In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includ...In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includes the air-fluid coupling and the nonlinearuncertainties, makes it difficult to have a consistent process performance. An integrated dispensingprocess model is first introduced and then its input-output regression relationship is used todesign a run to run control methodology for this process. The controller takes EWMA scheme and itsstability region is given. Experimental results verify the effectiveness of the proposed run to runcontrol method for dispensing process.展开更多
BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to ad...BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.展开更多
This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible col...This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible colour difference,thus investigating the required accuracy level fordyeing dispensing.This leads to the selection of one critical colour-difference dimension of threefrom CMC (1:c) measurement.The results reveal that the concentration change in dye dispensing ismost critical for change of Hue in a computer controlled system.The formula describing the rela-tionship Of △E and △H in CMC (2:1) measurement is selected for further investigation.展开更多
Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand ...Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand for improving print resolution towards the scale of a single cell has driven the development of precision nozzle extrusion,although the benefits gained remain ambiguous.Here,aided by in situ imaging,we investigated the dynamics of cell organisation through an extrusion-based microcapillary tip with picolitre precision through in-air or immersion deposition.The microcapillary extrusion setup,termed‘Picodis’,was demonstrated by generating droplets of colouring inks immersed in an immiscible medium.Next,using 3T3 fibroblast cells as an experimental model,we demonstrated the deposition of cell suspension,and pre-aggregated cell pellets.Then,the dynamic organisation of cells within the microcapillary tip was described,along with cell ejection and deposition upon exiting the tip opening.The vision-assisted approach revealed that when dispersed in a culture medium,the movements of cells were distinctive based on the flow profiles and were purely driven by laminar fluid flow within a narrow tip.The primary process limitations were cell sedimentation,aggregation and compaction,along with trapped air bubbles.The use of picolitre-level resolution microcapillary extrusion,although it provides some level of control for a small number of cells,does not necessarily offer a reliable method when a specified number of cells are required.Our study provides insights into the process limitations of high-resolution cell ink extrusion,which may be useful for optimising biofabrication processes of cell-laden constructs for biomedical research.展开更多
Based on the characteristics of parallel dispensers in automated picking system, an order-picking optimization problem is presented. Firstly, the working principle of parallel dispensers is introduced, which implies t...Based on the characteristics of parallel dispensers in automated picking system, an order-picking optimization problem is presented. Firstly, the working principle of parallel dispensers is introduced, which implies the time cost of picking each order is influenced by the order-picking sequence. So the order-picking optimization problem can be classified as a dynamic traveling salesman problem (TSP). Then a mathematical model of the problem is established and an improved max-min ant system (MMAS) is adopted to solve the model. The improvement includes two aspects. One is that the initial assignment of ants depends on a probabilistic formula instead of a random deployment; the other is that the heuristic factor is expressed by the extra picking time of each order instead of the total. At last, an actual simulation is made on an automated picking system with parallel dispensers. The simulation results proved the optimization value and the validity of improvement on MMAS.展开更多
Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked me...Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked medicine dispensing medicine management.Methods:The PDCA theory was used to analyze the data,to find out the causes of the problem,and to formulate the corresponding countermeasures to intervene.The data of the naked medicine/adverse drug events satisfaction degree of the inpatients in 18 inpatient departments given for the adoption of PDCA cycle in January 2017 were set as the observation group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before adoption of PDCA cycle in December 2016 was set as the control group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before and after adoption of PDCA cycle was observed and analyzed.Results:The number of the naked medicine/adverse drug events after implementing the method of PDCA cycle management rate was significantly lower than before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).The satisfaction degree of the inpatients after implementing the method of PDCA cycle management rate was significantly higher than that before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).Conclusion:Application of PDCA cycle in the management of the naked medicine dispensing about the automatic package can help to reduce the adverse drug events,to improve the safety of drug treatment,and to increase the patients’satisfaction degree.展开更多
Slotting strategy heavily influences the throughput and operational cost of automated order picking system with multiple dispenser types, which is called the complex automated order picking system (CAOPS). Existing ...Slotting strategy heavily influences the throughput and operational cost of automated order picking system with multiple dispenser types, which is called the complex automated order picking system (CAOPS). Existing research either focuses on one aspect of the slotting optimization problem or only considers one part of CAOPS, such as the Low-volume Dispensers, to develop corresponding slotting strategies. In order to provide a comprehensive and systemic approach, a fluid-based slotting strategy is proposed in this paper. The configuration of CAOPS is presented with specific reference to its fast-picking and restocking subsystems. Based on extended fluid model, a nonlinear mathematical programming model is developed to determine the optimal volume allotted to each stock keeping unit (SKU) in a certain mode by minimize the restocking cost of that mode. Conclusion from the allocation model is specified for the storage modules of high-volume dispensers and low-volume dispensers. Optimal allocation of storage resources in the fast-picking area of CAOPS is then discussed with the aim of identifying the optimal space of each picking mode. The SKU assignment problem referring to the total restocking cost of CAOPS is analyzed and a greedy heuristic with low time complexity is developed according to the characteristics of CAOPS. Real life application from the tobacco industry is presented in order to exemplify the proposed slotting strategy and assess the effectiveness of the developed methodology. Entry-item-quantity (EIQ) based experiential solutions and proposed-model-based near-optimal solutions are compared. The comparison results show that the proposed strategy generates a savings of over 18% referring to the total restocking cost over one-year period. The strategy proposed in this paper, which can handle the multiple dispenser types, provides a practical quantitative slotting method for CAOPS and can help picking-system-designers make slotting decisions efficiently and effectively.展开更多
To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amo...To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amount dispensed in each cycle. Taking account of gas compressibility, an intelligent model-based control strategy is proposed to compensate the deviation of adhesive amount dispensed from the desired one. Both simulations and experiments show that the dispensing consistency is greatly improved by using the model-based control strategy developed in this paper.展开更多
To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsula...To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsulant amount dispensed.Based on the simple and effective model,a run by run (RbR) supervisory control scheme is delivered to compensate the variation resulting from gas volume change in the syringe.Both simulation and experiment have shown that the dispensing consistency has been greatly improved with the model-based RbR control strategy developed in this paper.展开更多
With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence ...With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence of different structures on dispensing velocity and angle of KE-rod were studied through analyzing the images. All these can be helpful for the design of new concept anti tactical ballistic missile(ATBM) KE-rod warheads.展开更多
The problem of H2 output feedback control for generalized system with structural uncertainties is studied using linear matrix inequality approach. A sufficient condition Of linear matrix inequality is presented such t...The problem of H2 output feedback control for generalized system with structural uncertainties is studied using linear matrix inequality approach. A sufficient condition Of linear matrix inequality is presented such that the closed-loop system is stable and satisfies H2 performance for all admissible uncertainties. Furthermore, the solution of the controller is given. An H2 output feedback controller is designed in the airborne dispenser pitch channel, and the simulation results show that the controller is effective.展开更多
In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine di...In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine dispensing. However, automating the dispensing, or having it replaced by artificial intelligence (AI) will not, eradicate human error. Thus, measures against human error will continue to serve as an important topic. Therefore, hospitals are required to improve the efficiency of the pharmacy department. For these purposes, attention has now shifted to Supply Processing and Distribution (SPD). In this study, we measured for the gaze of the pharmacist and SPD, and examined the factors affecting dispensing error;moreover, we examined prevention of the human error. In the results of the eye tracking, SPD members tended to spend a greater number of gaze time and gaze counts, for each medicine, on “medicines” and “picking lists,” than pharmacists. On the other hand, when pharmacists picking medicines, they performed various work operations in parallel, such as checking the prescription and looking the next shelf location. It was conjectured that SPD members had more clearly defined items to check when picking, compared to pharmacists. This may have possibly led to a lower chance of dispensing errors being introduced by SPD members. These results suggest that the process of selection is not a mandatory requirement of pharmacists during the action of dispensing. Instead, SPD members, pharmacy assistants, or automatic dispensing devices could serve as substitutes for picking. It is suggested that pharmacists should spend more time and effort on prescription inspection, medicines checking and dosing operations.展开更多
Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effe...Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effect of labelling on the quality of drug dispensing and patient knowledge about dispensed drugs in Jimma University model and specialized hospital outpatient Pharmacies. Individual packages with prescribed drugs were examined using pretested questionnaire and observational check lists during the dispensing process. Patients’ knowledge about drugs dispensed to them was assessed at the exit interview using a pretested questionnaire. Out of 743 prescribed drugs, 682 (91.8%) were dispensed to 426 patients. The average labelling score (range from 0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI 1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35 to 3.64) for model and outpatient pharmacy, respectively, while the overall average knowledge score was 3.46 (95% CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose followed by frequency of administration, duration of treatment, and the reason for prescription. Literacy status of patients had a significant effect on their knowledge (p 0.05). We recommend that corrective measures targeting both, labelling and patients’ knowledge should be implemented to improve the patients’ safety and drug therapy adherence.展开更多
Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the ...Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the quantity of the active ingredient in the medication that has been dispensed and the quantities that have been mixed together. Therefore, special prevention measures are considered essential. In this study, we examined the work content of pharmacists’ powdered medication dispensing, using an eye-tracking technology of measuring a human eye movement, and studied on factors that affect medical incident. Participants were five pharmacists with 8 to 26 years of working experience (expert), and five pharmacists with less than one year of working experience (newcomer). Gaze measurement experiments were implemented for powdered medication dispensing during regular work activity. The gaze measurement equipment used was Tobii Pro Glasses 2. Based on the results of the eye tracking, newcomer had a longer dispensing time than expert for all powdered medication dispensing. In particular, it was suggested that there is a close relationship to “years of experience” and “weighing and mixing skills.” Experts did unwasted and efficient movements, when preparing the dispensing apparatus, taking medications from the shelves, and scanning the barcode in the powders dispensing checking system. These movements led to shorter working time in experts. In contrast, newcomer had individual differences at the dispensing. Even with the same pharmacist, the work progression differed depending upon the prescription. Therefore, it is thought that the factor of common error was inadequate check and overlooked. The state that it’s messy on the workplace is also considered highly likely to cause dispensing mistakes. At the weighing, expert started weighing after the inspection of the prescription and checking weighed amount. However, certain newcomer dispensed to depend on the powders dispensing checking system only for the weighing process, without the inspection of the prescription or checking weighed amount. Irregular doses for infants and older patients require fine adjustments;therefore, the powders dispensing checking system may not find all dispensing errors. It is important for a pharmacist to, first, be written calculated weight on the prescription and checked by themselves, and next to begin dispensation work. In the future, as well as the powdered medication dispensing, it is necessary to make use of measures for preventing errors in the various dispensing process, such as the medication inspection, sterile products preparation, clinical practice et al.展开更多
[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identi...[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.展开更多
Objective: Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology: A retrospective cohort study...Objective: Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology: A retrospective cohort study compares the units of analogueinsulin consumed with the expense per patient during the periods of December/l 4-May/15 versus December/15-May/16. Statisticaltreatment is applied to data obtained and the results are analyzed. Results: The expense per patient during the period ofDecember/15-May/16 was statistically less than the one during the same period on the year before (December/14-May/15), having astate dispensing saving per patient of US$ 1.34 per month. And a saving per patient in the pharmaceutical care is approximatelyUS$ 2.82 per month. Conclusions: Cost savings in care of insulin-dependent diabetic population enrolled in the subsidized plan waspossible due to the development of cost/effective dispensing strategies that allowed access and safety of insulin therapy.展开更多
Parametric Accelerated Life Testing (ALT) was used to improve the reliability of ice-maker system with a fractured helix upper dispenser in field. By using bond graphs and state equations, a variety of mechanical load...Parametric Accelerated Life Testing (ALT) was used to improve the reliability of ice-maker system with a fractured helix upper dispenser in field. By using bond graphs and state equations, a variety of mechanical loads in the assembly were analyzed. The acceleration factor was derived from a generalized life-stress failure model with a new load concept. To reproduce the failure modes and mechanisms causing the fracture, new sample size equation was derived. The sample size equation with the acceleration factor also enabled the parametric accelerated life testing to quickly reproduce early failure in field. Consequently, the failure modes and mechanisms found were identical with those of the failed sample. The design of this testing should help an engineer uncover the design parameters affecting the reliability of fractured helix upper dispenser in field. By eliminating the design flaws, gaps and weldline, the B1 life of the redesign of helix upper dispenser is now guaranteed to be over 10 years with a yearly failure rate of 0.1% that is the reliability quantitative test specifications (RQ).展开更多
Objective:To evaluate the level of understanding(knowledge),beliefs(attitude),and behavior(practice)of staff nurses toward medication errors(MEs).Methods:Self-administered questionnaires were distributed to nursing pr...Objective:To evaluate the level of understanding(knowledge),beliefs(attitude),and behavior(practice)of staff nurses toward medication errors(MEs).Methods:Self-administered questionnaires were distributed to nursing professionals who had at least 1 year of work experience.Each questionnaire contained 19 items assessing“knowledge,”“attitude,”and“practice”attributes toward MEs.Results:Responses from 47 nursing respondents were included for the final analysis.The mean knowledge score was 3.8±1.1(out of 6);66%and 79%of the respondents had awareness of medication repor ting systems and interventions in preventing MEs,respectively.Lack of adequate knowledge in recognizing MEs(P=0.003),or presuming MEs are not as important enough to be reported(P=0.002),was considered as the major reason for under-repor ting of MEs.Nurses with higher knowledge score were against administration of medication through a different route than that prescribed by the physician(P=0.023),and tried to rectify an ME(P=0.020)and stayed with the patient until an oral medication had been swallowed(P=0.037).Conclusions:The nursing professionals were aware of the ME repor ting system and methods to prevent the occurrence of MEs.They also exhibited a positive attitude and followed optimal practices in controlling MEs.展开更多
The aim of this paper is to highlight the role of pharmaceutical care at community pharmacies in Pakistan. The paper draws on the literature related to current dispensing practices at community pharmacies in developin...The aim of this paper is to highlight the role of pharmaceutical care at community pharmacies in Pakistan. The paper draws on the literature related to current dispensing practices at community pharmacies in developing countries as well as in Pakistan. There are approximately 63,000 community pharmacies in Pakistan, and according to an estimate, 80% of the medicines are being distributed through this channel to majority of the population. They often lack adequate facilities, staffing and equipments. Absence of pharmacists and their roles being performed by the non-qualified personnel working at community pharmacies are a common practice. There are 8102 pharmacists who are categorized as a category, 31,000 pharmacy technicians categorized in B & C category in the country. There is a shortage of pharmacists who could be engaged for ensuring good pharmacy practices. There are only ten percent of the total pharmacists who work at community pharmacies in the country according to the Pharmacy Council of Pakistan. All kind of medicines are freely available irrespective of their status as prescription or over the counter drugs. The paper highlights that the professional role of pharmacist in hospitals and community pharmacies is switching from dispensing and sale of drugs, to patient counselling. But, the concept of pharmaceutical care at community pharmacies has not been acknowledged yet in Pakistan. The process of prescription handling is poor and patients are often treated without a proper prescription. Prescription validation, drug labeling and patient counseling are the missing components in effective patient management at the community pharmacies. The paper concludes that although laws exist, but due to lack of accountability and weak regulatory framework their proper implementation is not witnessed. Moreover, due to lack of research and evidence related to problems in dispensing practices in healthcare system of Pakistan, the counteractive actions for resolving these problems are limited.展开更多
Al_2O_3–CaO–SiC-based ceramic composites with four different compositions were sintered at 1700℃ for 3 h in an air furnace. The phase analysis, microstructural characterization, and elemental composition determinat...Al_2O_3–CaO–SiC-based ceramic composites with four different compositions were sintered at 1700℃ for 3 h in an air furnace. The phase analysis, microstructural characterization, and elemental composition determination of the developed composites were performed by X-ray diffraction(XRD), field-emission scanning electron microscopy(FESEM), and energy-dispersive X-ray(EDAX) analysis, respectively. The shrinkage, thermal properties, and electrical resistivity of the composites were also studied. The experimental results showed the effects of adding silicon carbide and calcia to alumina on the thermal, electrical, and shrinkage properties of the resultant composites. Among the four investigated ceramic composites, the one composed of 99 wt% alumina, 0.5 wt% CaO, and 0.5 wt% SiC exhibited the best characteristics for use as a potting material in a dispenser cathode of a microwave tube. The material exhibited slight expansion instead of shrinkage during drying or firing. Other properties of the composite powder, such as its thermal properties and electrical resistivity, were comparable to those of a commercial alumina powder.展开更多
基金This project is supported by National Natural Science Foundation of China (No.50390063, 50390064), Research Grant Council of HK SAR (CityU1086/01E)and City University of HK Applied R&D Project(No.9620002).
文摘In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includes the air-fluid coupling and the nonlinearuncertainties, makes it difficult to have a consistent process performance. An integrated dispensingprocess model is first introduced and then its input-output regression relationship is used todesign a run to run control methodology for this process. The controller takes EWMA scheme and itsstability region is given. Experimental results verify the effectiveness of the proposed run to runcontrol method for dispensing process.
基金supported by a Resident Research Grant from the University of Cincinnati Department of Emergency Medicineby a Research Fellowship Award from the Emergency Medicine Foundationby an Institutional Clinicaland Translational Science Award,NIH/NCRR Grant Number 5UL1RR026314-02
文摘BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.
文摘This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible colour difference,thus investigating the required accuracy level fordyeing dispensing.This leads to the selection of one critical colour-difference dimension of threefrom CMC (1:c) measurement.The results reveal that the concentration change in dye dispensing ismost critical for change of Hue in a computer controlled system.The formula describing the rela-tionship Of △E and △H in CMC (2:1) measurement is selected for further investigation.
基金supported by the European Research Council(ERC-St G,758865,to YYSH)the financial support from the W.D.Armstrong Trust and the Macao Postgraduate Scholarship Fund。
文摘Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand for improving print resolution towards the scale of a single cell has driven the development of precision nozzle extrusion,although the benefits gained remain ambiguous.Here,aided by in situ imaging,we investigated the dynamics of cell organisation through an extrusion-based microcapillary tip with picolitre precision through in-air or immersion deposition.The microcapillary extrusion setup,termed‘Picodis’,was demonstrated by generating droplets of colouring inks immersed in an immiscible medium.Next,using 3T3 fibroblast cells as an experimental model,we demonstrated the deposition of cell suspension,and pre-aggregated cell pellets.Then,the dynamic organisation of cells within the microcapillary tip was described,along with cell ejection and deposition upon exiting the tip opening.The vision-assisted approach revealed that when dispersed in a culture medium,the movements of cells were distinctive based on the flow profiles and were purely driven by laminar fluid flow within a narrow tip.The primary process limitations were cell sedimentation,aggregation and compaction,along with trapped air bubbles.The use of picolitre-level resolution microcapillary extrusion,although it provides some level of control for a small number of cells,does not necessarily offer a reliable method when a specified number of cells are required.Our study provides insights into the process limitations of high-resolution cell ink extrusion,which may be useful for optimising biofabrication processes of cell-laden constructs for biomedical research.
基金supported by National Natural Science Foundation of China (No.50175064)
文摘Based on the characteristics of parallel dispensers in automated picking system, an order-picking optimization problem is presented. Firstly, the working principle of parallel dispensers is introduced, which implies the time cost of picking each order is influenced by the order-picking sequence. So the order-picking optimization problem can be classified as a dynamic traveling salesman problem (TSP). Then a mathematical model of the problem is established and an improved max-min ant system (MMAS) is adopted to solve the model. The improvement includes two aspects. One is that the initial assignment of ants depends on a probabilistic formula instead of a random deployment; the other is that the heuristic factor is expressed by the extra picking time of each order instead of the total. At last, an actual simulation is made on an automated picking system with parallel dispensers. The simulation results proved the optimization value and the validity of improvement on MMAS.
文摘Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked medicine dispensing medicine management.Methods:The PDCA theory was used to analyze the data,to find out the causes of the problem,and to formulate the corresponding countermeasures to intervene.The data of the naked medicine/adverse drug events satisfaction degree of the inpatients in 18 inpatient departments given for the adoption of PDCA cycle in January 2017 were set as the observation group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before adoption of PDCA cycle in December 2016 was set as the control group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before and after adoption of PDCA cycle was observed and analyzed.Results:The number of the naked medicine/adverse drug events after implementing the method of PDCA cycle management rate was significantly lower than before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).The satisfaction degree of the inpatients after implementing the method of PDCA cycle management rate was significantly higher than that before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).Conclusion:Application of PDCA cycle in the management of the naked medicine dispensing about the automatic package can help to reduce the adverse drug events,to improve the safety of drug treatment,and to increase the patients’satisfaction degree.
基金supported by China Scholarship Council (Grant No.2007102074)National Natural Science Foundation of China (Grant No.50175064)+2 种基金Georgia Institute of Technology Visiting Research EngineerProgram of the United States (Grant No. 2401247)Graduate InnovationFoundation of Shandong University, China (Grant No. yzc09066)Costal International Logistics Company of the United States (Project No.20080727)
文摘Slotting strategy heavily influences the throughput and operational cost of automated order picking system with multiple dispenser types, which is called the complex automated order picking system (CAOPS). Existing research either focuses on one aspect of the slotting optimization problem or only considers one part of CAOPS, such as the Low-volume Dispensers, to develop corresponding slotting strategies. In order to provide a comprehensive and systemic approach, a fluid-based slotting strategy is proposed in this paper. The configuration of CAOPS is presented with specific reference to its fast-picking and restocking subsystems. Based on extended fluid model, a nonlinear mathematical programming model is developed to determine the optimal volume allotted to each stock keeping unit (SKU) in a certain mode by minimize the restocking cost of that mode. Conclusion from the allocation model is specified for the storage modules of high-volume dispensers and low-volume dispensers. Optimal allocation of storage resources in the fast-picking area of CAOPS is then discussed with the aim of identifying the optimal space of each picking mode. The SKU assignment problem referring to the total restocking cost of CAOPS is analyzed and a greedy heuristic with low time complexity is developed according to the characteristics of CAOPS. Real life application from the tobacco industry is presented in order to exemplify the proposed slotting strategy and assess the effectiveness of the developed methodology. Entry-item-quantity (EIQ) based experiential solutions and proposed-model-based near-optimal solutions are compared. The comparison results show that the proposed strategy generates a savings of over 18% referring to the total restocking cost over one-year period. The strategy proposed in this paper, which can handle the multiple dispenser types, provides a practical quantitative slotting method for CAOPS and can help picking-system-designers make slotting decisions efficiently and effectively.
基金This work was supported by National Natural Science Foundation of China (No.50390063,50390064)the National Basic Research Program of China (973 Program) (No.2003CB716207).
文摘To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amount dispensed in each cycle. Taking account of gas compressibility, an intelligent model-based control strategy is proposed to compensate the deviation of adhesive amount dispensed from the desired one. Both simulations and experiments show that the dispensing consistency is greatly improved by using the model-based control strategy developed in this paper.
基金the startup research foundation of China Three Gorge University (No.0620070124)
文摘To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsulant amount dispensed.Based on the simple and effective model,a run by run (RbR) supervisory control scheme is delivered to compensate the variation resulting from gas volume change in the syringe.Both simulation and experiment have shown that the dispensing consistency has been greatly improved with the model-based RbR control strategy developed in this paper.
文摘With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence of different structures on dispensing velocity and angle of KE-rod were studied through analyzing the images. All these can be helpful for the design of new concept anti tactical ballistic missile(ATBM) KE-rod warheads.
基金Sponsored by the Ministerial Level Advanced Research Foundation (G423BQ0110)
文摘The problem of H2 output feedback control for generalized system with structural uncertainties is studied using linear matrix inequality approach. A sufficient condition Of linear matrix inequality is presented such that the closed-loop system is stable and satisfies H2 performance for all admissible uncertainties. Furthermore, the solution of the controller is given. An H2 output feedback controller is designed in the airborne dispenser pitch channel, and the simulation results show that the controller is effective.
文摘In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine dispensing. However, automating the dispensing, or having it replaced by artificial intelligence (AI) will not, eradicate human error. Thus, measures against human error will continue to serve as an important topic. Therefore, hospitals are required to improve the efficiency of the pharmacy department. For these purposes, attention has now shifted to Supply Processing and Distribution (SPD). In this study, we measured for the gaze of the pharmacist and SPD, and examined the factors affecting dispensing error;moreover, we examined prevention of the human error. In the results of the eye tracking, SPD members tended to spend a greater number of gaze time and gaze counts, for each medicine, on “medicines” and “picking lists,” than pharmacists. On the other hand, when pharmacists picking medicines, they performed various work operations in parallel, such as checking the prescription and looking the next shelf location. It was conjectured that SPD members had more clearly defined items to check when picking, compared to pharmacists. This may have possibly led to a lower chance of dispensing errors being introduced by SPD members. These results suggest that the process of selection is not a mandatory requirement of pharmacists during the action of dispensing. Instead, SPD members, pharmacy assistants, or automatic dispensing devices could serve as substitutes for picking. It is suggested that pharmacists should spend more time and effort on prescription inspection, medicines checking and dosing operations.
文摘Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effect of labelling on the quality of drug dispensing and patient knowledge about dispensed drugs in Jimma University model and specialized hospital outpatient Pharmacies. Individual packages with prescribed drugs were examined using pretested questionnaire and observational check lists during the dispensing process. Patients’ knowledge about drugs dispensed to them was assessed at the exit interview using a pretested questionnaire. Out of 743 prescribed drugs, 682 (91.8%) were dispensed to 426 patients. The average labelling score (range from 0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI 1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35 to 3.64) for model and outpatient pharmacy, respectively, while the overall average knowledge score was 3.46 (95% CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose followed by frequency of administration, duration of treatment, and the reason for prescription. Literacy status of patients had a significant effect on their knowledge (p 0.05). We recommend that corrective measures targeting both, labelling and patients’ knowledge should be implemented to improve the patients’ safety and drug therapy adherence.
文摘Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the quantity of the active ingredient in the medication that has been dispensed and the quantities that have been mixed together. Therefore, special prevention measures are considered essential. In this study, we examined the work content of pharmacists’ powdered medication dispensing, using an eye-tracking technology of measuring a human eye movement, and studied on factors that affect medical incident. Participants were five pharmacists with 8 to 26 years of working experience (expert), and five pharmacists with less than one year of working experience (newcomer). Gaze measurement experiments were implemented for powdered medication dispensing during regular work activity. The gaze measurement equipment used was Tobii Pro Glasses 2. Based on the results of the eye tracking, newcomer had a longer dispensing time than expert for all powdered medication dispensing. In particular, it was suggested that there is a close relationship to “years of experience” and “weighing and mixing skills.” Experts did unwasted and efficient movements, when preparing the dispensing apparatus, taking medications from the shelves, and scanning the barcode in the powders dispensing checking system. These movements led to shorter working time in experts. In contrast, newcomer had individual differences at the dispensing. Even with the same pharmacist, the work progression differed depending upon the prescription. Therefore, it is thought that the factor of common error was inadequate check and overlooked. The state that it’s messy on the workplace is also considered highly likely to cause dispensing mistakes. At the weighing, expert started weighing after the inspection of the prescription and checking weighed amount. However, certain newcomer dispensed to depend on the powders dispensing checking system only for the weighing process, without the inspection of the prescription or checking weighed amount. Irregular doses for infants and older patients require fine adjustments;therefore, the powders dispensing checking system may not find all dispensing errors. It is important for a pharmacist to, first, be written calculated weight on the prescription and checked by themselves, and next to begin dispensation work. In the future, as well as the powdered medication dispensing, it is necessary to make use of measures for preventing errors in the various dispensing process, such as the medication inspection, sterile products preparation, clinical practice et al.
基金Young Scholar Program of Hebei Pharmaceutical Association Hospital Pharmaceutical Research Project(2020—Hbsyxhqn0029)Science and Technology Research and Development Project of Chengde City,Hebei Province(201706A043).
文摘[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.
文摘Objective: Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology: A retrospective cohort study compares the units of analogueinsulin consumed with the expense per patient during the periods of December/l 4-May/15 versus December/15-May/16. Statisticaltreatment is applied to data obtained and the results are analyzed. Results: The expense per patient during the period ofDecember/15-May/16 was statistically less than the one during the same period on the year before (December/14-May/15), having astate dispensing saving per patient of US$ 1.34 per month. And a saving per patient in the pharmaceutical care is approximatelyUS$ 2.82 per month. Conclusions: Cost savings in care of insulin-dependent diabetic population enrolled in the subsidized plan waspossible due to the development of cost/effective dispensing strategies that allowed access and safety of insulin therapy.
文摘Parametric Accelerated Life Testing (ALT) was used to improve the reliability of ice-maker system with a fractured helix upper dispenser in field. By using bond graphs and state equations, a variety of mechanical loads in the assembly were analyzed. The acceleration factor was derived from a generalized life-stress failure model with a new load concept. To reproduce the failure modes and mechanisms causing the fracture, new sample size equation was derived. The sample size equation with the acceleration factor also enabled the parametric accelerated life testing to quickly reproduce early failure in field. Consequently, the failure modes and mechanisms found were identical with those of the failed sample. The design of this testing should help an engineer uncover the design parameters affecting the reliability of fractured helix upper dispenser in field. By eliminating the design flaws, gaps and weldline, the B1 life of the redesign of helix upper dispenser is now guaranteed to be over 10 years with a yearly failure rate of 0.1% that is the reliability quantitative test specifications (RQ).
文摘Objective:To evaluate the level of understanding(knowledge),beliefs(attitude),and behavior(practice)of staff nurses toward medication errors(MEs).Methods:Self-administered questionnaires were distributed to nursing professionals who had at least 1 year of work experience.Each questionnaire contained 19 items assessing“knowledge,”“attitude,”and“practice”attributes toward MEs.Results:Responses from 47 nursing respondents were included for the final analysis.The mean knowledge score was 3.8±1.1(out of 6);66%and 79%of the respondents had awareness of medication repor ting systems and interventions in preventing MEs,respectively.Lack of adequate knowledge in recognizing MEs(P=0.003),or presuming MEs are not as important enough to be reported(P=0.002),was considered as the major reason for under-repor ting of MEs.Nurses with higher knowledge score were against administration of medication through a different route than that prescribed by the physician(P=0.023),and tried to rectify an ME(P=0.020)and stayed with the patient until an oral medication had been swallowed(P=0.037).Conclusions:The nursing professionals were aware of the ME repor ting system and methods to prevent the occurrence of MEs.They also exhibited a positive attitude and followed optimal practices in controlling MEs.
文摘The aim of this paper is to highlight the role of pharmaceutical care at community pharmacies in Pakistan. The paper draws on the literature related to current dispensing practices at community pharmacies in developing countries as well as in Pakistan. There are approximately 63,000 community pharmacies in Pakistan, and according to an estimate, 80% of the medicines are being distributed through this channel to majority of the population. They often lack adequate facilities, staffing and equipments. Absence of pharmacists and their roles being performed by the non-qualified personnel working at community pharmacies are a common practice. There are 8102 pharmacists who are categorized as a category, 31,000 pharmacy technicians categorized in B & C category in the country. There is a shortage of pharmacists who could be engaged for ensuring good pharmacy practices. There are only ten percent of the total pharmacists who work at community pharmacies in the country according to the Pharmacy Council of Pakistan. All kind of medicines are freely available irrespective of their status as prescription or over the counter drugs. The paper highlights that the professional role of pharmacist in hospitals and community pharmacies is switching from dispensing and sale of drugs, to patient counselling. But, the concept of pharmaceutical care at community pharmacies has not been acknowledged yet in Pakistan. The process of prescription handling is poor and patients are often treated without a proper prescription. Prescription validation, drug labeling and patient counseling are the missing components in effective patient management at the community pharmacies. The paper concludes that although laws exist, but due to lack of accountability and weak regulatory framework their proper implementation is not witnessed. Moreover, due to lack of research and evidence related to problems in dispensing practices in healthcare system of Pakistan, the counteractive actions for resolving these problems are limited.
基金financial support of Council of Scientific and Industrial Research (CSIR), India Through network Project (No. MTDDC-PSC0101)
文摘Al_2O_3–CaO–SiC-based ceramic composites with four different compositions were sintered at 1700℃ for 3 h in an air furnace. The phase analysis, microstructural characterization, and elemental composition determination of the developed composites were performed by X-ray diffraction(XRD), field-emission scanning electron microscopy(FESEM), and energy-dispersive X-ray(EDAX) analysis, respectively. The shrinkage, thermal properties, and electrical resistivity of the composites were also studied. The experimental results showed the effects of adding silicon carbide and calcia to alumina on the thermal, electrical, and shrinkage properties of the resultant composites. Among the four investigated ceramic composites, the one composed of 99 wt% alumina, 0.5 wt% CaO, and 0.5 wt% SiC exhibited the best characteristics for use as a potting material in a dispenser cathode of a microwave tube. The material exhibited slight expansion instead of shrinkage during drying or firing. Other properties of the composite powder, such as its thermal properties and electrical resistivity, were comparable to those of a commercial alumina powder.