ANALYTIC APPROXIMATE SOLUTION FOR NONLINEAR DYNAMICMODELING OF THE ROTATING ELASTIC 2D BEAM WITH A SINGLE CRACK

In this paper, the 2D lateral vibration analysis of a rotating cracked beam as a rotary structure is investigated through the Homotopy perturbation analysis and compared with the numerical Newmark-beta (Nβ) algorithm. The structure and crack are modeled as the Euler-Bernoulli (EB) theory and simple torsional spring, respectively. The nonlinear equations of motion are derived using Galerkin and the Assumed Mode Method (AMM). The system’s stability is analyzed through phase plane and time response for different angular velocities of the base, initial values, external disturbances, crack stiffness, and locations. A comparative study presents simulation results for free (first nonlinear frequency) and forced vibration. It is shown that the proposed semi-analytical approach is beneficial as it provides a benchmark for a more precise analysis and further investigation of cracked rotary structures

Prehospital emergency response times for stroke patients in Iran: a cross-sectional study

Background: Stroke is considered as one of the most important causes of emergency medical services (EMS) dispatch worldwide. Stroke is a time-sensitive condition and rapid transport of the patients improves the prognosis. In this study, we described prehospital emergency response times for stroke patients in Isfahan, Iran. Methods: In the current cross-sectional descriptive study, suspected stroke patients who were transported by EMS in Isfahan, Iran, from June 2022 to June 2023 were included. The data was extracted from patients’ files. The time interval between the receipt of a call and the EMS arrival at the scene (arrival time), the time interval between on-scene EMS arrival and the ambulance departure to the medical center (stroke scene time), and the time it takes to reach the medical center (transport time) were collected. Results:  Overall, 79 patients with a mean age of 71.56 ± 12.03 were included. EMS diagnosed 63 (79.75%) of the patients with a definite diagnosis and 14 (17.72%) with probable stroke. Two false negative results were found. The average arrival time, was 11.56 ± 6.60 minutes, on-scene stroke time was 13.85 ± 7.23 minutes and the average transport time was 11.90 ± 6.08 minutes. The mean total EMS response time was 37.90 ±11.29 minutes. Conclusion: Overall, our study showed that while the EMS transport time is longer than ideal, the total time to transport to the hospital is short enough not to affect the outcome. EMS was also found to be adept at spotting the signs of stroke and rapidly starting the process of treatment

Detection of COVID-19 Using Heart Rate and Blood Pressure: Lessons Learned from Patients with ARDS

The world has been affected by COVID-19 coronavirus. At the time of this study, the number of infected people in the United States is the highest globally (7.9 million infections). Within the infected population, patients diagnosed with acute respiratory distress syndrome (ARDS) are in more life-threatening circumstances, resulting in severe respiratory system failure. Various studies have investigated the infections to COVID-19 and ARDS by monitoring laboratory metrics and symptoms. Unfortunately, these methods are merely limited to clinical settings, and symptom-based methods are shown to be ineffective. In contrast, vital signs (e.g., heart rate) have been utilized to early-detect different respiratory diseases in ubiquitous health monitoring. We posit that such biomarkers are informative in identifying ARDS patients infected with COVID-19. In this study, we investigate the behavior of COVID-19 on ARDS patients by utilizing simple vital signs. We analyze the long-term daily logs of blood pressure and heart rate associated with 70 ARDS patients admitted to five University of California academic health centers (containing 42506 samples for each vital sign) to distinguish subjects with COVID-19 positive and negative test results. In addition to the statistical analysis, we develop a deep neural network model to extract features from the longitudinal data. Using only the first eight days of the data, our deep learning model is able to achieve 78.79% accuracy to classify the vital signs of ARDS patients infected with COVID-19 versus other ARDS diagnosed patients

Pregnant women's daily patterns of well-being before and during the COVID-19 pandemic in Finland: Longitudinal monitoring through smartwatch technology

Background: Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things-based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland.Methods: A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22-36) or late miscarriages (gestational weeks 12-21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37-42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using a smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables.Results: The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women's subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later.Conclusions: The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep.</div

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral

Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs).&nbsp;Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings.&nbsp;Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran.&nbsp;Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p&lt;0.001).&nbsp;Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions

The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Automation of nucleic acid amplification-based diagnostic assays for point-of-care use

Every year infectious diseases are among the top major causes of death worldwide. Infectious diseases disproportionately impact resource-poor areas. While most developed countries have the ability to screen and quickly detect infectious diseases in humans, animals, and plants, developing countries lack this ability. In such areas, access to medical treatment and testing facilities is severely limited. Additionally, developing countries are more densely populated, which makes infectious disease surveillance exceedingly more difficult. As a result of this, infectious diseases tend to spread more quickly and outbreaks tend to occur more often in developing countries. Additionally, the increasing rate of antimicrobial resistant infections and emergence of novel infectious diseases increase the likelihood of global pandemic occurrence. It is evident that developing novel devices for detection of infectious diseases would be greatly beneficial to global health. It is important to note that developed countries would benefit equally from such a device. Pandemics tend to burden the economy and put strain on resources even in developed countries. The impact of such a device is determined by a set of criteria put forth by the World Health Organization (WHO). Based on the ASSURED criteria, an ideal device for point-of-care (POC) diagnostics must be affordable, sensitive, specific; and yet it must also be user-friendly, rapid and robust, equipment free, and deliverable to end-users. Additionally, this device must be easily adaptable for detection of novel pathogens. The nucleic acid amplification test (NAAT) meets many of these criteria. However, NAAT’s current workflow involves many user liquid handling steps as well as a thermocycler. This thesis aims to address these issues by first automating isothermal nucleic acid amplification, followed by coupling the amplification step with the lateral-flow immunoassay (LFA), which is a paper-based diagnostic device. Thus, taking advantage of the affordability and POC features of the LFA. The aim of these efforts is to work toward the ultimate goal of developing a device that receives the patient sample, then carries out all the steps in NAAT in an automated manner and produces results with just a push of a single button

Automation of nucleic acid amplification-based diagnostic assays for point-of-care use

Every year infectious diseases are among the top major causes of death worldwide. Infectious diseases disproportionately impact resource-poor areas. While most developed countries have the ability to screen and quickly detect infectious diseases in humans, animals, and plants, developing countries lack this ability. In such areas, access to medical treatment and testing facilities is severely limited. Additionally, developing countries are more densely populated, which makes infectious disease surveillance exceedingly more difficult. As a result of this, infectious diseases tend to spread more quickly and outbreaks tend to occur more often in developing countries. Additionally, the increasing rate of antimicrobial resistant infections and emergence of novel infectious diseases increase the likelihood of global pandemic occurrence. It is evident that developing novel devices for detection of infectious diseases would be greatly beneficial to global health. It is important to note that developed countries would benefit equally from such a device. Pandemics tend to burden the economy and put strain on resources even in developed countries. The impact of such a device is determined by a set of criteria put forth by the World Health Organization (WHO). Based on the ASSURED criteria, an ideal device for point-of-care (POC) diagnostics must be affordable, sensitive, specific; and yet it must also be user-friendly, rapid and robust, equipment free, and deliverable to end-users. Additionally, this device must be easily adaptable for detection of novel pathogens. The nucleic acid amplification test (NAAT) meets many of these criteria. However, NAAT’s current workflow involves many user liquid handling steps as well as a thermocycler. This thesis aims to address these issues by first automating isothermal nucleic acid amplification, followed by coupling the amplification step with the lateral-flow immunoassay (LFA), which is a paper-based diagnostic device. Thus, taking advantage of the affordability and POC features of the LFA. The aim of these efforts is to work toward the ultimate goal of developing a device that receives the patient sample, then carries out all the steps in NAAT in an automated manner and produces results with just a push of a single button