Automatic Adjustment of the Inspiratory Trigger and Cycling-Off Criteria Improved Patient-Ventilator Asynchrony During Pressure Support Ventilation

Background: Patient-ventilator asynchrony is common during pressure support ventilation (PSV) because of the constant cycling-off criteria and variation of respiratory system mechanical properties in individual patients. Automatic adjustment of inspiratory triggers and cycling-off criteria based on waveforms might be a useful tool to improve patient-ventilator asynchrony during PSV.Method: Twenty-four patients were enrolled and were ventilated using PSV with different cycling-off criteria of 10% (PS10), 30% (PS30), 50% (PS50), and automatic adjustment PSV (PSAUTO). Patient-ventilator interactions were measured.Results: The total asynchrony index (AI) and NeuroSync index were consistently lower in PSAUTO when compared with PS10, PS30, and PS50, (P < 0.05). The benefit of PSAUTO in reducing the total AI was mainly because of the reduction of the micro-AI but not the macro-AI. PSAUTO significantly improved the relative cycling-off error when compared with prefixed controlled PSV (P < 0.05). PSAUTO significantly reduced the trigger error and inspiratory effort for the trigger when compared with a prefixed trigger. However, total inspiratory effort, breathing patterns, and respiratory drive were not different among modes.Conclusions: When compared with fixed cycling-off criteria, an automatic adjustment system improved patient-ventilator asynchrony without changes in breathing patterns during PSV. The automatic adjustment system could be a useful tool to titrate more personalized mechanical ventilation.

Enhanced pose adjustment system for wing-box assembly in large aircraft manufacturing

Strict quality requirements in aircraft manufacturing demand high accuracy concerning pose alignments of aircraft structures. However, even though a pose adjustment system does pass the accuracy verification, the pose of the large complex structure has difficulty in smoothly and efficiently converging on the desired pose in large aircraft assembly. To solve this problem, we developed a pose adjustment system enhanced by integrating physical simulation for the wing-box assembly of a large aircraft. First, the development of the pose adjustment system, which is the base of the digital pose alignment of a large aircraft’s outer wing panel, is demonstrated. Then, the pose alignment principles of duplex and multiple assembly objects based on the best-fit strategy are successively explored. After that, the contributor analysis is conducted for nonideal pose alignment, in which the influences of thermal and gravity deformations on the pose alignment are discussed. Finally, a physical simulation-assisted pose alignment method considering multisource errors, which uses the Finite Element Analysis (FEA) to integrate temperature fluctuation and gravity field effects, is developed. Compared with a conventional digital pose adjustment system driven by the classical best-fit, the deviations of the Key Characteristic Points (KCPs) significantly decreased despite the impacts of thermal and gravity deformations. The developed pose alignment system has been applied to large aircraft wing-box assembly in Aviation Industry Corporation of China, Ltd. It provides an improved understanding of the pose alignment of large-scale complex structures.

Formation of Long-Term Fiscal Sustainability of Kazakhstan Using the Rule Structural Budget Balance

The purpose of the study is to substantiate the potential of using the results of modeling potential GDP and estimating the output gap to comply with fiscal rules that are adequate for the corresponding economic cycle of the economy of Kazakhstan. The methods of economic, statistical, graphical, system, functional analysis, economic and mathematical modeling are applied. To achieve this goal, the analysis of Kazakhstan’s fiscal stability was carried out based on the assessment of Kazakhstan’s potential GDP and the calculation of output gaps, which were carried out based on the dynamic series method of the reported real GDP in 2005 prices for 1991-2019 using the Hodrick-Prescott filter (CP) using the EViews 10 econometric package. The current mechanism for using the output gap indicator in Kazakhstan’s fiscal policy does not have sufficient flexibility. For a timely response of the budget system to changes in the economic situation in the country or abroad, considering the output gap, it is important to introduce an automatic adjustment system that can eliminate contradictions and inconsistencies when making macroeconomic policy decisions by the main regulator and the government of the country. To do this, there is a need to revise the existing fiscal policy based on building a system of new budget rules on countercyclical principles. The proposed alternative fiscal model with the introduction of the rule on the structural balance of the budget is aimed at ensuring long-term fiscal stability, which does not allow for a pro-cyclical policy.

An Application of a Deep Q-Network Based Dynamic Fare Bidding System to Improve the Use of Taxi Services during Off-Peak Hours in Seoul

The problem of structural imbalance in terms of supply and demand due to changes in traffic patterns by time zone has been continuously raised in the mobility market. In Korea, unlike large overseas cities, the waiting time tolerance increases during the daytime when supply far exceeds demand, resulting in a large loss of operating profit. The purpose of this study is to increase taxi demand and further improve driver’s profits through real-time fare discounts during off-peak daytime hours in Seoul, Korea. To this end, we propose a real-time fare bidding system among taxi drivers based on a dynamic pricing scheme and simulate the appropriate fare discount level for each regional time zone. The driver-to-driver fare competition system consists of simulating fare competition based on the multi-agent Deep Q-Network method after developing a fare discount index that reflects the supply and demand level of each region in 25 districts in Seoul. According to the optimal fare discount level analysis in the off-peak hours, the lower the OI Index, which means the level of demand relative to supply, the higher the fare discount rate. In addition, an analysis of drivers’ profits and matching rates according to the distance between the origin and destination of each region showed up to 89% and 65% of drivers who actively offered discounts on fares. The results of this study in the future can serve as the foundation of a fare adjustment system for varying demand and supply situations in the Korean mobility market.

Water Saving Control of Turfgrass Irrigation Robot Using Genetic Simulated Annealing Algorithm

Artificial intelligence through the robotic system offers a solution to the quest for an autonomous system with high cutting efficiency for lawn mowing. Because of the current trimming and maintenance operations on grasslands and gardens, it is essential to develop autonomous and efficient lawn pruning electromechanical equipment. This paper describes the design and construction of a high-performance automated grass trimming and irrigating robot. This device cuts and irrigates grass automatically with little human intervention. A genetic simulated annealing algorithm was employed to optimize motor parameters, specifically design a set of mowing mechanisms and mowing height adjustment system. The prototype was tested, which mainly includes the running status evaluation of the walking module, the mowing module, the cutter head lifting module, and the collision detection module. This robot can save water while watering the lawns, reduce labor costs, and improve mowing efficiency. We note that the proposed system can be implemented on a large scale under natural conditions in the future, which will be helpful in robotics applications and cutting grass on lawns and playing grounds.

How the COVID-19 pandemic can distort risk adjustment of health plan payment

The COVID-19 pandemic has led to disruptions in healthcare utilization and spending. While some changes might persist (e.g. substitution of specialist visits by online consultations), others will be transitory (e.g. fewer surgical procedures due to cancellation of treatments). This paper discusses the implications of transitory changes in healthcare utilization and spending for risk adjustment of health plan payment. In practice, risk adjustment methodologies typically consist of two steps: (1) calibration of payment weights for a given set of risk adjusters and (2) calculation of payments to insurers by combining the calibrated weights with enrollee characteristics. In this paper, we first introduce a simple conceptual framework for analyzing the (potential) distortions from the pandemic for both steps and then provide a hypothetical illustration of how these distortions can lead to under- or overpayment of insurers. The size of these under-/overpayments depends on (1) the impact of the pandemic on patterns in utilization and spending, (2) the distribution of risk types across insurers, (3) the extent to which insurers are disproportionately affected by the pandemic, and (4) features of the risk adjustment system.

Kinematic Analysis and Performance Test of a 6-DOF Parallel Platform with Dense Ball Shafting as a Revolute Joint

To meet the special requirements of the third mirror adjustment system for an optical telescope, a 6-P-RR-R-RR parallel platform using offset RR-joints is designed with high precision, a large load-to-size ratio and high stiffness. In order to improve the adjustment accuracy and the stiffness of the whole mechanism, each rotating joint in the subchain is designed as a zero-gap bead shaft system. When compared with a traditional Hooke joint, the offset RR joint has certain characteristics, including large carrying capacity and easy processing and adjustment, that effectively reduce the risk of interference with the joint during rotation and increase the working space of the entire machine. Because of the additional variables introduced by the offset joints, the kinematics problem becomes much more complicated. Regarding the P-RRRRR series subchain, the kinematics model is established using the Denavit–Hartenberg parameter method and then solved by the numerical iteration method. The stiffness of the parallel platform is analyzed and tested, including static and fundamental frequency. Motion performance testing of the parallel platform is performed.

Spontaneous activity competes with externally evoked responses in sensory cortex

The interaction between spontaneous and externally evoked neuronal activity is fundamental for a functional brain. Increasing evidence suggests that bursts of high-power oscillations in the 15- to 30-Hz beta-band represent activation of internally generated events and mask perception of external cues. Yet demonstration of the effect of beta-power modulation on perception in real time is missing, and little is known about the underlying mechanism. Here, we used a closed-loop stimulus-intensity adjustment system based on online burst-occupancy analyses in rats involved in a forepaw vibrotactile detection task. We found that the masking influence of burst occupancy on perception can be counterbalanced in real time by adjusting the vibration amplitude. Offline analysis of firing rates (FRs) and local field potentials across cortical layers and frequency bands confirmed that beta-power in the somatosensory cortex anticorrelated with sensory evoked responses. Mechanistically, bursts in all bands were accompanied by transient synchronization of cell assemblies, but only beta-bursts were followed by a reduction of FR. Our closed loop approach reveals that spontaneous beta-bursts reflect a dynamic state that competes with external stimuli.