Medical costs of children admitted to the neonatal intensive care unit: The role and possible economic impact of WES in early diagnosis

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Paretic versus non-paretic stepping responses following pelvis perturbations in walking chronic-stage stroke survivors

Background: The effects of a stroke, such as hemiparesis, can severely hamper the ability to walk and to maintain balance during gait. Providing support to stroke survivors through a robotic exoskeleton, either to provide training or daily-life support, requires an understanding of the balance impairments that result from a stroke. Here, we investigate the differences between the paretic and non-paretic leg in making recovery steps to restore balance following a disturbance during walking. Methods: We perturbed 10 chronic-stage stroke survivors during walking using mediolateral perturbations of various amplitudes. Kinematic data as well as gluteus medius muscle activity levels during the first recovery step were recorded and analyzed. Results: The results show that this group of subjects is able to modulate foot placement in response to the perturbations regardless of the leg being paretic or not. Modulation in gluteus medius activity with the various perturbations is in line with this observation. In general, the foot of the paretic leg was laterally placed further away from the center of mass than that of the non-paretic leg, while subjects spent more time standing on the non-paretic leg. Conclusions: The findings suggest that, though stroke-related gait characteristics are present, the modulation with the various perturbations remains unaffected. This might be because all subjects were only mildly impaired, or because these stepping responses partly occur through involuntary pathways which remain unaffected by the complications after the stroke

Joint maintenance-inventory optimisation of parallel production systems

We model a joint inspection and spare parts inventory policy for maintaining machines in a parallel system, where simultaneous downtime seriously impacts upon production performance and has a significant financial consequence. This dependency between system components means that analysis of realistic maintenance models is intractable. Therefore we use simulation and a numerical optimisation tool to study the cost-optimality of several policies. Inspection maintenance is modelled using the delay-time concept. Critical spare parts replenishment is considered using several variants of a periodic review policy. In particular, our results indicate that the cost-optimal policy is characterised by equal frequencies of inspection and replenishment, and delivery of spare parts that coincides with maintenance intervention. In general, our model provides a framework for studying the interaction of spare parts ordering with maintenance scheduling. The sensitivity analysis that we present offers insights for the effective management of such parallel systems, not only in a paper-making plant, which motivates our modelling development, but also in other manufacturing contexts