Managing Elective and Non-elective Case Assignments for an Operating Room Suite

The success of operating room management depends on all levels of decision making, from strategic to tactical and operational decisions. One key decision in systems with block booking is to assign sufficient amount of block time to surgeons and surgery groups. While the typical method of block assignment identifies the share of surgery groups from OR times based on average of past usage, this method does not count for the difference between cost of under and overtime. One of the goals of this research is to develop a decision framework for block assignment. This work is presented in chapter two. In this part first, I provide with the linear program that finds the length of block assigned to surgery groups while considering the amount of past undertime and overtime. This model then simplifieded through valid assumptions. In addition, a case study is conducted to support the usefulness of the method. The results show that 12 months of past data is sufficient amount of data to use in this method. Also, this method of block allocation out performs the existing time series method in literature. Another key decision in an OR suite is to how manage elective and non-elective surgeries. The short and long term decisions regarding these two surgery types can change the waiting time of patients and the number of turned away surgeries. In order to accommodate elective and non-elective surgeries at lower cost to system and patients, both short and long term decisions play important roles. The long term decisions regarding the combination of rooms to choose in the system as well as the allocation to choose with the selected room combination are important decisions for OR managers. For short time decision making on the day of surgery a policy that indicate how to use share resources among the two surgery types is another important decision that OR managers need to nd an answer to. In this research I try to provide with methods and models that can guide managers in decision making process. In this research using Markov decision processes (MDP), I introduce a model that could be used to find the optimal policy for use of operating rooms that are considered as shared resources while minimizing the overall cost of the system including waiting, turn-away and overtime. For that I focus on the system with a dedicated OR to non-elective surgeries and a flexible (shared) OR. I also model this system using simulation with Arena, by relaxing the MDP assumptions of steady state and the arrival and surgery times to find a policy that can minimize the cost of system. The simulation better reflects the real system of hospitals however it takes a long time to find a policy using taking simulation approach. In addition to that, the policy from simulation does not guarantee optimality. Moreover, the result of case study shows that relaxing MDP assumptions, simulation model finds the same policy as MDP. However, the MDP model could find an optimal policy in seconds. Although MDP could be used to model the most common existing combinations of operating rooms, however, the optimal policy from MDP may be hard to implement. Therefore I use Markov chain to model combinations of operating rooms and define policies to be used on the day of surgery for accommodating elective and non-elective surgeries. I compare the performance of systems under defined policies by considering input parameters at different levels. I also consider several allocations under each system to find the best system and allocation. Results of this work shows that overall system with all flexible ORs has the minimum cost. However, some other systems may perform better in specific situations and scenarios. The best policy (among the studied policies) is depending on the room combinations and the chosen allocation

Criteria of institutional selection, service quality, adjustment and satisfaction among international postgraduate students

Increasing trends of students going abroad for further studies in the last two decades has motivated higher education institutions to find the criteria of institutional selection of international students, improve the service quality of education and reduce the adjustment problems of these students to keep them satisfied. Malaysia is one of the countries which always try to achieve high academic standards in the education system to reach the global market. For this purpose, this study used two sets of quantitative questionnaire and distributed them among two groups of international postgraduate students in Universiti Teknologi Malaysia (UTM). The first questionnaire is SERVQUAL, Adjustment and Satisfaction (SAS) questionnaire which was distributed among 353 respondents in UTM. Four dimensions of service quality namely tangible, consistency, assurance and compassion were obtained. Furthermore, high level of adjustment and low level of service quality and satisfaction from the respondents’ perspective were observed. In addition, the study represented the relationship and differences in these based on demography. The second instrument is Analytical Hierarchy Process (AHP) Questionnaire which was distributed to 30 international postgraduate students in UTM. AHP findings indicated that “Academic Qualification” is the most satisfactory criterion of institutional selection while “Study Abroad” is the lowest. Additionally, this study was able to show that international postgraduate students in UTM have negative perceptions of education service quality in this university. In the case of UTM, international postgraduate students tend to compare UTM with the education in academic universities of US, UK, Australia and Europe as the standard and general class for higher education and they may also compare the fees with service quality in UTM

LEARNING AND STUDY STRATEGIES INVENTORY (LASSI) AND ITS RELATIONSHIP WITH UNIVERSITY STUDENTS' ACADEMIC ACHIEVEMENT

Lack of learning and study strategies (LASS) is one of the most important reasons for frustration and academic failure in student, so learning and study strategies resemble a tool applied in solving academic problems, assisting the students to develop the skills required in their academic course. Identifying and enhancing these strategies helps the person go through college education successfully depending on their own capabilities, discovering and strengthening them. So, the aim of the present study is the use of Learning and Study Strategies Inventory (LASSI) and its relationship with university students' academic achievement. The study results did not show remarkable relationship between the three main LASS and academic achievement (AA) among students of Guilan University of Medical Science and levels of LASS are very low among these students. Concerning the criticality of the students' AA, the academicians of this university are recommended to take some measures in order to decrease academic failure and improve it via boosting the students' knowledge and skill.Keywords: study strategies, students, academic achievement, learnin

The Role of Transitional Justice in Reconstruction of Relations between Parties in the Peacebuilding Process in War-Torn Societies after Civil Conflict, Riots, and Protests Leading to Violence

Reconstruction of post-conflict relations in a post-conflict country is at the core of addressing the issue of peacebuilding and transitional justice as a means of establishing peace and preventing the recurrence of conflict in such societies. The main questions of the discussion are whether it is possible to create trust in fragmented and war-torn societies and how the reconstruction of relations between the involved parties achieved in the post-conflict period is. The current research is based on the opinion that the reconstruction of relations between the parties in the post-conflict period in war-torn societies through transitional justice tools can help consolidate peace and prevent the return of conflict. Transitional justice processes are among the influential factors that play a role in the peacebuilding process, especially in its communication dimension. The present research seeks to explain an integrated approach to the transitional justice process; an approach that involves rebuilding relationships through the elements and mechanisms of transitional justice, such as justice, truth-telling, acknowledgment, apology, forgiveness, and the like. Utilization of library data and international documents and procedures in the form of descriptive-analytical research has helped this study to prove this approach

Green and practical synthesis of benzopyran and 3-sunstituted coumarin derivatives by Brønsted acid ionic liquid [(CH2)4SO3HMIM][HSO4]

Different benzopyran and 3-substituted coumarin derivatives were synthesized by a green and practical procedure in the presence of catalytic amount of Brønsted acid ionic liquid (BAIL) [(CH2)4SO3HMIM][HSO4] in water.KEY WORDS: Benzopyran derivatives, 3-Substituted coumarin derivatives, Brønsted acid ionic liquid, 1-(4-Sulfonic acid)butyl-3-methylimidazolium hydrogen sulfate Bull. Chem. Soc. Ethiop. 2011, 25(2), 315-320.

Cardio-Oncology and the COVID-19 Pandemic

As one of the novel interesting fields of cardiology, cardio-oncology focuses on monitoring, detecting, and treating cardiovascular diseases caused due to chemotherapy or radiotherapy side effects. It has been observed that cardiovascular patients have a higher risk of viral infections and poorer treatment outcomes. COVID-19 is a disease caused by the new coronavirus, SARS-CoV-2, which emerged in Wuhan, China, in 2019 and then distributed worldwide. Recent evidence showed that the risk of COVID-19 and its mortality rate is higher in patients suffering from cardiovascular side effects of cancer therapies. Additional diagnosis complexity in cardio-oncology is another problem due to overlapping with COVID-19. Therefore, the cardio-oncology community had to re-evaluate the best clinical care in the COVID-19 pandemic. The present study aims to review previous studies focusing on the interaction between COVID-19 and cardio-oncology, which will pave the way for studying human diseases overlapping with COVID-19

Comparing Neonatal Intensive Care Unit Nursing Support in Mothers With Newborn Abstinence Syndrome (NAS) and Mothers of Healthy Neonates

Background: The experience of having neonates in the Neonatal Intensive Care Unit (NICU) is a psychological crisis. It might cause many emotional problems for parents. Entire parental support is among the duties of the healthcare team. Therefore, this study aimed to compare the nursing support received by the mothers with Newborn Abstinence Syndrome (NAS) and the mothers of other neonates admitted to the NICU.Methods: The present cross-sectional descriptive-analytic study was conducted in the selected hospitals in Kerman Province, Iran. In total, 62 mothers with NAS and 61 non-addicted mothers with neonates admitted to the NICU were selected through convenience sampling method. The inclusion criteria were neonates under the care of parents, neonate admitted to the NICU for at least 24 hours, opiate dependence in the case group mothers, and no substance dependence in the control group mothers. The amount of nursing support for mothers having neonates with NAS was compared with that of the control mothers. The study groups were homogenized in terms of the study variables (neonate age, gender, and the duration of hospitalization). The required data were collected by the Nurse-Parent Support Tool (NPST) and analyzed in SPSS.Results: The study results revealed that among the neonates of 123 mothers, 75 (60.97%) were boys, and 58(39.02%) were girls. The majority of neonates in both groups were breastfed. The Mean±SD age of the mothers in the case and control group were 31.93±7.25 and 28.99±4.36 years, respectively. The nursing support level was desirable in both groups, and no significant difference was found in this regard (P>0.05). Furthermore, the level of nursing support in emotional, information-communication, self-esteem, and quality caregiving support dimensions was desirable in both groups.Conclusion: The obtained results revealed that nurses’ support was desirable in both groups. The prevalence of maternal addiction and the impact of this social harm on neonates who were admitted are essential. Furthermore, families having neonates with NAS need more support from the healthcare staff and nurses, in comparison with healthy parents; thus, the importance of this issue should be addressed in training and briefing courses for nurses

A Novel Neural Network Approach for Predicting the Arrival Time of Buses for Smart On-Demand Public Transit

Among the major public transportation systems in cities, bus transit has its problems, including more accuracy and reliability when estimating the bus arrival time for riders. This can lead to delays and decreased ridership, especially in cities where public transportation is heavily relied upon. A common issue is that the arrival times of buses do not match the schedules, resulting in latency for fixed schedules. According to the study in this paper on New York City bus data, there is an average delay of around eight minutes or 491 seconds mismatch between the bus arrivals and the actual scheduled time. This research paper presents a novel AI-based data-driven approach for estimating the arrival times of buses at each transit point (station). Our approach is based on a fully connected neural network and can predict the arrival time collectively across all bus lines in large metropolitan areas. Our neural-net data-driven approach provides a new way to estimate the arrival time of the buses, which can lead to a more efficient and smarter way to bring the bus transit to the general public. Our evaluation of the network bus system with more than 200 bus lines, and 2 million data points, demonstrates less than 40 seconds of estimated error for arrival times. The inference time per each validation set data point is less than 0.006 ms

A Projection-Based Support Vector Machine Algorithm for Induction Motors’ Bearing Fault Detection

This paper proposes a binary fault detection algorithm for detecting inner raceway bearing faults in a 4KW induction motor. The algorithm uses Support Vector Machine (SVM) and Projection Recurrent Neural Network (PRNN) techniques and is based on data collected experimentally at different speeds and load conditions. Time and frequency contents of the three-phase stator currents are analysed using Discrete Wavelet Transform (DWT), Power Spectral Density (PSD), and cepstrum analysis. A feature set is obtained using various statistical measures, and feature selection algorithms are used to select the most relevant features. The SVM is then trained using these features, and its optimisation problem is formulated as Constrained Nonlinear Programming (NCP). A PRNN is proposed to solve the NCP and obtain the optimal decision boundary of the SVM. The study demonstrates that the accuracy of the algorithm depends on the type of kernel function and the number of relevant features selected. The results suggest that the proposed algorithm is effective in detecting inner raceway bearing faults in induction motors

Richard Ford's The Bascombe Trilog from Ego Psychology Perspective

Richard Ford's The Bascombe Trilogy manifests vivid traces of psycho-social and intrapersonal conflicts. The deep correlation between the historical and the personal in Ford's trilogy can be analyzed from the perspective of Erik Erikson's ego psychology and the emphasis he puts on the social and cultural factors on identity formation. The last four stages of ego development proposed by Erikson are utilized in this research to unravel the mechanisms behind the main character's individuation. "Role diffusion" and "repudiation" in adulthood, "intimacy" and "isolation" in young adulthood, "generativity" and "stagnation" in middle adulthood, and finally, "integrity" and "despair" in old adulthood compose the theoretical framework of this study. The main question to be answered in the process of this study is: How does Ford depict the multiple social, cultural, and historical impacts of American nationalism on Frank's character from his childhood to adolescence? The researchers show that the first two stages result in role confusion and isolation due to the lack of solid historical background, absence of reliable role models, and traumatic experiences such as war. The point is, in these novels, Ford weaves personal identity with national identity, displaying multiple historical and cultural subjectivity models already set for American-ness as his main character seeks solutions to evade them through therapeutic self-fashioning. Tracing the last two stages of Erikson's ego psychology in the novels bears witness to the possibility of generativity and integrity only through reconciliation with mortality and putting into practice the senses of communality and nurture. It can be concluded that Ford's trilogy is looking for a loophole from all the confusion, isolation, and alienation in the postmodern mediatized world of political lies and personal illusions; a spark of integrity that is lit not by self-delusion and shibboleths, but realizing the reality of mortality, the need for communality and nurture