energy requirements, on renewable energy generation and on regeneration of existing urban areas. These targets need to be solved with a systemic approach, considering several aspects simultaneously such as climate conditions, lighting conditions, solar radiation, PV potential, etc. The solar access analysis is an already known method to analyze the solar potentials, but in current years, simulation tools have provided more effective opportunities to perform this type of analysis, in particular in the early design stage. Nowadays, the study of the solar access is related to the easiness of the use of simulation tools, in rapid and easy way, during the design process. This study presents a comparison of three simulation tools, from the point of view of the user, with the aim to highlight differences in the easy-to-use of these tools. Using a real urban context as case study, three tools; Ecotect, Townscope and Heliodon, are tested, performing models and simulations and examining the capabilities and output results of solar access analysis. The evaluation of the ease-to-use of these tools is based on some detected parameters and features, such as the types of simulation, requirements of input data, types of results, etc. As a result, a framework is provided in which features and capabilities of each tool are shown. This framework shows the differences among these tools about functions, features and capabilities. The aim of this study is to support users and to improve the integration of simulation tools for solar access with the design process.

Keywords: energy building design tools, solar access analysis, solar potential, urban planning

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Authors: Yansong Zhang, Xueyuan Li, Junjie Zhou, Xufeng Yin, Shihua Yuan, Shuxian Liu

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Aiming at the verification of control algorithms for skid-steering vehicles, a vehicle simulation model of 6×6 electric skid-steering unmanned vehicle was established based on Trucksim and Simulink. The original transmission and steering mechanism of Trucksim are removed, and the electric skid-steering model and a closed-loop controller for the vehicle speed and yaw rate are built in Simulink. The simulation results are compared with the ones got by theoretical formulas. The results show that the predicted tire mechanics and vehicle kinematics of Trucksim-Simulink simulation model are closed to the theoretical results. Therefore, it can be used as an effective approach to study the dynamic performance and control algorithm of skid-steering vehicle. In this paper, a method of motion control based on feed forward control is also designed. The simulation results show that the feed forward control strategy can make the vehicle follow the target yaw rate more quickly and accurately, which makes the vehicle have more maneuverability.

Keywords: skid-steering, Trucksim-Simulink, feedforward control, dynamics

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Authors: Iva Dvornik, Sandro Božić, Žana Božić Brkić

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System-dynamic simulating modelling is one of the most appropriate and successful scientific methods of the complex, non-linear, natural, technical and organizational systems. In the recent practice its methodology proved to be efficient in solving the problems of control, behavior, sensitivity and flexibility of the system dynamics behavior having a high degree of complexity, all these by computing simulation i.e. “under laboratory conditions” what means without any danger for observed realities. This essay deals with the research of the gas turbine dynamic process as well as the operating pump units and transformation of gas energy into hydraulic energy has been simulated. In addition, system mathematical model has been also researched (gas turbine- centrifugal pumps – pipeline pressure system – storage vessel).

Keywords: system dynamics, modelling, centrifugal pump, turbine, gases, continuous and discrete simulation, heuristic optimisation

Procedia PDF Downloads 109

Authors: A. Rajabpour, A. Hadizadeh Kheirkhah

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Heat transfer is of great importance to biological systems in order to function properly. In the present study, specific heat capacity as one of the most important heat transfer properties is calculated for a soluble in water Lysozyme protein. Using equilibrium molecular dynamics (MD) simulation, specific heat capacities of pure water, dry lysozyme, and lysozyme-water solution are calculated at 300K for different weight fractions. It is found that MD results are in good agreement with ideal binary mixing rule at small weight fractions. Results of all simulations have been validated with experimental data.

Keywords: specific heat capacity, molecular dynamics simulation, lysozyme protein, equilibrium

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Authors: Hariti Rafika, Fekih Malika, Saighi Mohamed

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Heat transfer by natural convection in storage tanks for LNG is extremely related to heat gains through the walls with thermal insulation is not perfectly efficient. In this paper, we present the study of natural convection in the unsteady regime for natural gas in aware phase using the fluent software. The gas is just on the surface of the liquid phase. The CFD numerical method used to solve the system of equations is based on the finite volume method. This numerical simulation allowed us to determine the temperature profiles, the stream function, the velocity vectors and the variation of the heat flux density in the vapor phase in the LNG storage tank volume. The results obtained for a general configuration, by numerical simulation were compared to those found in the literature.

Keywords: numerical simulation, natural convection, heat gains, storage tank, liquefied natural gas

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Authors: Deepa, Yashbir Singh, Shi Yi Wu, Michael Friebe, Joao Manuel R. S. Tavares, Hu Wei-Chih

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Cardiovascular disease can be detected by measuring the regional and global wall motion of the left ventricle (LV) of the heart; In this study, we designed a dynamic simulation tool using Computed Tomography (CT) images to assess the difference between actual and simulated left ventricular functions. Thirteen healthy subjects were involved in the study with actual and simulated left ventricular functions. In this research, we found the high correlation between actual left ventricular wall motion and simulated left ventricular wall motion. Our results confirm that our simulation tool is feasible for simulating left ventricular motion.

Keywords: cardiac imaging, left-ventricular remodeling, cardiac wall motion, myocardial functions

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Authors: Ziyu Diao, Yanyan Zhang, Zhentao Liu, Ruidong Yan

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The update frequency of wear profile in main bearing wear prognosis of internal combustion engine plays an important role in the calculation efficiency and accuracy. In order to investigate the appropriate cycle index of the simplified working condition of wear simulation, the main bearing-crankshaft journal friction pair of a diesel engine in service was studied in this paper. The method of multi-body dynamics simulation was used, and the wear prognosis model of the main bearing was established. Several groups of cycle indexes were set up for the wear calculation, and the maximum wear depth and wear profile were compared and analyzed. The results showed that when the cycle index reaches 3, the maximum deviation rate of the maximum wear depth is about 2.8%, and the maximum deviation rate comes to 1.6% when the cycle index reaches 5. This study provides guidance and suggestions for the optimization of wear prognosis by selecting appropriate value of cycle index according to the requirement of calculation cost and accuracy of the simulation work.

Keywords: cycle index, deviation rate, wear calculation, wear profile

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Authors: Tomáš Vyčítal

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In a simulation model of a railway system it is important, besides other crucial algorithms, to have correct behaviour of train overtaking in stochastic conditions. This problem is being addressed in many simulation tools focused on railway traffic, however these are not very human-realistic. The goal of this paper is to create a more human-realistic overtaking decision support system for the use in railway traffic simulations. A fuzzy system has been chosen for this task as fuzzy systems are well-suited for human-like decision making. The fuzzy system designed takes into account timetables, train positions, delays and buffer times as inputs and provides an instruction to overtake or not overtake.

Keywords: decision-making support, fuzzy systems, simulation, railway, transport

Procedia PDF Downloads 142

Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

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Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

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Authors: Mariia Timofeeva, Andrew Ooi, Eric K. W. Poon, Peter Barlis

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Atherosclerotic plaque build-up, commonly known as stenosis, limits blood flow and hence oxygen and nutrient supplies to the heart muscle. Thus, assessment of its severity is of great interest to health professionals. Numerical simulation of the fractional flow reserve (FFR) has proved to be well correlated with invasively measured FFR used for physiological assessment of the severity of coronary stenosis in arteries. Atherosclerosis may impact the diseased artery in several locations causing serial stenoses, which is a complicated subset of coronary artery disease that requires careful treatment planning. However, hemodynamic of the serial sequential stenoses in coronary arteries has not been extensively studied. The hemodynamics of the serial stenoses is complex because the stenoses in the series interact and affect the flow through each other. To address this, serial stenoses in a 3.4 mm left anterior descending (LAD) artery are examined in this study. Two diameter stenoses (DS) are considered, 30 and 50 percent of the reference diameter. Serial stenoses configurations are divided into three groups based on the order of the stenoses in the series, spacing between them, and deviation of the stenoses’ symmetry (eccentricity). A patient-specific pulsatile waveform is used in the simulations. Blood flow within the stenotic artery is assumed to be laminar, Newtonian, and incompressible. Results for the FFR are reported. Based on the simulation results, it can be deduced that the larger drop in pressure (smaller value of the FFR) is expected when the percentage of the second stenosis in the series is bigger. Varying the distance between the stenoses affects the location of the maximum drop in the pressure, while the minimal FFR in the artery remains unchanged. Eccentric serial stenoses are characterized by a noticeably larger decrease in pressure through the stenoses and by the development of the chaotic flow downstream of the stenoses. The largest drop in the pressure (about 4% difference compared to the axisymmetric case) is obtained for the serial stenoses, where both the stenoses are highly eccentric with the centerlines deflected to the different sides of the LAD. In conclusion, varying configuration of the sequential serial stenoses results in a different distribution of FFR through the LAD. Results presented in this study provide insight into the clinical assessment of the severity of the coronary serial stenoses, which is proved to depend on the relative position of the stenoses and the deviation of the stenoses’ symmetry.

Keywords: computational fluid dynamics, coronary artery, fractional flow reserve, serial stenoses

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Authors: Gabriela Chmelikova, Ludmila Hurajova, Pavol Bozek

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Current era has brought hand in hand with the vast and fast development of technologies enormous pressure on individuals to keep being well - oriented in their professional fields. Almost all projects in the real world require an interdisciplinary perspective. These days we notice some cases when students face that real requirements for jobs are in contrast to the knowledge and competences they gained at universities. Interlacing labor market and university programs is a big issue these days. Sometimes it seems that higher education only “chases” reality. Simulation-based learning can support students’ touch with real demand on competences and knowledge of job world. The contribution provided a descriptive study of some cases of simulation-based teaching environment in different courses at STU MTF in Trnava and discussed how students and teachers perceive this model of teaching-learning approach. Finally, some recommendations are proposed how to enhance closer relationship between academic world and labor market.

Keywords: interdisciplinary approach, simulation-based learning, students' job readiness, teaching environment in higher education

Procedia PDF Downloads 273

Authors: A. Sebti Bouzid, S. Igoud, L. Aoudjit, H. Lebik

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Mathematical modeling and numerical simulation have emerged over the past two decades as one of the key tools for design and optimize performances of physical and chemical processes intended to water disinfection. Water photolysis is an efficient and economical technique to reduce bacterial contamination. It exploits the germicidal effect of solar ultraviolet irradiation to inactivate pathogenic microorganisms. The design of photo-reactor operating in continuous disinfection system, required tacking in account the hydrodynamic behavior of water in the reactor. Since the kinetic of disinfection depends on irradiation intensity distribution, coupling the hydrodynamic and solar radiation distribution is of crucial importance. In this work we propose a numerical simulation study for hydrodynamic and solar irradiation distribution in a tubular photo-reactor. We have used the Computational Fluid Dynamic code Fluent under the assumption of three-dimensional incompressible flow in unsteady turbulent regimes. The results of simulation concerned radiation, temperature and velocity fields are discussed and the effect of inclination angle of reactor relative to the horizontal is investigated.

Keywords: solar water disinfection, hydrodynamic modeling, solar irradiation modeling, CFD Fluent

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Authors: Shiyun Liu

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Radiant heating systems work fundamentally differently from air systems by taking advantage of both radiant and convective heat transfer to remove space heating load. There are rare studies on differences of heating systems between all-air system and radiant floor system. This paper uses the method of simulation based on state-space to calculate the indoor temperature and wall temperature of each system and shows how the dynamic heat transfer in rooms conditioned by a radiant system is different from an air system. Then this paper analyses the changes of indoor temperature of these two systems, finding out the differences between all-air heating system and radiant floor heating system to help the designer choose a more suitable heating system.

Keywords: radiant floor, all-air system, thermal comfort, simulation, heating system

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Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

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Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

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Authors: Samia Rabet, Rachida Chemini, Gerhard Schäfer, Farid Aiouache

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The textile industry generates large quantities of wastewater, which poses significant environmental problems due to its complex composition and high levels of pollutants loaded principally with heavy metals, large amounts of COD, and dye. Separation treatment methods are often known for their effectiveness in removing contaminants whereas membrane separation techniques are a promising process for the treatment of textile effluent due to their versatility, efficiency, and low energy requirements. This study focuses on the modeling and simulation of membrane separation technologies with a cross-flow filtration process for textile effluent treatment. It aims to explore the application of mathematical models and computational simulations using ASPEN Plus Software in the prediction of a complex and real effluent separation. The results demonstrate the effectiveness of modeling and simulation techniques in predicting pollutant removal efficiencies with a global deviation percentage of 1.83% between experimental and simulated results; membrane fouling behavior, and overall process performance (hydraulic resistance, membrane porosity) were also estimated and indicating that the membrane losses 10% of its efficiency after 40 min of working.

Keywords: membrane separation, ultrafiltration, textile effluent, modeling, simulation

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

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Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: congenital, Zika virus, microcephaly, reverse transcriptase polymerase chain reaction

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Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

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Authors: Xu Rumin, Chen Jianyi, Yue Ti, Wang Yaan

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With the rapid development of subsea oil and gas exploitation, the demand for the related underwater process equipment is increasing fast. In order to reduce the energy consuming, people tend to separate the gas and oil phase directly on the seabed. Accordingly, an advanced separator is needed. In this paper, the pressure drop of a new type of separator named Gas Liquid Cylindrical Cyclone (GLCC) which is used in the subsea system is investigated by both experiments and numerical simulation. In the experiments, the single phase flow and gas-liquid two phase flow in GLCC were tested. For the simulation, the performance of GLCC under both laboratory and industrial conditions was calculated. The Eulerian model was implemented to describe the mixture flow field in the GLCC under experimental conditions and industrial oil-natural gas conditions. Furthermore, a relationship among Euler number (Eu), Reynolds number (Re), and Froude number (Fr) is generated according to similarity analysis and simulation data, which can present the GLCC separation performance of pressure drop. These results can give reference to the design and application of GLCC in deep sea.

Keywords: dimensionless analysis, gas-liquid cylindrical cyclone, numerical simulation, pressure drop

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Authors: J. Fernandez, N. Aguilar, R. Fernandez de Canete, J. C. Ramos-Diaz

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In this paper, a simulation model of the glucose-insulin system for a patient undergoing diabetes Type 1 is developed by using a causal modeling approach under system dynamics. The OpenModelica simulation environment has been employed to build the so called causal model, while the glucose-insulin model parameters were adjusted to fit recorded mean data of a diabetic patient database. Model results under different conditions of a three-meal glucose and exogenous insulin ingestion patterns have been obtained. This simulation model can be useful to evaluate glucose-insulin performance in several circumstances, including insulin infusion algorithms in open-loop and decision support systems in closed-loop.

Keywords: causal modeling, diabetes, glucose-insulin system, diabetes, causal modeling, OpenModelica software

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Authors: Mateusz Paszko, Konrad Pietrykowski, Krzysztof Skiba

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Due to low-altitude and relatively low flight speed, today’s combat assets like missile weapons equipped with infrared guidance systems are one of the most important threats to the helicopters performing combat missions. Especially meaningful in helicopter aviation is infrared emission by exhaust gases, regressed to the surroundings. Due to high temperature, exhaust gases are a major factor in detectability of a helicopter performing air combat operations. This study presents the results of simulating the flow of the mixture of exhaust and air in the flow duct of an injective exhaust cooler, adapted to cooperate with the PZL 10W turbine engine. The simulation was performed using a numerical model and the ANSYS Fluent software. Simulation computations were conducted for set flight conditions of the PZL W-3 Falcon helicopter. The conclusions resulting from the conducted numerical computations should allow for optimisation of the flow duct geometry in the cooler, in order to achieve the greatest possible temperature reduction of exhaust exiting into the surroundings. It is expected that the obtained results should be useful for further works related to the development of the final version of exhaust cooler for the PZL W-3 Falcon helicopter.

Keywords: exhaust cooler, helicopter, numerical simulation, stealth

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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Authors: Zeineb Seboui, Samar Dabbabi

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In this paper, we study the performance of Cu₂ZnSnS₄ (CZTS) based solar cell. In our knowledge, it is for the first time that the FTO/ZnO:Co/CZTS structure is simulated using the SILVACO-Atlas 2D simulation. Cu₂ZnSnS₄ (CZTS), ZnO:Co and FTO (SnO₂:F) layers have been deposited on glass substrates by the spray pyrolysis technique. The extracted physical properties, such as thickness and optical parameters of CZTS layer, are considered to create a new input data of CZTS based solar cell. The optimization of CZTS electron affinity and thickness is performed to have the best FTO/ZnO: Co/CZTS efficiency. The use of CZTS absorber layer with 3.99 eV electron affinity and 3.2 µm in thickness leads to the higher efficiency of 16.86 %, which is very important in the development of new technologies and new solar cell devices.

Keywords: CZTS solar cell, characterization, electron affinity, thickness, SILVACO-atlas 2D simulation

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Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

Abstract:

Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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Authors: Sai Hung Cheung, Zhe Shao

Abstract:

It is of our great interest to quantify the risk to structural dynamic systems due to earthquake-induced tsunamis in view of recent earthquake-induced tsunamis in Padang, 2004 and Tohoku, 2011 which brought huge losses of lives and properties. Despite continuous advancement in computational simulation of the tsunami and wave-structure interaction modeling, it still remains computationally challenging to evaluate the reliability of a structural dynamic system when uncertainties related to the system and its modeling are taken into account. The failure of the structure in a tsunami-wave-structural system is defined as any response quantities of the system exceeding specified thresholds during the time when the structure is subjected to dynamic wave impact due to earthquake-induced tsunamis. In this paper, an approach based on a novel integration of a recently proposed moving least squares response surface approach for stochastic sampling and the Subset Simulation algorithm is proposed. The effectiveness of the proposed approach is discussed by comparing its results with those obtained from the Subset Simulation algorithm without using the response surface approach.

Keywords: response surface, stochastic simulation, structural reliability tsunami, risk

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Authors: Juan Manuel Sanchez-Cartas, Gonzalo Leon

Abstract:

A price competition algorithm for ABMs based on game theory principles is proposed to deal with the simulation of theoretical market models. The algorithm is applied to the classical Hotelling’s model and to a two-sided market model to show it leads to the optimal behavior predicted by theoretical models. However, when theoretical models fail to predict the equilibrium, the algorithm is capable of reaching a feasible outcome. Results highlight that the algorithm can be implemented in other simulation models to guarantee rational users and endogenous optimal behaviors. Also, it can be applied as a tool of verification given that is theoretically based.

Keywords: agent-based models, algorithmic game theory, multi-sided markets, price optimization

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Authors: El Hansali Hasnaa, Bennani Mohammed

Abstract:

Hexapod legged robot’s missions, particularly in irregular and dangerous areas, require high stability and high precision. In this paper, we consider the rectangular architecture body of legged robots with six legs distributed symmetrically along two sides, each leg contains three degrees of freedom for greater mobility. The aim of this work is planning tripod gait trajectory, based on the computing of the kinematic model to determine the joint variables in the lifting and the propelling phases. For this, appropriate coordinate frames are attached to the body and legs in order to obtain clear representation and efficient generation of the system equations. A simulation in MATLAB software platform is developed to confirm the kinematic model and various trajectories to the tripod gait adopted by the hexapod robot in its locomotion.

Keywords: hexapod legged robot, inverse kinematic model, simulation in MATLAB, tripod gait

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