Hybrid Conceptual Modeling for Simulation: An Ontology Approach during Covid-19

The recent outbreak of Covid-19 caused by SARS-CoV-2 infection that started in Wuhan, China, has quickly spread worldwide. Due to the aggressive number of cases, the entire healthcare system has to respond and make decisions promptly to ensure it does not fail. Researchers have investigated the integration between ontology, algorithms and process modeling to facilitate simulation modeling in emergency departments and have produced a Minimal-Viable Simulation Ontology (MVSimO). However, the 'minimalism' of the ontology has yet to be explored to cover pandemic settings. Responding to this, modelers must redesign services that are Covid-19 safe and better reflect changing realities. This study proposes a novel method that conceptualizes processes within the domain from a Discrete-Event Simulation (DES) perspective and utilizes prediction data from an Agent-Based Simulation (ABS) model to improve the accuracy of existing models. This hybrid approach can be helpful to support local decision making around resources allocation. © 2021 IEEE.

TB-INDUCED BRONCHIECTASIS IN A HISPANIC MALE WITH COMMON VARIABLE IMMUNODEFICIENCY AND CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR CARRIER

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Bronchiectasis is a chronic condition characterized by irreversibly dilated bronchi leading to a debilitating respiratory syndrome with excessive sputum production and recurrent infections. The presence of radiologic findings of bronchiectasis should alert clinicians to explore other causes including congenital defects, chronic inflammation, immune deficiencies, opportunistic infections and assess functional lung capacity as multiple etiologies contributed to bronchiectasis in our patient. We present the case of a middle-aged Hispanic male diagnosed with bronchiectasis in the setting of active Mycobacterium tuberculosis (MTB), common variable immunodeficiency (CVID), and cystic fibrosis carrier. CASE PRESENTATION: A 44-year-old Hispanic male with a history of SARS-CoV 2 infection presented with worsening cough and fatigue. He reported subjective fever, night sweats, weight loss, and yellowish sputum production. CT chest showed diffuse bronchial dilatation and thickening, diffuse bronchiectasis, multifocal cavitary lesions in bilateral upper lobes, and tree in bud nodularity. QuantiFERON-TB Gold was indeterminate. However, acid fast bacilli was seen on smear and culture. PCR confirmed MTB complex. He was found to have low IgG and IgM levels 661 and 26 respectively. Genetic testing showed a heterozygous cystic fibrosis transmembrane conductance regulator (CFTR) D508 gene mutation. He was treated with quadruple therapy with rifampin, isoniazid, pyrazinamide, ethambutol and referred to an immunologist for immunoglobulin therapy. DISCUSSION: Bronchiectasis is a cycle of airway damage creating an environment conductive to chronic colonization of bacteria causing an inflammatory response leading to further injury. Our biggest diagnostic challenge was to determine if bronchiectasis was due to an infection or developed due to an underlying predisposition. His clinical symptoms were worrisome for tuberculosis;however, diffuse bronchial dilation was concerning for other concurrent pathologies which warranted further work up. Bronchiectasis may be classified as cystic fibrosis induced bronchiectasis and non-cystic fibrosis bronchiectasis (NCFB). Cystic fibrosis is an autosomal recessive disorder. While bronchiectasis is classically associated in CF patients, it has also been reported in patients having one gene mutation, like our patient. Furthermore, MTB and CVID are also documented causes of bronchiectasis. Pharmacological treatment is challenging and depends on the etiology. However, non-pharmacological treatment, such as chest physiotherapy centered on mobilizing and eliminating mucosal secretion, is used to manage bronchiectasis. CONCLUSIONS: The rise in the incidence of bronchiectasis in the US annually demands the understanding of the disease's etiology and characteristic features as effective treatment is directed towards its cause. REFERENCE #1: Lesan, A., & Lamle, A. E. (2019). Short review on the diagnosis and treatment of bronchiectasis. Medicine and pharmacy reports, 92(2), 111–116. https://doi.org/10.15386/cjmed-1060 REFERENCE #2: Miller, A. C., Comellas, A. P., Hornick, D. B., Stoltz, D. A., Cavanaugh, J. E., Gerke, A. K., Welsh, M. J., Zabner, J., & Polgreen, P. M. (2020). Cystic fibrosis carriers are at increased risk for a wide range of cystic fibrosis-related conditions. Proceedings of the National Academy of Sciences of the United States of America, 117(3), 1621–1627. https://doi.org/10.1073/pnas.1914912117 REFERENCE #3: Pasteur, M. C., Bilton, D., Hill, A. T., & British Thoracic Society Bronchiectasis non-CF Guideline Group (2010). British Thoracic Society guideline for non-CF bronchiectasis. Thorax, 65 Suppl 1, i1–i58. https://doi.org/10.1136/thx.2010.136119 DISCLOSURES: No relevant relationships by Jane Parks, source=Web Response No relevant relationships by Niyanta Patel, source=Web Response No relevant relationships by Nathaniel Rodriguez, source=Web Response No relevant relationships by Joshuam Ruiz Vega, source=W b Response No relevant relationships by Zoheb Sulaiman, source=Web Response

Implementation of a room temperature control system in patient rooms with positive COVID-19 patients

Technology development triggers the development of human thought to be able to create innovations to improve performance. The increasing cases of COVID-19 infection mean that you should seek to break the chain of this virus by self-isolation. However, the purpose of self-isolation rooms should be considered especially at rooms without air conditioning. These technological innovations are needed to provide comfort for patients and families. The goal of this study is to give families of COVID-19 positive patients easy access to their loved ones’ rooms without having to physically enter the room. The procedure is artificial intelligence with Arduino programming using Arduino IDE that is part of the micro controller board. Microcontrolled systems can be thought of as being like an integrated computer system packaged in a single chip. The result showed the temperature control system tool was able to work well with a temperature error rate of 1.13%. It is known that in COVID-19-positive patients it is very helpful for families to monitor room temperature and for patients to rest comfortably.