A new framework for warehouse assessment using a Genetic-Algorithm driven analytic network process.

A novel way of integrating the genetic algorithm (GA) and the analytic network process (ANP) is presented in this paper in order to develop a new warehouse assessment scheme, which is developed through various stages. First, we define the main criteria that influence a warehouse performance. The proposed algorithm that integrates the GA with the ANP is then utilized to determine the relative importance values of the defined criteria and sub-criteria by considering the interrelationships among them, and assign strength values for such interrelationships. Such an algorithm is also employed to linguistically present the relative importance and the strength of the interrelationships in a way that can circumvent the use of pairwise comparisons. Finally, the audit checklist that consists of questions related to the criteria is integrated with the proposed algorithm for the development of the warehouse assessment scheme. Validated on 45 warehouses, the proposed scheme has been shown to be able to identify the warehouse competitive advantages and the areas where more improvements can be achieved.

Transparent predictive modelling of the twin screw granulation process using a compensated interval type-2 fuzzy system.

In this research, a new systematic modelling framework which uses machine learning for describing the granulation process is presented. First, an interval type-2 fuzzy model is elicited in order to predict the properties of the granules produced by twin screw granulation (TSG) in the pharmaceutical industry. Second, a Gaussian mixture model (GMM) is integrated in the framework in order to characterize the error residuals emanating from the fuzzy model. This is done to refine the model by taking into account uncertainties and/or any other unmodelled behaviour, stochastic or otherwise. All proposed modelling algorithms were validated via a series of Laboratory-scale experiments. The size of the granules produced by TSG was successfully predicted, where most of the predictions fit within a 95% confidence interval.

Intelligent model-based advisory system for the management of ventilated intensive care patients. Part II: Advisory system design and evaluation.

The optimisation of ventilatory support is a crucial issue for the management of respiratory failure in critically ill patients, aiming at improving gas exchange while preventing ventilator-induced dysfunction of the respiratory system. Clinicians often rely on their knowledge/experience and regular observation of the patient's response for adjusting the level of respiratory support. Using a similar data-driven decision-making methodology, an adaptive model-based advisory system has been designed for the clinical monitoring and management of mechanically ventilated patients. The hybrid blood gas patient model SOPAVent developed in Part I of this paper and validated against clinical data for a range of patients lung abnormalities is embedded into the advisory system to predict continuously and non-invasively the patient's respiratory response to changes in the ventilator settings. The choice of appropriate ventilator settings involves finding a balance among a selection of fundamentally competing therapeutic decisions. The design approach used here is based on a goal-directed multi-objective optimisation strategy to determine the optimal ventilator settings that effectively restore gas exchange and promote improved patient's clinical conditions. As an initial step to its clinical validation, the advisory system's closed-loop stability and performance have been assessed in a series of simulations scenarios reconstructed from real ICU patients data. The results show that the designed advisory system can generate good ventilator-setting advice under patient state changes and competing ventilator management targets.

Absolute electrical impedance tomography (aEIT) guided ventilation therapy in critical care patients: simulations and future trends.

Thoracic electrical impedance tomography (EIT) is a noninvasive, radiation-free monitoring technique whose aim is to reconstruct a cross-sectional image of the internal spatial distribution of conductivity from electrical measurements made by injecting small alternating currents via an electrode array placed on the surface of the thorax. The purpose of this paper is to discuss the fundamentals of EIT and demonstrate the principles of mechanical ventilation, lung recruitment, and EIT imaging on a comprehensive physiological model, which combines a model of respiratory mechanics, a model of the human lung absolute resistivity as a function of air content, and a 2-D finite-element mesh of the thorax to simulate EIT image reconstruction during mechanical ventilation. The overall model gives a good understanding of respiratory physiology and EIT monitoring techniques in mechanically ventilated patients. The model proposed here was able to reproduce consistent images of ventilation distribution in simulated acutely injured and collapsed lung conditions. A new advisory system architecture integrating a previously developed data-driven physiological model for continuous and noninvasive predictions of blood gas parameters with the regional lung function data/information generated from absolute EIT (aEIT) is proposed for monitoring and ventilator therapy management of critical care patients.

A hybrid hierarchical decision support system for cardiac surgical intensive care patients. Part II. Clinical implementation and evaluation.

OBJECTIVE: Patients emerging from cardiac surgery can display varying degrees of cardiovascular instability arising from potentially complex, multi-factorial and interlinked causes. Stabilization and control of the cardiovascular system are currently managed by healthcare experts using experiential knowledge, and, in some centers, manually inputted decision pathway algorithms. This paper describes a clinical trial undertaken to determine the basic functioning of a clinical decision support system (CDSS) designed and constructed by the authors to facilitate the control of the major cardiovascular components in the early post-operative phase. Part II follows Part I's description of the software and simulation testing of the CDSS, and describes the hardware setup of a patient monitoring and CDSS. The system is evaluated on three post-cardiac surgery intensive care patients whom had all undergone cardio-pulmonary bypass. METHODS: The study was approved by the Sheffield Teaching Hospitals National Health Service (NHS) Foundation Trust Research Ethics Committee and conducted at the North Trent cardio-thoracic surgical unit and cardiac intensive care unit (CICU), Northern General Hospital, Sheffield (UK). Patients considered as 'very likely' to require active intervention to support the cardiovascular function following routine cardiac surgery were recruited during pre-operative surgical and anesthetic assessment, giving written informed consent when admitted for their operation. These patients underwent routine induction and maintenance of anesthesia by a non-study consultant anesthetist and the operation performed. There were no restrictions placed on the types of invasive monitoring used, on the use of trans-oesophageal echocardiography, drug selection, or the anesthetic agents selected by the clinicians performing the operations. All patients had full, routine invasive and non-invasive monitoring applied, including electrocardiography, central venous and peripheral arterial catheterisation, urine outputs and central temperature. After chest closure the patients were transferred to the CICU, sedated and ventilated, and the study commenced by the study anesthetist (1st author). The patients were in a clinically stable condition when admitted to the unit, and were attended by the treating clinicians until the handover to the study anesthetist occurred. The LiDCOplus (lithium dilution cardiac output) monitor (LiDCO Limited, Flowers Building, Granta Park, Cambridge CB1 6GU, United Kingdom) was calibrated after attachment to the patient's arterial line, and the patient's beat-to-beat hemodynamic data transferred to the host laptop computer. The CDSS graphical interface displays the patient's clinical details and specific cardiovascular data and prompts the anesthetist to input the target ranges for each parameter, and select a suitable advisor frequency. This is the frequency with which the therapeutic advice is displayed on screen with an audible prompt for a control inputs from the anesthetist. In each case this was selected to be 30s. When the study anesthetist agreed with the CDSS advice (administration of fluid, commencing a drug, altering the drug infusion rate) the syringe motif on the "Advisor Infusion Rates" panel of the graphical interface was 'clicked' on and the infusion rate immediately and manually inputted to Graseby 3400 pumps. If any disagreement between the anesthetist and the computer's advice arose, the syringe motif on the "Expert Infusion Rates" panel of the preferred drug was 'clicked' on and the expert's therapeutic decision (e.g. infusion rate) was entered in the corresponding data field and then applied to the pump. During all trials, data was stored for off-line analysis. RESULTS: The CDSS successfully selected suitable drug therapies for each case and advised reasonable and appropriate infusion rates such that the study anesthetist did not have to override the suggested CDSS instructions and infusion rates. Under differing clinical conditions the system was able to maintain clinically appropriate and stable control of the cardiovascular system (CVS), with good profiles under noisy physiological measurements, and was readily able to regain control following transient deterioration of the patient hemodynamic parameters (coughing, or during blood sampling).

A hybrid hierarchical decision support system for cardiac surgical intensive care patients. Part I: Physiological modelling and decision support system design.

OBJECTIVE: To develop a clinical decision support system (CDSS) that models the different levels of the clinician's decision-making strategies when controlling post cardiac surgery patients weaned from cardio pulmonary bypass. METHODS: A clinical trial was conducted to define and elucidate an expert anesthetists' decision pathway utilised in controlling this patient population. This data and derived knowledge were used to elicit a decision-making model. The structural framework of the decision-making model is hierarchical, clearly defined, and dynamic. The decision levels are linked to five important components of the cardiovascular physiology in turn, i.e. the systolic blood pressure (SBP), central venous pressure (CVP), systemic vascular resistance (SVR), cardiac output (CO), and heart rate (HR). Progress down the hierarchy is dependent upon the normalisation of each physiological parameter to a value pre-selected by the clinician via fluid, chronotropes or inotropes. Since interventions at each and every level cause changes and disturbances in the other components, the proposed decision support model continuously refers back decision outcomes back to the SBP which is considered to be the overriding supervisory safety component in this hierarchical decision structure. The decision model was then translated into a computerised decision support system prototype and comprehensively tested on a physiological model of the human cardiovascular system. This model was able to reproduce conditions experienced by post-operative cardiac surgery patients including hypertension, hypovolemia, vasodilation and the systemic inflammatory response syndrome (SIRS). RESULTS: In all the simulated patients scenarios considered the CDSS was able to initiate similar therapeutic interventions to that of the expert, and as a result, was also able to control the hemodynamic parameters to the prescribed target values.

A closed-loop hybrid physiological model relating to subjects under physical stress.

OBJECTIVE: The objective of this research study is to derive a comprehensive physiological model relating to subjects under physical stress conditions. The model should describe the behaviour of the cardiovascular system, respiratory system, thermoregulation and brain activity in response to physical workload. METHODS AND MATERIAL: An experimental testing rig was built which consists of recumbent high performance bicycle for inducing the physical load and a data acquisition system comprising monitors and PCs. The signals acquired and used within this study are the blood pressure, heart rate, respiration, body temperature, and EEG signals. The proposed model is based on a grey-box based modelling approach which was used because of the sufficient level of details it provides. Cardiovascular and EEG Data relating to 16 healthy subject volunteers (data from 12 subjects were used for training/validation and the data from 4 subjects were used for model testing) were collected using the Finapres and the ProComp+ monitors. For model validation, residual analysis via the computing of the confidence intervals as well as related histograms was performed. RESULTS: Closed-loop simulations for different subjects showed that the model can provide reliable predictions for heart rate, blood pressure, body temperature, respiration, and the EEG signals. These findings were also reinforced by the residual analyses data obtained, which suggested that the residuals were within the 90% confidence bands and that the corresponding histograms were of a normal distribution. A higher intelligent level was added to the model, based on neural networks, to extend the capabilities of the model to predict over a wide range of subjects dynamics. CONCLUSION: The elicited physiological model describing the effect of physiological stress on several physiological variables can be used to predict performance breakdown of operators in critical environments. Such a model architecture lends itself naturally to exploitation via feedback control in a 'reverse-engineering' fashion to control stress via the specification of a safe operating range for the psycho-physiological variables.

Modelling and multivariable control in anaesthesia using neural-fuzzy paradigms Part II. Closed-loop control of simultaneous administration of propofol and remifentanil.

OBJECTIVE: Part II of this research study is concerned with the development of a closed-loop simulation linking the patient model as well as the fuzzy relational classifier already introduced in Part I with a control algorithm. The overall architecture is in fact a system advisor, which provides information to the anaesthetist about the adequate infusion-rates of propofol and remifentanil simultaneously. METHODS AND MATERIAL: The developed fuzzy multivariable controller includes three rule-bases and takes into account the synergetic interactions between the above drugs and uses such knowledge to achieve rapidly the desired depth of anaesthesia (DOA) level. RESULTS: The result of the study is a closed-loop control scheme, which adjusts efficiently the infusion-rates of two drugs in response to DOA changes. This controller can either be used in an advisory mode or closed-loop feedback mode in the operating theatre during surgery. CONCLUSION: It is hoped that this control scheme coupled with the patient model presented in Part I of this study will be used routinely in the operating theatre in the very near future.

Modelling and multivariable control in anaesthesia using neural-fuzzy paradigms. Part I. Classification of depth of anaesthesia and development of a patient model.

OBJECTIVE: The first part of this research relates to two strands: classification of depth of anaesthesia (DOA) and the modelling of patient's vital signs. METHODS AND MATERIAL: First, a fuzzy relational classifier was developed to classify a set of wavelet-extracted features from the auditory evoked potential (AEP) into different levels of DOA. Second, a hybrid patient model using Takagi-Sugeno Kang fuzzy models was developed. This model relates the heart rate, the systolic arterial pressure and the AEP features with the effect concentrations of the anaesthetic drug propofol and the analgesic drug remifentanil. The surgical stimulus effect was incorporated into the patient model using Mamdani fuzzy models. RESULTS: The result of this study is a comprehensive patient model which predicts the effects of the above two drugs on DOA while monitoring several vital patient's signs. CONCLUSION: This model will form the basis for the development of a multivariable closed-loop control algorithm which administers "optimally" the above two drugs simultaneously in the operating theatre during surgery.

SIVA: a hybrid knowledge-and-model-based advisory system for intensive care ventilators.

The Sheffield Intelligent Ventilator Advisor is a hybrid knowledge-and-model-based advisory system designed for intensive care ventilator management. It consists of a top-level fuzzy rule-based module to give the qualitative component of the advice, and a lower-level model-based module to give the quantitative component of the advice. It is structured to offer adaptive patient-specific decision support. It can be operated in either invasive or noninvasive modes depending on the availability of data from invasive clinical measurements. The user can choose between the full-advisory mode and the clinician-directed mode. The advice given by the top-level module has been validated against retrospective real patient data and compared with intensivists expertise and performance under simulation conditions. Closed-loop simulations were performed assuming various clinical scenarios including sudden changes in the patient parameters such as the shunt or deadspace with noise and disturbances. They have shown that the advice given was appropriate and the blood gases resulting from the closed-loop decision support were acceptable. The system was also shown to be tolerant to noise and disturbances. It is implemented in MATLAB/SIMULINK and LabVIEW.

Clustering files of chemical structures using the fuzzy k-means clustering method.

This paper evaluates the use of the fuzzy k-means clustering method for the clustering of files of 2D chemical structures. Simulated property prediction experiments with the Starlist file of logP values demonstrate that use of the fuzzy k-means method can, in some cases, yield results that are superior to those obtained with the conventional k-means method and with Ward's clustering method. Clustering of several small sets of agrochemical compounds demonstrate the ability of the fuzzy k-means method to highlight multicluster membership and to identify outlier compounds, although the former can be difficult to interpret in some cases.