Case Report Central Venous Line Insertion Revealing Partial Anomalous Pulmonary Venous Return: Diagnosis and Management

Central venous line malposition is a well-known complication of line insertion. Rarely, it can be mal-positioned in an anomalous pulmonary vein. We present an unusual case of a 56-year-old woman that was found to have partial anomalous pulmonary venous return on central venous line insertion. In this report, we describe a systematic approach to diagnosis and management of this unusual situation

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Monitoring Big Data Streams Using Data Stream Management Systems: Industrial Needs, Challenges, and Improvements

Real-time monitoring systems are important for industry since they allow for avoiding unplanned system stops and keeping system availability high. The technical requirements for such systems include being both scalable and online, as the amount of generated data is increasing with time. Therefore, monitoring systems must integrate tools that can manage and analyze the data streams. The data stream management system is a stream processing tool that has the ability to manage and support operations on data streams in real-time. Several researchers have proposed and tested real-time monitoring systems which have the ability to search big data streams. In this paper, the research works that discuss the analysis of online data streams for fault detection in industry are reviewed. Based on the literature analysis, the industrial needs and challenges of monitoring big data streams are presented. Furthermore, feasible suggestions for improving the real-time monitoring system are proposed

Mining data streams to increase ‎industrial product availability

Improving product quality is always of industrial interest. Product availability, a function of product maintainability and reliability, is an example of a measurement that can be used to evaluate product quality. Product availability and cost are two units which are especially important to manage in the context of the manufacturing industry, especially where industry is interested in selling or buying offers with increased service content. Industry in general uses different strategies for increasing equipment availability; these include: corrective (immediate or delayed) and preventive strategies. Preventive strategies may be further subdivided into scheduled and predictive (condition-based) maintenance strategies. In turn, predictive maintenance may also be subdivided into scheduled inspection and continuously monitored. The predictive approach can be achieved by early fault detection. Fault detection and diagnosis methods can be classified into three categories: data-driven, analytically based, and knowledge-based methods. In this thesis, the focus is mainly on fault detection and on data-driven models.Furthermore, industry is generating an ever-increasing amount of data, which may eventually become impractical to store and search, and when the data rate is increasing, eventually impossible to store. The ever-increasing amount of data has prompted both industry and researchers to find systems and tools which can control the data on the fly, as close to real-time as possible, without the need to store the data itself. Approaches and tools such as Data Stream Mining (DSM) and Data Stream Management Systems (DSMS) become important. For the work reported in this thesis, DSMS and DSM have been used to control, manage and search data streams, with the purpose of supporting increased availability of industrial products.Bosch Rexroth Mellansel AB (formerly Hägglunds Drives AB) has been the industrial partner company during the course of the work reported in this thesis. Related data collection concerning the functionality of the BRMAB hydraulic system has been performed in collaboration with other researchers in Computer Aided Design at Luleå University of Technology.The research reported in this thesis started with a review of data stream mining algorithms and their applications in monitoring. Based on the review, a data stream classification method, i.e. Grid-based classifier, was proposed, tested and validated (Paper A). Also, a fault detection system based on DSM and DSMS was proposed and tested, as reported in Paper A. Thereafter, a data stream predictor was integrated into the proposed fault detection system to detect failures earlier, thus demonstrating how data stream prediction can be used to gain more time for proactive response actions by industry (Paper B). Further development included an automatic update method which allows the proposed fault detection system to be able to overcome the problem of concept drift (Paper E). The proposed and modified fault detection systems were tested and verified using data collected in collaboration with Bosch Rexroth Mellansel AB (BRMAB). The requirements for the proposed fault detection system and how it can be used in product development and design of the support system were also discussed (Paper C). In addition, the performance of a knowledge-based method and a data- driven method for detecting failures in high-volume data streams from industrial equipment have been compared (Paper D). It was found that both methods were able to detect all faults without any false alert. Finally, the possible implications of using cloud services for supporting industrial availability are discussed in Paper F. Further discussions regarding the research process and the relations between the appended papers can be found in Chapter 2, Figure 4 and in Chapter 5, Figure 21.The results showed that the proposed and modified fault detection systems achieved good performance in detecting and predicting failures on time (see Paper A and Paper B). In Paper C, it is shown how data stream management systems may be used to increase product availability awareness. Also, both the data-driven method and the knowledgebased method were suitable for searching data streams (see Paper D). Paper E shows how the challenge of concept drift, i.e. the situation in which the statistical properties of a data stream change over time, was turned to an advantage, since the authors were able to develop a method to automatically update the safe operation limits of the one-class data-driven models.In general, detecting faults and failures on time prevents unplanned stops and may improve both maintainability and reliability of industrial systems and, thus, their availability (since availability is a function of maintainability and reliability). By the results, this thesis demonstrates how DSM and DSMS technologies can be used to increase product availability and thereby increase product quality in terms of availability.Godkänd; 2013; 20130423 (ahmalz); Tillkännagivande disputation 2013-05-24 Nedanstående person kommer att disputera för avläggande av teknologie doktorsexamen. Namn: Ahmad Alzghoul Ämne: Datorstödd maskinkonstruktion/Computer Aided Design Avhandling: Mining Data Streams to Increase Industrial Product Availability Opponent: Professor Patrik Eklund, Institutionen för datavetenskap, Umeå universitet Ordförande: Professor Lennart Karlsson, Institutionen för teknikvetenskap och matematik, Luleå tekniska universitet Tid: Måndag den 17 juni 2013, kl 09.00 Plats: E231, Luleå tekniska universitet</p

Improving availability of industrial products through data stream mining

Products of high quality are of great interest for industrial companies. The quality of a product can be considered in terms of production cost, operating cost, safety and product availability, for example. Product availability is a function of maintainability and reliability. Monitoring prevents unplanned stops, thus increasing product availability by decreasing needed maintenance. Through monitoring, failures can be detected and/or avoided. Detecting failures eliminates extra costs such as costs associated with machinery damage and dissatisfied customers, and time is saved since stops can be scheduled, instead of having unplanned stops. Product monitoring can be done through searching the data generated from sensors installed on products.Nowadays, the data can be collected at high rates as part of a data stream. Therefore, data stream management systems (DSMS) and data stream mining (DSM) are being used to control, manage and search the data stream. This work investigated how the availability of industrial products can be increased through the use of DSM and DSMS technologies.A review of the data stream mining algorithms and their applications in monitoring was conducted. Based on the review, a new data stream classification method, i.e. Grid-based classifier was proposed, tested and validated. Also, a fault detection system based on DSM and DSMS technologies was proposed. The proposed fault detection system was tested using data collected from Hägglunds Drives AB (HDAB) hydraulic motors. Thereafter, a data stream predictor was integrated into the proposed fault detection system to detect failures earlier, thus gaining more time for response actions. The modified fault detection system was tested and showed good performance. The results showed that the proposed fault detection system, which is based on DSM and DSMS technologies, achieved good performance (with classification accuracy around 95%) in detecting failures on time. Detecting failures on time prevents unplanned stops and may improve the maintainability of the industrial systems and, thus, their availability.Godkänd; 2011; 20111025 (ahmalz); LICENTIATSEMINARIUM Ämnesområde: Datorstödd maskinkonstruktion/Computer Aided Design Examinator: Professor Lennart Karlsson, Institutionen för teknikvetenskap och matematik, Luleå tekniska universitet Diskutant: Doctor Erik Zeitler, Department of Information Technology, Uppsala University Tid: Måndag den 19 december 2011 kl 09.00 Plats: E231, Luleå tekniska universite

Screening Web Breaks in a Pressroom by Soft Computing Screening Web Breaks in a Pressroom by Soft Computing

his guidance and help. And I am greatly indebted to my parents for their love, support and inspiration. Finally I would like to thank everyone who contributed to this project. III Screening web breaks in a pressroom by soft computing IV Abstract Web breaks are considered as one of the most significant runnability problems in a pressroom. This work concerns the analysis of relation between various parameters (variables) characterizing the paper, printing press, the printing process and the web break occurrence. A large number of variables, 61 in total, obtained off-line as well as measured online during the printing process are used in the investigation. Each paper reel is characterized by a vector x of 61 components. Two main approaches are explored. The first one treats the problem as a data classification task into &quot;break&quot; and &quot;non break&quot; classes. The procedures of classifier training, the selection of relevant input variables and the selection of hyper-parameters of the classifier are aggregated into one process based on genetic search. The second approach combines procedures of genetic search based variable selection and data mapping into a low dimensional space. The genetic search process results into a variable set providing the best mapping according to some quality function. The empirical study was performed using data collected at a pressroom in Sweden. The total number of data points available for the experiments was equal to 309. Amongst those, only 37 data points represent the web break cases. The results of the investigations have shown that the linear relations between the independent variables and the web break frequency are not strong. Three important groups of variables were identified, namely Lab data (variables characterizing paper properties and measured off-line in a paper mill lab), Ink registry (variables characterizing operator actions aimed to adjust ink registry) and Web tension. We found that the most important variables are: Ink registry Y LS MD (adjustments of yellow ink registry in machine direction on the lower paper side), Air permeability (characterizes paper porosity), Paper grammage, Elongation MD, and four variables characterizing web tension: Moment mean, Min sliding Mean, Web tension variance, and Web tension mean. The proposed methods were helpful in finding the variables influencing V Screening web breaks in a pressroom by soft computing the occurrence of web breaks and can also be used for solving other industrial problems. V

Screening Web Breaks in a Pressroom by Soft Computing

Web breaks are considered as one of the most significant runnability problems in a pressroom. This work concerns the analysis of relation between various parameters (variables) characterizing the paper, printing press, the printing process and the web break occurrence. A large number of variables, 61 in total, obtained off-line as well as measured online during the printing process are used in the investigation. Each paper reel is characterized by a vector x of 61 components. Two main approaches are explored. The first one treats the problem as a data classification task into "break" and "non break" classes. The procedures of classifier training, the selection of relevant input variables and the selection of hyper-parameters of the classifier are aggregated into one process based on genetic search. The second approach combines procedures of genetic search based variable selection and data mapping into a low dimensional space. The genetic search process results into a variable set providing the best mapping according to some quality function. The empirical study was performed using data collected at a pressroom in Sweden. The total number of data points available for the experiments was equal to 309. Amongst those, only 37 data points represent the web break cases. The results of the investigations have shown that the linear relations between the independent variables and the web break frequency are not strong. Three important groups of variables were identified, namely Lab data (variables characterizing paper properties and measured off-line in a paper mill lab), Ink registry (variables characterizing operator actions aimed to adjust ink registry) and Web tension. We found that the most important variables are: Ink registry Y LS MD (adjustments of yellow ink registry in machine direction on the lower paper side), Air permeability (character- izes paper porosity), Paper grammage, Elongation MD, and four variables characterizing web tension: Moment mean, Min sliding Mean, Web tension variance, and Web tension mean. The proposed methods were helpful in finding the variables influencing the occurrence of web breaks and can also be used for solving other industrial problems

Soft computing applications in wind power systems : a review and analysis

This paper reviews, analyses, discusses and summarises the recent research and development and trends in the applications of soft computing in the field of wind power systems. We show the usage and the influence of soft computing on the different aspects of wind power systems especially in the field of operation and maintenance. This work provides the state of the art in this area which will be a good guidance for future research work. The main results achieved from the study show that the soft computing techniques are adequate for solving the different challenges at the different phases of the life cycle processes of wind power systems.  Using the various soft computing techniques with wind power systems proved to be useful for the wind energy business. Using these tools contribute by improving the robustness of the decisions at different phases of the system's life cycle. Soft computing can enhance the efficiency and effectiveness of the operation and maintenance of offshore wind power systems through improving the availability levels. Thus, providing secure, sustainable and competitive energy supply for the future

Gender and Women's Issues Under the American Administrations over the period 1970-2015

[eng] Studying gender and women’s issues under the American Administrations over the period 1970-2015 is very important, so this thesis examines the impact of changing ruling Party on women's issues specifically gender and women’s representation inside politics, women’s attainment in education, women inside workforce, and violence against women. There are many interpretations and reports on gender cases in the U.S, and these reports participated in presenting women’s issues in the political arena. This thesis will shape a collective perspective behind retreating women’s rights and it will go in details about women’s issues to shed a light over the roots of women’s problem in the contemporary history of the United States of America. During the last four decades, surveys about women, and studies have been studying different issues about women, but researchers still search explanation about the reasons behind gender and women’s representation in politics. This thesis will study the performances of every American Administration to explain how and why women’s issues fragmented in every term of presidency, and why the legislative process was fragmenting the cases of women over a long period of time without a comprehensive understanding of women’s rights and women’s representation in politics. This thesis find out that women are underrepresented due to the change in political parties’ agendas that happened over the period (1970-2015).[spa] Estudiar el género y las cuestiones de las mujeres bajo las Administraciones estadounidenses durante el período 1970-2015 es muy importante, por lo que esta tesis examina el impacto que supone el cambio del partido gobernante en los asuntos de las mujeres específicamente el género y la representación de las mujeres dentro de la política, el logro de las mujeres en la educación, las mujeres dentro de la fuerza de trabajo y la violencia contra las mujeres. Hay muchas interpretaciones e informes sobre casos de género en los EE. UU, y estos informes contribuyeron en la presentación de los problemas de las mujeres en la arena política. Esta tesis muestra una perspectiva colectiva detrás de la retirada de los derechos de las mujeres y ofrece detalles sobre los temas de las mujeres para arrojar luz sobre las raíces del problema de las mujeres en la historia contemporánea de los Estados Unidos de América. Durante las últimas cuatro décadas, estudios y encuestas sobre mujeres han estado trabajado diferentes temas sobre las mujeres, pero los investigadores aún buscan explicaciones sobre las razones que hay detrás del género y la representación de las mujeres en la política. Esta tesis estudiará los desempeños de cada administración estadounidense para explicar cómo y por qué las cuestiones de las mujeres se fragmentaron en cada período presidencial, y por qué el proceso legislativo estaba fragmentando los casos de mujeres durante un largo período de tiempo, sin una comprensión integral de los derechos de las mujeres y la representación de las mujeres en la política. Esta tesis demuestra que las mujeres están infra representadas debido al cambio en las agendas de los partidos gobernantes durante el período 1970-2015.[cat] Estudiar el gènere i les qüestions de les dones sota les Administracions nord-americanes durant el període 1970-2015 és molt important, de manera que aquesta tesi examina l'impacte que suposa el canvi del partit governant en els assumptes de les dones específicament el gènere i la representació de les dones dins de la política, l'assoliment de les dones en l'educació, les dones dins de la força de treball i la violència contra les dones. Hi ha moltes interpretacions i informes sobre casos de gènere en els EUA, i aquests informes van contribuir a la presentació dels problemes de les dones en l'arena política. Aquesta tesi mostra una perspectiva col·lectiva darrere de la retirada dels drets de les dones i ofereix detalls sobre els temes de les dones per donar llum sobre les arrels del problema de les dones en la història contemporània dels Estats Units d'Amèrica. Durant les últimes quatre dècades, estudis i enquestes sobre dones han treballat diferents temes sobre les dones, però els investigadors encara busquen explicacions sobre les raons que hi ha darrere del gènere i la representació de les dones en la política. Aquesta tesi estudiarà els acompliments de cada administració nord-americana per explicar com i per què les qüestions de les dones es van fragmentar en cada període presidencial, i per què el procés legislatiu estava fragmentant els casos de dones durant un llarg període de temps, sense una comprensió integral dels drets de les dones i la representació de les dones en la política. Aquesta tesi demostra que les dones estan infrarepresentades a causa del canvi en les agendes dels partits governants durant el període 1970-2015