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In accordance with global economic prosperity, the frequencies of food delivery and takeout orders have been increasing. The pandemic life, specifically arising from COVID-19, rapidly expanded the food delivery service. Thus, the massive generation of disposable plastic food containers has become significant environmental problems. Establishing a sustainable disposal platform for plastic packaging waste (PPW) of food delivery containers has intrigued particular interest. To comprise this grand challenge, a reliable thermal disposable platform has been suggested in this study. From the pyrolysis process, a heterogeneous plastic mixture of PPW was converted into syngas and value-added hydrocarbons (HCs). PPW collected from five different restaurants consisted of polypropylene (36.9 wt%), polyethylene (10.5 wt%), polyethylene terephthalate (18.1 wt%), polystyrene (13.5 wt%), polyvinyl chloride (4.2 wt%), and other composites (16.8 wt%). Due to these compositional complexities, pyrolysis of PPW led to formations of a variety of benzene derivatives and aliphatic HCs. Adapting multi-stage pyrolysis, the different chemicals were converted into industrial chemicals (benzene, toluene, styrene, etc.). To selectively convert HCs into syngas (H2 and CO), catalytic pyrolysis was adapted using supported Ni catalyst (5 wt% Ni/SiO2). Over Ni catalyst, H2 was produced as a main product due to C[sbnd]H bond scission of HCs. When CO2 was used as a co-reactant, HCs were further transformed to H2 and CO through the chemical reactions of CO2 with gas phase HCs. CO2-assisted catalytic pyrolysis also retarded catalyst deactivation inhibiting coke deposition on Ni catalyst. © 2022 Elsevier B.V.
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The demand of retail e-commerce has been rapidly growing due to the digitalization and the COVID-19 pandemic, and thus, the stress on e-fulfilment services continues to increase nowadays. To fulfil daily customers’ orders, effective inventory replenishment is of the essence in order to strike a balance between inventory management costs and service level. This paper describes an enhanced inventory replenishment approach by using reinforcement learning to deal with non-stationary and uncertain demand from customers. The proposed approach relaxes the assumption of stationary demand distribution considered in typical inventory models. Conventional policies derived from such models cannot guarantee optimal re-order quantities, when demand distribution is non-stationary over time. Consequently, reinforcement learning is adopted in the proposed approach to improve feasible solutions continuously in a dynamic business environment. In comparison to the conventional base stock policy, our proposed approach provides cost saving opportunities ranging from 28.5 to 41.3% in a simulated environment. It is found that the value of using data-driven solution approaches to deal with the practical inventory management problem is effective. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Background. Donning personal protective equipment (PPE) and performing cardiopulmonary resuscitation (CPR) are stressful tasks for healthcare professionals, particularly during the COVID-19 pandemic. This study aimed to assess the effectiveness of simulation training on donning PPE and performing CPR with PPE put on for nurses at a geriatric step-down hospital. Methods. A lecture and simulation training on donning PPE and performing CPR were provided for nurses. Confidence in donning PPE and performing CPR, knowledge of CPR, and satisfaction of participants were assessed before training (baseline), after the lecture, and after the simulation training. Results. 50 nurses (33 women and 17 men) attended both the lecture and simulation training, accounting for 90% of nurses in the department. Self-rated confidence in donning PPE and performing CPR improved significantly after the lecture (both p<0.001) and again after the simulation training (both p<0.001). Knowledge of CPR improved significantly after the lecture (p<0.001). Self-rated satisfaction of participants was high (9.3±0.3). Conclusion. Simulation training on donning PPE and performing CPR with PPE put on significantly improves the knowledge and confidence of nurses in a geriatric step-down hospital. This may contribute to improved patient outcomes, particularly during the COVID-19 pandemic. © 2022 The Hong Kong Geriatrics Society and Hong Kong Association of Gerontology.
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RATIONALE: Advances in PAH management and well-established treatment guidelines have improved the prognosis for patients. However, the extent to which guidelines are implemented in real-world practice and the relationship between guidelines and real-world patient outcomes remain in question. To assess real-world treatment and outcomes, a new type of comprehensive, integrated patient data repository (CIPDR) was created. Here, we describe the process to create this repository to enable interpretation of the collected data. METHODS: The TRIO CIPDR was created with guidance from six pulmonologists who have experience in design of and/or participation in PH registries (e.g. REVEAL). The CIPDR includes data elements of demographics, disease, comorbidities, laboratory data, pulmonary function testing, functional status, PAH treatment, reasons for treatment discontinuation/switch, hospitalizations, and death, which are collected through HIPAA-secure online forms. To minimize entry errors, participating sites received form training and ongoing support, and each form contained logic to identify improbable entries. All data were deidentified prior to storage in secure, redundant servers. The site engagement, data collection forms, data storage, and data output processes were all designed to allow both retrospective and prospective data collection and for near-immediate repository expansion through addition of other PAH-treating centers. Eleven Pulmonary Hypertension Association-certified care centers initially contributed to the CIPDR though two centers were unable to continue participation due to COVID19 impact. Central IRB approval was obtained though many sites independently received approval for the repository protocol by their IRBs. To facilitate enrollment, specialty pharmacy data corresponding to each site were used to identify potential patients and pre-populate qualification forms. Each site reviewed and qualified patients who met repository criteria: age >18 years, prescribed PAH-specific medications, and confirmation of PAH diagnosis by right heart catheterization (mean Pulmonary Arterial Pressure ≥25mmHg, Pulmonary Capillary Wedge Pressure ≤15 mmHg, and Pulmonary Vascular Resistance ≥3.0 Wood Units at rest). The initial data collection included care encounters between Jan 2019 and Dec 2020 and data concerning diagnosis, onset of symptoms, procedures, and laboratory values closest to enrollment. After completion of data collection, all data were reviewed by Trio Health and adjudicated with each site. RESULTS: Of 3200 patients identified as potentially qualified, 1009 were initially enrolled and their retrospective data encompassing 4489 visits collected. Descriptive measures of the repository are presented in the TABLE. CONCLUSION: The Trio CIPDR is an important step forward to uniquely characterize the patient journey ,treatment patterns, and outcomes for patients with PAH.
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Purpose or Objective There is increasing focus on developing and implementing quality and service improvement methodology in healthcare practice with it recognised that these principles must be embedded in the governance framework and culture of services. Radiotherapy (RT) pathways are complex and multidisciplinary. This project aims to develop a quality assessment (QA) tool for evaluating operational/technical aspects of RT service within and across different departments. Materials and Methods A multidisciplinary team (MDT) scoping exercise was undertaken within a single large RT centre and theme analysis was cross referenced with associated literature and theories to inform the development of the QA tool. The tool was validated in three different clinical scenarios and the associated processes were refined through MDT inquiries. There as 5 steps to completing the tool as a collaborative MDT. 1. Framing the question Questions can be categorised into two categories. Category 1: Direct comparison between the same service/pathway in two different departments. Category 2: Comparison of two alternative pathways in a single department. 2. Identifying drivers Primary and secondary drivers for answering the given question should be discussed and noted to allow for considered evaluation of scoring following completion of the tool 3. Scoping Review of the metrics/measures of quality and efficiency/resource for different aspects of the pathway should be identified under the headings outlined below. - Structure: Consider the attributes of the service/ pathway such as e.g. Staff to patient ratios, Skill Mix/Pay banding - Process: Consider how each procedure/system of work interacts in order to achieve the outcomes as defined by clinical policies and procedures. - Outcome: Measures should consider the impact on potential endpoints. 4. Scoring Each aspects of the pathway identified under the different headings is discussed and scored according to the scoring matrix for both the quality and efficiency/productivity (table 1). Only a quality score is applied to the outcomes. (Table presented.)ale Results) Clinical example 1 (COVID initiative): telephone vs face to face on treatment consultation Completing the QA tool identified not only that there were comparable outcomes with significant efficiency and potential quality improvement via telephone consultation but also highlighted where enhancement of other areas of the patient pathway were needed. This mitigated patient care risk to allow benefits from this service improvement to be realised.) Clinical example 2: Treatment verification for prostate SABR CBCT vs Fiducial Utilising the tool in this clinical example identified key lines of enquiry from both a clinical and technical perspective and promoted an objective evidence-based approach to evaluating the necessities of fiducials in the context of prostate imaged guided radiotherapy. A pathway change was implemented. Clinical example 3: Eclipse pathway vs Pinnacle pathway The tool was implemented following an MDT incident review meeting. Figure1 shows the visual output after completing the tool scoring comparing the two palliative RT pathways utilising two different RT planning systems. Points 1,2 relate to structure, 3,4,5 to process and 6 the outcome. It was evident that despite the outcome of the two pathways being comparable, pathway 2 represented a quality improvement not only in quality including risk but also efficiency features of the pathway and was implemented in practice. $Φg Conclusion The QA tool can support collaborative service improvements and enhance the governance process within RT services. Analysing the themes of user feedback from those who were involved in the piloting of the QA tool indicated that the tool was supportive in, • Objective independent discussion. • Encouraging collaboration between different professions. • Promoting an evidence-based approach across all aspects of the pathway. • Provided a useful output for reporting within governance process. • Future work has been planned to valid te the tool in a multicentre setting. Future work has been planned to validate the tool in a multicentre setting.
ABSTRACT
New product development to enhance companies’ competitiveness and reputation is one of the leading activities in manufacturing. At present, achieving successful product design has become more difficult, even for companies with extensive capabilities in the market, because of disorganisation in the fuzzy front end (FFE) of the innovation process. Tremendous amounts of information, such as data on customers, manufacturing capability, and market trend, are considered in the FFE phase to avoid common flaws in product design. Because of the high degree of uncertainties in the FFE, multidimensional and high-volume data are added from time to time at the beginning of the formal product development process. To address the above concerns, deploying big data analytics to establish industrial intelligence is an active but still under-researched area. In this paper, an intelligent product design framework is proposed to incorporate fuzzy association rule mining (FARM) and a genetic algorithm (GA) into a recursive association-rule-based fuzzy inference system to bridge the gap between customer attributes and design parameters. Considering the current incidence of epidemics, such as the COVID-19 pandemic, communication of information in the FFE stage may be hindered. Through this study, a recursive learning scheme is established, therefore, to strengthen market performance, design performance, and sustainability on product design. It is found that the industrial big data analytics in the FFE process achieve greater flexibility and self-improvement mechanism on the evolution of product design.