A Smart Mass Customization Design Tool: a Case Study of a Portable Ramp for Wheelchair Users

Portable ramps are generally used by wheelchair users, provide temporary solution to increase accessibility in their daily lives. Portable ramps should allow for modifications in terms of weight, length, load bearing capacity, ease of handling, storage and further design parameters. Different types of portable ramps can be found in the market; however, their modifications cannot go beyond just length modification, or they allow to select just some restricted width options. However, portable ramps are quite suitable for mass customization concept which helps to satisfy customer while being involved in design step. This study aims to determine the wheelchair users’ expectations and correspondingly to offer a smart mass customization design tool which potential users are able to interact with easily. To this end, a case study is conducted with a rollable ramp which is designed and developed within the scope of 1512 – Entrepreneurship Multi-phase Programme (Teknogirişim Sermaye Desteği Programı) of The Scientific and Technological Research Council of Turkey (TÜBİTAK). The methodology and its implementation are described elaborately, and example of a parametric smart customization tool design are illustrated in this study. First, the preliminary study is explained briefly. Afterward, the desired modification parameters are determined with literature and patent survey as well as observation and interviews with the potential users. After systematic review and evaluation of user experiences, the model is assessed

Design based exploration of medical system adoption: Case of wheelchair ramps

This study focuses on the exploration of wheelchair users\u27 expectations from portable ramps and their adoption factors, then correspondingly offers a smart mass customization design tool. Briefly, portable ramps are generally used by wheelchair users, and provide a temporary solution to increase accessibility in their daily lives. In this research, a rollable ramp was examined as this prototype was developed in a prior funded research and thesis study. Our aim in this study is to explore the critical factors of satisfaction of users\u27 and potential users\u27 of portable ramps. To maximize the usability of portable ramp in various outdoor/indoor spaces and physical structures, an efficient permutation of flexible/adjustable components is offered. The research includes flexibility and customization and many external factors effective for adoption of portable ramp. In this context, three research methods were applied; semi structured-face-to-face interviews, observation, and experimental study. The constructs of the survey were extracted from literature and patent reviews then refined during observation and interviews. Wheelchair users answered a web-based survey with multiple constructs. The survey uncovered that personalization, flexibility, extension capability, and cost is critical. As well, users prefer the chance to try the model before purchasing. The effort needed to carry and learn how to use the ramp seems to be one of the key factors. It is also found that the user\u27s life style and product match has an effect on adoption. At the end of the study, a smart mass customization design tool will be developed, which potential users or sales representatives are able to easily interact with in order to customize the portable ramp

Thrombus crossing through a patent foramen ovale

Paradoxical embolism across a patent foramen ovale (PFO) is a rare clinical entity and the thrombus is rarely caught passing through a PFO. A 65-year-old woman presented with dyspnea and pleuritic chest pain. Lower extremity venous Doppler ultrasound showed bilaterally extensive thrombosis at deep veins. Transthoracic echocardiographic examination showed two masses in both left and right atriums. In transesophageal echocardiography (TEE) interatrial septum was thin and aneurysmatic and a thrombus wedged through a patent foramen ovale and lodged in both atriums was demonstrated. We considered this mass as a thrombus crossing through a patent foramen ovale. He refused surgery and during anticoagulation therapy the patient had brachial artery embolism. Embolectomy material was reported as a thrombus. (C) 2007 Elsevier Ireland Ltd. All rights reserved

Coronary ischemia induced Wolf Parkinson White syndrome

A 60-year-old woman was admitted to cardiology clinic because of typical chest pain. The presenting electrocardiography (ECG) revealed sinus rhythm and T wave inversion on inferolateral wall. Her chest pain relapsed at second day of admission and electrocardiogram recorded during chest pain had ECG changes consistent with Wolf Parkinson White (WPW) syndrome. She underwent cardiac catheterization and borderline lesion was detected in proximal of left anterior descending artery and direct stent implantation was performed. This is the first case report in which acute ischemia may induce typical ECG changes of WPW in a patient with concealed WPW syndrome. We concluded that acute coronary ischemia may manifest concealed WPW syndrome. (C) 2007 Elsevier Ireland Ltd. All rights reserved

Prognostic value of right ventricular strain pattern on ECG in COVID-19 patients

Objective: COVID-19 spread worldwide, causing severe morbidity and mortality and this process still continues. The aim of this study to investigate the prognostic value of right ventricular (RV) strain in patients with COVID-19

Platelet activation and inflammatory response in patients with non-dipper hypertension

Objective: Non-dipper hypertensives had about three times the risk of atherosclerotic events than hypertensives whose blood pressure was > 10% lower at night compared to daytime (dippers). Platelet activation and inflammatory response may derive from most atherosclerotic events. Mean platelet volume (MPV) is a determinant of platelet activation and high sensitive C-reactive protein (hs-CRP) is the best candidate assay to identify and monitor the inflammatory response. We aimed to determine whether MPV and hs-CRP levels are elevated in non-dipper patients compared to dippers and healthy controls. In addition, we tried to find out if MPV and CRP are related to each other or not in non-dipper hypertensives

Plasma B-type natriuretic peptide in diagnosing inferior myocardial infarction with right ventricular involvement

Background B-type natriuretic peptide (BNP) is secreted from the ventricles in response to volume expansion and pressure overload. We aimed to investigate plasma BNP levels in inferior myocardial infarction (MI) with and without right ventricular MI (RVMI)

Left Ventricular Strain and Strain Rate Echocardiography Analysis in Patients with Total and Subtotal Occlusion in the Infarct-Related Left Anterior Descending Artery

Background: Numerous studies show that percutaneous coronary intervention has no clinical benefit in patients with total occlusion. Both regional and global left ventricle (LV) functions may be evaluated in detail by strain (S) and strain rate (SR) echocardiography. The purpose of this study is to evaluate whether S and SR echocardiography may be used to determine the total occlusion. Method: Sixty stable patients who have total or subtotal occlusion in the infarct-related left anterior descending artery were enrolled (Total occlusion group: 35 and subtotal occlusion group: 25 patients). In all patients, LV longitudinal S and SR data were obtained from total 14 segments. Results: S values of middle and apical segments of LV were significantly lower in the total occlusion groups. In SR analysis, middle and apical values of all walls were significantly different between the groups. The total SR of the middle and apical segments was significantly lower in the total occlusion group (respectively, total SR in middle segments: -3.4 +/- 0.8% vs. -4.6 +/- 1.0%, P < 0.00001 and total SR in apical segments: -1.7 +/- 0.5% vs. -2.8 +/- 0.6%, P = 0.001). The total SR values of four walls were also significantly lower in the total occlusion group (-10.3 +/- 2.0% vs. -13 +/- 3.1%, P < 0.0001). For predicting total occlusion, the highest sensitivity levels (84%) were obtained in SR of middle-anterior segment. SR of middle-septum and middle-lateral segments has the highest specificity levels (86%). Conclusion: Total occlusion in stable patients with acute coronary syndrome has an unfavorable effect on the LV regional and global functions. Patients with total occlusion may be identified by S and SR echocardiography. (Echocardiography 2011;28:203-209)