The use of extracorporeal membrane oxygenation (ECMO) to support patients with cardiac arrest, cardiogenic shock, and acute respiratory distress syndrome is rising worldwide.
While ECMO may save the ...lives of some of our sickest patients, the outlook of ECMO survivorship remains uncertain. Defining longer-term functional and neuropsychiatric outcomes in ECMO survivors is important for 3 reasons. First, critically ill patients are at high risk of experiencing postintensive care syndrome (PICS), defined as new physical, cognitive, or psychological impairments that present in survivors of critical illness after hospital discharge.
PICS is associated with more severe illness and longer intensive care unit length of stay.
Because ECMO is reserved for patients with refractory shock or hypoxia, patients treated with ECMO represent a severely ill patient population with prolonged length of stay, putting them at particularly high risk of developing PICS. Second, ECMO is associated with direct neurologic injury, including both macrohemorrhages and microhemorrhages, infarcts, and diffuse hypoxic-ischemic brain injury that likely contribute to long-term outcomes.
Finally, ECMO is very expensive. A recent study determined that the average cost per admission for patients with COVID-19 placed on ECMO was nearly $850,000 more than those who received only mechanical ventilation.
Understanding patient-centered outcomes will be an integral part of future cost-effectiveness analyses.
In the present analysis incompressible two dimensional mixed convection flow of MHD Eyring-Powell nanofluid over a stretching sheet is investigated numerically. The governing highly nonlinear partial ...differential equations are converted into ordinary differential equations by using a similarity approach. Numerical solutions of the nonlinear ordinary differential equations are found by using a shooting method. Effects of various parameters are displayed graphically for velocity, temperature and concentration profiles. Also quantities of practical interest i.e skin friction coefficient, Nusselt number and Sherwood number are presented graphically and tabularly.
This paper aims to introduce a novel family of probability distributions by the well-known method of the T-X family of distributions. The proposed family is called a "Novel Generalized Exponent Power ...X Family" of distributions. A three-parameters special sub-model of the proposed method is derived and named a "Novel Generalized Exponent Power Weibull" distribution (NGEP-Wei for short). For the proposed family, some statistical properties are derived including the hazard rate function, moments, moment generating function, order statistics, residual life, and reverse residual life. The well-known method of estimation, the maximum likelihood estimation method is used for estimating the model parameters. Besides, a comprehensive Monte Carlo simulation study is conducted to assess the efficacy of this estimation method. Finally, the model selection criterion such as Akaike information criterion (AINC), the correct information criterion (CINC), the Bayesian information criterion (BINC), the Hannan-Quinn information criterion (HQINC), the Cramer-von-Misses (CRMI), and the ANDA (Anderson-Darling) are used for comparison purpose. The comparison of the NGEP-Wei with other rival distributions is made by Two COVID-19 data sets. In terms of performance, we show that the proposed method outperforms the other competing methods included in this study.
This study observes the numerical analysis of Powell-Eyring hybrid nanofluid along a stretching sheet. The movement of sheet in x-direction is taken to be the source of motion in the fluid. ...Nanoparticles are considered as agents for increasing thermal properties of fluids. This research emphasizes the amalgamation of copper oxide and carbon nanotubes with engine oil as a base fluid. A significant increase is observed by adding these agents. Porous medium is considered using Darcy law. Magnetics field is also taken for studying mass transfer analysis. For heat transfer mechanisms, thermophoresis and Brownian diffusions are taken into account. The whole procedure is shown through nonlinear differential equations. Appropriate transformations are used for simplification purposes. After transformations, partial differential equations are converted into ordinary differential equations and handled through numerical technique. Shooting numerical technique has been used to solve the governing system of equations, and the obtained results are thoroughly examined and discussed graphically. The thermal characteristics of the hybrid nanofluid are analyzed, in the presence of thermal radiation and thermophoresis effects. To validate our results, a comparison analysis is drawn with existing literature in some specific scenarios.
OBJECTIVES:To perform a scoping literature review of cognitive, psychiatric, and quality of life outcomes in adults undergoing extracorporeal membrane oxygenation for any indication.
DATA SOURCES:We ...searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO from inception to June 2019.
STUDY SELECTION:Observational studies, clinical trials, qualitative studies, and case series with at least 10 adult subjects were included for analysis. Outcomes of interest consisted of general or domain-specific cognition, psychiatric illness, and quality of life measures that included both mental and physical health.
DATA EXTRACTION:Study selection, data quality assessment, and interpretation of results were performed by two independent investigators in accordance with the PRISMA statement.
DATA SYNTHESIS:Twenty-two articles were included in this review. Six described cognitive outcomes, 12 described psychiatric outcomes of which two were qualitative studies, and 16 described quality of life outcomes. Cognitive impairment was detected in varying degrees in every study that measured it. Three studies examined neuroimaging results and found neurologic injury to be more frequent in venoarterial versus venovenous extracorporeal membrane oxygenation, but described a variable correlation with cognitive impairment. Rates of depression, anxiety, and post-traumatic stress disorder were similar to other critically ill populations and were related to physical disability after extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation survivors’ physical quality of life was worse than population norms but tended to improve with time, while mental quality of life did not differ significantly from the general population. Most studies did not include matched controls and instead compared outcomes to previously published values.
CONCLUSIONS:Extracorporeal membrane oxygenation survivors experience cognitive impairment, psychiatric morbidity, and worse quality of life compared with the general population and similar to other survivors of critical illness. Physical disability in extracorporeal membrane oxygenation patients plays a significant role in psychiatric morbidity. However, it remains unclear if structural brain injury plays a role in these outcomes and whether extracorporeal membrane oxygenation causes secondary brain injury.
The simultaneous monitoring of both the process mean and dispersion has gained considerable attention in statistical process control, especially when the process follows the normal distribution. This ...paper introduces a novel Bayesian adaptive maximum exponentially weighted moving average (Max-EWMA) control chart, designed to jointly monitor the mean and dispersion of a non-normal process. This is achieved through the utilization of the inverse response function, particularly suitable for processes conforming to a Weibull distribution. To assess the effectiveness of the proposed control chart, we employed the average run length (ARL) and the standard deviation of run length (SDRL). Subsequently, we compared the performance of our proposed control chart with that of an existing Max-EWMA control chart. Our findings suggest that the proposed control chart demonstrates a higher level of sensitivity in detecting out-of-control signals. Finally, to illustrate the effectiveness of our Bayesian Max-EWMA control chart under various Loss Functions (LFs) for a Weibull process, we present a practical case study focusing on the hard-bake process in the semiconductor manufacturing industry. This case study highlights the adaptability of the chart to different scenarios. Our results provide compelling evidence of the exceptional performance of the suggested control chart in rapidly detecting out-of-control signals during the hard-bake process, thereby significantly contributing to the improvement of process monitoring and quality control.
The memory-type control charts, such as cumulative sum (CUSUM) and exponentially weighted moving average control chart, are more desirable for detecting a small or moderate shift in the production ...process of a location parameter. In this article, a novel Bayesian adaptive EWMA (AEWMA) control chat utilizing ranked set sampling (RSS) designs is proposed under two different loss functions, i.e., square error loss function (SELF) and linex loss function (LLF), and with informative prior distribution to monitor the mean shift of the normally distributed process. The extensive Monte Carlo simulation method is used to check the performance of the suggested Bayesian-AEWMA control chart using RSS schemes. The effectiveness of the proposed AEWMA control chart is evaluated through the average run length (ARL) and standard deviation of run length (SDRL). The results indicate that the proposed Bayesian control chart applying RSS schemes is more sensitive in detecting mean shifts than the existing Bayesian AEWAM control chart based on simple random sampling (SRS). Finally, to demonstrate the effectiveness of the proposed Bayesian-AEWMA control chart under different RSS schemes, we present a numerical example involving the hard-bake process in semiconductor fabrication. Our results show that the Bayesian-AEWMA control chart using RSS schemes outperforms the EWMA and AEWMA control charts utilizing the Bayesian approach under simple random sampling in detecting out-of-control signals.
The objective of this study is to investigate the behavior of the Bayesian exponentially weighted moving average (EWMA) control chart in the presence of measurement error (ME). It explores the impact ...of different ranked set sampling designs and loss functions on the performance of the control chart when ME is present. The analysis incorporates a covariate model, multiple measurement methods, and a conjugate prior to account for ME. The performance evaluation of the proposed Bayesian EWMA control chart with ME includes metrics such as average run length and standard deviation of run lengths. The findings, obtained through Monte Carlo simulation and real data application, indicated that ME significantly affects the performance of the Bayesian EWMA control chart when RSS schemes are employed. Particularly noteworthy is the superior performance of the median RSS scheme compared to the other two schemes in the presence of ME.
Current artifact aims to investigate attributes of nanofluidic transport mechanism developed for dynamics of Williamson liquid over an extendable cylinder with novel physical aspects of magnetic ...field. Additionally, Newtonian heating is accounted at cylinder surface and Reynold viscosity model is implemented to delineate the aspects of temperature dependent viscosity. Thermophoresis, Brownian motion, and variable viscosity effects have been studied for heat and mass transfer analysis. Formulation of problems characterized by governing physical laws is conceded in the form of dimensional partial differential setup by executing boundary layer approach. Conversion of attained differential system into ODE’s is engrossed by capitalizing similarity transformations. Numerical procedures (Runge-Kutta and shooting) are implemented to resolve the problem and to attain solution. Effectiveness of sundry variables on associated distributions is revealed through graphical and tabular manner. Quantities of interest are also manipulated against the involved variables. Comparison of results to certify the numerical code is checked by making assessment with existing studies and found remarkable agreement.
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