Modeling and Optimizing Patient Flows

constructing a consistent process model and its simulation can be instrumental to be used in healthcare issues such as Consistent patient flow modeling. Current process modeling techniques used in healthcare are intuitive and imprecise such as flowcharts, unified modeling language activity diagram (UML AD) and business process modeling notation (BPMN). These techniques are vague in process description and cannot fully capture the complexities of the types of activities and types of temporal constraints between them. Additionally, to schedule patient flows; current modeling techniques does not offer any mechanism so healthcare relies on critical path method(CPM) and program evaluation review technique (PERT) that also have limitations i.e. finish-start barrier. It is imperative that temporal constraints between the start and/or end of a process needs to be specified, e.g., the start of A precedes the start (or end) of B, etc., however, these approaches failed to provide us with a mechanism for handling these temporal situations. This paper proposes a framework that provides enumeration of core concepts to describe a general knowledge base for Business and Healthcare domains. Algorithms are provided to represent the semantics of concepts i.e. based on their ontology. Furthermore, this logical basis is supported by Point graph (PG); a graphical tool, which has a formal translation to a point interval temporal logic (PITL) is used to simulate Patient flows for enhanced reasoning and correct representation. We will briefly evaluate an illustrative discharge patient flow example initially modeled using Unified Modeling Language Activity Diagram (UML AD) with the intention to compare with the technique presented here for its potential use to model patient flows

Modeling Patient Flows: A Temporal Logic Approach

Constructing a consistent process model can be instrumental in streamlining healthcare issues. Current process modeling techniques used in healthcare, such as flowcharts, unified modeling language activity diagram (UML AD), and business process modeling notation (BPMN) are intuitive and imprecise. These techniques are vague in process description and cannot fully capture the complexities of the types of activities and full extent of temporal constraints between them. Additionally, to schedule patient flows, current modeling techniques do not offer any mechanism, so healthcare relies on critical path method (CPM) and program evaluation review technique (PERT), that also have limitations i.e. finish-start barrier. It is imperative that temporal constraints between the start and/or end of a process needs to be specified, e.g., the start of A precedes the start (or end) of B, etc., however, these approaches failed to provide us with a mechanism for handling these temporal situations. This paper proposes a framework that provides enumeration of core terms/concepts to describe a general knowledge basis for Business and Healthcare domains. Definitions are provided to present the semantics of concepts i.e. based on their ontology. Furthermore, this logical basis is supported by Point graph (PG) notation; a graphical tool, which has a formal translation to a point interval temporal logic (PITL), and is used to model Patient flows suitable for enhanced reasoning and correct representation. We will evaluate an illustrative discharge patient flow example initially modeled using Unified Modeling Language Activity Diagram (UML AD) with the intention to compare with the technique presented here for its potential use to model patient flows

Giant choroid plexus papilloma of the third ventricle

Abstract are not provided by the author/publishe

Gas-producing brain abscess

A case of a known psychiatric patient who presented with rapid neurological deterioration is reported. Neuroimaging revealed a gas-producing brain abscess in left parietal lobe with a contiguous focus of infection in the adjacent bone and scalp initiated by obsessive scalp scratching. On complete surgical excision of abscess, followed by culture-based antibiotic therapy, a good neurological recovery was achieved with minimal residual deficits at follow-up

Potential drug-drug interactions in the neurology ward of a tertiary care hospital in Peshawar, Pakistan

Purpose: To identify and report the prevalence of potential drug-drug interactions (pDDIs) in a neurology ward, as well as their levels and association with risk factors.Methods: The study was conducted in the neurology ward of Northwest General Hospital Peshawar, Pakistan. Medical records of 205 randomly selected patients were retrospectively reviewed for potential drug-drug interactions using Micromedex Drug-Reax Software.Results: The total number of interactions identified were 633. About 96 % of the patients showed at least one type of potential interaction regardless of its severity. The identified pDDIs were categorized on the basis of severity, scientific evidence and onset. Based on severity, of the total of 633 pDDIs, 62.2 % were of major type while 31.8 % were of moderate type. On the basis of scientific evidence, 16.42 % were excellent type, 32.22 % in good category while fair category was the highest (55.60 %). The onset categories such as rapid (27.64 %), delayed (24.96 %) and non-specified onset (53.71 %) were also noted.Conclusion: Computerized DDIs programs are very helpful in minimizing harmful drug interactions. With this type of program, this better patient health outcomes can be achieved.Keywords: Drug-drug interaction, Patients, Drug reactio

Experimental investigation of damage progression and strength of countersunk composite joints

An experimental investigation is conducted into the damage progression and strength of bolted joints with fibre-reinforced composite laminates and countersunk fasteners. The main goal of the experimental investigation is to characterise the effect of the countersink geometry on the load-carrying capacity of single lap joints in comparison to the straight-shank case. The effects of bolt torque, clearance and countersink height ratio on the damage progression and joint strength are also studied. Experimental tests and detailed microscopy studies are conducted on a bearing test specimen with a straight-edged hole, and several single-lap joint configurations with countersunk fasteners. It is found that introduction of the countersunk hole roughly halves the bearing stress, and causes delamination for some configurations. This delamination is primarily located at the start of the countersink region, though is found to be triggered by other damage mechanisms and has only minor influence on the results. Bolt torque increases the density of through-thickness damage though limits its extension from the hole edge, whilst bolt clearance causes localisation of the damage region. Increasing the ratio of the countersink depth to the laminate thickness reduces the extent of bearing and promotes bending, with a change to net section failure at large ratios

The effect of clearance on single lap countersunk composite joints

An experimental investigation was conducted into the effects of bolt-hole clearance on the static strength and damage progression behaviour of single lap countersunk composite bolted joints. Joints were manufactured from carbon/epoxy plain weave fabric and tested with three different bolt clearance levels. The experimental results showed that the bolt-hole clearance had a minimal effect on the ultimate failure load of the bolted joint. However, a significant reduction (approx. 22%) was observed in the bearing damage initiation load, consistent with difference in the through-thickness damage profile. Finite element analysis was conducted, and was able to accurately capture the load-displacement behaviour and through-thickness damage profile of the joints