A new strain-based finite element for plane elasticity problems

Purpose The purpose of this paper is to develop a new quadrilateral strain-based element. The element has five nodes, four at the corners as well as an internal node. Design/methodology/approach Through the introduction of the internal node, the numerical performance of the element proved to be superior to existing elements in the literature, even though a static condensation is required. Findings From several numerical examples, it is shown that convergence can be achieved with the use of only a small number of finite elements. The proposed element can be used to solve general plane linear elasticity problems resulting in excellent results. Originality/value The results obtained are comparable with those given by the robust element Q8

Perceptions of the Changing Healthcare Environment: A Florida Perspective

This study reviewed public perceptions of healthcare, including the public’s opinions of healthcare reform. The study’s objective was to examine how opinions are affected by individual differences such as age, income, race, and current insurance. It used telephone survey responses from the citizens of Florida to provide a more empirical look at the views of the population. Overall, the study findings provided important insight into the perceptions of Floridians of important components of the Patient Protection and Affordable Care Act (ACA) including cost, affordability, Medicaid expansion, and universal access to care. The results of this study indicate that whereas income, type of insurance held, race, education, and age have some impact on response to the statements posed, party affiliation is the best indicator of individuals\u27 perceptions of the policies. In addition, results suggest that policymakers should consider more effective and targeted ACA educational campaigns for those populations that are older, more educated, and with higher incomes. They also should consider identifying and implementing opportunities to expand the Medicaid program because there is such broad support for its expansion

PRESENTATION OF TOW SABIR ELEMENT RESULTS WITH IRREGULAR SHAPES

In 1985, Sabir developed two membrane finite elements having an additional nodal degree of freedom (DRILLINGROTATION). The main objective of this important development is to contribute in modeling the complex structures havingonly simple geometrical shape. In this paper, a new analytical integration expression is developed in order to model structureshave complex geometrical shape. It is of importance to know how these elements will behave when they have irregular shapes

Telehealth: Advances in Alternative Payment Models

Introduction Previous studies indicated that telehealth services may improve hospital performance. However, the extent to which these telehealth provisions would improve hospital total performance score under the hospital value-based purchasing (HVBP) programme is not clear. The aim of this study is to examine the association between telehealth provision and hospital performance. Methods We performed a retrospective analysis of the association between the provision of telehealth services and 2699 hospital’s total performance score (TPS) on the 2018 HVBP programme and its four domains. Multivariate regression models were used to analyse TPS and hospital performance on each domain. Telehealth services offered by a hospital was categorically operationalized as hospitals with no telehealth services, with one to two telehealth services, and with three or more telehealth services. Results Hospitals with one to two telehealth services have TPS (ß coefficient = 1.50; 95% confident intervals (CI): 0.28, 2.73; p \u3c 0.05) and hospitals with three or more telehealth services have higher efficiency and cost reduction (ß = 1.10; 95% CI: 0.32, 1.87; p \u3c 0.01) domain scores. However, the impact of telehealth on clinical care, person and community engagement, and safety domain scores was not significant. Discussion The expansion of hospital telehealth service provision can improve not only the efficiency of care, but also the total performance of the hospital. Since total performance is directly associated with hospital payments from the government, these findings have significant practice and policy implications. In addition, the effect of telehealth on other quality measures such as clinical care and safety needs further investigation

Outcomes of viral myocarditis in patients with and without COVID-19: a nationwide analysis from the United States

UNLABELLED: Cardiovascular complications contribute to 40% of coronavirus disease 2019 (COVID-19) related deaths. The viral myocarditis associated with COVID-19 accounts for significant morbidity and mortality. How COVID-19 myocarditis compares to other viral myocardites is unknown. METHODS: The authors conducted a retrospective cohort study using the National Inpatient Sample database to identify adult patients hospitalized for viral myocarditis in 2020 and to compare outcomes between those with and without COVID-19. The primary study outcome was in-hospital mortality. Secondary outcomes included in-hospital complications, length of stay, and total costs. RESULTS: The study population included 15 390 patients with viral myocarditis, of whom 5540 (36%) had COVID-19. After adjustment for baseline characteristics, patients with COVID-19 had higher odds of in-hospital mortality [adjusted odds ratio (aOR) 3.46, 95% CI 2.57-4.67], cardiovascular complications (aOR 1.46, 95% CI 1.14-1.87) including cardiac arrest (aOR 2.07, 95% CI 1.36-3.14), myocardial infarction (aOR 2.97, 95% CI 2.10-4.20), venous thromboembolism (aOR 2.01, 95% CI 1.25-3.22), neurologic complications (aOR 1.82, 95% CI 1.10-2.84), renal complications (aOR 1.72, 95% CI 1.38-2.13), and hematologic complications (aOR 1.32, 95% CI 1.10-1.74), but lower odds of acute heart failure (aOR 0.60, 95% CI 0.44-0.80). The odds of pericarditis, pericardial effusion/tamponade, cardiogenic shock, and the need for vasopressors or mechanical circulatory support were similar. Patients with COVID-19 had longer length of stay (7 days vs. 4 days, P\u3c0.01) and higher total costs ($21,308 vs.$14,089, P\u3c0.01). CONCLUSIONS: Among patients with viral myocarditis, COVID-19 is associated with higher in-hospital mortality and cardiovascular, neurologic, renal, and hematologic complications compared to non-COVID-19 viruses

Effect of Boundary Conditions on the Behavior of Stiffened and Un-Stiffened Cylindrical Shells

The effect of boundary conditions is very important in the analysis of cylindrical shells, and is rarely studied in the literature due to its difficult experimental simulation. For large structures such as shell roofs, the type of boundary supports is among the major factors that can minimize the stresses and deflections. In this study, experimental and numerical investigations of the effect of different boundary supports for stiffened and un-stiffened cylindrical shells were conducted. Two different models of the stiffened and un-stiffened cylindrical shells with different boundary conditions, “pinned and with rigid diaphragms”, were studied. It was shown that by using rigid diaphragms for cylindrical shells, the deflections are minimized by 80%, and by (45–50) % for the stiffened cylindrical shells. From the experimental investigations and the numerical results obtained, the efficiency of the proposed boundary support types for cylindrical shells is confirmed, which can result in economic benefits

Satisfiability by Maxwell-Boltzmann and Bose-Einstein Statistical Distributions

Recent studies in theoretical computer science have exploited new algorithms and methodologies based on statistical physics for investigating the structure and the properties of the Satisfiability (SAT) problem. We propose a characterization of the SAT problem as a physical system, using both quantum and classi-cal statistical-physical models. We associate a graph to an SAT instance and we prove that a Bose-Einstein condensation occurs in the instance with higher probability if the quantum distribution is adopted in the gen-eration of the graph. Conversely, the fit-get-rich behavior is more likely if we adopt the Maxwell-Boltzmann distribution. Our method allows a comprehensive analysis of the SAT problem based on a new definition of entropy of an instance, without requiring the computation of its truth assignments. The entropy of an SAT instance increases in the satisfiability region as the number of free variables in the instance increases. Finally, we develop six new solvers for the MaxSAT problem based on quantum and classical statistical dis-tributions, and we test them on random SAT instances, with competitive results. We experimentally prove that the performance of the solvers based on the two distributions depends on the criterion used to flag clauses as satisfied in the SAT solving process