Heart surgery waiting time: Assessing the effectiveness of an action

Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. Patients and Methods: This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Results: Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. Conclusions: It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for increasing patients’ emotionally readiness. © 2015, Iranian Red Crescent Medical Journal

Semantic frames of tašxis (“identification”) in Persian: A corpus-based study

One of the lexical conceptual relations in language is the polysemy relation by which Finch (2000) and Saeed (2009) mean that a word or lexeme has more than one meaning. In polysemy, out of the polysemous word, multiple meanings are interpreted which are closely related to each other. According to what Richards and Schmidt (1985) define, the semantic units composed of a sequence of events or affairs which are relevant to specific situations evoke their own semantic frames. In fact, a frame is a representation of the context including the sentence in which linguistic items are presented (Matthews, 1997). The concept of Frame was primarily proposed by Fillmore (1977; 1982; 1985) in 1970s. The present research has been done in two phases with the goal of comparing the semantic frames of the word tašxis (Identification) by determining the relationship among them in a way that first the sentences containing it were looked up in the Persian Corpus of Bijankhan. Then, the sentences including tašxis (Identification) were separated from the sentences comprising different inflectional forms of the verb tašxis dādan (to identify). Afterwards, each sentence was converted into its equivalent noun/adjective phrase. In the second phase, the English equivalents of Identification in each phrase were obtained from three different Persian to English dictionaries to be able to extract the semantic frames for them. After extracting the frames, each English counterpart called Lexical Unit in the FrameNet alongside its semantic frame was compared to other frames and ultimately the following conclusions were drawn: the contexts where Identification is used are classified into 5 categories as linguistics, medical science, law, security checking and politics. Regarding the same usage of some words in two categories, four semantic frames are evoked out of five contexts all of which share the concept of the capability of making distinction and that of making decision

A Comparative Analysis of the Price of Insulin in Canada and the United States

There\u27s frequent discourse regarding the rising cost of insulin in the US. Insulin is a drug that over 7 million people rely on for survival, and it has tripled in cost over the last decade. The pricing regulation of the drug is dependent on multiple stakeholders, including wholesalers, pharmacy benefit managers, and manufacturing companies. Due to the lack of governmental intervention in the process of pharmaceutical cost regulation in the US, data on the price negotiations and the rebate system between these entities is unavailable in public records, making it difficult to determine a primary cause as the root of the issue of insulin costs. This paper attempts to understand the policies in place that impact the nature of insulin affordability and assesses the Canadian regulation of the cost of insulin to understand the discrepancy between the affordability in Canada in comparison to the affordability of insulin in US. A literature review was conducted to examine the policies and congressional discourse in order to analyze the current insulin market and the policies currently in discussion. Ultimately the discrepancy between the nature of health care in Canada and in the US is characterized by the underlying social principles that govern each country in terms of health policy. The Canadian health care system is built on the foundation that health care is a human right, whereas in the United States, health care is a commodity. The effect of this ideology is observed in the costs and regulation of pharmaceutical insulin

(R2025) Improving the LDA Linear Discriminant Analysis Method by Eliminating Redundant Variables for the Diagnosis of COVID-19 Patients

Nowadays, with the increase in data production speed, the process of data analysis has faced many problems because this big data is often accompanied by plug-in data and redundant data. Therefore, the use of dimensional methods in the pre-data analysis stage is necessary. In data mining, dimensional reduction is one of the most important steps in data pre-processing. Principal component analysis (PCA) and linear discriminant analysis (LDA) are often used to reduce dimensions in data mining. The LDA method is a monitored and controlled method but the PCA is not controlled method. When the number of samples in classes is large and when training data is uniformly distributed, LDA works better. LDA is a traditional statistical method for classification. In this research, we improve the LDA method by identifying and removing redundant variables. Then we use this improved LDA method to classify the diagnosis data of Covid-19 patients

A simulation-based optimization model for balancing economic profitability and working capital efficiency using system dynamics and genetic algorithms

Economic uncertainty has been increasing, as evidenced by recent fluctuations in global markets and unpredictable economic indicators such as volatile demand, stock market fluctuations, and unpredictable interest rates. Economic profitability and working capital efficiency are pivotal indicators of a business's financial health, both of which are adversely impacted by economic uncertainty. However, these metrics may diverge as distinct objectives drive them. There exists a gap in the literature regarding effective strategies for managing the trade-off between these metrics under economic uncertainty. This study addresses this gap by introducing a simulation-based optimization model that integrates system dynamics simulation and genetic algorithms. The proposed model aims to balance economic profitability and working capital efficiency within inventory management under partial trade credit. A recent real case study demonstrates the model's applicability and reveals its superiority over conventional system dynamics simulation modeling. With its capacity to inform strategic and tactical decision-making, this model emerges as a valuable tool for supply chain and financial managers seeking to ensure financial stability amidst economic volatility

A Study of Formation and Dissociation of Gas Hydrate

The estimation of gas hydrate volume in closed systems such as pipelines during shut-in time has a great industrial importance. A method is presented to estimate the volume of formed or decomposed gas hydrate in closed systems. The method was used to estimate the volume of formed gas hydrate in a gas hydrate crystallizer under different subcoolings of 0.2, 0.3, 0.6 and 4.6 degrees C, and initial pressures of 2000 and 2500 psi. The rate of gas hydrate formation increased with increases in subcooling and initial pressure. The aim of the second part of the study was the evaluation of the formation of gas hydrate and ice phases in a super-cooled methane-water system under the cooling rates of 0.45 and 0.6 degrees C/min, and the initial pressures of 1500, 2000 and 2500 psi, in pure and standard sea water-methane gas systems. The high cooling rate conditions are likely to be present in pipelines or around a wellbore producing from gas hydrate reservoir. Results showed that the initial pressure and the chemical composition of the water had little effect on the ice and gas hydrate formation temperatures, which were in the range of -8 +/- 0.2 degrees C in all the tests using the cooling rate of 0.45 degrees C/min. In contrast, the increase in the cooling rate from 0.45 to 0.6 degrees C/min decreased the ice and gas hydrate formation temperatures from -8 degrees C to -9 degrees C. In all tests, ice formed immediately after the formation of gas hydrate with a time lag less than 2 seconds. Finally, an analytical solution was derived for estimating induced radial and tangential stresses around a wellbore in a gas hydrate reservoir during gas production. Gas production rates between 0.04 to 0.12 Kg of gas per second and production times between 0.33 to 8 years were considered. Increases in production time and production rate induced greater radial and tangential stresses around the wellbore

COMPARISON OF BEARING CAPACITY OF FOOTINGS WITH SAME AREA RESTING ON REINFORCED SAND

ABSTRACT: The Paper presented from an experimental study for circular and square footing with same area that resting on sand bed. The steel model footing with 12 cm diameter (113 cm 2 ) and square footing with 10.6 cm width in sand with relative density 60% were used. For reinforced conditions geogrid layers were used. The settlementload responses of the tests were investigated. Results indicated that ultimate bearing capacity increased in square footing in comparison with circular footing, and when reinforcements used with embedment depth (u/D=0.42 or u/B=0.47), the bearing capacity ratio (BCR) was increased greatly in circular footing in comparison with square footing. The BCR increases with increasing the number of geotextile layers for both of the footings (square and circular) but for reinforced conditions the geogrid layers have a better effect for circular footing in comparison with square footing and the rate of increasing BCR for circular footing is higher than square footing

Deploying hybrid modelling to support the development of a digital twin for supply chain master planning under disruptions

Supply chains operate in a highly distuptive environment where a SC master plan should be updated in line with disruptions to ensure that a high service level is provided to customers while total cost is minimised. There is an absence of knowledge of how a SC master plan should be updated to cope with disruptions using hybrid modelling. To fill this gap, we present a hybrid modelling framework to update a SC master plan in presence of disruptions. The proposed framework, which is a precursor to a SC digital twin, integrates simulation, machine learning, and optimisation to identify the production, storage, and distribution values that maximise SC service level while minimising total cost under disruptions. This approach proves effective in a SC disrupted by demand increase and lead time extension. Results show that employing hybrid modelling leads to a noticeable improvement in service level and total cost. The outcome of the new knowledge on using hybrid modelling for managing disruptions provides essential learning for the extension of modelling through a digital twin for SC master planning. We observe that in the presence of disruptions it is more economical to keep higher inventory at downstream SC members than the upstream SC members