Internet of Vehicles Based On Cellular-Vehicle-To-Everything (C-V2X)

In line with the development of automotive and traffic systems, high mobility and density in different road topologies cause scalability and delay issues due to frequent disconnection between communication nodes. From a safety aspect, Cellular-V2X (C-V2X) wireless technology was introduced by the Third Generation Partnership Project Organization (3GPP) to realise the transmission of emergency messages at critical times, anywhere. Specifically, Mode 4 C-V2X supports side-link communication without relying on a base station to provide network coverage. However, Mode 4 is susceptible to several limitations, which include half-duplex transmission, packet collision, and propagation errors that will cause intermittent connectivity issues. It is also difficult to determine appropriate parameter configurations that can increase the spectrum efficiency of dense networks to facilitate reliable and low-latency networks. The objective of this paper is to investigate the effectiveness of a Mode 4 C-V2X system under different road topologies and traffic scenarios. The study adopts a Krauss vehicular mobility model based on SUMO software to model normal and dense networks in a highway and a road intersection scenario, then perform simulation using OMNET++ software to analyse the impact of different physical layer (PHY) configurations such as modulation and coding scheme, packet size, number of resource block allocation, as well as the probability of resource reservation. The results show that the optimal configuration of parameters depends on the scenario. For highway scenarios, a lower MCS and a higher number of RBs are recommended. For road intersection scenarios, a higher MCS and a lower number of RBs are recommended. The packet size should also be in accordance with the requirements of the application used. The findings of this study can be used to assist in the design of an optimal intelligent transportation system using adaptive C-V2X parameters that can be automatically adjusted under different scenarios and network conditions

Internet of Vehicles Based On Cellular-Vehicle-To-Everything (C-V2X)

In line with the development of automotive and traffic systems, high mobility and density in different road topologies cause scalability and delay issues due to frequent disconnection between communication nodes. From a safety aspect, Cellular-V2X (C-V2X) wireless technology was introduced by the Third Generation Partnership Project Organization (3GPP) to realise the transmission of emergency messages at critical times, anywhere. Specifically, Mode 4 C-V2X supports side-link communication without relying on a base station to provide network coverage. However, Mode 4 is susceptible to several limitations, which include half-duplex transmission, packet collision, and propagation errors that will cause intermittent connectivity issues. It is also difficult to determine appropriate parameter configurations that can increase the spectrum efficiency of dense networks to facilitate reliable and low-latency networks. The objective of this paper is to investigate the effectiveness of a Mode 4 C-V2X system under different road topologies and traffic scenarios. The study adopts a Krauss vehicular mobility model based on SUMO software to model normal and dense networks in a highway and a road intersection scenario, then perform simulation using OMNET++ software to analyse the impact of different physical layer (PHY) configurations such as modulation and coding scheme, packet size, number of resource block allocation, as well as the probability of resource reservation. The results show that the optimal configuration of parameters depends on the scenario. For highway scenarios, a lower MCS and a higher number of RBs are recommended. For road intersection scenarios, a higher MCS and a lower number of RBs are recommended. The packet size should also be in accordance with the requirements of the application used. The findings of this study can be used to assist in the design of an optimal intelligent transportation system using adaptive C-V2X parameters that can be automatically adjusted under different scenarios and network conditions

Effective Maintenance by Reducing Failure-Cause Misdiagnosis in Semiconductor Industry (SI)

Increasing demand diversity and volume in semiconductor industry (SI) have resulted in shorter product life cycles. This competitive environment, with high-mix low-volume production, requires sustainable production capacities that can be achieved by reducing unscheduled equipment breakdowns. The fault detection and classification (FDC) is a well-known approach, used in the SI, to improve and stabilize the production capacities. This approach models equipment as a single unit and uses sensors data to identify equipment failures against product and process drifts. Besides its successful deployment for years, recent increase in unscheduled equipment breakdown needs an improved methodology to ensure sustainable capacities. The analysis on equipment utilization, using data collected from a world reputed semiconductor manufacturer, shows that failure durations as well as number of repair actions in each failure have significantly increased. This is an evidence of misdiagnosis in the identification of failures and prediction of its likely causes. In this paper, we propose two lines of defense against unstable and reducing production capacities. First, equipment should be stopped only if it is suspected as a source for product and process drifts whereas second defense line focuses on more accurate identification of failures and detection of associated causes. The objective is to facilitate maintenance engineers for more accurate decisions about failures and repair actions, upon an equipment stoppage. In the proposed methodology, these two lines of defense are modeled as Bayesian network (BN) with unsupervised learning of structure using data collected from the variables (classified as symptoms) across production, process, equipment and maintenance databases. The proofs of concept demonstrate that contextual or statistical information other than FDC sensor signals, used as symptoms, provide reliable information (posterior probabilities) to find the source of product/process quality drifts, a.k.a. failure modes (FM), as well as potential failure and causes. The reliability and learning curves concludes that modeling equipment at module level than equipment offers 45% more accurate diagnosis. The said approach contributes in reducing not only the failure durations but also the number of repair actions that has resulted in recent increase in unstable production capacities and unscheduled equipment breakdowns

Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia

Stress-induced hyperglycemia is common in critically ill patients, but there is uncertainty about what constitutes an optimal blood glucose target range for glycemic control. Furthermore, to reduce the rate of hyperglycemic and hypoglycemic events, model-based glycemic control protocols have been introduced, such as the stochastic targeted (STAR) glycemic control protocol. This protocol has been used in the intensive care units of Christchurch and Gyulà Hospital since 2010, and in Malaysia since 2017. In this study, we analyzed the adaptability of the protocol and identified the blood glucose target range most favorable for use in the Malaysian population. Virtual simulation results are presented for two clinical cohorts: one receiving treatment by the STAR protocol itself and the other receiving intensive insulin therapy by the sliding scale method. Performance and safety were analyzed using five clinical target ranges, and best control was simulated at a target range of 6.0–10.0 mmol/L. This target range had the best balance of performance, with the lowest risk of hypoglycemia and the lowest requirement for nursing interventions. The result is encouraging as the STAR protocol is suitable to provide better and safer glycemic control while using a target range that is already widely used in Malaysian intensive care units

Probabilistic glycemic control decision support in icu: proof of concept using Bayesian network

Glycemic control in critically ill patients is complex in terms of patients’ response to care and treatment. The variability and the search for improved insulin therapy outcomes have led to the use of human physiology model based on per-patient metabolic condition to provide automated recommendations. One of the most promising solution for this is the STAR protocol which is based on a clinically validated ICING insulin and nutrition physiological model, however this approach does not consider demographical background such as age, weight, height and ethnicity. This article presents the extension to their personalized care solution by integrating per-patient demographical and upon admission to intensive care conditions to automate decision support for clinical staffs. In this context, a virtual study was conducted on 210 retrospectives critically ill patients’ data. To provide a ground, the integration concept is presented roughly, but the details are given in terms of a proof of concept using Bayesian Network, linking the admission background and the STAR control’s performance. The proof of concept study shows the feasibility and the clinical potential to employ the probabilistic method as a decision support towards a more personalized care. ************************************************************************************* Kawalan glisemik dalam pesakit kritikal di unit rawatan rapi adalah rumit dari segi tindak balas pesakit terhadap penjagaan dan rawatan. Sifat keberubahan individu dan pencarian hasil terapi insulin yang lebih baik telah membawa kepada penggunaan model matematik fisiologi manusia berdasarkan keadaan metabolik pesakit untuk memberikan cadangan rawatan secara individu. Salah satu penyelesaian yang paling menjanjikan harapan adalah protokol STAR yang berdasarkan kepada model fisiologi insulin-nutrisi-glukosa yang telah disahkan secara klinikal. Namun pendekatan ini tidak mengambil kira latar belakang demografi seperti umur, berat, ketinggian dan etnik. Artikel ini membentangkan lanjutan kepada penyelesaian rawatan secara peribadi mereka dengan mengintegrasikan informasi demografi pesakit dan keadaan mereka semasa dimasukkan ke dalam unit rawatan rapi untuk mengautomasikan sokongan keputusan untuk kakitangan unit. Dalam konteks ini, satu kajian ‘virtual’ dilakukan pada data 210 pesaki. Sebagai kajian kes, konsep integrasi dibentangkan secara kasar, tetapi butiran diberikan dari segi bukti konsep yang menggunakan Rangkaian Bayesian, menghubungkan latar belakang kemasukan ke unit dan prestasi kawalan STAR. Bukti kajian kes menunjukkan 71.43% dan 73.90% ketepatan dan kebolehlaksanaan unjuran masing-masing dengan dataset ujian. Dengan lebih banyak data, rangkaian Bayesian yang lebih baik dipercayai boleh dihasilkan. Walaubagaimanapun, keputusan ini menunjukkan kemungkinan rangkaian ini bertindak sebagai pengelas yang berkesan dengan menggunakan data dari unit rawatan rapi dan prestasi kawalan glisemik untuk menjadi asas sokongan keputusan bersifat probabilistik, peribadi dan automatic dalam unit rawatan rapi

Virtual trial of glycaemic control performance and nursing workload assessment in diabetic critically ill patients

Tight glycaemic control in critically ill patients is used to reduce mortality in intensive care units. However, its usage is debatable in reducing hypoglycaemia or accurately maintain normoglycaemia level. This paper presents the assessment for two 'wider' Stochastic TARgeted (STAR) glycemic controllers, namely Controller A (blood glucose (BG) target 4.4-8.0 mmol/L) and Controller B (BG target 4.4-10.0 mmol/L) with 1 to 3 hour nursing interventions. These controllers were assessed to determine the better control on diabetic and non-diabetic patients. 66 diabetic and 66 non-diabetic critically ill patient's data from Hospital Tunku Ampuan Afzan (HTAA) were employed for virtual trial simulations with a clinically validated physiological model. Performance metrics were assessed within the percentage time in band (TIB) of 4.4 to 8.0 mmol/L, 4.4 to 10.0 mmol/L, and 6.0 to 10.0 mmol/L. Controller A shows better performance in normoglycaemic TIB of 4.4 to 10.0 mmol/L where non-diabetic and diabetic patients achieved 92.5% and 83.8% respectively. In conclusion, Controller A is higher in efficiency and safer to be used for both patients cohorts. However, higher clinical interventions in diabetic patients within this control raise the alarm to reduce nursing workload. This is believed to improve clinical interventions burnout and ensure patient's comfortability. © 2018 Authors

Model-based glycemic control in a Malaysian intensive care unit: performance and safety study

Background: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals’ intensive care units (ICUs) since 2010. Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety. Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clinical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases. Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment. © 2019 Abu-Samah et al

Virtual trial of glycaemic control performance and nursing workload assessment in diabetic critically ill patients

Tight glycaemic control in critically ill patients is used to reduce mortality in intensive care units. However, its usage is debatable in reducing hypoglycaemia or accurately maintain normoglycaemia level. This paper presents the assessment for two ‘wider’ Stochastic TARgeted (STAR) glycemic controllers, namely Controller A (blood glucose (BG) target 4.4-8.0 mmol/L) and Controller B (BG target 4.4-10.0 mmol/L) with 1 to 3 hour nursing interventions. These controllers were assessed to determine the better control on diabetic and non-diabetic patients. 66 diabetic and 66 non-diabetic critically ill patient’s data from Hospital Tunku Ampuan Afzan (HTAA) were employed for virtual trial simulations with a clinically validated physiological model. Performance metrics were assessed within the percentage time in band (TIB) of 4.4 to 8.0 mmol/L, 4.4 to 10.0 mmol/L, and 6.0 to 10.0 mmol/L. Controller A shows better performance in normoglycaemic TIB of 4.4 to 10.0 mmol/L where non-diabetic and diabetic patients achieved 92.5% and 83.8% respectively. In conclusion, Controller A is higher in efficiency and safer to be used for both patients cohorts. However, higher clinical interventions in diabetic patients within this control raise the alarm to reduce nursing workload. This is believed to improve clinical interventions burnout and ensure patient’s comfortability

Insulin sensitivity and blood glucose level of sepsis patients in the intensive care unit

Sepsis and hyperglycemia are highly associated with increases in mortality rates, particularly in the critically ill patients. Sepsis diagnosis has been proven challenging due to delay in getting the blood culture results. Thus, often clinical experiences overrule the protocol to prevent the worsening outcome of the patients. In some cases, the erroneous clinical judgement cause antibiotic resistance and even adverse clinical outcomes. This paper investigates the correlation between two parameters; insulin sensitivity and blood glucose level among sepsis patients. The blood glucose level is measured at the bedside during the patient's stay, whereas insulin sensitivity is obtained using the validated glucose-insulin model. Thus, the insulin sensitivity is a specific parameter of the patient, unregimented of the protocol given to the patient. The same parameters, blood glucose and insulin sensitivity, are also compared to the non-sepsis patients to establish a relationship that can be used for sepsis diagnosis. Given the availability of these two parameters that can be captured rapidly and instantly, a significant relationship can, therefore, help clinicians to identify sepsis at an early stage without second-guessing

Assessment of glycemic control protocol (STAR) through compliance analysis amongst Malaysian ICU patients

Purpose: This paper presents an assessment of an automated and personalized stochastic targeted (STAR) glycemic control protocol compliance in Malaysian intensive care unit (ICU) patients to ensure an optimized usage. Patients and Methods: STAR proposes 1– 3 hours treatment based on individual insulin sensitivity variation and history of blood glucose, insulin, and nutrition. A total of 136 patients recorded data from STAR pilot trial in Malaysia (2017–quarter of 2019*) were used in the study to identify the gap between chosen administered insulin and nutrition intervention as recommended by STAR, and the real intervention performed. Results: The results show the percentage of insulin compliance increased from 2017 to first quarter of 2019* and fluctuated in feed administrations. Overall compliance amounted to 98.8% and 97.7% for administered insulin and feed, respectively. There was higher average of 17 blood glucose measurements per day than in other centres that have been using STAR, but longer intervals were selected when recommended. Control safety and performance were similar for all periods showing no obvious correlation to compliance. Conclusion: The results indicate that STAR, an automated model-based protocol is positively accepted among the Malaysian ICU clinicians to automate glycemic control and the usage can be extended to other hospitals already. Performance could be improved with several propositions