Search results for: Upper limb disorders

Authors: Babak Borzouei, Seyed Habibollah Mousavi-Bahar

Abstract:

Recently, there has been a considerable increase in the number of procedures carried out under regional anesthesia. However, percutaneous nephrolithotomy (PCNL) procedures are usually performed under general anesthesia. The aim of this study was to assess the safety and efficacy of PCNL under spinal anesthesia in patients with renal calculi. We describe our 9 years experience of performing PCNL under spinal anesthesia for 387 patients with large stones of the upper urinary tract, with regard to the effectiveness and side effects. All patients received spinal anesthetics (Lidocain 5%, or Bupivacaine 0.75%) and underwent PCNL in prone position. The success rate was 94.1%. The incidence of complications was 11.6%. PCNL under spinal anesthesia is feasible, safe, and well-tolerated in management of patients with renal stones.

Keywords: percutaneous nephrolithotomy, spinal anesthesia, renal calculi

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Authors: Naoto Suzuki

Abstract:

A decline in visual sensitivity at arbitrary points on the retina can be measured using a precise perimetry apparatus along with a fundus camera. However, the retinal layer associated with this decline cannot be identified accurately with current medical technology. To investigate cryptogenic diseases, such as macular dystrophy, acute zonal occult outer retinopathy (AZOOR), and multiple evanescent white dot syndrome (MEWDS), we evaluated an electroretinogram (ERG) function that allows moving the center of the multifocal hexagonal stimulus array to a chosen position. Macular dystrophy is a generalized term used for a variety of functional disorders of the macula lutea, and the ERG shows a diminution of the b-wave in these disorders. AZOOR causes an acute functional disorder to an outer layer of the retina, and the ERG shows a-wave and b-wave amplitude reduction as well as delayed 30 Hz flicker responses. MEWDS causes acute visual loss and the ERG shows a decrease in a-wave amplitude. We combined an electroretinographic optical system and a perimetric optical system into an experimental apparatus that has the same optical system as that of a fundus camera. We also deployed an EO-50231 Edmund infrared camera, a 45-degree cold mirror, a lens with a 25-mm focal length, a halogen lamp, and an 8-inch monitor. Then, we also employed a differential amplifier with gain 10, a 50 Hz notch filter, a high-pass filter with a 21.2 Hz cut-off frequency, and two non-inverting amplifiers with gains 1001 and 11. In addition, we used a USB-6216 National Instruments I/O device, a NE-113A Nihon Kohden plate electrode, a SCB-68A shielded connector block, and LabVIEW 2017 software for data retrieval. The software was used to generate the multifocal hexagonal stimulus array on the computer monitor with C++Builder 10.2 and to move the center of the array toward the left and right and up and down. Cone and bright flash ERG results were observed using the moving ERG function. The a-wave, b-wave, c-wave, and the photopic negative response were identified with cone ERG. The moving ERG function allowed the identification of the retinal layer causing visual alterations.

Keywords: Moving ERG, multifocal ERG, precise perimetry, retinal layers, visual sensitivity

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Authors: Y. Shpungin

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Estimating the reliability of a computer network has been a subject of great interest. It is a well known fact that this problem is NP-hard. In this paper we present a very efficient combinatorial approach for Monte Carlo reliability estimation of a network with unreliable nodes and unreliable edges. Its core is the computation of some network combinatorial invariants. These invariants, once computed, directly provide pure and simple framework for computation of network reliability. As a specific case of this approach we obtain tight lower and upper bounds for distributed network reliability (the so called residual connectedness reliability). We also present some simulation results.

Keywords: Combinatorial invariants, Monte Carlo simulation, reliability, unreliable nodes and unreliable edges.

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Authors: Farshad Kheiri

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Iran Central Plateau encompasses a large proportion of this country. The weather in these flat plains is warm and arid with very little precipitation. Different attempts in architecture have been done to alleviate the weather severity of this area and create a living place compatible with humans’ comfort criteria. Investigations have showed that some of the most successful approaches in traditional architecture of the area has been forgotten or are not being used widely. As sustainability is defined as an appropriate solution for environmental, economical, and social disorders, this research is a try to demonstrate the sustainability in aforementioned architecture and based on these studies, propounds solutions for today architecture in hot arid zones.

Keywords: Hot arid climatic zone, Iranian Architecture, Sustainability, Vernacular architecture.

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Authors: Ikmal Hisyam Mohamad Paris, Lilly Suriani Affendey, Norwati Mustapha

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In this paper we compare the accuracy of data mining methods to classifying students in order to predicting student-s class grade. These predictions are more useful for identifying weak students and assisting management to take remedial measures at early stages to produce excellent graduate that will graduate at least with second class upper. Firstly we examine single classifiers accuracy on our data set and choose the best one and then ensembles it with a weak classifier to produce simple voting method. We present results show that combining different classifiers outperformed other single classifiers for predicting student performance.

Keywords: Classification, Data Mining, Prediction, Combination of Multiple Classifiers.

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Authors: Hidehiko Okada

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The author previously proposed an extension of differential evolution. The proposed method extends the processes of DE to handle interval numbers as genotype values so that DE can be applied to interval-valued optimization problems. The interval DE can employ either of two interval models, the lower and upper model or the center and width model, for specifying genotype values. Ability of the interval DE in searching for solutions may depend on the model. In this paper, the author compares the two models to investigate which model contributes better for the interval DE to find better solutions. Application of the interval DE is evolutionary training of interval-valued neural networks. A result of preliminary study indicates that the CW model is better than the LU model: the interval DE with the CW model could evolve better neural networks. 

Keywords: Evolutionary algorithms, differential evolution, neural network, neuroevolution, interval arithmetic.

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Authors: Abhijit Mitra

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we propose a new normalized LMS (NLMS) algorithm, which gives satisfactory performance in certain applications in comaprison with con-ventional NLMS recursion. This new algorithm can be treated as a block based simplification of NLMS algorithm with significantly reduced number of multi¬ply and accumulate as well as division operations. It is also shown that such a recursion can be easily implemented in block floating point (BFP) arithmetic, treating the implementational issues much efficiently. In particular, the core challenges of a BFP realization to such adaptive filters are mainly considered in this regard. A global upper bound on the step size control parameter of the new algorithm due to BFP implementation is also proposed to prevent overflow in filtering as well as weight updating operations jointly.

Keywords: Adaptive algorithm, Block floating point arithmetic, Implementation issues, Normalized least mean square methods

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Authors: Mohamed A. Elsherif, A. Malekmohammadi

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An exploration in the competency of the optical multilevel Mapping Multiplexing Technique (MMT) system in tolerating to the impact of nonlinearities as Self Phase Modulation (SPM) during the presence of dispersion compensation methods. The existence of high energy pulses stimulates deterioration in the chirp compression process attained by SPM which introduces an upper power boundary limit. An evaluation of the post and asymmetric prepost fiber compensation methods have been deployed on the MMT system compared with others of the same bit rate modulation formats. The MMT 40 Gb/s post compensation system has 1.4 dB enhancements to the 40 Gb/s 4-Arysystem and less than 3.9 dB penalty compared to the 40 Gb/s OOK-RZsystem. However, the optimized Pre-Post asymmetric compensation has an enhancement of 4.6 dB compared to the Post compensation MMT configuration for a 30% pre compensation dispersion.

Keywords: Dispersion compensation, mapping multiplexing technique, self-phase modulation.

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Authors: Shaina Nagpal, Amit Gupta

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In this work, all optical Stimulated Brillouin Scattering (SBS) generated single sideband with suppressed carrier is presented to provide better efficiency. The generation of single sideband and enhanced carrier power signal using the SBS technique is further used to strengthen the low shifted sideband and to suppress the upshifted sideband. These generated single sideband signals are able to work at high frequency ranges. Also, generated single sideband is validated over 90 km transmission using single mode fiber with acceptable bit error rate. The results for an equivalent are then compared so that the acceptable technique is chosen and also the required quality for the optimum performance of the system is reported.

Keywords: Stimulated Brillouin scattering, radio over fiber, upper side band, quality factor.

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Authors: Nor Fadzillah Mohd Mokhtar, Norihan Md Arifin, Roslinda Nazar, Fudziah Ismail, MohamedSuleiman

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The stability analysis of Marangoni convection in porous media with a deformable upper free surface is investigated. The linear stability theory and the normal mode analysis are applied and the resulting eigenvalue problem is solved exactly. The Darcy law and the Brinkman model are used to describe the flow in the porous medium heated from below. The effect of the Crispation number, Bond number and the Biot number are analyzed for the stability of the system. It is found that a decrease in the Crispation number and an increase in the Bond number delay the onset of convection in porous media. In addition, the system becomes more stable when the Biot number is increases and the Daeff number is decreases.

Keywords: Deformable, Marangoni, Porous, Stability.

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Authors: Rohit Gupta, Ravinder Agarwal

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Surface electromyographic (sEMG) signal has the potential to identify the human activities and intention. This potential is further exploited to control the artificial limbs using the sEMG signal from residual limbs of amputees. The paper deals with the development of multichannel cost efficient sEMG signal interface for research application, along with evaluation of proposed class dependent statistical approach of the feature selection method. The sEMG signal acquisition interface was developed using ADS1298 of Texas Instruments, which is a front-end interface integrated circuit for ECG application. Further, the sEMG signal is recorded from two lower limb muscles for three locomotions namely: Plane Walk (PW), Stair Ascending (SA), Stair Descending (SD). A class dependent statistical approach is proposed for feature selection and also its performance is compared with 12 preexisting feature vectors. To make the study more extensive, performance of five different types of classifiers are compared. The outcome of the current piece of work proves the suitability of the proposed feature selection algorithm for locomotion recognition, as compared to other existing feature vectors. The SVM Classifier is found as the outperformed classifier among compared classifiers with an average recognition accuracy of 97.40%. Feature vector selection emerges as the most dominant factor affecting the classification performance as it holds 51.51% of the total variance in classification accuracy. The results demonstrate the potentials of the developed sEMG signal acquisition interface along with the proposed feature selection algorithm.

Keywords: Classifiers, feature selection, locomotion, sEMG.

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Authors: A.K.Jayanthy, N.Sujatha, M.Ramasubba Reddy

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Microcirculation is essential for the proper supply of oxygen and nutritive substances to the biological tissue and the removal of waste products of metabolism. The determination of blood flow in the capillaries is therefore of great interest to clinicians. A comparison has been carried out using the developed non-invasive, non-contact and whole field laser speckle contrast imaging (LSCI) based technique and as well as a commercially available laser Doppler blood flowmeter (LDF) to evaluate blood flow at the finger tip and elbow and is presented here. The LSCI technique gives more quantitative information on the velocity of blood when compared to the perfusion values obtained using the LDF. Measurement of blood flow in capillaries can be of great interest to clinicians in the diagnosis of vascular diseases of the upper extremities.

Keywords: Blood flow, Laser Doppler flowmeter, LSCI, speckle

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Authors: I. Turk Cakir, A. Senol, A. T. Tasci, O. Cakir

Abstract:

We study the anomalous WWγ and WWZ couplings by calculating total cross sections of two processes at the LHeC with electron beam energy Ee=140 GeV and the proton beam energy Ep=7 TeV, and at the FCC-ep collider with the polarized electron beam energy Ee=80 GeV and the proton beam energy Ep=50 TeV. At the LHeC with electron beam polarization, we obtain the results for the difference of upper and lower bounds as (0.975, 0.118) and (0.285, 0.009) for the anomalous (Δκγ, λγ) and (Δκz, λz) couplings, respectively. As for FCC-ep collider, these bounds are obtained as (1.101, 0.065) and (0.320, 0.002) at an integrated luminosity of Lint=100 fb^-1.

Keywords: Anomalous Couplings, Future Circular Collider, Large Hadron electron Collider, W-boson and Z-boson.

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Authors: Gabi N. Nehme

Abstract:

Below-knee amputees commonly experience asymmetrical gait patterns. It is generally believed that ischemia is related to the formation of pressure sores due to uneven distribution of forces. Micro-vascular responses can reveal local malnutrition. Changes in local skin blood supply under various external loading conditions have been studied for a number of years. Radionuclide clearance, photo-plethysmography, trans-cutaneous oxygen tension along with other studies showed that the blood supply would be influenced by the epidermal forces, and the rate and the amount of blood supply would decrease with increased epidermal loads being shear forces or normal forces. Several cases of socket designs were investigated using Finite Element Model (FEM) and Design of Experiment (DOE) to increase flexibility and minimize the pressure at the limb/socket interface using ultra high molecular weight polyethylene (UHMWPE) and polyamide 6 (PA6) or Duraform. The pressure reliefs at designated areas where reducing thickness is involved are seen to be critical in determination of amputees’ comfort and are very important to clinical applications. Implementing a hole between the Patellar Tendon (PT) and Distal Tibia (DT) would decrease stiffness and increase prosthesis range of motion where flexibility is needed. In addition, displacement and prosthetic energy storage increased without compromising mechanical efficiency and prosthetic design integrity.

Keywords: Patellar tendon, distal tibia, prosthetic socket, relief areas, hole implementation.

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Authors: M.Imanova, G.Mehdiyeva, V.Ibrahimov

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Solution of some practical problems is reduced to the solution of the integro-differential equations. But for the numerical solution of such equations basically quadrature methods or its combination with multistep or one-step methods are used. The quadrature methods basically is applied to calculation of the integral participating in right hand side of integro-differential equations. As this integral is of Volterra type, it is obvious that at replacement with its integrated sum the upper limit of the sum depends on a current point in which values of the integral are defined. Thus we receive the integrated sum with variable boundary, to work with is hardly. Therefore multistep method with the constant coefficients, which is free from noted lack and gives the way for finding it-s coefficients is present.

Keywords: Volterra integro-differential equations, multistepmethods, finite-difference methods, initial value problem

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Authors: Amin Mojiri, Akiyoshi Ohashi, Tomonori Kindaichi

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Synthetic domestic wastewater was treated via combining treatment methods, including electrochemical oxidation, adsorption, and sequencing batch reactor (SBR). In the upper part of the reactor, an anode and a cathode (Ti/RuO₂-IrO₂) were organized in parallel for the electrochemical oxidation procedure. Sodium sulfate (Na₂SO₄) with a concentration of 2.5 g/L was applied as the electrolyte. The voltage and current were fixed on 7.50 V and 0.40 A, respectively. Then, 15% working value of the reactor was filled by activated sludge, and 85% working value of the reactor was added with synthetic wastewater. Powdered cockleshell, 1.5 g/L, was added in the reactor to do ion-exchange. Response surface methodology was employed for statistical analysis. Reaction time (h) and pH were considered as independent factors. A total of 97.0% biochemical oxygen demand, 99.9% phosphorous and 88.6% cadmium were eliminated at the optimum reaction time (80.0 min) and pH (6.4).

Keywords: Adsorption, electrochemical oxidation, metals, sequencing batch reactor.

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Authors: P. S. A. Souza, M. R. C. Marques, M. M. Rigo, A. A. Cerqueira, J. L. Paiva, F. Merçon, D. V. Perez

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Produced water (PW), which is water extracted along with oil, is the largest waste stream in the oil and gas industry. With the proper treatment, this wastewater can be used in agricultural irrigation. This study evaluated the effects the application of PW treated by electroflocculation (EF) and combined electroflocculation-reverse osmosis (EF-RO) on soil salinity and sodification parameters. Excessive sodium levels in PW treated by EF may affect soil structural stability and plant growth, and tends to accumulate in upper layers, displacing the nutrient K to deeper layers of the soil profile. PW treated by EF-RO did not promote salinization and soil sodification, indicating that this combined technique may be a viable alternative for oily water treatment aiming at irrigation use in semiarid regions.

Keywords: Electroflocculation, irrigation, produced water, reverse osmosis, soil.

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Authors: T. Teruzzi, S. Antonietti, C. Mosca, C. Paglia

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This paper discusses the causes of the structural failure in a tower crane. The structural collapse occurred at the upper joints of the extension element used to increase the height of the crane. The extension element consists of a steel lattice structure made with angular profiles and plates joined to the tower element by arc welding. Macroscopic inspection of the sections showed that the break was always observed on the angular profiles at the weld bead edge. The case study shows how, using mechanical characterization, chemical analysis of the steel and macroscopic and microscopic metallographic examinations, it was possible to obtain significant evidence that identified the mechanism causing the breakage. The analyses identified the causes of the structural failure as the use of materials that were not suitable for welding and poor performance in the welding joints.

Keywords: Failure, weld, microstructure, microcracks.

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Authors: Mikhail P. Strongin, Ragupathi Soundararajan

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The purpose of this work is fast design optimization of the seal chamber. The study includes the mass transfer between lower and upper chamber on seal chamber for hot water application pumps. The use of Fluent 12.1 commercial code made it possible to capture complex flow with heat-mass transfer, radiation, Tailor instability, and buoyancy effect. Realizable k-epsilon model was used for turbulence modeling. Radiation heat losses were taken into account. The temperature distribution at seal region is predicted with respect to heat addition. Results show the possibilities of the model simplifications by excluding the water domain in low chamber from calculations. CFD simulations permit to improve seal chamber design to meet target water temperature around the seal. This study can be used for the analysis of different seal chamber configurations.

Keywords: CFD, heat transfer, seal chamber, high temperature water

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Authors: Thanutch Sukwimolseree, Preeyaphorn Kosa

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Many problems are occurred in watershed due to human activity and economic development. The purpose is to determine the effects of the land use change on surface runoff using land use map on 1980, 2001 and 2008 and daily weather data during January 1, 1979 to September 30, 2010 applied to SWAT. The results can be presented that the polynomial equation is suitable to display that relationship. These equations for land use in 1980, 2001 and 2008 are consisted of y = -0.0076x⁵ + 0.1914x⁴–1.6386x³ + 6.6324x²–8.736x + 7.8023(R² = 0.9255), y = -0.0298x⁵ + 0.8794x⁴ - 9.8056x³ + 51.99x² - 117.04x + 96.797; (R² = 0.9186) and y = -0.0277x⁵ + 0.8132x⁴ - 8.9598x³ + 46.498x²–101.83x +81.108 (R² = 0.9006), respectively. Moreover, if the agricultural area is the largest area, it is a sensitive parameter to concern surface runoff.

Keywords: Land use, Runoff, SWAT, Upper Mun River Basin.

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Authors: Zurriati Mohd Ali, Wahyu Kuntjoro, Wirachman Wisnoe

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The aerodynamics characteristics of a blended-wing body (BWB) aircraft were obtained in Universiti Teknologi MARA low speed wind tunnel. The scaled-down of BWB model consisted of a canard as its horizontal stabilizer. There were four canards with different aspect ratio used in the experiments. Canard setting angles were varied from -20q to 20q. All tests were conducted at velocity of 35 m/s, with Mach number 0.1. At low angles of attacks, the increment of lift slope for various canards aspect ratio is small and almost constant. Higher canard aspect ratio will cause higher drag. However, canard has a high effect to the moment at zero lift, CM,0.The visualization using mini tuff was performed to observe the airflow at the upper surface of canard. KeywordsAerodynamics,blended-wing body, canard, wind tunnel.

Keywords: Aerodynamics, blended-wing body, canard, wind tunnel.

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Authors: Hasliza A. Rahim, Fareq Malek, Nur A. M. Affendi, Azuwa Ali, Norshafinash Saudin, Latifah Mohamed

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This paper presents the experimental investigation of on-body channel fading at 2.45 GHz considering two effects of the user body movement; stationary and mobile. A pair of body-worn antennas was utilized in this measurement campaign. A statistical analysis was performed by comparing the measured on-body path loss to five well-known distributions; lognormal, normal, Nakagami, Weibull and Rayleigh. The results showed that the average path loss of moving arm varied higher than the path loss in sitting position for upper-arm-to-left-chest link, up to 3.5 dB. The analysis also concluded that the Nakagami distribution provided the best fit for most of on-body static link path loss in standing still and sitting position, while the arm movement can be best described by log-normal distribution.

Keywords: On-Body channel communications, fading characteristics, statistical model.

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Authors: John Mark Lampos, Virgilio Sison

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Two constructions of unit-memory binary convolutional codes from linear block codes over the finite semi-local ring F2r +vF2r , where v2 = v, are presented. In both cases, if the linear block code is systematic, then the resulting convolutional encoder is systematic, minimal, basic and non-catastrophic. The Hamming free distance of the convolutional code is bounded below by the minimum Hamming distance of the block code. New examples of binary convolutional codes that meet the Heller upper bound for systematic codes are given.

Keywords: Convolutional codes, semi-local ring, free distance, Heller bound.

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Authors: W. Wu, S. Utili

Abstract:

Based on the kinematic approach of limit analysis, a full set of upper bound solutions for the stability of homogeneous rock slopes subjected to tension cracks are obtained. The generalized Hoek-Brown failure criterion is employed to describe the non-linear strength envelope of rocks. In this paper, critical failure mechanisms are determined for cracks of known depth but unspecified location, cracks of known location but unknown depth, and cracks of unspecified location and depth. It is shown that there is a nearly up to 50% drop in terms of the stability factors for the rock slopes intersected by a tension crack compared with intact ones. Tables and charts of solutions in dimensionless forms are presented for ease of use by practitioners.

Keywords: Hoek-Brown failure criterion, limit analysis, rock slope, tension cracks.

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Authors: A.A.Sharizli, N.A.Abu Osman, A.A.Saifizul

Abstract:

An Automated Rapid Maxillary Expander (ARME) is a specially designed microcontroller-based orthodontic appliance to overcome the shortcomings imposed by the traditional maxillary expansion appliances. This new device is operates by automatically widening the maxilla (upper jaw) by expanding the midpalatal suture [1]. The ARME appliance that has been developed is a combination of modified butterfly expander appliance, micro gear, micro motor, and microcontroller to automatically produce light and continuous pressure to expand the maxilla. For this study, the functionality of the system is verified through laboratory tests by measure the forced applied to the teeth each time the maxilla expands. The laboratory test results show that the developed appliance meets the desired performance specifications consistently.

Keywords: Maxillary Expansion, Microcontroller, Automated, Orthodontist, Force Analysis.

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Authors: Kotaro Miura, Makoto Sakamoto, Yuji Tanabe

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We focus on internal stress and displacement of an elastic axisymmetric contact problem for indentation of a layer-substrate body. An elastic layer is assumed to be perfectly bonded to an elastic semi-infinite substrate. The elastic layer is smoothly indented with a flat-ended cylindrical indenter. The analytical and exact solutions were obtained by solving an infinite system of simultaneous equations using the method to express a normal contact stress at the upper surface of the elastic layer as an appropriate series. This paper presented the numerical results of internal stress and displacement distributions for hard-coating system with constant values of Poisson’s ratio and the thickness of elastic layer.

Keywords: Indentation, contact problem, stress distribution, coating materials, layer-substrate body.

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Authors: Haider M. Alsaeq

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This research investigates the effects of the opening shape and location on the structural behavior of reinforced concrete deep beam with openings, while keeping the opening size unchanged. The software ANSYS 12.1 is used to handle the nonlinear finite element analysis. The ultimate strength of reinforced concrete deep beam with opening obtained by ANSYS 12.1 shows fair agreement with the experimental results, with a difference of no more than 20%. The present work concludes that the opening location has much more effect on the structural strength than the opening shape. It was concluded that placing the openings near the upper corners of the deep beam may double the strength, and the use of a rectangular narrow opening, with the long sides in the horizontal direction, can save up to 40% of structural strength of the deep beam.

Keywords: Deep Beams, Finite Element, Opening, Reinforced Concrete.

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Authors: Nazar Zaki, Safaai Deris, Hany Alashwal

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Detecting protein-protein interactions is a central problem in computational biology and aberrant such interactions may have implicated in a number of neurological disorders. As a result, the prediction of protein-protein interactions has recently received considerable attention from biologist around the globe. Computational tools that are capable of effectively identifying protein-protein interactions are much needed. In this paper, we propose a method to detect protein-protein interaction based on substring similarity measure. Two protein sequences may interact by the mean of the similarities of the substrings they contain. When applied on the currently available protein-protein interaction data for the yeast Saccharomyces cerevisiae, the proposed method delivered reasonable improvement over the existing ones.

Keywords: Protein-Protein Interaction, support vector machine, feature extraction, pairwise alignment, Smith-Waterman score.

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Authors: M. Mahdavi, M. Ismail, K. Jumari, Z. M. Hanapi

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For the sensor network to operate successfully, the active nodes should maintain both sensing coverage and network connectivity. Furthermore, scheduling sleep intervals plays critical role for energy efficiency of wireless sensor networks. Traditional methods for sensor scheduling use either sensing coverage or network connectivity, but rarely both. In this paper, we use random scheduling for sensing coverage and then turn on extra sensor nodes, if necessary, for network connectivity. Simulation results have demonstrated that the number of extra nodes that is on with upper bound of around 9%, is small compared to the total number of deployed sensor nodes. Thus energy consumption for switching on extra sensor node is small.

Keywords: Wireless sensor networks, energy efficient network, performance analysis, network coverage.

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Authors: Mahmoud A. El-Banna

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The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Keywords: Discharge Time, Healthcare, Hospitals, Patients, Process Improvement, Six Sigma, Simulation

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