A decision support system for the development of voyage and maintenance plans for ships

The waterborne sector faces nowadays significant challenges due to several environmental, financial and other concerns. Such challenges may be addressed, among others, by optimising voyage plans, and diagnosing as early as possible engine failures that may lead to performance degradation. These two issues are addressed by the Decision Support System (DSS) presented herein, which focuses on the operation of merchant ships. For the development of voyage plans, a multicriteria decision problem is developed and handled with the PROMETHE method, while a multivariable control chart is used for the fault diagnosis problem. A MATLAB-based software implementation of the DSS has been developed adopting a modular architecture, while, in order to provide a generic software solution, the required input data are retrieved from dedicated web-services, following specific communication and data exchange protocols

Do patients accurately represent their experiences after hip and knee replacements?

Background To investigate discrepancies, if any, between the complications that patients report on the patient-reported outcome measures (PROMs) questionnaire and what is formally recorded in their medical records. Methodology A retrospective analysis of PROMs-reported complications was performed at a single elective center for all patients who had an elective primary total knee or hip replacement between April 2016 and March 2017. Corresponding patient medical records were then analyzed to correlate the PROMs with any documentation of postoperative complications, which similar to the PROMs data were categorized into wound complications, urinary complications, readmission, and further operative procedures. Results A set of 54 complete patient records were compared to the corresponding PROMs data. The combined overall positive predictive value was 0.47 while the overall negative predictive value was 0.91. Concordance between patients and the medical records was 70.4% for wound complication, 66.7% for urinary complications, 83.3% for readmission, and 96.3% for reoperation. Conclusion PROMs data are becoming increasingly important in auditing and planning healthcare provision. This study highlights a significant level of discrepancy between the PROMs-reported complication rates and those documented in the medical records. There is a visible disparity between patient perception and the medical definition of postoperative complications. Further patient education and empowerment are required in preparation for arthroplasty

Estimation of the Optimal Statistical Quality Control Sampling Time Intervals Using a Residual Risk Measure

Background: An open problem in clinical chemistry is the estimation of the optimal sampling time intervals for the application of statistical quality control (QC) procedures that are based on the measurement of control materials. This is a probabilistic risk assessment problem that requires reliability analysis of the analytical system, and the estimation of the risk caused by the measurement error. Methodology/Principal Findings: Assuming that the states of the analytical system are the reliability state, the maintenance state, the critical-failure modes and their combinations, we can define risk functions based on the mean time of the states, their measurement error and the medically acceptable measurement error. Consequently, a residual risk measure rr can be defined for each sampling time interval. The rr depends on the state probability vectors of the analytical system, the state transition probability matrices before and after each application of the QC procedure and the state mean time matrices. As optimal sampling time intervals can be defined those minimizing a QC related cost measure while the rr is acceptable. I developed an algorithm that estimates the rr for any QC sampling time interval of a QC procedure applied to analytical systems with an arbitrary number of critical-failure modes, assuming any failure time and measurement error probability density function for each mode. Furthermore, given the acceptable rr, it can estimate the optimal QC sampling time intervals

Optimal spare parts management for vessel maintenance scheduling

Condition-based monitoring is used as part of predictive maintenance to collect real-time information on the healthy status of a vessel engine, which allows for a more accurate estimation of the remaining life of an engine or its parts, as well as providing a warning for a potential failure of an engine part. An engine failure results in delays and down-times in the voyage of a vessel, which translates into additional cost and penalties. This paper studies a spare part management problem for maintenance scheduling of a vessel operating on a given route that is defined by a sequence of port visits. When a warning on part failure is received, the problem decides when and to which port each part should be ordered, where the latter is also the location at which the maintenance operation would be performed. The paper describes a mathematical programming model of the problem, as well as a shortest path dynamic programming formulation for a single part which solves the problem in polynomial time complexity. Simulation results are presented in which the models are tested under different scenarios

Comparative LCA technology improvement opportunities for a 1.5 MW wind turbine in the context of an offshore wind farm

Wind energy is playing an increasingly important role in the development of cleaner and more efficient energy technologies leading to projections in reliability and performance of future wind turbine designs. This paper presents life cycle assessment (LCA) results of design variations for a 1.5 MW wind turbine due to the potential for advances in technology to improve the performance of a 1.5 MW wind turbine. Five LCAs have been conducted for design variants of a 1.5 MW wind turbine. The objective is to evaluate potential environmental impacts per kilowatt hour of electricity generated for a 114 MW onshore wind farm. Results for the baseline turbine show that higher contributions to impacts were obtained in the categories Ozone Depletion Potential, Marine Aquatic Eco-toxicity Potential, Human Toxicity Potential and Terrestrial Eco-toxicity Potential compared to Technology Improvement Opportunities (TIOs) 1 to 4. Compared to the baseline turbine, TIO 1 showed increased impact contributions to Abiotic Depletion Potential, Acidification Potential, Eutrophication Potential, Global Warming Potential and Photochemical Ozone Creation Potential, and TIO 2 showed an increase in contributions to Abiotic Depletion Potential, Acidification Potential and Global Warming Potential. Additionally, lower contributions to all the environmental categories were observed for TIO 3 while increased contributions towards Abiotic Depletion Potential and Global Warming Potential were noted for TIO 4. A comparative LCA study of wind turbine design variations for a particular power rating has not been explored in the literature. This study presents new insight into the environmental implications related with projected wind turbine design advancements

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Geometric Variations of Modular Head-Stem Taper Junctions of Total Hip Replacements

Taper degradation in Total Hip Replacements (THR) has been identified as a clinical concern, and the degradation occurring at these interfaces has received increased interest in recent years. Wear and corrosion products produced at the taper junction are associated with adverse local tissue responses, leading to early failure and revision surgery. Retrieval and in-vitro studies have found that variations in taper design affect degradation. However, there is a lack of consistent understanding within the literature of what makes a good taper interface. Previous studies assessed different design variations using their global parameters assuming a perfect cone such as: taper length, cone angle and diameters. This study assessed geometrical variations of as-manufactured head and stem tapers and any local deviations from their geometry. The purpose of this study was to provide a greater insight into possible engagement, a key performance influencing parameter predicted by Morse taper connection theory. This was achieved by taking measurements of twelve different commercially available male tapers and six female tapers using a coordinate measurement machine (CMM). The results suggested that engagement is specific to a particular head-stem couple. This is subject to both their micro-scale deviations, superimposed on their macro-scale differences. Differences in cone angles between female and male tapers from the same manufacturer was found to create a predominately proximal contact. However, distally mismatched couples are present in some metal-on-metal head-stem couples. On a local scale, different deviation patterns were observed from the geometry which appeared to be linked to the manufacturing process. Future work will look at using this measurement methodology to fully characterise an optimal modular taper junction for a THR prosthesis