Development and usability testing of a Web-based decision aid for families of patients receiving prolonged mechanical ventilation.

BACKGROUND: Web-based decision aids are increasingly important in medical research and clinical care. However, few have been studied in an intensive care unit setting. The objectives of this study were to develop a Web-based decision aid for family members of patients receiving prolonged mechanical ventilation and to evaluate its usability and acceptability. METHODS: Using an iterative process involving 48 critical illness survivors, family surrogate decision makers, and intensivists, we developed a Web-based decision aid addressing goals of care preferences for surrogate decision makers of patients with prolonged mechanical ventilation that could be either administered by study staff or completed independently by family members (Development Phase). After piloting the decision aid among 13 surrogate decision makers and seven intensivists, we assessed the decision aid's usability in the Evaluation Phase among a cohort of 30 surrogate decision makers using the Systems Usability Scale (SUS). Acceptability was assessed using measures of satisfaction and preference for electronic Collaborative Decision Support (eCODES) versus the original printed decision aid. RESULTS: The final decision aid, termed 'electronic Collaborative Decision Support', provides a framework for shared decision making, elicits relevant values and preferences, incorporates clinical data to personalize prognostic estimates generated from the ProVent prediction model, generates a printable document summarizing the user's interaction with the decision aid, and can digitally archive each user session. Usability was excellent (mean SUS, 80 ± 10) overall, but lower among those 56 years and older (73 ± 7) versus those who were younger (84 ± 9); p = 0.03. A total of 93% of users reported a preference for electronic versus printed versions. CONCLUSIONS: The Web-based decision aid for ICU surrogate decision makers can facilitate highly individualized information sharing with excellent usability and acceptability. Decision aids that employ an electronic format such as eCODES represent a strategy that could enhance patient-clinician collaboration and decision making quality in intensive care.

An online daily diary study of alcohol use using Amazon's mechanical turk

Introduction and Aims: In recent years, unprecedented levels of Internet access and the widespread growth of emergent communication technologies have resulted in significantly greater population access for substance use researchers. Despite the research potential of such technologies, the use of the Internet to recruit individuals for participation in event-level research has been limited. The purpose of this paper is to provide a brief account of the methods and results from an online daily diary study of alcohol use. Design and Methods: Participants were recruited using Amazon's Mechanical Turk. Eligible participants completed a brief screener assessing demographics and health behaviours, with a subset of individuals subsequently recruited to participate in a 2 week daily diary study of alcohol use. Results: Multilevel models of the daily alcohol data derived from the Mechanical Turk sample (n=369) replicated several findings commonly reported in daily diary studies of alcohol use. Discussion and Conclusions: Results demonstrate that online participant recruitment and survey administration can be a fruitful method for conducting daily diary alcohol research. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Mechanistic-based Design-Integrated Reliability Validation Framework for Mechanical Systems

Abstract: New product design challenges, related to customer needs, product usage and environments, face companies when they expand their product offerings to new markets; Some of the main challenges are: the lack of quantifiable information, product experience and field data. Designing reliable products under such challenges requires flexible reliability assessment processes that can capture the variables and parameters affecting the product overall reliability and allow different design scenarios to be assessed. These challenges also suggest a mechanistic (Physics of Failure-PoF) reliability approach would be a suitable framework to be used for reliability assessment. Mechanistic Reliability recognizes the primary factors affecting design reliability. This research views the designed entity as a “system of components required to deliver specific operations”; it addresses the above mentioned challenges by; Firstly: developing a design synthesis that allows a descriptive operations/ system components relationships to be realized; Secondly: developing component’s mathematical damage models that evaluate components Time to Failure (TTF) distributions given: 1) the descriptive design model, 2) customer usage knowledge and 3) design material properties; Lastly: developing a procedure that integrates components’ damage models to assess the mechanical system’s reliability over time. Analytical and numerical simulation models were developed to capture the relationships between operations and components, the mathematical damage models and the assessment of system’s reliability. The process was able to affect the design form during the conceptual design phase by providing stress goals to meet component’s reliability target. The process was able to numerically assess the reliability of a system based on component’s mechanistic TTF distributions, besides affecting the design of the component during the design embodiment phase. The process was used to assess the reliability of an internal combustion engine manifold during design phase; results were compared to reliability field data and found to produce conservative reliability results. The research focused on mechanical systems, affected by independent mechanical failure mechanisms that are influenced by the design process. Assembly and manufacturing stresses and defects’ influences are not a focus of this research.

An integrated approach to flow, thermal and mechanical modeling of electronics devices

The future success of many electronics companies will depend to a large extent on their ability to initiate techniques that bring schedules, performance, tests, support, production, life-cycle-costs, reliability prediction and quality control into the earliest stages of the product creation process. Earlier papers have discussed the benefits of an integrated analysis environment for system-level thermal, stress and EMC prediction. This paper focuses on developments made to the stress analysis module and presents results obtained for an SMT resistor. Lifetime predictions are made using the Coffin-Manson equation. Comparison with the creep strain energy based models of Darveaux (1997) shows the shear strain based method to underestimate the solder joint life. Conclusions are also made about the capabilities of both approaches to predict the qualitative and quantitative impact of design changes.

Thermal, mechanical and optical modelling of VCSEL packaging

Hybrid OECB (Opto-Electrical Circuit Boards) are expected to make a significant impact in the telecomm switches arena within the next five years, creating optical backplanes with high speed point-to-point optical interconnects. OECB's incorporate short range optical interconnects, and are based on VCSEL (Vertical Cavity Surface Emitting Diode) and PD (Photo Diode) pairs, connected to each other via embedded waveguides in the OECB. The VCSEL device is flip-chip assembled onto an organic substrate with embedded optical waveguides. The performance of the VCSEL device is governed by the thermal, mechanical and optical characteristics of this assembly. During operation, the VCSEL device will heat up and the thermal change together with the CTE mismatch in the materials, will result in potential misalignment between the VCSEL apertures and the waveguide openings in the substrate. Any degree of misalignment will affect the optical performance of the package. This paper will present results from a highly coupled modelling analysis involving thermal, mechanical and optical models. The paper will also present results from an optimisation analysis based on Design of Experiments (DOE).

Micro-mechanical parameterisations for continuum modelling of granular material using the discrete element method

The present work uses the discrete element method (DEM) to describe assemblies of particulate bulk materials. Working numerical descriptions of entire processes using this scheme are infeasible because of the very large number of elements (1012 or more in a moderately sized industrial silo). However it is possible to capture much of the essential bulk mechanics through selective DEM on important regions of an assembly, thereafter using the information in continuum numerical descriptions of particulate processes. The continuum numerical model uses population balances of the various components in bulk solid mixtures. It depends on constitutive relationships for the internal transfer, creation and/or destruction of components within the mixture. In this paper we show the means of generating such relationships for two important flow phenomena – segregation whereby particles differing in some important property (often size) separate into discrete phases, and degradation, whereby particles break into sub-elements, through impact on each other or shearing. We perform DEM simulations under a range of representative conditions, extracting the important parameters for the relevant transfer, creation and/or destruction of particles in certain classes within the assembly over time. Continuum predictions of segregation and degradation using this scheme are currently being successfully validated against bulk experimental data and are beginning to be used in schemes to improve the design and operation of bulk solids process plant.

Mathematical modelling of the behaviour of granular material in a computational fluid dynamics framework using micro-mechanical models

In this paper, a Computational Fluid Dynamics framework is presented for the modelling of key processes which involve granular material (i.e. segregation, degradation, caking). Appropriate physical models and sophisticated algorithms have been developed for the correct representation of the different material components in a granular mixture. The various processes, which arise from the micromechanical properties of the different mixture species can be obtained and parametrised in a DEM / experimental framework, thus enabling the continuum theory to correctly account for the micromechanical properties of a granular system. The present study establishes the link between the micromechanics and continuum theory and demonstrates the model capabilities in simulations of processes which are of great importance to the process engineering industry and involve granular materials in complex geometries.

Use of a coupled mechanical-acoustic computational model to identify failure mechanisms in paper production

In this paper, a couple mechanical-acoustic system of equations is solved to determine the relationship between emitted sound and damage mechanisims in paper under controlled stress conditions. The simple classical expression describing the frequency of a plucked string to its material properties is used to generate a numberical representation of the microscopic structue of the paper, and the resulting numerical model is then used to simulate the vibration of a range of simple fibre structures when undergoing two distinct types of damange mechanisms: (a)fibre/fibre bond failure, (b) fibre failure. The numercial results are analysed to determine whether there is any detectable systematic difference between the resulting acoustic emissions of the two damage processes. Fourier techniques are then used to compare th computeed results against experimental measurements. Distinct frequency components identifying each type of damage are shown to exist, and in this respect theory and experiments show good correspondece. Hence, it is shown, that althrough the mathematical model represents a grossly-simplified view of the complex structure of the paper, it nevertheless provides a good understanding of the underlying micro-mechanisms characterising its proeperties as a stress-resisting structure. Use of the model and acoompanying software will enable operators to identify approaching failure conditions in the continuous production of paper from emitted sound signals and take preventative action.

Thermo-mechanical modelling of power electronics module structures

Power electronic modules distinguish themselves from other modules by their high power operation. These modules are used extensively in high power application markets such as aerospace, automotive, industrial and traction and drives. This paper discusses typical packaging technologies for power electronics modules. It also discusses the latest results from a UK research project investigating the physics-of-failure approach to reliability analysis and predictions for power modules. An integrated design enviroment for incorporating of affects of uncertainty into the design environment was outlined.

Thermo-mechanical analysis of the packaging process for micro-electronic displays

Micro-electronic displays are sensitive devices and its performance is easily affected by external environmental factors. To enable the display to perform in extreme conditions, the device must be structurally strengthened, the effects of this packaging process was investigated. A thermo-mechanical finite element analysis was used to discover potential problems in the packaging process and to improve the overall design of the device. The main concern from the analysis predicted that displacement of the borosilicate glass and the Y stress of the adhesive are important. Using this information a design which reduced the variation of displacement and kept the stress to a minimum was suggested

Analysis of the thermo mechanical effects on packaging process of performance enhanced AMLCD's and the optical performance of the display

The performance enhancement of AMLCD's has been hindered with problems encountered during the curing process, such as window framing and de-lamination of the glass and adhesive. A thermo-mechanical analysis using FEA was conducted to help optimise the design of the rugged display and enhance the optical performance.

Thermal-mechanical analysis of flexible substrates during lead-free solder reflow

This paper presents modeling results about the performance of flexible substrates when subjected to higher lead-free reflow temperatures. Both adhesiveless and adhesive types of polyimide substrates were studied. Finite element (FE) models of flex substrates were built, two copper tracks located in the centre of the substrate was considered. The thermal induced shear stress in the flex substrate during the lead-free reflow process was studied and the effect of the design changes including the track thickness, flex thickness, and copper width were studied. For both types of flexes, the one of most important variables for minimizing damage to the substrate is the height of the copper tracks. The height of flex and the width of copper track show less impact. Beside of the geometry effects, the increase in reflow peak temperature can also result in a significant increase in the interfacial stress between the copper track and flex. Higher stresses were identified within the adhesive flex due to the big CTE mismatch between the copper and adhesive/dielectric

Review of methods to predict solder joint reliability under thermo-mechanical cycling

Solder joints are often the cause of failure in electronic devices, failing due to cyclic creep induced ductile fatigue. This paper will review the modelling methods available to predict the lifetime of SnPb and SnAgCu solder joints under thermo-mechanical cycling conditions such as power cycling, accelerated thermal cycling and isothermal testing, the methods do not apply to other damage mechanisms such as vibration or drop-testing. Analytical methods such as recommended by the IPC are covered, which are simple to use but limited in capability. Finite element modelling methods are reviewed, along with the necessary constitutive laws and fatigue laws for solder, these offer the most accurate predictions at the current time. Research on state-of-the-art damage mechanics methods is also presented, although these have not undergone enough experimental validation to be recommended at present

An analysis of the changes to the mechanical and acoustical properties of paper caused by the damage mechanisms present in the fibre structure

This paper will analyse two of the likely damage mechanisms present in a paper fibre matrix when placed under controlled stress conditions: fibre/fibre bond failure and fibre failure. The failure process associated with each damage mechanism will be presented in detail focusing on the change in mechanical and acoustic properties of the surrounding fibre structure before and after failure. To present this complex process mathematically, geometrically simple fibre arrangements will be chosen based on certain assumptions regarding the structure and strength of paper, to model the damage mechanisms. The fibre structures are then formulated in terms of a hybrid vibro-acoustic model based on a coupled mass/spring system and the pressure wave equation. The model will be presented in detail in the paper. The simulation of the simple fibre structures serves two purposes; it highlights the physical and acoustic differences of each damage mechanism before and after failure, and also shows the differences in the two damage mechanisms when compared with one another. The results of the simulations are given in the form of pressure wave contours, time-frequency graphs and the Continuous Wavelet Transform (CWT) diagrams. The analysis of the results leads to criteria by which the two damage mechanisms can be identified. Using these criteria it was possible to verify the results of the simulations against experimental acoustic data. The models developed in this study are of specific practical interest in the paper-making industry, where acoustic sensors may be used to monitor continuous paper production. The same techniques may be adopted more generally to correlate acoustic signals to damage mechanisms in other fibre-based structures.