Exploration of Teaching Reform of TCM Dispensing Technology in Higher Vocational Colleges Based on Traditional Chinese Medicine Skills Competition

This paper aims to thoroughly explore the teaching reform of Traditional Chinese Medicine(TCM)dispensing technology in higher vocational colleges,with a focus on the Traditional Chinese Medicine Skills Competition.By analyzing the current teaching status and main challenges of TCM dispensing technology,and aligning with the requirements of the skills competition,a series of detailed and practical teaching reform measures are proposed.These measures are designed to comprehensively improve the teaching quality of TCM dispensing technology in higher vocational colleges,enhance students’practical skills and professional qualities,and ultimately meet the demand for high-quality,skilled talents in the field of TCM.

RUN TO RUN CONTROL OF TIME-PRESSURE DISPENSING SYSTEM

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.

Modeling and Control of Time-pressure Dispensing for Semiconductor Manufacturing

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.

Analysis of the application and practice of PDCA cycle in management of the naked medicine dispensing——the quality and safety of the drug

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.

Run by Run Control of Time-pressure Dispensing for Electronics Encapsulation

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.

An automated dispensing system for improving medication timing in the emergency department

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.

SENSITIVITY OF THE CONCENTRATION CHANGE OF DYE DISPENSING USING COMPUTER SYSTEMS

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.

Directional Dispensing of KE-Rod

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.

Importance of labelling and patient knowledge to ensure proper care during drug dispensing: A case study from a tertiary hospital in Ethiopia

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.

Study of Factors Affecting Medical Incident: 1. Dispensing

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.

Jetting-based bioprinting:process,dispense physics,and applications

Jetting-based bioprinting facilitates contactless drop-on-demand deposition of subnanoliter droplets at well-defined positions to control the spatial arrangement of cells,growth factors,drugs,and biomaterials in a highly automated layer-by-layer fabrication approach.Due to its immense versatility,jetting-based bioprinting has been used for various applications,including tissue engineering and regenerative medicine,wound healing,and drug development.A lack of in-depth understanding exists in the processes that occur during jetting-based bioprinting.This review paper will comprehensively discuss the physical considerations for bioinks and printing conditions used in jetting-based bioprinting.We first present an overview of different jetting-based bioprinting techniques such as inkjet bioprinting,laser-induced forward transfer bioprinting,electrohydrodynamic jet bioprinting,acoustic bioprinting and microvalve bioprinting.Next,we provide an in-depth discussion of various considerations for bioink formulation relating to cell deposition,print chamber design,droplet formation and droplet impact.Finally,we highlight recent accomplishments in jetting-based bioprinting.We present the advantages and challenges of each method,discuss considerations relating to cell viability and protein stability,and conclude by providing insights into future directions of jetting-based bioprinting.

Study of Factors Affecting Medical Incident: 2 Powdered Medication Dispensing

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.

Microcapillary cell extrusion deposition with picolitre dispensing resolution

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.

Novel consistency control strategy for jet dispensing

A new consistency control method for jet dispensing is proposed. First, the working parameters, namely, viscosity, supply pressure and supply time, are experimentally investigated. Then, the glue viscosity is approximated by a polynomial model using the least square method. Based on this model and temperatme control implemented using the Dahlin principle, the viscosity of the glue can be maintained at a constant value. Then, the viscosity model of the glue is applied to deriving the droplet mass as the nominal model of the temperature controller. The robustness of the temperature controller is analyzed by applying the small gain theory. The glue supply pressure controller is designed using the consistency control strategy, and the robustness is analyzed. Finall）, simulations and experiments are conducted using a jet dispensing control system. The results show that the proposed control strategy can significantly improve the droplet consistency.

Economic Impact of a Dispensing Analog Insulin Strategy to Diabetic Patients

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.

Effect of Healthcare Failure Mode and Effect Analysis on Reducing Error Risk of Neonatal Parenteral Nutrition Solution Dispensing

[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.

ORDER-PICKING OPTIMIZATION FOR AUTOMATED PICKING SYSTEM WITH PARALLEL DISPENSERS

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.

Fluid-based Slotting Optimization for Automated Order Picking System with Multiple Dispenser Types

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.

ACCELERATED LIFE TEST STUDIES OF NEW COATED DISPENSER CATHODES

The life of impregnated Ba-W cathodes with a new construction have been evaluated using an accelerated life test at three different temperatures (1170℃,1130℃,1090℃) and constant current density (2A/cm^2).According to the relationship of life with operating temperatures,an accelerated equation has been set up.The cathode life at normal operating temperature is deducted based on the accelerated equation.The results show that life of the novel cathode exceeds 190,000 hour at a current density of 2A/cm^2.

A NEW Ba-W DISPENSER CATHODE IMPREGNATED WITH BARIUM YTTERBATE

A new kind of Ba-W dispenser cathode impregnated with barium ytterbate has been deve-loped.It has good properties;high coefficient of secondary emission,strong ability of resisting oxygenpoisoning,high thermionic emission current density and more uniform emission on the cathode surface.The cathode is suitable for using as an electron emitter for microwave tubes,especially magnetrons.