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Rigorous Coupled Wave Analysis (RCWA) method is highly efficient for the simulation of diffraction efficiency and field distribution patterns in periodic structures and textured optoelectronic devices. GPU has been increasingly used in complex scientific problems such as climate simulation and the latest Covid-19 spread model. In this paper, we break down the RCWA simulation problem to key computational steps (eigensystem solution, matrix inversion/multiplication) and investigate speed performance provided by optimized linear algebra GPU libraries in comparison to multithreaded Intel MKL CPU library running on IRIDIS 5 supercomputer (1 NVIDIA v100 GPU and 40 Intel Xeon Gold 6138 cores CPU). Our work shows that GPU outperforms CPU significantly for all required steps. Eigensystem solution becomes 60% faster, Matrix inversion improves with size achieving 8x faster for large matrixes. Most significantly, matrix multiplication becomes 40x faster for small and 5x faster for large matrix sizes. © 2023 SPIE.
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Following the elaboration of a Tunnel Safety Documentation for the T4 tunnel, several deviations from the European and national Standards were identified. Moreover, due the tunnels' special characteristics and its ageing equipment, the rehabilitation plan had not only to upgrade the level of safety to "Category A” as per the ADR agreement, but also to perform heavy maintenance works and provide sustainable solutions for the tunnel operations and the local community. The construction methodology poses significant challenges in the operation and the construction. Therefore, special provisions, technical and operational, were required in order for the transport of heavy and dangerous goods vehicles to be allowed in the tunnel during construction. The Covid pandemic and the geopolitical conditions (Ukraine war), seem to negatively affect the projects' duration and financing. With a budget of more than €20M, it is the first tunnel upgrade project of this magnitude and complexity in Greece, that sets the basis as refence for future tunnel upgrades. © 2023 The Author(s).
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Aim: To determine the intraoperative Ramsay sedation score after dexmedetomidine infusion in patients undergoing perineal surgery. Study design: Descriptive study. Place and duration of study: Department of Anaesthesia, JPMC, Karachi from 13th February 2021 to 13th August 2021. Methodology: One hundred and seventy four patients who met the diagnostic criteria were enrolled. Result(s): The mean age was 46.51 years with the standard deviation of +/-10.87. 66 (37.9%) were male and 108 (62.1%) were female. Whereas, mean duration of surgery, Ramsay sedation score at 5 minutes, 15 minutes, 30 minutes, height, weight and BMI in our study was 1.41+/-0.40 hours, 1.72+/-0.44, 3.51+/-0.60, 4.57+/-0.62, 165.62+/-8.23 cm, 68.34+/-8.23 kg and 24.85+/-3.34 kg/m2 respectively. Conclusion(s): Intraoperative dexmedetomidine proved beneficial in perineal surgeries and could be served as a potent sedative drug.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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In the aircraft cabin, passengers must share a confined environment with other passengers during boarding, flight, and disembarkation, which poses a risk for virus transmission and requires risk-appropriate mitigation strategies. Spacing between passenger groups during boarding and disembarkation reduces the risk of transmission, and optimized sequencing of passenger groups helps to significantly reduce boarding and disembarkation time. We considered passenger groups to be an important factor in overall operational efficiency. The basic idea of our concept is that the members of a group should not be separated, since they were already traveling as a group before entering the aircraft. However, to comply with COVID-19 regulations, different passenger groups should be separated spatially. For the particular challenge of disembarkation, we assume that passenger groups will be informed directly when they are allowed to leave for disembarkation. Today, cabin lighting could be used for this information process, but in a future digitally connected cabin, passengers could be informed directly via their personal devices. These devices could also be used to check the required distances between passengers. The implementation of optimized group sequencing has the potential to significantly reduce boarding and disembarkation times, taking into account COVID-19 constraints. © 2022 ICAS. All Rights Reserved.
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This unprecedented time of the COVID-19 outbreak challenged the status-quo whether it is on business operation, political leadership, scientific capability, engineering implementation, data analysis, and strategic thinking, in terms of resiliency, agility, and innovativeness. Due to some identified constraints, while addressing the issue of global health, human ingenuity has proven again that in times of crisis, it is our best asset. Constraints like limited testing capacity and lack of real-time information regarding the spread of the virus, are the highest priority in the mitigation process, aside from the development of vaccines and the pushing through of vaccination programs. Using the available Chest X-Ray Images dataset and an AI-Computer Vision Technique called Convolutional Neural Network, features of the images were extracted and classified as COVID-19 positive or not. This paper proposes the usage of the 18-layer Residual Neural Network (ResNet-18) as an architecture instead of other ResNet with a higher number of layers. The researcher achieves the highest validation accuracy of 99.26%. Moving forward, using this lower number of layers in training a model classifier, resolves the issue of device constraints such as storage capacity and computing resources while still assuring highly accurate outputs. © 2022 IEEE.
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Leading up to its landing on Mars on February 18, 2021, the Mars 2020 Perseverance rover Surface Mission Operations System (MOS) underwent a verification and validation (V&V) campaign consisting of a series of Super Thread Tests and Operational Readiness Tests. This V&V campaign emphasized incremental testing, mission scenario and capability coverage, and the Test-As-You-Fly approach wherever possible. Although the elements that comprise the Surface System underwent their own internal V&V campaigns, the system-level tests were vital in uncovering findings observable only through the integrated and flight-like nature of these Surface Mission Operations System V & V tests. The COVID-19 pandemic posed additional challenges, including limited facility access, constrained in-person activities, changes to operations paradigms, and evolving safety protocols in the midst of the testing campaign and preparation for surface operations. This paper describes the Verification and Validation campaign of the Mars 2020 Perseverance Rover Surface Mission Operations System that led to the readiness for rover operations on Mars. © 2023 IEEE.
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Purpose This study compares doctor staffing level and the scale of medical education in China with those of other countries and proposes policy recommendations for future adjustments to the scale of China's medical education. Design/Approach/Methods This study employs a literature review and descriptive analysis. Findings China had 1.98 medical doctors per 1,000 people in 2018, ranking 85th out of the 193 member-states of the World Health Organization (WHO). In 2017, China had 1.99 practicing doctors per 1,000 people, only ranking above Turkey (1.88) in Organisation for Economic Co-operation and Development (OECD) countries. China had only 10.28 medical graduates per 100,000 people—placing in the bottom third of OECD countries. China's provision of 1.4 medical schools per 10 million people was also significantly lower than the global average (3.9). However, the average number of students enrolled in medical schools (509) in China was significantly higher than the global average (160). Originality/Value Although the scale of admission in undergraduate medical education must be expanded in China, this needs to be achieved while controlling the average number of medical students per school and reducing enrollment in low-quality medical schools. Furthermore, it is necessary to establish new medical schools while improving the operating level of existing ones.
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Introduction: The COVID-19 pandemic caused significant decreases in outpatient procedures, many of which are required before to antireflux operation (ARS). The purpose of this study was to add functional luminal imaging probe (FLIP) to esophagogastroduodenoscopy (EGD) and esophageal pH monitoring to assess its utility in decreasing the need for follow up studies in patients being evaluated for ARS. Method(s): Retrospective observational study was performed on 81 patients being evaluated for GERD who underwent EGD, pH monitoring, and FLIP. Data collected included average distensibility index (DI) at 60 mL, presence of repetitive anterograde or retrograde contractions, hiatal hernia dimensions, pathology results, pH data, and need for follow-up testing. Result(s): Based on FLIP results, HRM was recommended in 35 patients (43.2%). This included 14 patients with DI suggestive of significant esophagogastric junction outflow obstruction, eight of whom completed HRM with four confirmed as achalasia. FLIP results were suspicious for eosinophilic esophagitis (EoE) in four patients of which one was confirmed as EoE on biopsy. Gastric emptying study was felt to be necessary for 11 patients before to ARS. Conclusion(s): FLIP identified patients with possible alternative pathologies including achalasia and EoE that would otherwise be a contraindication to ARS. FLIP at the time of EGD and pH monitoring is useful as it guides the clinical decision on need for additional outpatient procedures, which may be difficult to obtain in pandemic conditions. FLIP was effective at reducing the requirements for further follow-up testing in the majority of patients being evaluated for potential ARS.
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Introduction: Coronavirus disease-2019 (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused a global health crisis. Initially considered a respiratory tract pathogen, it can cause multiple organ dysfunction. It has also been described to predispose to venous and arterial thromboembolism;however, limited published data is available regarding mesenteric thrombosis COVID-19. Clinicians should be aware of the life-threatening situation in COVID-19 patients. Method(s): A case series analysis of 9 patients admitted and managed under department of operation over a duration of 13 months from September 2020 to September 2021 Results: Out of the total of 9 cases of intestinal ischemia, 3 were COVID-19 positive (rapid antigen, RT PCR or CORADS 4 or higher), overall mortality being 55.5% and patients with COVID- 19 were found to have 100% mortality in the study. Mortality in conservatively managed patients was 100%, Mortality in surgically managed patients was 42.8%. Pre operative acidosis, hypoxia and hypotension were found to be important determinants of outcome of the disease. Conclusion(s): Treatment of COVID - 19 and intestinal Ischemia should go simultaneously and in line with the latest evidence based guidelines of COVID 19, Patients who survive an acute event are likely to die of other complications related to the COVID-19 like ARDS, Disseminated Intravascular Coagulation etc that could have predisposed them to intestinal ischemia. Perioperative acidosis, hypoxia and hypotension are important determinants of the outcome of the course of the disease.
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Aim: While recent evidence describes atypical outcomes of coronavirus disease 2019 (COVID-19) in elderly patients, the frequency of delirium and associated outcomes in elderly patients with COVID-19 (coronavirus disease 2019) infection undergoing emergency surgery are not well defined. This study aims to determine the effect of COVID-19 on postoperative delirium and postoperative death in elderly patients undergoing emergency surgery. Material(s) and Method(s): This descriptive and cross-sectional study was conducted in general surgery, orthopedics, and cardiovascular surgery clinics of a public hospital, including 30 days of follow-up between April 1 and May 1, 2021. All patients who were admitted to these clinics for emergency surgery intervention on these dates constituted the study population, while a total of 140 patients aged >=65 years, who met the study criteria, formed the sample of the study. Descriptive Characteristics Form and Nursing Delirium Screening Scale (Nu-DESC) were used as data collection tools in the study. SPSS 25.0 statistical program was used for data analysis. Result(s): Thirty (42.85%) of the SARS-CoV-2 positive (n=70) patients developed delirium in the study. 12.9% (n=18) of the patients died within 30 days of follow-up after surgery. There were 30 (69.8) of 70 SARS-CoV-2 positive patients who developed delirium, and 12 patients (25.5) died after testing positive for COVID-19, with a mean of 8.08T1.56 days within 30 days of admission. Discussion(s): These findings may lead to a poor clinical prognosis for COVID-19 infection delirium and postoperative death in patients over 65 years of age undergoing emergency surgery.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Objectives: Development of new and repurposed medicines in response to the COVID-19 pandemic has occurred at an unprecedented rate, resulting in a dynamic pipeline marked by significant challenges and successes. This analysis provides an overview of the vaccines and therapies undergoing clinical evaluation or with recent approval for the treatment and prevention of COVID-19 in global markets. Method(s): For this analysis, COVID-19 pipeline medicines are defined in three categories: vaccines, new treatments and repurposed medicines. GlobalData is the primary data source for this study, in addition to online databases from Health Canada, the US FDA, and the EMA. International markets examined include the US and geographic Europe (excluding Russia and Turkey). Result(s): As of November 2022, the global pipeline contained over 600 therapies and vaccines undergoing Phase I, II, III clinical trials or pre-registration for the prevention and treatment of COVID-19. Preventive and repurposed medicines include antivirals, immunoglobulins, monoclonal antibodies, cellular therapies, and convalescent plasma. In Canada, twelve medicines, including six vaccines, have been approved for COVID-19. The number of global approvals is greater, with approximately 9 vaccines on the market in OECD countries. In addition to pre-exposure preventative therapies, manufacturers are also developing COVID-19 drugs to be used as prophylactic therapy. The analysis identifies new oral antiviral treatments and preventative therapies in the pipeline and under review in various jurisdictions globally. Conclusion(s): This research provides a clearer picture of the characteristics and evolution of the market for new and emerging COVID-19 medicines, which will help policy-makers and other stakeholders understand and anticipate the unique pressures of the COVID-19 pandemic.Copyright © 2023
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This article uses data from several publicly available databases to show that the distribution of intellectual property for frontier technologies, including those useful for sustainable development, is very highly skewed in favor of a handful of developed countries. The intellectual property rights (IPR) regime as it exists does not optimize the global flow of technology and know-how for the attainment of the sustainable development goals and is in need of updating. Some features of the Fourth Industrial Revolution imply that the current system of patents is even more in need of reform than before. COVID-19 vaccines and therapies and the vast inequality in access to these has highlighted the costs of inaction. We recommend several policy changes for the international IPR regime. Broadly, these fall into three categories: allowing greater flexibility for developing countries, reassessing the appropriateness of patents for technologies that may be considered public goods, and closing loopholes that allow for unreasonable intellectual property protections.
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According to the significant impacts of social media and the internet on all facets of our lives in general and the business world in particular, many business owners and entrepreneurs who are looking to expand their clientele or start their own ventures have moved to the virtual world, particularly when they want to advance their careers. For the reasons mentioned above, this article aims to ascertain how social media networks impact business operations, with a focus on how they affect entrepreneurship growth. Facebook and Instagram are the two most useful social media platforms. The findings indicate that Facebook and Instagram have a significant impact on increasing entrepreneurship and household income in Jordan. © 2023 IEEE.
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The purpose of this paper is to capture the direct and indirect effects of COVID-19 emerging risks on construction projects' success in developing countries from the contractors' perspective. To achieve this, we collected data from Iraqi construction industry and conducted the following multistage research methodology: (1) preliminary investigation with four construction contractors to identify the success indicators of construction projects;(2) focus group session with 11 experts to identify the COVID-19 emerging risks for the construction industry;(3) semistructured interviews with seven construction experts to develop several hypotheses on the effect of COVID-19 emerging risks on project success;(4) survey data collection from 99 construction contractors;and (5) development of a structural equation model (SEM) to analyze the effects of COVID-19 emerging risks on project success. The results of the SEM analysis show that financial market (FM)-related risks, supply chain operations (SCO)-related risks, health and safety of construction workforce (HSCW)-related risks, organizational implications (OI)-related risks, and contractual implications (CI)-related risks have a significant impact on construction projects success. CI-related risks have the strongest total effects on project success, followed by OI-related risks, FM-related risks, HSCW-related risks, and SCO-related risks, respectively. The results also emphasis the significant mediation role of CI between COVID-19 emerging risks and project success. This study contributes to the body of knowledge and contracting companies by helping researchers and construction contractors to better understand how the key risk factors emerging from extreme conditions like the COVID-19 pandemic affect construction projects' success and may serve as a guideline for developing effective response strategies. © 2023 American Society of Civil Engineers.
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Aim: This study investigated the effectiveness and prospect of applying virtual simulation operation (VSO) as a novel teaching tool in clinical skill and operation courses. Methods: A comparative test and survey study on the teaching effect of VSO was conducted with the clinical skill and operation course as the test course. The test group students received offline courses combined with online VSO practice. In contrast, the control group students received offline courses combined with instructional video review. The two groups were assessed using the Chinese medical school clinical medicine professional level test and a questionnaire survey. Results: The test group students scored significantly higher than the control group in the skills test (score difference: 3.43, 95% CI: 2.05-4.80) (p < 0.001). Additionally, a significant increase in the percentage of high-and intermediate-score ranges and a decrease in the percentage of low-score ranges was observed (p < 0.001). According to the questionnaire survey, 80.56% of the students were willing to continue using virtual simulation in their subsequent clinical skill and operation learning. Further, 85.19% of the students believed that the VSO is superior because it is unrestricted by time and space and can be performed anywhere and anytime compared to traditional operation training. Conclusion: VSO teaching can improve skills and examination performance. An entirely online operation that does not need special equipment can break through the spatiotemporal limitations of traditional skills courses. VSO teaching also suits the ongoing COVID-19 pandemic situation. Virtual simulation, a new teaching tool, has good application prospects.
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Background and aim The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on healthcare systems. Several local infection control methods were put in place, which have now evolved and continued in some form or the other. According to various research, as the time duration for distinct phases in the pathway rose, trauma theatre efficiency reduced. However, there is no literature, to our knowledge, that has explicitly looked at theatre utilisation and cost efficiency compared them and expressed theatre efficiency in these terms. The aim of this article is to study theatre efficiency in terms of utilisation and costs before and during the pandemic and understand the influence of infection control protocols on these. Materials and methods The data were collected retrospectively from the ORMIS theatre management software (iPath Softwares, Ohio), from December 2019 (pre-COVID) and December 2020 (COVID). Turnaround time, utilisation time and combined operative time were defined and compared. Costs incurred due to over-running, under-running and turnaround time were compared. Results Theatre utilization was 101% during COVID and 86.63% pre-COVID. The average cost of over-running as well as under-running a theatre list during the pandemic was significantly higher. Conclusion Optimal theatre utilisation and reduced time between cases improve theatre efficiency. Turnaround time, if reduced, can not only decrease costs but also increase efficiency.Theatre utilisation and efficiency can be maintained even with new infection control protocols, but these are not cost-efficient.
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OBJECTIVES: The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management. METHODS: A systematic search was conducted in 5 databases and selected grey literature websites. RESULTS: Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure. CONCLUSIONS: PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.
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COVID-19 , Public Health , Humans , Emergencies , COVID-19/epidemiology , Public Health Administration/methods , WorkforceABSTRACT
This new edition presents a fully-updated and expanded look at current Good Manufacturing Practice (cGMP) for cell therapy products. It provides a complete discussion of facility design and operation including details specific to cord blood banking, cell processing, vector production and qualification of a new facility. Several chapters cover facility infrastructure including cleaning and maintenance, vendor qualification, writing a Standard Operating Procedure, staff training, and process validation. The detailed and invaluable product information covers topics like labelling, release and administration, transportation and shipment, et al. Further chapters cover relevant topics like writing and maintaining investigational new drug applications, support opportunities in North America and the European Union, commercial cell processing and quality testing services, and financial considerations for academic GMP facilities. A chapter on future directions rounds out Cell Therapy: cGMP Facilities and Manufacturing making it essential reading for any cell therapy professional involved in the development, use, or management of this type of facility. © Springer Nature Switzerland AG 2009, 2022, Corrected Publication 2022.
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This article examines COVAX, a public private partnership, from a public law perspective. It asks whether COVAX is a legitimate and appropriate instrument with regard to the goal of distributing COVID-19 vaccines in a globally equitable manner and enabling equal access to vaccination worldwide. By developing public-legal legitimacy standards for this purpose, the article critically distances itself from the outset from considering the use of private actors and forms of action in public functions ('privatization') essentially as a release of market economy rationality, which enables efficiency and effectiveness gains and relieves the public sector. With the public law perspective, the article questions precisely whether private-law, market-based action is appropriate with respect to the global distribution of vaccines in the pandemic.