Search results for: high fidelity human patient simulation

Authors: N. K. Singh, S. Sarkar

Abstract:

Direct numerical simulation (DNS) is used to study the evolution of a boundary layer that was laminar initially followed by separation and then reattachment owing to generation of turbulence. This creates a closed region of recirculation, known as the laminar-separation bubble. The present simulation emulates the flow environment encountered in a modern LP turbine blade, where a laminar separation bubble may occur on the suction surface. The unsteady, incompressible three-dimensional (3-D) Navier-Stokes (NS) equations have been solved over a flat plate in the Cartesian coordinates. The adverse pressure gradient, which causes the flow to separate, is created by a boundary condition. The separated shear layer undergoes transition through appearance of ╬ø vortices, stretching of these create longitudinal streaks. Breakdown of the streaks into small and irregular structures makes the flow turbulent downstream.

Keywords: Adverse pressure gradient, direct numerical simulation, laminar separation bubble.

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Authors: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

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This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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Authors: S. Pattnaik, A. K. Panda, Aroul K., K. K. Mahapatra

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This paper proposes a zero-voltage transition (ZVT) PWM synchronous buck converter, which is designed to operate at low output voltage and high efficiency typically required for portable systems. To make the DC-DC converter efficient at lower voltage, synchronous converter is an obvious choice because of lower conduction loss in the diode. The high-side MOSFET is dominated by the switching losses and it is eliminated by the soft switching technique. Additionally, the resonant auxiliary circuit designed is also devoid of the switching losses. The suggested procedure ensures an efficient converter. Theoretical analysis, computer simulation, and experimental results are presented to explain the proposed schemes.

Keywords: DC-DC Converter, Switching loss, Synchronous Buck, Soft switching, ZVT.

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Authors: Bindu Sankar, Jaideep Chakraborty, Rashmi Nawlakha, A. Venkatesan, S. Raghupathy, T. Jayanthi, S.A.V. Satya Murty

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Component handling system is one of the important sub systems of Prototype Fast Breeder Reactor (PFBR) used for fuel handling. Core handling system is again a sub system of component handling system. Core handling system consists of in-vessel and ex-vessel subassembly handling. In-vessel core handling involves transfer arm, large rotatable plug and small rotatable plug operations. Modeling and simulation of in-vessel core handling is a part of development of Prototype Fast Breeder Reactor Operator Training Simulator. This paper deals with simulation and modeling of operations of transfer arm, large rotatable plug and small rotatable plug needed for in-vessel core handling. Process modeling was developed in house using platform independent Cµ code with OpenGL (Open Graphics Library). The control logic models and virtual panel were modeled using simulation tool.

Keywords: Animation, Core Handling System, Prototype Fast Breeder Reactor, Simulator

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Authors: S. Banerjee, A. Apte Deshpande, N. Mandi, S. Padmanabhan

Abstract:

We report a novel fusion tag for expressing recombinant proteins in E. coli. The fusion tag is the C-terminus part of the human GMCSF gene comprising 45 amino acids, which aid in over expression of otherwise non expressible genes. Expression of hIFN a2b with this fusion tag also escapes the requirement of rare codons for expression. This is also a first report of a small fusion tag of human origin having affinity to heparin sepharose column facilitating the purification of fusion protein.

Keywords: fusion tag, bacterial expression, rare codons, human GMCSF

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Authors: Marília Guterres Ferreira, Raul Sidnei Wazlawick

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As seen in literature, about 70% of the improvement initiatives fail, and a significant number do not even get started. This paper analyses the problem of failing initiatives on Software Process Improvement (SPI), and proposes good practices supported by motivational tools that can help minimizing failures. It elaborates on the hypothesis that human factors are poorly addressed by deployers, especially because implementation guides usually emphasize only technical factors. This research was conducted with SPI deployers and analyses 32 SPI initiatives. The results indicate that although human factors are not commonly highlighted in guidelines, the successful initiatives usually address human factors implicitly. This research shows that practices based on human factors indeed perform a crucial role on successful implantations of SPI, proposes change management as a theoretical framework to introduce those practices in the SPI context and suggests some motivational tools based on SPI deployers experience to support it.

Keywords: Change management, human factors, motivation, software process improvement.

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Authors: V. Balanica, W. I. D. Rae, M. Caramihai, S. Acho, C. P. Herbst

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Mammographic images and data analysis to facilitate modelling or computer aided diagnostic (CAD) software development should best be done using a common database that can handle various mammographic image file formats and relate these to other patient information. This would optimize the use of the data as both primary reporting and enhanced information extraction of research data could be performed from the single dataset. One desired improvement is the integration of DICOM file header information into the database, as an efficient and reliable source of supplementary patient information intrinsically available in the images. The purpose of this paper was to design a suitable database to link and integrate different types of image files and gather common information that can be further used for research purposes. An interface was developed for accessing, adding, updating, modifying and extracting data from the common database, enhancing the future possible application of the data in CAD processing. Technically, future developments envisaged include the creation of an advanced search function to selects image files based on descriptor combinations. Results can be further used for specific CAD processing and other research. Design of a user friendly configuration utility for importing of the required fields from the DICOM files must be done.

Keywords: Database Integration, Mammogram Classification, Tumour Classification, Computer Aided Diagnosis.

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Authors: Tadashi Watanabe

Abstract:

Transient shape variation of a rotating liquid dropletis simulated numerically. The three dimensional Navier-Stokes equations were solved by using the level set method. The shape variation from the sphere to the rotating ellipsoid, and to the two-robed shapeare simulated, and the elongation of the two-robed droplet is discussed. The two-robed shape after the initial transient is found to be stable and the elongation is almost the same for the cases with different initial rotation rate. The relationship between the elongation and the rotation rate is obtained by averaging the transient shape variation. It is shown that the elongation of two-robed shape is in good agreement with the existing experimental data. It is found that the transient numerical simulation is necessary for analyzing the largely elongated two-robed shape of rotating droplet.

Keywords: Droplet, rotation, two-robed shape, transient simulation.

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Authors: Marina Gorunescu, Florin Gorunescu, Kenneth Revett

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Hepatocellular carcinoma, also called hepatoma, most commonly appears in a patient with chronic viral hepatitis. In patients with a higher suspicion of HCC, such as small or subtle rising of serum enzymes levels, the best method of diagnosis involves a CT scan of the abdomen, but only at high cost. The aim of this study was to increase the ability of the physician to early detect HCC, using a probabilistic neural network-based approach, in order to save time and hospital resources.

Keywords: Early HCC diagnosis, probabilistic neural network.

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Authors: Oon-Seng Tan

Abstract:

Human Computer Interaction (HCI) has been an emerging field that draws in the experts from various fields to enhance the application of computer programs and the ease of computer users. HCI has much to do with learning and cognition and an emerging approach to learning and problem-solving is problembased learning (PBL). The processes of PBL involve important cognitive functions in the various stages. This paper will illustrate how closely related fields to HCI, PBL and cognitive psychology can benefit from informing each other through analysing various cognitive functions. Several cognitive functions from cognitive function disc (CFD) would be presented and discussed in relation to human-computer interface. This paper concludes with the implications of bridging the gaps amongst these disciplines.

Keywords: problem-based learning, human computerinteraction, cognitive psychology, Cognitive Function Disc (CFD)

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Authors: Toshinori Takabatake, Yoshikazu Komano

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Recently, the improvements in processing performance of a computer and in high speed communication of an optical fiber have been achieved, so that the amount of data which are processed by a computer and flowed on a network has been increasing greatly. However, in a client-server system, since the server receives and processes the amount of data from the clients through the network, a load on the server is increasing. Thus, there are needed to introduce a server with high processing ability and to have a line with high bandwidth. In this paper, concerning to P2P networks to resolve the load on a specific server, a criterion called an Indexed-Priority Metric is proposed and its performance is evaluated. The proposed metric is to allocate some files to each node. As a result, the load on a specific server can distribute them to each node equally well. A P2P file sharing system using the proposed metric is implemented. Simulation results show that the proposed metric can make it distribute files on the specific server.

Keywords: peer-to-peer, file-sharing system, load-balancing, dependability

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Authors: M. M. Karkhanehchi, A. Ammani

Abstract:

A simple analytical model has been developed to optimize biasing conditions for obtaining maximum linearity among lattice-matched, pseudomorphic and metamorphic HEMT types as well as enhancement and depletion HEMT modes. A nonlinear current-voltage model has been simulated based on extracted data to study and select the most appropriate type and mode of HEMT in terms of a given gate-source biasing voltage within the device so as to employ the circuit for the highest possible output current or voltage linear swing. Simulation results can be used as a basis for the selection of optimum gate-source biasing voltage for a given type and mode of HEMT with regard to a circuit design. The consequences can also be a criterion for choosing the optimum type or mode of HEMT for a predetermined biasing condition.

Keywords: Biasing, characteristic, linearity, simulation.

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Authors: R. Litt, A. Brown

Abstract:

Aims: We aimed to assess the efficiency of ‘Attend Anywhere’ orthodontic clinics within a district general hospital during COVID- 19. Our secondary aim was to pilot a questionnaire to assess patient satisfaction with virtual orthodontic appointments. Design: The study design is a service evaluation including pilot questionnaire. Methods: The average number of patients seen per virtual clinic and the number of patients failing to attend was compared to face-to-face clinics. The capability of virtual appointments to be successful in preventing the need for a face-to-face appointment was assessed. Patients were invited to complete a telephone pilot questionnaire focusing on patient satisfaction and accessibility. Results: There was a small increase in the number of patients failing to attend virtual appointments, with a third of the patients who did not attend failing to receive the appointment link. 81.9% of virtual clinic appointments were successful and prevented the need for a face-to-face appointment. Overall patients were very satisfied with their virtual orthodontic appointment and the majority required no assistance to access the service. Conclusions: The use of ‘Attend Anywhere’ clinics in orthodontics offers patients and clinicians an effective and efficient alternative to face-to-face appointments that patients on average find easy to use and completely satisfactory.

Keywords: Clinics, COVID-19, orthodontics, patient satisfaction, virtual.

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Authors: Kemalettin Erbatur, Özer Koca, Evrim Taşkıran, Metin Yılmaz, Utku Seven

Abstract:

Recent fifteen years witnessed fast improvements in the field of humanoid robotics. The human-like robot structure is more suitable to human environment with its supreme obstacle avoidance properties when compared with wheeled service robots. However, the walking control for bipedal robots is a challenging task due to their complex dynamics. Stable reference generation plays a very important role in control. Linear Inverted Pendulum Model (LIPM) and the Zero Moment Point (ZMP) criterion are applied in a number of studies for stable walking reference generation of biped walking robots. This paper follows this main approach too. We propose a natural and continuous ZMP reference trajectory for a stable and human-like walk. The ZMP reference trajectories move forward under the sole of the support foot when the robot body is supported by a single leg. Robot center of mass trajectory is obtained from predefined ZMP reference trajectories by a Fourier series approximation method. The Gibbs phenomenon problem common with Fourier approximations of discontinuous functions is avoided by employing continuous ZMP references. Also, these ZMP reference trajectories possess pre-assigned single and double support phases, which are very useful in experimental tuning work. The ZMP based reference generation strategy is tested via threedimensional full-dynamics simulations of a 12-degrees-of-freedom biped robot model. Simulation results indicate that the proposed reference trajectory generation technique is successful.

Keywords: Biped robot, Linear Inverted Pendulum Model, Zero Moment Point, Fourier series approximation.

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Authors: Shatirah Akib, Hossein Basser, Hojat Karami, Afshin Jahangirzadeh

Abstract:

Bridge piers which are constructed in the track of high water rivers cause some variations in the flow patterns. This variation mostly is a result of the changes in river sections. Decreasing the river section, bridge piers significantly impress the flow patterns. Once the flow approaches the piers, the stream lines change their order, causing the appearance of different flow patterns around the bridge piers. New flow patterns are created following the geometry and the other technical characteristics of the piers. One of the most significant consequences of this event is the scour generated around the bridge piers which threatens the safety of the structure. In order to determine the properties of scour holes, to find maximum depth of the scour is an important factor. In this manuscript a numerical simulation of the scour around Marand-Soofian route bridge piers has been carried out via SSIIM 2.0 Software and the amount of maximum scour has been achieved subsequently. Eventually the methods for retrofitting of bridge piers against scours and also the methods for decreasing the amount of scour have been offered.

Keywords: Scour, Bridge pier, numerical simulation, SSIIM 2.0.

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Authors: Hadeel Salim Alkutubi

Abstract:

The objective of this study is to introduce estimators to the parameters and survival function for Weibull distribution using three different methods, Maximum Likelihood estimation, Standard Bayes estimation and Modified Bayes estimation. We will then compared the three methods using simulation study to find the best one base on MPE and MSE.

Keywords: Maximum Likelihood estimation , Bayes estimation, Jeffery prior information, Simulation study

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Authors: Yoshifumi Sakamoto, Kouichi Ono, Takeo Nakada, Yousuke Kubo, Hiroto Yasuura

Abstract:

This paper describes a system-level SoC energy consumption estimation method based on a dynamic behavior of embedded software in the early stages of the SoC development. A major problem of SOC development is development rework caused by unreliable energy consumption estimation at the early stages. The energy consumption of an SoC used in embedded systems is strongly affected by the dynamic behavior of the software. At the early stages of SoC development, modeling with a high level of abstraction is required for both the dynamic behavior of the software, and the behavior of the SoC. We estimate the energy consumption by a UML model-based simulation. The proposed method is applied for an actual embedded system in an MFP. The energy consumption estimation of the SoC is more accurate than conventional methods and this proposed method is promising to reduce the chance of development rework in the SoC development. ∈

Keywords: SoC, Embedded Sytem, Energy Consumption, Dynamic behavior, UML, Modeling, Model-based simulation

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Authors: Wong Poh Lee, Mohd. Azam Osman, Abdullah Zawawi Talib, Ahmad Izani Md. Ismail

Abstract:

Traffic congestion has become a major problem in many countries. One of the main causes of traffic congestion is due to road merges. Vehicles tend to move slower when they reach the merging point. In this paper, an enhanced algorithm for traffic simulation based on the fluid-dynamic algorithm and kinematic wave theory is proposed. The enhanced algorithm is used to study traffic congestion at a road merge. This paper also describes the development of a dynamic traffic simulation tool which is used as a scenario planning and to forecast traffic congestion level in a certain time based on defined parameter values. The tool incorporates the enhanced algorithm as well as the two original algorithms. Output from the three above mentioned algorithms are measured in terms of traffic queue length, travel time and the total number of vehicles passing through the merging point. This paper also suggests an efficient way of reducing traffic congestion at a road merge by analyzing the traffic queue length and travel time.

Keywords: Dynamic, fluid-dynamic, kinematic wave theory, simulation, traffic congestion.

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Authors: Z. Jannoo, B. W. Yap, N. Auchoybur, M. A. Lazim

Abstract:

The two common approaches to Structural Equation Modeling (SEM) are the Covariance-Based SEM (CB-SEM) and Partial Least Squares SEM (PLS-SEM). There is much debate on the performance of CB-SEM and PLS-SEM for small sample size and when distributions are nonnormal. This study evaluates the performance of CB-SEM and PLS-SEM under normality and nonnormality conditions via a simulation. Monte Carlo Simulation in R programming language was employed to generate data based on the theoretical model with one endogenous and four exogenous variables. Each latent variable has three indicators. For normal distributions, CB-SEM estimates were found to be inaccurate for small sample size while PLS-SEM could produce the path estimates. Meanwhile, for a larger sample size, CB-SEM estimates have lower variability compared to PLS-SEM. Under nonnormality, CB-SEM path estimates were inaccurate for small sample size. However, CB-SEM estimates are more accurate than those of PLS-SEM for sample size of 50 and above. The PLS-SEM estimates are not accurate unless sample size is very large.  

Keywords: CB-SEM, Monte Carlo simulation, Normality conditions, Nonnormality, PLS-SEM.

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Authors: Hassan Baghgar Bostan Abad, Ali Yazdian Varjani, Taheri Asghar

Abstract:

Variable speed drives are growing and varying. Drives expanse depend on progress in different part of science like power system, microelectronic, control methods, and so on. Artificial intelligent contains hard computation and soft computation. Artificial intelligent has found high application in most nonlinear systems same as motors drive. Because it has intelligence like human but there are no sentimental against human like angriness and.... Artificial intelligent is used for various points like approximation, control, and monitoring. Because artificial intelligent techniques can use as controller for any system without requirement to system mathematical model, it has been used in electrical drive control. With this manner, efficiency and reliability of drives increase and volume, weight and cost of them decrease.

Keywords: Artificial intelligent, electrical motor, intelligent drive and control,

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Authors: Min Goo Choi, Jung Hoon Jung, Jae Wook Jeon

Abstract:

Assessment for image quality traditionally needs its original image as a reference. The conventional method for assessment like Mean Square Error (MSE) or Peak Signal to Noise Ratio (PSNR) is invalid when there is no reference. In this paper, we present a new No-Reference (NR) assessment of image quality using blur and noise. The recent camera applications provide high quality images by help of digital Image Signal Processor (ISP). Since the images taken by the high performance of digital camera have few blocking and ringing artifacts, we only focus on the blur and noise for predicting the objective image quality. The experimental results show that the proposed assessment method gives high correlation with subjective Difference Mean Opinion Score (DMOS). Furthermore, the proposed method provides very low computational load in spatial domain and similar extraction of characteristics to human perceptional assessment.

Keywords: No Reference, Image Quality Assessment, blur, noise.

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Authors: Hind Bouami, Patrick Millot

Abstract:

Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedback helps identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled. 

Keywords: Life-critical systems, situation awareness, human-machine interaction, decision-making.

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Authors: Bo-Wei Song, Yun-Jung Lee

Abstract:

This paper presents an intention interface and controller for a wire-driven heavy object lifting system that assists the operator with moving a heavy object. The handler is designed to allow a comfortable working posture for the operator. Plus, as a human assistive system, the operator is involved in the control loop, where a fuzzy control system is used to consider the human control characteristics. The effectiveness and performance of the proposed system are proved by experiments.

Keywords: Fuzzy controller, Handler design, Heavy object lifting system, Human-assistive device, Human-in-the-loop system.

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Authors: Stefanie Heinke, Carina Pereira, Jan Spillner, Steffen Leonhardt

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Severe heart failure is a common problem that has a significant effect on health expenditures in industrialized countries; moreover it reduces patient-s quality of life. However, current research usually focuses either on detailed modeling of the heart or on detailed modeling of the cardiovascular system. Thus, this paper aims to present a sophisticated model of the heart enhanced with an extensive model of the cardiovascular system. Special interest is on the pressure and flow values close to the heart since these values are critical to accurately diagnose causes of heart failure. The model is implemented in Dymola an object-oriented, physical modeling language. Results achieved with the novel model show overall feasibility of the approach. Moreover, results are illustrated and compared to other models. The novel model shows significant improvements.

Keywords: Cardiovascular system, heart, modeling.

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Authors: M. Salih Taci, N. Tayebi, I. Bozkır

Abstract:

In this paper, the equivalent circuit of the ideal single-phase power transformer with its appropriate voltage current measurement was presented. The calculated values of the voltages and currents of the different connections single phase normal transformer and the results of the simulation process are compared. As it can be seen, the calculated results are the same as the simulated results. This paper includes eight possible different transformer connections. Depending on the desired voltage level, step-down and step-up application transformer is considered. Modelling and analysis of a system consisting of an equivalent source, transformer (primary and secondary), and loads are performed to investigate the combinations. The obtained values are simulated in PSpice environment and then how the currents, voltages and phase angle are distributed between them is explained based on calculation.

Keywords: Transformer, simulation, equivalent model, parallel series combinations.

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Authors: A. T. Omarova, G. N. Nakipova

Abstract:

This article discusses the principles of object-oriented human capital development using the technology program. Also the article includes priorities of the strategy of industrial-innovative development of Kazakhstan in conditions of integration activity into the world community. The article shows the tasks of human resource management in the implementation of industrial and innovation development, particularities of Kazakhstan's theory of management staff, as well as due to the specificity of the Kazakhstan authorities. In the article had considered the factors which are affecting to the people in the organization and also had considered mechanisms of HRM within organization in the conditions of innovative development in Kazakhstan.

Keywords: Programming, management of human resources, innovation, investment, innovation process, HRD model, innovative development, integration, management, transformation, economic potential, competitiveness.

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Authors: A.R. Aswatha, T. Basavaraju, S. Sandeep Kumar

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Timing driven physical design, synthesis, and optimization tools need efficient closed-form delay models for estimating the delay associated with each net in an integrated circuit (IC) design. The total number of nets in a modern IC design has increased dramatically and exceeded millions. Therefore efficient modeling of interconnection is needed for high speed IC-s. This paper presents closed–form expressions for RC and RLC interconnection trees in current mode signaling, which can be implemented in VLSI design tool. These analytical model expressions can be used for accurate calculation of delay after the design clock tree has been laid out and the design is fully routed. Evaluation of these analytical models is several orders of magnitude faster than simulation using SPICE.

Keywords: IC design, RC/RLC Interconnection, VLSI Systems.

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Authors: Xu Zhang, Qi Jiang, Liwei Li, Weiwei Cui, Jijun Cui, Yang Cao, Hairong Zhao

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A kind of crash energy absorption structure adopted by vehicle simulator crash testing equipment based on mechanical energy storage was studied. Dynamic explicit finite element simulation was achieved for thin-walled tube structure under different conditions of section shape, thickness and inducement groove style. Crash energy absorption property of the structure was obtained. After optimization, a reasonable structure was given which can meet current vehicle crash regulation. And the optimized structure can be adopted in vehicle simulator, which can increase the practicability of the testing equipment.

Keywords: thin-walled tube structure, crash energy absorption, deceleration, finite element simulation

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Authors: Ashwani K. Rana, Narottam Chand, Vinod Kapoor

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In this paper, gate leakage current has been mitigated by the use of novel nanoscale MOSFET with Source/Drain-to-Gate Non-overlapped and high-k spacer structure for the first time. A compact analytical model has been developed to study the gate leakage behaviour of proposed MOSFET structure. The result obtained has found good agreement with the Sentaurus Simulation. Fringing gate electric field through the dielectric spacer induces inversion layer in the non-overlap region to act as extended S/D region. It is found that optimal Source/Drain-to-Gate Non-overlapped and high-k spacer structure has reduced the gate leakage current to great extent as compared to those of an overlapped structure. Further, the proposed structure had improved off current, subthreshold slope and DIBL characteristic. It is concluded that this structure solves the problem of high leakage current without introducing the extra series resistance.

Keywords: Gate tunneling current, analytical model, spacer dielectrics, DIBL, subthreshold slope.

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: Empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer.

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