Virtual Workflow Research Articles

Treatment outcomes of digital nasoalveolar moulding in infants with cleft lip and palate: A systematic review with meta-analysis.

The aim of this systematic review was to compare the treatment outcomes of digital nasoalveolar moulding (dNAM) technique with conventional nasoalveolar moulding (cNAM) or non-presurgical intervention protocol in infants with unilateral (UCLP) or bilateral (BCLP) cleft lip and palate. A bibliometric search by MEDLINE (via Ovid), Embase, Cochrane Library, grey literature and manual method was conducted without language restriction until November 2023. Literature screening and data extraction were undertaken in Covidence. The risk of bias was evaluated using the Newcastle-Ottawa Scale and RoB-2. Pooled effect sizes were determined through random-effects statistical model using R-Software, and the certainty of evidence was assessed using the GRADE approach. Among 775 retrieved articles, nine studies were included for qualitative synthesis (6-UCLP, 3-BCLP), with only three eligible UCLP studies for meta-analysis. In the UCLP group, very low certainty of evidence indicated no difference in alveolar cleft width (SMD, 0.13 mm; 95% CI, -0.31 to 0.57; I2, 0%), soft tissue (lip) cleft gap, nasal width, nasal height, and columellar deviation angle changes between dNAM and cNAM. In the BCLP group, qualitative synthesis suggested similar changes in alveolar, lip, and nasal dimensions with dNAM and cNAM. In both cleft groups (UCLP, BCLP), reduced alveolar cleft width was observed in the dNAM group compared to the non-presurgical intervention protocol, along with fewer clinical visits and reduced chairside time for dNAM compared to cNAM. It can be concluded that the treatment outcomes with dNAM were comparable to cNAM in reducing malformation severity and were advantageous in terms of chairside time and clinical visit frequency. However, the overall quality of evidence is very low and standardization is needed for the virtual workflow regarding the alveolar movements and growth factor algorithms. Registration: PROSPERO-database (CRD42020186452).

Fully digital occlusion planning in orthognathic surgery – A crossover study

Orthognathic surgery enables patients with severe jaw malocclusions to normalise their chewing function and, as such, to improve their quality of life. Over the last few years, digitalisation has been set in motion by intraoral scanners and the improvement of planning software in the field of oral and maxillofacial surgery. Previous studies based on plaster cast models showed that the virtual occlusion based on digitally scanned models can be comparable to conventional methods. This retrospective crossover study aimed to prove that the virtual occlusion finding with the IPS CaseDesigner® (version 2.3.5.2, KLS Martin, Tuttlingen, Germany) is accurate enough to use intraoral scans exclusively. Materials and methodsA total of 23 orthognathic surgery patients receiving an intraoral scan for their treatment were included in this study. Two experienced maxillofacial surgeons haptically performed the occlusion finding on three-dimensional (3D) stereolithographic models using the fully digital pathway. One surgeon repeated the procedure a second time to evaluate intra-observer variability. The study aimed to show the difference between these two planning methods by upholding the surgical accuracy of less than 2 mm in translation and 2° in rotation. The conventional haptic occlusion was set as a reference throughout the whole study. The data were tested with a one-sample Wilcoxon test for the fit into the surgical accuracy. ResultsThe difference between the virtual and conventional groups was significantly smaller than the surgical accuracy (all p < 0.001). Both translational movements (anterior/posterior (median 0.51 mm [0.28, 0.88]), left/right (median 0.46 mm [0.20, 0.87]), cranial/caudal (median 0.37 mm [0.11, 0.69])) and rotations (Roll (median 0.71° [0.29, 1.35]), Pitch (median 0.72° [0.29, 1.44]), Yaw (median 1.09° [0.33, 1.60])) were in the range of surgical accuracy (2 mm/2°). The most significant differences were found in the anterior/posterior translation (median 0.51 mm [0.28, 0.88]) and the Yaw rotation (median 1.09° [0.33, 1.60]). ConclusionThese results demonstrate that the entirely virtual workflow in orthognathic surgery, including intraoral scanning and the virtual semi-automatic occlusion finding, represents a reliable and state-of-the-art alternative to the conventional haptic method.

Teledermatology: Simulating Hybrid Workflows for Telemedicine Education.

Given the importance of telemedicine in improving healthcare access for underserved patients, professional students need experience using virtual clinical workflows. We developed an educational workshop with (1) readings, (2) a knowledge assessment test, (3) dermatology and teledermatology lectures, (5) a telemedicine simulation with a standardized patient, and (6) a debriefing session. The simulation included a "hybrid" workflow with live videoconferencing and store-and-forward image review. We measured student performance using three American Association of Medical Colleges (AAMC) Telemedicine Competencies for medical education. Ninety-eight medical and physician assistant students completed this workshop between 2021 and 2022, and 80% were entrustable or approaching entrustment in each competency. Some students struggled with data collection and technology use. Our results suggest that this workshop offers a practical and generalizable way to teach about multiple virtual workflows and strengthen students' telemedicine competencies.

Multi-objective evolutionary scheduling based on collaborative virtual workflow model and adaptive rules for flexible production process with operation reworking

Dynamic event disturbances during production such as reworking of defective operations more challenge scheduling optimization. Efficient response to operation reworking is crucial for collaborative optimization of production quality and scheduling performance. Given the complex constraints within production processes of jobs involving key operation reworking and uncertainty of dynamic disturbances, a two-level virtual workflow modeling method and a multi-objective evolutionary scheduling algorithm with adaptive rules (MOESA-AR) based on collaborative virtual workflow framework are proposed. Virtual workflow modeling fulfills linear abstraction of tasks to be scheduled and priority constraints. Through decision arrangement, task state tracking and information feedback, collaborative virtual workflow model constitutes framework for dynamic update of task workflows and real-time response to rescheduling triggered by event disturbances. MOESA-AR adopts two-dimensional chromosome evolution and heuristic rule training to adapt to the complexity of scheduling optimization. Adaptive strategy of dispatching rules enhances the dynamic adaptability of decision-making to variable scheduling scenarios, thereby improving the dominance level of multi-objective trade-off optimization under changing demand conditions. Experiments confirm the superiority of MOESA-AR in improving scheduling performance and the effectiveness of collaborative virtual workflow scheduling framework in responding to dynamic disturbances.

Comparative study of colour stability and shape retention: From virtual reconstruction to physical restoration of a porcelain figurine

By providing a virtual workflow, the reconstruction of missing parts of a porcelain figurine is facilitated. A CT scan enabled the virtual reconstruction by repositioning an existing part. Ten materials were selected to find a suitable material for the physical reconstruction: two traditional restoration materials, six Additive Manufacturing (AM) materials and two ceramic AM materials. After artificial ageing, these materials were evaluated on their colour and shape, complemented by a visual observation survey and a literature search on Volatile Organic Compounds. For each of these parameters scores were given to rank the materials. None of the materials scored best in all aspects, so the final decision remains a trade-off. The overall most successful and safe-to-use material is porcelain plaster Zellaan, cast from an intermediary 3D print. PLA (Fused Deposition Modelling) has the overall lowest score and is to be avoided for this case study and future case studies.

Improving Cranial Vault Remodeling for Unilateral Coronal Craniosynostosis-Introducing Automated Surgical Planning.

Cranial vault remodeling (CVR) for unicoronal synostosis is challenging due to the asymmetric nature of the deformity. Computer-automated surgical planning has demonstrated success in reducing the subjectivity of decision making in CVR in symmetric subtypes. This proof of concept study presents a novel method using Boolean functions and image registration to automatically suggest surgical steps in asymmetric craniosynostosis. The objective of this study is to introduce automated surgical planning into a CVR virtual workflow for an asymmetric craniosynostosis subtype. Virtual workflows were developed using Geomagic Freeform Plus software. Hausdorff distances and color maps were used to compare reconstruction models to the preoperative model and a control skull. Reconstruction models were rated as high or low performing based on similarity to the normal skull and the amount of advancement of the frontal bone (FB) and supra-orbital bar (SOB). Fifteen partially and fully automated workflow iterations were carried out. FB and SOB advancement ranged from 3.08 to 10.48mm, and -1.75 to 7.78mm, respectively. Regarding distance from a normal skull, models ranged from .85 to 5.49mm at the FB and 5.40 to 10.84mm at the SOB. An advancement of 8.43mm at the FB and 7.73mm at the SOB was achieved in the highest performing model, and it differed to a comparative normal skull by .02mm at the FB and .48mm at the SOB. This is the first known attempt at developing an automated virtual surgical workflow for CVR in asymmetric craniosynostosis. Key regions of interest were outlined using Boolean operations, and surgical steps were suggested using image registration. These techniques improved post-operative skull morphology.

MasitinibL shows promise as a drug-like analog of masitinib that elicits comparable SARS-Cov-2 3CLpro inhibition with low kinase preference

SARS-CoV-2 infection has led to several million deaths worldwide and ravaged the economies of many countries. Hence, developing therapeutics against SARS-CoV-2 remains a core priority in the fight against COVID-19. Most of the drugs that have received emergency use authorization for treating SARS-CoV-2 infection exhibit a number of limitations, including side effects and questionable efficacy. This challenge is further compounded by reinfection after vaccination and the high likelihood of mutations, as well as the emergence of viral escape mutants that render SARS-CoV-2 spike glycoprotein-targeting vaccines ineffective. Employing de novo drug synthesis or repurposing to discover broad-spectrum antivirals that target highly conserved pathways within the viral machinery is a focus of current research. In a recent drug repurposing study, masitinib, a clinically safe drug against the human coronavirus OC43 (HCoV-OC43), was identified as an antiviral agent with effective inhibitory activity against the SARS-CoV-2 3CLpro. Masitinib is currently under clinical trial in combination with isoquercetin in hospitalized patients (NCT04622865). Nevertheless, masitinib has kinase-related side effects; hence, the development of masitinib analogs with lower anti–tyrosine kinase activity becomes necessary. In this study, in an attempt to address this limitation, we executed a comprehensive virtual workflow in silico to discover drug-like compounds matching selected pharmacophore features in the SARS-CoV-2 3CLpro-bound state of masitinib. We identified a novel lead compound, “masitinibL”, a drug-like analog of masitinib that demonstrated strong inhibitory properties against the SARS-CoV-2 3CLpro. In addition, masitinibL further displayed low selectivity for tyrosine kinases, which strongly suggests that masitinibL is a highly promising therapeutic that is preferable to masitinib.

Cone Beam Computed Tomography and Virtual Cloning: A Review

AbstractWith the use of technologies, dental office workflow is moving toward a more efficient and cost-effective approach. Digitalization of dental records and computer-assisted imaging techniques have simplified workflow. Innovation and introduction of cone beam computed tomography, proface (facial three-dimensional [3D] soft-tissue capture), intraoral scan, planning software, and 3D printers has changed the dental profession. Clinical practice uses virtual workflows, and digital dentistry is a new development. The purpose of this article is to update the dental professionals with different available technologies for the creation of a virtual patient and digital tools that can be used for diagnosis, treatment planning, and follow-up of patients. The advantages of digital dentistry and future scope are highlighted in this article.

Multi-Objective Workflow Optimization Algorithm Based on a Dynamic Virtual Staged Pruning Strategy

Time, cost, and quality are critical factors that impact the production of intelligent manufacturing enterprises. Achieving optimal values of production parameters is a complex problem known as an NP-hard problem, involving balancing various constraints. To address this issue, a workflow multi-objective optimization algorithm, based on the dynamic virtual staged pruning (DVSP) strategy, was proposed to optimize multi-stage nonlinear production processes. The algorithm establishes a virtual workflow model based on the actual production process and proposes a pruning strategy to eliminate the indirect constraint relationship between tasks. A virtual hierarchical strategy is employed to divide the task node set, and the Pareto optimal service set is calculated through backward iteration in stages. The optimal path is generated through forward scheduling, and the global optimal solution is obtained. The algorithm was compared with the minimum critical path algorithm (MCP) and the partial critical path budget balance scheduling algorithm (PCP-B2). The experimental results demonstrated that the DVSP can improve product quality, reduce production costs, and ensure production stability while completing production tasks. This paper used a pruning strategy and virtual workflow modeling methods to achieve dynamic multi-objective optimization scheduling for nonlinear feedback manufacturing processes.

Multi-Objective Multi-Stage Optimize Scheduling Algorithm for Nonlinear Virtual Work-Flow Based on Pareto

Work-flow scheduling is for finding the allocation method to achieve optimal resource utilization. In the scheduling process, constraints, such as time, cost and quality, need to be considered. How to balance these parameters is a NP-hard problem, and the nonlinear manufacturing process increases the difficulty of scheduling, so it is necessary to provide an effective heuristic algorithm. Aiming at these problems, a multi-objective nonlinear virtual work-flow model was set up, and a multi-objective staged scheduling optimization algorithm with the objectives of minimizing cost and time and maximizing quality was proposed. The algorithm includes three phases: the virtualization phase abstracts tasks and services into virtual nodes to generate a virtual work-flow model; the virtual scheduling phase divides optimized segments and obtains the solution set through reverse iteration; the generation phase obtains the scheduling path according to the Pareto dominance. The proposed algorithm performed 10.5% better in production quality than the minimum critical path algorithm, reduced the time to meet the time constraint by 9.1% and saves 13.7% more of the cost than the production accuracy maximization algorithm.

Virtual-First: A virtual workflow for new patient consultation, engagement and education in orthodontics

Virtual-First is a new patient enquiry system and workflow to provide a screening virtual orthodontic consultation to a potential orthodontic patient. The workflows and systems presented in this paper are an example of how virtual technologies can be integrated by an orthodontic practice, as an additional supplement, to provide a more engaged, educational and screening model for new patients potentially reducing time and costs that are associated with existing traditional orthodontic consultation models. Using Artificial Intelligence (AI) driven technologies, automated or semi-automated responses can be created to increase practice efficiency and reduce administrative time and errors by the orthodontic teams and professionals. This paper also highlights the challenges to technologies and provides advise on improvements in such systems in the future.

Enabling Patients as Partners on Virtual Teams: A Scoping Review.

Developing partnerships among patients and healthcare providers improves quality of virtual care. Successful patient engagement is influenced by digital literacy. Although adults (35-64) with chronic health challenges may be motivated to use virtual services, they may not have the required skills or orientation to effectively participate on their virtual team. This scoping review aimed to identify resources available to enable adults with chronic health challenges to participate as partners on their virtual teams. Peer-reviewed and grey literature data from 2011 to 2022 were searched. A total of 432 peer-reviewed and 357 grey literature sources were retrieved and screened, and 14 and 84 sources, respectively, met the inclusion criteria. Relevant information from the sources was extracted and analyzed in duplicate and synthesized qualitatively. Key findings include (1) virtual workflow processes/frameworks, (2) 'webside manner' guidelines which emphasize "the how" as opposed to "the what" of facilitating team interactions, and (3) virtual patient support personnel. Overall, analyses suggest there are persisting gaps to be addressed in synchronous virtual care resources for adults with chronic health challenges.

A comparative study to measure the sagittal condylar inclination using mechanical articulator, virtual articulator and jaw tracking device.

To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAIOS-CBCT and VAIOS-FS. Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAIOS-CBCT, VAIOS-FS, and JTD compared with MA was evaluated by Bland-Altman analysis. Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAIOS-CBCT (P = .028). Significant differences were not found between MA and VAIOS-FS (P > .05). Bland-Altman plots indicated VAIOS-CBCT, VAIOS-FS, and JTD were considered to substitute MA with high 95% limits of agreement. The workflow of VAIOS-FS provided an alternative approach to measure the SCI compared with MA.

3D U-Net Segmentation Improves Root System Reconstruction from 3D MRI Images in Automated and Manual Virtual Reality Work Flows.

Magnetic resonance imaging (MRI) is used to image root systems grown in opaque soil. However, reconstruction of root system architecture (RSA) from 3-dimensional (3D) MRI images is challenging. Low resolution and poor contrast-to-noise ratios (CNRs) hinder automated reconstruction. Hence, manual reconstruction is still widely used. Here, we evaluate a novel 2-step work flow for automated RSA reconstruction. In the first step, a 3D U-Net segments MRI images into root and soil in super-resolution. In the second step, an automated tracing algorithm reconstructs the root systems from the segmented images. We evaluated the merits of both steps for an MRI dataset of 8 lupine root systems, by comparing the automated reconstructions to manual reconstructions of unaltered and segmented MRI images derived with a novel virtual reality system. We found that the U-Net segmentation offers profound benefits in manual reconstruction: reconstruction speed was doubled (+97%) for images with low CNR and increased by 27% for images with high CNR. Reconstructed root lengths were increased by 20% and 3%, respectively. Therefore, we propose to use U-Net segmentation as a principal image preprocessing step in manual work flows. The root length derived by the tracing algorithm was lower than in both manual reconstruction methods, but segmentation allowed automated processing of otherwise not readily usable MRI images. Nonetheless, model-based functional root traits revealed similar hydraulic behavior of automated and manual reconstructions. Future studies will aim to establish a hybrid work flow that utilizes automated reconstructions as scaffolds that can be manually corrected.

Prompt Pain Relief from Bone Metastases: The Virtual Simulation Program

<h3>Purpose/Objective(s)</h3> Patients commonly present to radiation oncology with painful bone metastases. A major bottleneck in delaying treatment of these patients is scheduling a separate CT simulation appointment. We implemented an alternative radiation planning workflow, which utilized a pre-existing diagnostic CT scan "virtual simulation" in lieu of acquiring an additional CT simulation scan. We hypothesized this would significantly decrease the time interval between initial consultation and treatment start date. <h3>Materials/Methods</h3> Patients meeting strict criteria were selected for virtual simulation. This included only those with painful bone metastases in the thorax/abdomen/pelvis/upper femur who would be treated with palliative intent using standard AP/PA or opposed lateral fields. A recent (within 30 days) diagnostic CT scan clearly visualizing the target volume and surrounding anatomy was required for treatment planning and for daily IGRT treatment purposes. Descriptive statistics were used to analyze time from consultation to start of treatment in virtual versus in-person simulation patients. Before and after the virtual simulation study period, surveys were administered to all stakeholders (physicians, nurses, dosimetrists, physicists, and radiation therapists) to assess staff satisfaction of virtual simulation workflow using a Likert scale. Staff were surveyed on their stress levels, how rushed they felt, and overall level of satisfaction. A 1–5-point scale was used with higher numbers indicating worse outcomes such as increased stress, being more rushed, and less satisfaction. <h3>Results</h3> 24 patients were palliatively treated for painful bone metastases as part of this pilot virtual simulation project from May 2021 to January 2022. Median number of fractions for all courses was one fraction. A reference group of 40 patients palliatively treated with in-person CT simulation from February 2021 to July 2021 was also retrospectively reviewed. Median time from consult to start of treatment for in-person CT simulation patients was 167 hours (6.96 days). In comparison, median time from consult to start of treatment for virtual simulation patients was 71 hours (2.96 days). Median duration of treatment itself was 12 minutes for virtual simulation patients versus 9 minutes for in-person simulation patients. 20 surveys were collected prior to the virtual simulation while 15 surveys were collected after the time period. For virtual versus in-person workflows, staff felt less rushed (2.5 vs. 2.8), less stressed (2.0 vs. 2.5), and more satisfied overall (1.86 vs. 2.76). <h3>Conclusion</h3> The virtual simulation program decreased time from consult to start of treatment for patients requiring urgent palliative radiotherapy for painful bone metastases by 57.5% (6.96 vs. 2.96 days). The alternative virtual workflow did not decrease overall staff satisfaction.

Design and Virtual Workflow of a Patient Database for Clinical and Pharmaceutical Trials Part II: A Prototype for Endocrinology.

Background In previous work, we have reported that patient recruitment is closely related to electronic health records (EHR). As a result, the next step of investigation would lead to the implementation of research practices for using EHR in selecting patients for clinical trials. Towards that end, open-source software offers several integrated solutions that can meet the needs of an EHR and patient recruitment. Aim In the present work, we have designed a prototype of a patient recruitment system using open-source tools. The proposed prototype can draw data from a patient management system and present selected patients based on specific criteria. Methods For the objective of the present study, we have used the methodology described previously. In particular, we recorded numerous integrated solutions for EHR from the area of free and open-source software. Open Electronic Medical Records (OpenEMR) ranked first for functionality and second for usability efficiency. Hence, we relied on OpenEMR to design a prototype patient recruitment system. After the installation and commissioning of OpenEMR, we created appropriate test scenarios. Therefore, populated appropriate patient data in OpenEMR. PhpMyAdmin was installed and commissioned along with the OpenEMR installation. This tool is used to manage MySQL database systems. MySQL is the database system that programmers rely on to develop OpenEMR. Results A prototype patient recruitment system was designed, which draws data from a view of the OpenEMR database to present results based on criteria. Conclusions After the adaptation of the database and the design of the proposed solution, we concluded, based on the prototype results, that there is potential for developing an integrated patient recruitment management system. This management system can be based on the implementation of complex criteria and present results according to the needs of the end-user.

Digital Implantology full mouth reconstruction by complete 3D virtual workflow

The present case report demonstrates a fully integrated digital protocol for pretreatment surgical & restorative implant planning and execution of a hopeless dentition. A 56-year-old female patient presented with a periodontally compromised failing dentition. Preclinical Protocol Aesthetic analysis was done in EXOCAD using DSLR photographs and a face scan (DOF). Further to that IOS (3shape Trios) STL file & CBCT Dicom file were integrated into the EXOPLAN software for virtual implant planning. A fully guided surgical stent was printed on the 3D printer (BEGO) and PMMA temporaries were milled for immediate loading. Clinical Protocol: Following full mouth extraction the surgical guide was placed with fixation pins. Seven active implants in the upper jaw & six in the lower jaw were placed and subsequently loaded with milled PMMA temporaries using multi-unit abutments. Upon healing, after 4 months intraoral scanning was done using a multi-unit scan body; function was restored using a customized milled titanium bar with Zirconia framework. We observed advantages such as simplification of clinical steps with accurate reproduction of proposed planning done prior with complete digital workflow. The entire process provided us extreme precision in delivering the temporary and final prosthesis as planned prior to the surgery. The patient was extremely satisfied with the treatment and the situation remained stable at follow-up. Fully digital implant workflow is restoratively driven and provides predictable aesthetic and functional treatment outcomes. The procedure requires additional training for the implantologist and has a learning curve.

Multi-objective optimization scheduling for manufacturing process based on virtual workflow models

Currently, processing time, energy consumption and processing quality are three significant optimization objectives for manufacturing process. The variety of optimization objectives and the constraints of processes make the production scheduling an NP-hard problem. To improve processing quality, feedback processing is requisite in productive process, but the nonlinearity of feedback process causes further scheduling complexity. The purpose of this research is to realize the multi-objective optimization scheduling of manufacturing process with feedback process. To solve these problems, a virtual workflow modeling method for parallel manufacturing process of manifold varieties of jobs is proposed in this study, and based on the models, a Multi-Objective Virtual Workflow Scheduling Algorithm (MOVWSA) is contributed. In MOVWSA, the genetic evolution based on two-dimensional chromosome coding and weighted elite retention metrics is employed to select processing equipment for processes, and a sequence-selective strategy is proposed to specify processing order and starting time of each process. It is shown from the comparative test results on flexible job shop scheduling benchmark instances (MK01–MK10) that the proposed MOVWSA can provide more dominant static solutions for multi-objective optimization scheduling. The simulation test illustrates that MOVWSA with virtual workflow modeling is capable of dynamically adjusting the processing plans when reprocessing events occur to ensure the stability of processing with makespan and energy consumption. Consequently, the method contributed in this paper achieves the static and dynamic multi-objective optimization scheduling for manufacturing process with nonlinear feedback process by the two mechanisms of virtual modeling and evolutionary optimization.

Virtual Multiphase Flowmetering Using Adaptive Neuro-Fuzzy Inference System (ANFIS): A Case Study of Hai Thach-Moc Tinh Field, Offshore Vietnam

Summary For any oil and gas company, well-testing and performance-monitoring programs are expensive because of the cost of equipment and personnel. In addition, it may not be possible to obtain all of the necessary data for a reservoir for a period of time because of production demand constraints or changes in surface process conditions. To overcome these challenges, there are many studies on the implementation and value of virtual flowmetering (VFM) for real-time well performance prediction without any need for a comprehensive well-testing program. This paper presents the VFM model using an adaptive neuro-fuzzy inference system (ANFIS) at Hai Thach-Moc Tinh (HT-MT) gas-condensate field, offshore Vietnam. The ANFIS prediction model can tune all its membership functions (MFs) and consequent parameters to formulate the given inputs to the desired output with minimum error. In addition, ANFIS is a successful technique used to process large amounts of complex time series data and multiple nonlinear inputs-outputs (Salleh et al. 2017), thereby enhancing predictability. The authors have built ANFIS models combined with large data sets, data smoothing, and k-fold cross-validation methods based on the actual historical surface parameters such as choke valve opening, surface pressure, temperature, the inlet pressure of the gas processing system, etc. The prediction results indicate that the local regression “loess” data smoothing method reduces the processing time and gives both clustering algorithms the best results among the different data preprocessing techniques [highest value of R and lowest value of mean squared error (MSE), error mean, and error standard deviation]. The k-fold cross-validation technique demonstrates the capability to avoid the overfitting phenomenon and enhance prediction accuracy for the ANFIS subtractive clustering model. The fuzzy C-mean (FCM) model in the present study can predict the gas condensate production with the smallest root MSE (RMSE) of 0.0645 and 0.0733; the highest coefficient of determination (R2) of 0.9482 and 0.9337; and the highest variance account of 0.9482 and 0.9334 for training and testing data, respectively. Applied at the HT-MT field, the model allows the rate estimation of the gas and condensate production and facilitates the virtual flowmeter workflow using the ANFIS model.

Analysis of Virtual Versus In-Person Prospective Peer Review Workflow in a Multisite Academic Radiation Oncology Department

PurposeIn radiation oncology, peer review is a process where subjective treatment planning decisions are assessed by those independent of the prescribing physician. Before March 2020, all peer review sessions occurred in person; however due to the COVID-19 pandemic, the peer-review workflow was transitioned from in-person to virtual. We sought to assess any differences between virtual versus in-person prospective peer review. Methods and MaterialsPatients scheduled to receive nonemergent nonprocedural radiation therapy (RT) were presented daily at prospective peer-review before the start of RT administration. Planning software was used, with critical evaluation of several variables including treatment intent, contour definition, treatment target coverage, and risk to critical structures. A deviation was defined as any suggested plan revision. ResultsIn the study, 274 treatment plans evaluated in-person in 2017 to 2018 were compared with 195 plans evaluated virtually in 2021. There were significant differences in palliative intent (36% vs 22%; P = .002), but not in total time between simulation and the start of treatment (9.2 vs 10.0 days; P = .10). Overall deviations (8.0% in-person vs 2.6% virtual; P = .015) were significantly reduced in virtual peer review. ConclusionsProspective daily peer review of radiation oncology treatment plans can be performed virtually with similar timeliness of patient care compared with in-person peer review. A decrease in deviation rate in the virtual peer review setting will need to be further investigated to determine whether virtual workflow can be considered a standard of care.