Search results for: Armed force hospital.

Authors: Y. Li, Q. S. Zhang, H. Z. Huang, B. Y. Wu

Abstract:

The mechanism behind the electromigration and thermomigration failure in flip-chip solder joints with Cu-pillar bumps was investigated in this paper through using finite element method. Hot spot and the current crowding occurrs in the upper corner of copper column instead of solders of the common solder ball. The simulation results show that the change in thermal gradient is noticeable, which might greatly affect the reliability of solder joints with Cu-pillar bumps under current stressing. When the average applied current density is increased from 1×104 A/cm2 to 3×104 A/cm2 in solders, the thermal gradient would increase from 74 K/cm to 901 K/cm at an ambient temperature of 25°C. The force from thermal gradient of 901 K/cm can nearly induce thermomigration by itself. With the increase in applied current, the thermal gradient is growing. It is proposed that thermomigration likely causes a serious reliability issue for Cu column based interconnects.

Keywords: Simulation, Cu-pillar bumps, Electromigration, Thermomigration.

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Authors: György Á. Horváth, Piroska Harazin

Abstract:

The transition to sustainable development requires considerable investments from stakeholders, both financial and immaterial. However, accounting for such investments often poses a challenge, as ventures with intangible or non-financial returns remain oblivious to conventional accounting techniques and risk assessment. That such investments may significantly contribute to the welfare of those affected may act as a driving force behind attempting to bridge this gap. This gains crucial importance as investments must be also backed by governments and administrations; entities whose budget depends on taxpayers- contributions and whose tasks are based on securing the welfare of their citizens. Besides economic welfare, citizens also require social and environmental wellbeing too. However, administrations must also safeguard that welfare is guaranteed not only to present, but to future generations too. With already strained budgets and the requirement of sustainable development, governments on all levels face the double challenge of making both of these ends meet.

Keywords: Accounting, Administration and Government, RiskAssessment, Sustainable Development

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Authors: Tasnuva Tamanna, Sanjida Halim Topa

Abstract:

Sputum smear conversion after one month of antituberculosis therapy in new smear positive pulmonary tuberculosis patients (PTB+) is a vital indicator towards treatment success. The objective of this study is to determine the rate of sputum smear conversion in new PTB+ patients after one month under treatment of National Institute of Diseases of the Chest and Hospital (NIDCH). Analysis of sputum smear conversion was done by re-clinical examination with sputum smear microscopic test after one month. Socio-demographic and hematological parameters were evaluated to perceive the correlation with the disease status. Among all enrolled patients only 33.33% were available for follow up diagnosis and of them only 42.86% patients turned to smear negative. Probably this consequence is due to non-coherence to the proper disease management. 66.67% and 78.78% patients reported low haemoglobin and packed cell volume level respectively whereas 80% and 93.33% patients accounted accelerated platelet count and erythrocyte sedimentation rate correspondingly.

Keywords: Followed up patients, PTB+ patients, sputum smear conversion, and sputum smear microscopic test.

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Authors: N. Pritchard

Abstract:

Within architectural education, students arrive fore-armed with; their life-experience; knowledge gained from subject-based learning; their brains and more specifically their imaginations. The learning-by-doing that they embark on in studio-based/project-based learning calls for supervision that allows the student to proactively undertake research and experimentation with design solution possibilities. The degree to which this supervision includes direction is subject to debate and differing opinion. It can be argued that if the student is to learn-by-doing, then design decision making within the design process needs to be instigated and owned by the student so that they have the ability to personally reflect on and evaluate those decisions. Within this premise lies the problem that the student's endeavours can become unstructured and unfocused as they work their way into a new and complex activity. A resultant weakness can be that the design activity is compartmented and not holistic or comprehensive, and therefore, the student's reflections are consequently impoverished in terms of providing a positive, informative feedback loop. The construct proffered in this paper is that a supportive 'armature' or 'Heuristic-Framework' can be developed that facilitates a holistic approach and reflective learning. The normal explorations of architectural design comprise: Analysing the site and context, reviewing building precedents, assimilating the briefing information. However, the student can still be compromised by 'not knowing what they need to know'. The long-serving triad 'Firmness, Commodity and Delight' provides a broad-brush framework of considerations to explore and integrate into good design. If this were further atomised in subdivision formed from the disparate aspects of architectural design that need to be considered within the design process, then the student could sieve through the facts more methodically and reflectively in terms of considering their interrelationship conflict and alliances. The words facts and sieve hold the acronym of the aspects that form the Heuristic-Framework: Function, Aesthetics, Context, Tectonics, Spatial, Servicing, Infrastructure, Environmental, Value and Ecological issues. The Heuristic could be used as a Hermeneutic Model with each aspect of design being focused on and considered in abstraction and then considered in its relation to other aspect and the design proposal as a whole. Importantly, the heuristic could be used as a method for gathering information and enhancing the design brief. The more poetic, mysterious, intuitive, unconscious processes should still be able to occur for the student. The Heuristic-Framework should not be seen as comprehensive prescriptive formulaic or inhibiting to the wide exploration of possibilities and solutions within the architectural design process.

Keywords: Atomistic, hermeneutic, holistic, approach architectural design studio education.

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Authors: Marco Soares dos Santos, Jorge Augusto Ferreira, Camila Nicola Boeri, Fernando Neto da Silva

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The present paper proposes high performance nonlinear force controllers for a servopneumatic real-time fatigue test machine. A CompactRIO® controller was used, being fully programmed using LabVIEW language. Fuzzy logic control algorithms were evaluated to tune the integral and derivative components in the development of hybrid controllers, namely a FLC P and a hybrid FLC PID real-time-based controllers. Their behaviours were described by using state diagrams. The main contribution is to ensure a smooth transition between control states, avoiding discrete transitions in controller outputs. Steady-state errors lower than 1.5 N were reached, without retuning the controllers. Good results were also obtained for sinusoidal tracking tasks from 1/¤Ç to 8/¤Ç Hz.

Keywords: Hybrid Fuzzy Selecting, Control, Range Controllers, Servopneumatic Fatigue System.

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Authors: M. Dinakaran, P. Balasubramanie

Abstract:

With the demand of mobility by users, wireless technologies have become the hotspot developing arena. Internet Engineering Task Force (IETF) working group has developed Mobile IP to support node mobility. The concept of node mobility indicates that in spite of the movement of the node, it is still connected to the internet and all the data transactions are preserved. It provides location-independent access to Internet. After the incorporation of host mobility, network mobility has undergone intense research. There are several intricacies faced in the real world implementation of network mobility significantly the problem of nested networks and their consequences. This article is concerned regarding a problem of nested network called pinball route problem and proposes a solution to eliminate the above problem. The proposed mechanism is implemented using NS2 simulation tool and it is found that the proposed mechanism efficiently reduces the overload caused by the pinball route problem.

Keywords: Mobile IP, Pinball routing problem, NEMO

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Authors: Nuran Bahar, Mehmet A. Akcayol

Abstract:

In the aviation industry, many faults may occur frequently during the maintenance processes and assembly operations of complex structured aircrafts because of their high dependencies of components. These faults affect the quality of aircraft parts or developed modules adversely. Technical employee requires long time and high labor force while checking the correctness of each component. In addition, the person must be trained regularly because of the ever-growing and changing technology. Generally, the cost of this training is very high. Augmented Reality (AR) technology reduces the cost of training radically and improves the effectiveness of the training. In this study, the usage of AR technology in the aviation industry has been investigated and the effectiveness of AR with heads-up display glasses has been examined. An application has been developed for comparison of production process with AR and manual one.

Keywords: Aerospace, assembly quality, augmented reality, heads-up display.

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Authors: J. Y. Lee, H. S. Lim, S. H. Yoon

Abstract:

This paper presents an analysis of the diagonal crack widths of RC members with various types of materials by simulating a compatibility-aided truss model. The analytical results indicated that the diagonal crack width was influenced by not only the shear reinforcement ratio but also the yield strength of shear reinforcement and the compressive strength of concrete. The yield strength of shear reinforcement and the compressive strength of concrete decreased the diagonal shear crack width of RC members for the same shear force because of the change of shear failure modes. However, regarding the maximum shear crack width at shear failure, the shear crack width of the beam with high strength materials was greater than that of the beam with normal strength materials.

Keywords: Diagonal crack width, high strength stirrups, high strength concrete, RC members, shear behavior.

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Authors: Cory Cannon

Abstract:

In the current era of shrinking budgets, increasing amounts of worldwide natural disasters, state and non-state initiated conflicts within the world. The response has involved multinational coalitions to conduct effective military operations. The need for a Knowledge Management strategy when developing these coalitions have been overlooked in the past and the need for developing these accords early on will save time and help shape the way information and knowledge are transferred from the staff and action officers of the coalition to the decision-makers in order to make timely decisions within an ever changing environment. The aim of this paper is to show how Knowledge Management has developed within the United States military and how the transformation of working within a Combined/ Joint environment in both the Middle East and the Far East has improved relations between members of the coalitions as well as being more effective as a military force. These same principles could be applied to multinational corporations when dealing with cultures and decision-making processes.

Keywords: Civil-military, culture, joint environment, knowledge management.

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Authors: Cafer Görkem Pınar, İlker Coşar, Serkan Uzun, Atahan Çelebi, Mehmet Ali Ersoy, Ali Pınarbaşı

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In this study, it was numerically investigated that a 1:1 scale model of the Renault Clio MK4 SW brand vehicle aerodynamic analysis was performed in the commercial computational fluid dynamics (CFD) package program of ANSYS CFX 2021 R1 under steady, subsonic, and 3-D conditions. The model of vehicle used for the analysis was made independent of the number of mesh elements and the k-epsilon turbulence model was applied during the analysis. Results were interpreted as streamlines, pressure gradient, and turbulent kinetic energy contours around the vehicle at 50 km/h and 100 km/h speeds. In addition, the validity of the analysis was decided by comparing the drag coefficient of the vehicle with the values in the literature. As a result, the pressure gradient contours of the taillight of the Renault Clio MK4 SW vehicle were examined and the behavior of the total force at speeds of 50 km/h and 100 km/h was interpreted.

Keywords: CFD, k-epsilon, aerodynamics, drag coefficient, taillight.

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Authors: Jyoti Narayan, S. Choudhary

Abstract:

Nanowire arrays of copper with uniform diameters have been synthesized by potentiostatic electrochemical metal deposition (EMD) of copper sulphate and potassium chloride solution within the nano-channels of porous Indium-Tin Oxide (ITO), also known as Tin doped Indium Oxide templates. The nanowires developed were fairly continuous with diameters ranging from 110-140 nm along the entire length. Single as well as poly-crystalline copper wires have been prepared by application of appropriate potential during the EMD process. Scanning electron microscopy (SEM), high resolution transmission electron microscopy (HRTEM), small angle electron diffraction (SAED) and atomic force microscopy (AFM) were used to characterize the synthesized nano wires at room temperature. The electrochemical response of synthesized products was evaluated by cyclic voltammetry while surface energy analysis was carried out using a Goniometer.

Keywords: Electro-deposition, Metallic nano-wires, Nanomaterials, Template synthesis

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Authors: T. Hirata, G. H. Yokoyama, L. H. M. Duque

Abstract:

The posteroanterior manipulation technique is usually include in the procedure of the lumbar spine to evaluate the intervertebral motion according to mechanical resistance. The mechanical device with visual feedback was proposed that allows one to analysis the lumbar segments mobility “in vivo" facilitating for the therapist to take its treatment evolution. The measuring system uses load cell and displacement sensor to estimate spine stiffness. In this work, the device was tested by 2 therapists, female, applying posteroanterior force techniques to 5 volunteers, female, with frequency of approximately 1.2-1.8 Hz. A test-retest procedure was used for 2 periods of day. The visual feedback results small variation of forces and cycle time during 6 cycles rhythmic application. The stiffness values showed good agreement between test-retest procedures when used same order of maximum forces.

Keywords: Biomechanics, lumber spine stiffness, intervertebral manipulation device, visual feedback

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Authors: Reza Hadjiaghaie Vafaie, Aysan Madanpasandi, Behrooz Zare Desari, Seyedmohammad Mousavi

Abstract:

High lamination in microchannel is one of the main challenges in on-chip components like micro total analyzer systems and lab-on-a-chips. Electro-osmotic force is highly effective in chip-scale. This research proposes a microfluidic-based micropump for low ionic strength solutions. Narrow microchannels are designed to generate an efficient electroosmotic flow near the walls. Microelectrodes are embedded in the lateral sides and actuated by low electric potential to generate pumping effect inside the channel. Based on the simulation study, the fluid velocity increases by increasing the electric potential amplitude. We achieve a net flow velocity of 100 µm/s, by applying +/- 2 V to the electrode structures. Our proposed low voltage design is of interest in conventional lab-on-a-chip applications.

Keywords: Integration, electrokinetic, on-chip, fluid pumping, microfluidic.

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Authors: Nasser M. Amaitik, Ngwan F. Elsagzli

Abstract:

Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable for many reasons.    

The present study aims to apply the principles of lean in two different sectors, healthcare and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital, while the second case study was the Technical Company of Aluminum Sections in Benghazi, LIBYA. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes.

The results obtained from both case studies showed improvement in Capacity, Idle time and Utilized time.

Keywords: Healthcare service delivery, Idle time, Lean principles, Utilized time, Value stream mapping, Wastes.

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Authors: Ying Wang

Abstract:

Service trade is an important force of influencing economic development. A review on the related literatures is done firstly. Then through the construction of a Diamond Model, the main factors which influence the competitiveness of Chinese service trade are determined. With three competitiveness indexes served as the reference series respectively, the influencing factors served as the comparable series, three grey incidence models are then built up to conduct an empirical analysis on the main factors influencing the competitiveness of service trade after China entering WTO. The result indicates that urbanization level, open degree of service industry and foreign direct investment have larger impacts on Chinese service trade competitiveness, followed in turn by GDP in service industry and human capital, while commodity trade has the minimum impact. Further discussion provides train of thought for the upgrade of Chinese service trade competitiveness.

Keywords: Service Trade, Competitiveness, Diamond Model, Grey Incidence Model.

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Authors: Rana Khalid Naeem, Waseem Ahmed Khan, Muhammad Akhtar, Asif Mansoor

Abstract:

The Navier Stokes Equations (NSE) for an incompressible fluid of variable viscosity in the presence of an unknown external force in Von-Mises system x,\ are transformed, and some new exact solutions for a class of flows characterized by equation y f x a\b for an arbitrary state equation are determined, where f x is a function, \ the stream function, a z 0 and b are the arbitrary constants. In three, out of four cases, the function f x is arbitrary, and the solutions are the solutions of the flow equations for all the flows characterized by the equationy f x a\b. Streamline patterns for some forms of f x in unbounded and bounded regions are given.

Keywords: Bounded and unbounded region, Exact solution, Navier Stokes equations, Streamline pattern, Variable viscosity, Von- Mises system

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Authors: Olugbara O.O., Adebiyi A.A.

Abstract:

Most standard software development methodologies are often not applied to software projects in many developing countries of the world. The approach generally practice is close to what eXtreme Programming (XP) is likely promoting, just keep coding and testing as the requirement evolves. XP is an agile software process development methodology that has inherent capability for improving efficiency of Business Software Development (BSD). XP can facilitate Business-to-Development (B2D) relationship due to its customer-oriented advocate. From practitioner point of view, we applied XP to BSD and result shows that customer involvement has positive impact on productivity, but can as well frustrate the success of the project. In an effort to promote software engineering practice in developing countries of Africa, we present the experiment performed, lessons learned, problems encountered and solution adopted in applying XP methodology to BSD.

Keywords: Requirements engineering, Requirements elicitation, Extreme programming, Mobile Work force

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

Abstract:

Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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Authors: S. Zhuiykov, E. Kats

Abstract:

In recent times there has been a growing interest in the development of quasi-two-dimensional niobium pentoxide (Nb2O5) as a semiconductor for the potential electronic applications such as capacitors, filtration, dye-sensitised solar cells and gas sensing platforms. Therefore once the purpose is established, Nb2O5 can be prepared in a number of nano- and sub-micron-structural morphologies that include rods, wires, belts and tubes. In this study films of Nb2O5 were prepared on gold plated silicon substrate using spin-coating technique and subsequently by mechanical exfoliation. The reason this method was employed was to achieve layers of less than 15nm in thickness. The sintering temperature of the specimen was 800oC. The morphology and structural characteristics of the films were analyzed by Atomic Force Microscopy (AFM), Raman Spectroscopy, X-ray Photoelectron Spectroscopy (XPS).

Keywords: Mechanical exfoliation, niobium pentoxide, quazitwo- dimensional, semiconductor, sol-gel, spin-coating, two dimensional semiconductors.

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Authors: D. S. Mohale, A. V. Chandewar

Abstract:

Aim- Study was undertaken to investigate the effect of altered behavioral condition like depression on various oxidative stress markers and biochemical parameters in rats. Methods- Rats were subjected for short (21 days) and long term (84 days) social isolation; the rats displayed an increase in depression on force swim test relative to control. Various markers of oxidative stress like lipid per oxidation (LPO), reduced glutathione (GSH), Supers oxide dismutase (SOD), catalase (CAT) and biochemical parameters like SGOT, SGPT, and blood glucose were determined. Results- There was significant increase in the level of LPO and decrease in the levels of GSH, SOD and CAT after long term isolation. Biochemical parameters were significantly altered after social isolation. Conclusion- Increased oxidative stress in depression which may leads to alteration of biochemical parameters.

Keywords: Depression, Glucose, LPO, Oxidative stress.

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Authors: Majid Tolouei-Rad, Peter Kalivitis

Abstract:

Industrial robots become useless without end-effectors that for many instances are in the form of friction grippers. Commonly friction grippers apply frictional forces to different objects on the basis of programmers- experiences. This puts a limitation on the effectiveness of gripping force that may result in damaging the object. This paper describes various stages of design and development of a low cost sensor-based robotic gripper that would facilitate the task of applying right gripping forces to different objects. The gripper is also equipped with range sensors in order to avoid collisions of the gripper with objects. It is a fully functional automated pick and place gripper which can be used in many industrial applications. Yet it can also be altered or further developed in order to suit a larger number of industrial activities. The current design of gripper could lead to designing completely automated robot grippers able to improve the efficiency and productivity of industrial robots.

Keywords: Control system, end-effector, robot, sensor

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Authors: Sa’ed Abed, Mohammad H. Al Shayeji, Ovais Ahmed, Sahel Alouneh

Abstract:

Session Initiation Protocol (SIP) is a signaling layer protocol for building, adjusting and ending sessions among participants including Internet conferences, telephone calls and multimedia distribution. SIP facilitates user movement by proxying and forwarding requests to the present location of the user. In this paper, we provide a formal Specification and Description Language (SDL) and Message Sequence Chart (MSC) to model and define the Internet Engineering Task Force (IETF) SIP protocol and its sample services resulted from informal SIP specification. We create an “Abstract User Interface” using case analysis so that can be applied to identify SIP services more explicitly. The issued sample SIP features are then used as case scenarios; they are revised in MSCs format and validated to their corresponding SDL models.

Keywords: Modeling, MSC, SDL, SIP, validating.

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Authors: Seunghwan Lee

Abstract:

The lubricating properties of commercially available mucins originating from different animal organs, namely bovine submaxillary mucin (BSM) and porcine gastric mucin (PGM), have been characterized at polymeric surfaces for biomedical applications. Atomic force microscopy (AFM) and pin-on-disk tribometry have been employed for tribological studies at nanoscale and macroscale contacts, respectively. Polystyrene (PS) was employed to represent ‘rigid’ contacts, whereas poly(dimethylsiloxane) (PDMS) was employed to represent ‘soft contacts’. To understand the lubricating properties of mucins in correlation with the coverage on surfaces, adsorption properties of mucins onto the polymeric substrates have been characterized by means of optical waveguide light-mode spectroscopy (OWLS). Both mucins showed facile adsorption onto both polymeric substrates, but the lubricity was highly dependent upon the pH change between 2 and 7.

Keywords: Bovine submaxillary mucin (BSM), Porcine Gastric Mucin (PGM), lubricity, biomedical.

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Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

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Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: Laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery.

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Authors: Niloufar Ghoreishi, Ali Nekouzadeh

Abstract:

The stability of the flight during maneuvering and in response to probable perturbations is one of the most essential features of an aircraft that should be analyzed and designed for. In this study, we derived the non-linear governing equations of aircraft dynamics during the climb/descend phase and simulated a model aircraft. The corresponding force and moment dimensionless coefficients of the model and their variations with elevator angle and other relevant aerodynamic parameters were measured experimentally. The short-period mode and phugoid mode response were simulated by solving the governing equations numerically and then compared with the desired stability parameters for the particular level, category, and class of the aircraft model. To meet the target stability, a controller was designed and used. This resulted in significant improvement in the stability parameters of the flight.

Keywords: Flight stability, phugoid mode, short period mode, climb phase, damping coefficient.

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Authors: Aymen Laadhari

Abstract:

We present in this paper a fully implicit finite element method tailored for the numerical modeling of inextensible fluidic membranes in a surrounding Newtonian fluid. We consider a highly simplified version of the Canham-Helfrich model for phospholipid membranes, in which the bending force and spontaneous curvature are disregarded. The coupled problem is formulated in a fully Eulerian framework and the membrane motion is tracked using the level set method. The resulting nonlinear problem is solved by a Newton-Raphson strategy, featuring a quadratic convergence behavior. A monolithic solver is implemented, and we report several numerical experiments aimed at model validation and illustrating the accuracy of the proposed method. We show that stability is maintained for significantly larger time steps with respect to an explicit decoupling method.

Keywords: Finite element method, Newton method, level set, Navier-Stokes, inextensible membrane, liquid drop.

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Authors: Muhammad Wajid Tahir, Rubina Kauser, Majid Ali Tahir

Abstract:

Pakistani doctors (MBBS) are emigrating towards developed countries for professional adjustments. This study aims to highlight causes and consequences of doctors- brain drain from Pakistan. Primary data was collected from Mayo Hospital, Lahore by interviewing doctors (n=100) through systematic random sampling technique. It found that various socio-economic and political conditions are working as push and pull factors for brain drain of doctors in Pakistan. Majority of doctors (83%) declared poor remunerations and professional infrastructure of health department as push factor of doctors- brain drain. 81% claimed that continuous instability in political situation and threats of terrorism are responsible for emigration of doctors. 84% respondents considered fewer opportunities of further studies responsible for their emigration. Brain drain of doctors is affecting health sector-s policies / programs, standard doctor-patient ratios and quality of health services badly.

Keywords: Brain Drain, Emigration, Remuneration, Politicalinstability, MBBS doctors

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Authors: Kasra Afsahi, Maryam Soheilifar

Abstract:

Cerebrovascular accident (CVA) is a neurological side effect of COVID-19 disease wit high rate in pandemics. Effect of COVID-19 disease on disorder is unclear. In this cohort, patients with COVID-19 disease were assessed. 60 CVA cases were assessed in a referral hospital in 2020. The major factor was mortality and the cases were those with and without death. The groups were compared for all features about mortality in the patients with COVID-19 and CVA. Totally 23 out of 60 cases (38.3%) were expired. In univariate analysis there was significant association for death by ischemic heart disease (P = 0.015), high-severity stroke (P = 0.012), high C-reactive protein (CRP) (P = 0.001), high ESR (P = 0.009), pleural effusion (P = 0.005), pericardial effusion (P = 0.027), cardiomegaly (P = 0.005), ground glass opacity (P = 0.001), and consolidation (P = 0.001). Among these factors, there was significant association only for CRP (P = 0.001) and consolidation (P = 0.003) in multivariate analysis. Mortality in the cases with COVID-19-related CVA is one-third and it has relationship to elevated CRP and finding the consolidation in the computerized tomography scan of the lungs.

Keywords: COVID-19, stroke, prognosis, C-reactive protein, CRP.

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Authors: Ahmad Atieh, Masoud Kalantari, Roozbeh Ahmadi, Javad Dargahi, Muthukumaran Packirisamy, Mehrdad Hosseini Zadeh

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The present paper presents a finite element model and analysis for the interaction between a piezoresistive tactile sensor and biological tissues. The tactile sensor is proposed for use in minimally invasive surgery to deliver tactile information of biological tissues to surgeons. The proposed sensor measures the relative hardness of soft contact objects as well as the contact force. Silicone rubbers were used as the phantom of biological tissues. Finite element analysis of the silicone rubbers and the mechanical structure of the sensor were performed using COMSOL Multiphysics (v3.4) environment. The simulation results verify the capability of the sensor to be used to differentiate between different kinds of silicone rubber materials.

Keywords: finite element analysis, minimally invasive surgery, Neo-Hookean hyperelastic materials, tactile sensor.

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Authors: A. Appe, B. Poluparthi, L. Kasivajjula, U. Mv, S. Bagadi, P. Modi, A. Singh, H. Gunupudi, S. Troiano, J. Paul, J. Stovall, J. Yamamoto

Abstract:

The necessity of data-driven decisions in healthcare strategy formulation is rapidly increasing. A reliable framework which helps identify factors impacting a healthcare provider facility or a hospital (from here on termed as facility) market share is of key importance. This pilot study aims at developing a data-driven machine learning-regression framework which aids strategists in formulating key decisions to improve the facility’s market share which in turn impacts in improving the quality of healthcare services. The US (United States) healthcare business is chosen for the study, and the data spanning 60 key facilities in Washington State and about 3 years of historical data are considered. In the current analysis, market share is termed as the ratio of the facility’s encounters to the total encounters among the group of potential competitor facilities. The current study proposes a two-pronged approach of competitor identification and regression approach to evaluate and predict market share, respectively. Leveraged model agnostic technique, SHAP (SHapley Additive exPlanations), to quantify the relative importance of features impacting the market share. Typical techniques in literature to quantify the degree of competitiveness among facilities use an empirical method to calculate a competitive factor to interpret the severity of competition. The proposed method identifies a pool of competitors, develops Directed Acyclic Graphs (DAGs) and feature level word vectors, and evaluates the key connected components at the facility level. This technique is robust since it is data-driven, which minimizes the bias from empirical techniques. The DAGs factor in partial correlations at various segregations and key demographics of facilities along with a placeholder to factor in various business rules (for e.g., quantifying the patient exchanges, provider references, and sister facilities). Identified are the multiple groups of competitors among facilities. Leveraging the competitors' identified developed and fine-tuned Random Forest Regression model to predict the market share. To identify key drivers of market share at an overall level, permutation feature importance of the attributes was calculated. For relative quantification of features at a facility level, incorporated SHAP, a model agnostic explainer. This helped to identify and rank the attributes at each facility which impacts the market share. This approach proposes an amalgamation of the two popular and efficient modeling practices, viz., machine learning with graphs and tree-based regression techniques to reduce the bias. With these, we helped to drive strategic business decisions.

Keywords: Competition, DAGs, hospital, healthcare, machine learning, market share, random forest, SHAP.

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