Scheduling of home health care services based on multi-agent systems

Home Health Care (HHC) services are growing worldwide and, usually, the home care visits are manually planned, being a time and effort consuming task that leads to a non optimized solution. The use of some optimization techniques can significantly improve the quality of the scheduling solutions, but lacks the achievement of solutions that face the fast reaction to condition changes. In such stochastic and very volatile environments, the fast re-scheduling is crucial to maintain the system in operation. Taking advantage of the inherent distributed and intelligent characteristics of Multi-agent Systems (MAS), this paper introduces a methodology that combines the optimization features provided by centralized scheduling algorithms, e.g. genetic algorithms, with the responsiveness features provided by MAS solutions. The proposed approach was codified in Matlab and NetLogo and applied to a real-world HHC case study. The experimental results showed a significant improvement in the quality of scheduling solutions, as well as in the responsiveness to achieve those solutions.info:eu-repo/semantics/publishedVersio

Effects of low-intensity continuous ultrasound on hematological parameters of rats

Background: Low intensity ultrasound (US) has some well-known bio-effects which are of great importance to be considered. Objective: We conducted the present study to investigate the effects of low intensity continuous ultrasound on blood cells count in rat. Methods: Rats were anesthetized and blood samples were collected before US exposure. Then, they were exposed to US with nominal intensity of 0.2 W/cm2 at frequency of 3 MHz for a period of 10 minutes and this protocol was repeated for 7 days. Twenty four hours after the last US exposure, secondary blood samples were collected and the changes in blood parameters were evaluated. Results: Analysis revealed that platelets, hematocrit (HCT) and hemoglobin (HGB) were significantly different between experimental and sham groups but no difference between sham and control groups was observed. The results show that HCT and HGB of exposed rats were significantly reduced. Conclusion: This study shows that low intensity US may lead to side effects for hematological parameters such as reduction in the levels of HGB and HCT. © 2016 Shiraz University of Medical Sciences. All rights reserved

An Algorithm Informed by the Parathyroid Hormone Level Reduces Hypocalcemic Complications of Thyroidectomy

Ó The Author(s) 2010. This article is published with open access at Springerlink.com Background Measurement of the parathyroid hormone (PTH) level following total thyroidectomy (TTx) may allow prediction of postoperative hypocalcemia. We present an algorithmic method of managing hypocalcemia preemptively, based on the PTH level 1 h after operation. Materials and methods We examined 423 consecutive patients undergoing TTx at a single institution. A subset of patients were managed using an algorithm involving routine postoperative oral calcium administration and the early addition of oral calcitriol in patients with a low 1-h postoperative PTH level. Algorithm patients were compared to a concurrent, conventionally managed group. Outcomes measured included serum calcium levels, symptoms of hypocalcemia, postoperative complications, and receipt of intravenous (IV) calcium. Results The algorithm was applied in 135 patients, and 288 patients were managed conventionally. Critically low calcium levels (total calcium \7.5 mg/dl [1.88 mmol/l] or ionized calcium \0.94 mmol/l) were less common in algorithm patients (10.6 % vs. 25.3%; p \ 0.005). Much of this difference was attributable to the protective impact of the algorithm on patients undergoing TTx for cancer, 30% of whom developed critically low calcium levels when managed conventionally. Among patients requiring IV calcium, algorithm patients received fewer doses (1.29 vs

The Role of Inflammatory Mediators in the Pathogenesis of Otitis Media and Sequelae

This review deals with the characteristics of various inflammatory mediators identified in the middle ear during otitis media and in cholesteatoma. The role of each inflammatory mediator in the pathogenesis of otitis media and cholesteatoma has been discussed. Further, the relation of each inflammatory mediator to the pathophysiology of the middle and inner ear along with its mechanisms of pathological change has been described. The mechanisms of hearing loss including sensorineural hearing loss (SNHL) as a sequela of otitis media are also discussed. The passage of inflammatory mediators through the round window membrane into the scala tympani is indicated. In an experimental animal model, an application of cytokines and lipopolysaccharide (LPS), a bacterial toxin, on the round window membrane induced sensorineural hearing loss as identified through auditory brainstem response threshold shifts. An increase in permeability of the blood-labyrinth barrier (BLB) was observed following application of these inflammatory mediators and LPS. The leakage of the blood components into the lateral wall of the cochlea through an increase in BLB permeability appears to be related to the sensorineural hearing loss by hindering K+ recycling through the lateral wall disrupting the ion homeostasis of the endolymph. Further studies on the roles of various inflammatory mediators and bacterial toxins in inducing the sensorineumral hearing loss in otitis media should be pursued

Longshore sediment transport estimation using a fuzzy inference system

Accurate prediction of longshore sediment transport in the nearshore zone is essential for control of shoreline erosion and beach evolution. In this paper, a hybrid Adaptive-Network-Based FUZZY Inference System (ANFIS), Fuzzy Inference System (FIS), CERC, Walton-Bruno (WB) and Van Rijn (VR) formulae are used to predict and model longshore sediment transport in the surf zone. The architecture of ANFIS consisted of three inputs (breaking wave height), (breaking angle), (wave period) and one output (longshore sediment transport rate). For statistical comparison of predicted and measured sediment transport. bias, root mean square error and scatter index are used. The longshore sediment transport rate (LSTR) and wave characteristics at a 4 km-long beach on the central west coast of India are used as case Studies. The CERC, WB and VR methods are also applied to the same data. Results indicate that the errors of the ANFIS model in predicting wave parameters are less than those of the empirical formulas. The scatter index of the CERC, WB and VR methods in predicting LSTR is 51.9%, 27.9% and 22.5%, respectively, while the scatter index of the ANFIS model in the prediction of LSTR is 17.32%. A comparison of results reveals that the ANFIS model provides higher accuracy and reliability for LSTR estimation than the other techniques. (C) 2008 Elsevier Ltd. All rights reserved

Effect of ejaculation on serum prostate specific antigen level in screening and non-screening population

Background: The serum prostate specific antigen (PSA) levels are used for prostate cancer screening. Some conditions such as prostatitis, manipulation, and prostate cancer could influence on serum PSA. The impact of ejaculation on serum PSA is controversial. The aim of our study was to evaluate the relation of ejaculation and the levels of serum PSA. Materials and Methods: In this cross-sectional study, 60 healthy voluntary men below and over 50 years during the year 2009-2011 were participated. After history taking, physical examination, and identical lower urinary tract symptoms score (American Urologic Association Score = AUA); three blood samples were taken before, 1 and 24 h after ejaculation. Results: Patients categorized into a non-screening group (age less than 50 years, n = 25), and screening group (age = 50 years, n = 35). Our data showed significant PSA rising in both groups 1 h after ejaculation (P value < 0.05); however, comparison of PSA levels in both groups, before and 24 h after ejaculation showed no significant differences. Spearman coefficient of correlation was showed a positive correlation between PSA in all stage and AUA score in the second group, but there were no such correlation in the first group. Conclusion: There was a significant relationship between ejaculation and the levels of serum PSA in screening and non-screening patients. However, in non-screening men significant rising of PSA after 1 h of ejaculation was not important clinically (not achieve to greater than 4 ng/ml). Taking a history of ejaculation in men older 50 years especially with high AUA score could prevent false positive results and subsequent un-necessary work-ups

Cross-shore sediment transport estimation using fuzzy inference system in the swash zone

The interactions between fluid and sediment in the swash zone dominate the erosion or accretion of the beach, and they act as boundary conditions for nearshore hydrodynamic and morphodynamic models. Thus, the evaluation of sediment transport is of particular importance for many coastal processes and the design of coastal structures. In this paper, unlike conventional approaches, Fuzzy Inference System (FIS) and Adaptive-Network-Based Fuzzy Inference System (ANFIS) methods are used for the prediction and simulation of cross-shore sediment transport in the swash zone. The ANFIS and FIS are established using the free stream velocity time series, Shields parameter and antecedent sediment data. Statistical measures were used to evaluate the performance of the models. The cross-shore sediment transport rate and swash velocity time series for the swash experiments of Masselink and Hughes (1998) were used as case studies. Predicated on numerical results, it is found that the ANFIS-based predictions are slightly superior to the FIS-based predictions. Furthermore, numerical examples manifest that the neuro-fuzzy approach provides superior accuracy in sediment transport modeling without incorporating different multipliers for uprush and backwash