Impact of narcotics information management system on inappropriate benzodiazepine receptor agonist prescriptions: A quasi-experimental analysis in South Korea.

AIMS: The South Korean government implemented the narcotics information management system (NIMS) on 18 May 2018 to manage benzodiazepine receptor agonists (BzRAs) and narcotics effectively and establish a reporting mechanism for these drugs. This study assessed the effects of NIMS on inappropriate use of BzRAs. METHODS: Using national patient sample data from 2016 to 2020, we analysed adult outpatients who were prescribed oral BzRAs. We conducted a time series and segmented regression analysis using selected indicators to analyse the monthly variations related to the inappropriate use of these medications. RESULTS: The study revealed no significant changes in the indicators of inappropriate BzRA use following the NIMS implementation. Contrary to expectations, there was a significant increase in the proportion of patients exceeding defined daily dose (DDD) and in those receiving concurrent prescriptions of multiple BzRAs, following the implementation of NIMS. The immediate impact of the COVID-19 pandemic was an increase in DDD exceedance; however, overall, this did not significantly affect BzRA use. CONCLUSIONS: The introduction of NIMS did not significantly enhance the management of BzRA misuse. Additional measures, including continuous monitoring, system improvements and comprehensive education for prescribers and patients, are recommended to ensure the appropriate use of psychotropic medications.

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff.

Interventional radiology is a clinical practice with important benefits for patients, but which involves high radiation doses. The optimisation of radiation protection (RP) for paediatric interventional cardiology is a priority for both patients and staff. The use of diagnostic reference levels (DRLs) has been proposed by the International Commission on Radiological Protection to improve RP in imaging procedures. Dose management systems (DMSs) allow the automatic collection of dosimetric, geometric and technical data to assist the optimisation process, with a continuous audit of the procedures, generating alerts to implement corrective actions when necessary. Patient dose indicators may be analysed individually and for different radiation events (fluoroscopy and cine runs). Occupational doses per procedure may be analysed (if electronic dosimeters are available) and linked with patient doses for an integrated approach to RP. Regional optimisation programmes require data collection and processing from several countries to set and periodically update the DRLs. Patient data is anonymised, and each participating hospital has access to their data in a central computer server. Using DMSs may be one of the best ways to support these programs in the collection and analysis of data, raising alerts about high patient and occupational doses and suggesting optimisation actions.

Development of automated metabolite control using mid-infrared probe for bioprocesses and vaccine manufacturing.

Automation of metabolite control in fermenters is fundamental to develop vaccine manufacturing processes more quickly and robustly. We created an end-to-end process analytical technology and quality by design-focused process by replacing manual control of metabolites during the development of fed-batch bioprocesses with a system that is highly adaptable and automation-enabled. Mid-infrared spectroscopy with an attenuated total reflectance probe in-line, and simple linear regression using the Beer-Lambert Law, were developed to quantitate key metabolites (glucose and glutamate) from spectral data that measured complex media during fermentation. This data was digitally connected to a process information management system, to enable continuous control of feed pumps with proportional-integral-derivative controllers that maintained nutrient levels throughout fed-batch stirred-tank fermenter processes. Continuous metabolite data from mid-infrared spectra of cultures in stirred-tank reactors enabled feedback loops and control of the feed pumps in pharmaceutical development laboratories. This improved process control of nutrient levels by 20-fold and the drug substance yield by an order of magnitude. Furthermore, the method is adaptable to other systems and enables soft sensing, such as the consumption rate of metabolites. The ability to develop quantitative metabolite templates quickly and simply for changing bioprocesses was instrumental for project acceleration and heightened process control and automation. ONE-SENTENCE SUMMARY: Intelligent digital control systems using continuous in-line metabolite data enabled end-to-end automation of fed-batch processes in stirred-tank reactors.

Experimental and simulation investigation on suppressing thermal runaway in battery pack.

In order to address the issue of suppressing thermal runaway (TR) in power battery, a thermal generation model for power batteries was established and then modified based on experimental data. On the basis of simulation calculations, a scheme was designed to suppress thermal runaway of the battery module and battery pack, and samples were produced for testing. The results of the test and simulation calculations were very consistent, confirming the accuracy of the simulation calculation model. The results of thermal runaway test also demonstrate that the measures designed to suppress thermal runaway are effective and meet the design requirements.

Constraint Optimization Model for Dynamic Parking Space Allocation.

Managing car parking systems is a complex process because multiple constraints must be considered; these include organizational and operational constraints. In this paper, a constraint optimization model for dynamic parking space allocation is introduced. An ad hoc algorithm is proposed, presented, and explained to achieve the goal of our proposed model. This paper makes research contributions by providing an intelligent prioritization mechanism, considering user schedule shifts and parking constraints, and assigning suitable parking slots based on a dynamic distribution. The proposed model is implemented to demonstrate the applicability of our approach. A benchmark is constructed based on well-defined metrics to validate our proposed model and the results achieved.

Energy-water management system based on robust predictive control for open-field cultivation.

Food availability has been endangered by recent global events, where agriculture, the main food source for the global population, is expected to increase even more to fulfill the growing food demand. Along with food production, water and energy consumption are also increased, leading to over-extraction of groundwater and an excess emission of greenhouse gases due to fossil fuel consumption. In this context, a balance of these three resources is crucial; therefore, the water-energy-food nexus is considered to address the previous issues by designing an energy-water management system based on robust predictive control. This controller estimates the future worst-case scenario for multiple climatic conditions, such as solar radiation, ambient temperature, wind speed, precipitation, and groundwater recharge, to define an optimal irrigation volume, maximize crop growth, and minimize water consumption. At the same time, the controller schedules daily irrigation and groundwater extraction, considering energy availability from solar generation and storage, to fulfill the previously defined irrigation volume while minimizing operating costs. Climate prediction is done through fuzzy prediction intervals, whose lower or upper bound are used as worst-case to include climate uncertainty on the controller design. The energy-water management system is tested in different experiments, where results show that considering a robust approach ensures maximum crop development, avoids over-extraction of groundwater, and prioritizes renewable energy sources. This work proposes a robust energy-water management system designed to be sustainable. Considering the water-energy-food nexus, the system ensures food security and proper resource allocation, tackling global starvation, water availability, and energy access.

Towards Sustainable Solid Waste Management Systems: Empirical Evidence From Northern Malawi.

Solid waste management system in Mzuzu City is a growing concern due to its inefficiency and the resulting effect of accumulation of solid waste. In light of this environmental challenge, a study was conducted to assess the system's effectiveness. Through a mixed methods approach and random sampling, 400 respondents from 5 different areas of the city of Mzuzu were selected to provide comprehensive and unbiased responses. It was found that both the public and private sectors lack a complete commitment to sustainable waste management, citing reasons such as limited knowledge on recycling benefits, inadequate infrastructure and budgetary constraints. As a solution, the study proposes a government-led campaign to change attitudes towards waste production and promote recycling. Additionally, a Public-Private Partnership (PPP) should be utilised to develop policies and strategies that encourage private sector involvement in eco-friendly waste management. To further enhance recycling practices, support is needed in transitioning to circular economy waste management practices through regular education and training.

[Design and Application of an IVD Reagent Management Information Systems Based on Unique Code].

The management of in vitro diagnostic (IVD) reagents in hospitals often faces issues such as the lack of a unified coding system, unclear consumption patterns, and unknown cost-to-income ratios. It is necessary to employ information systems to achieve comprehensive, detailed, and traceable management of IVD reagents. An information management system for IVD reagents based on unique coding is introduced, which integrates admission, acceptance, and consumption processes through unique codes. The system calculates the income per experimental item based on the consumption of IVD reagents and the charge for each experimental item. The system enhances the efficiency of the IVD reagent supply chain management and promotes detailed oversight of IVD reagent usage.

Effective Charging of Commercial Lithium Cell by Triboelectric Nanogenerator with Ultrahigh Voltage Energy Management.

It is an increasingly mature application solution that triboelectric nanogenerator (TENG) supplies power to electronic devices through its power management system (PMS). However, the previous PMS is able to manage a limited voltage magnitude and the energy storage elements are limited to capacitors. This work proposes an ultrahigh voltage PMS (UV-PMS) to realize the charging of commercial lithium cells (LCs) by TENG. The design of UV-PMS enables energy management of TENGs with ultrahigh open-circuit voltages up to 3500 V and boosts the peak charging current from 30.9 µA to 2.77 mA, an increase of 89.64 times. With the introduction of UV-PMS, the effective charging capacity of LC charged by a TENG at a working frequency of 1.5 Hz for 1 h comes to 429.7 µAh, making a 75.3 times enhancement compared to charging by TENG directly. The maximum charging power comes to 1.56 mW. The energy storage efficiency is above 97% and the overall charge efficiency can be maintained at 81.2%. This work provides a reliable strategy for TENG to store energy in LC, and has promising applications in energy storage, LC's life, and self-powered systems.

Laboratory specimen rejection rate and associated factors among referred specimens at Debre Markos Referral Hospital, Ethiopia: prospective cross-sectional study.

Introduction: laboratory errors mostly emerge from the pre-analytical phase, mainly those related to collection, handling, transportation, and storage of diagnostic specimens. Specimen rejection due to improper sample collection, may lead to poor patient outcomes, such as incorrect diagnosis, inappropriate treatment, and death. This study aimed to assess the specimen rejection rate and associated factors among referred specimens at Debre Markos Referral Hospital. Methods: a prospective cross-sectional study design was applied from January 2020 to April 2020 to investigate specimen rejection rate and associated factors among referred specimens. The study population was all laboratory specimens referred for viral load, CD4 count, gene expert, and early infant diagnosis to the Debre Markos Referral Hospital laboratory. The statistical analysis was done with Statistical Package for Social Sciences version 20.0 software. Results: of the total of 2750 specimens submitted to the laboratory from January 2020 to April 2020, 37 (1.34%) specimens were rejected due to different reasons like insufficient volume, hemolysis, and an inappropriate specimen container. Specimen collector training status and experience had a significant association with the specimen rejection rate. Conclusion: the results of our study show that the specimen rejection rate among referred specimens was high, indicating that more interventions are required to decrease the specimen rejection rate.

"Reality is frequently inaccurate" A case study examining the whens and whys of post-live database changes in a UK clinical trials unit *Douglas Adams.

INTRODUCTION: Accurately estimating the costs of clinical trials is challenging. There is currently no reference class data to allow researchers to understand the potential costs associated with database change management in clinical trials. METHODS: We used a case-based approach, summarising post-live changes in eleven clinical trial databases managed by Sheffield Clinical Trials Research Unit. We reviewed the database specifications for each trial and summarised the number of changes, change type, change category, and timing of changes. We pooled our experiences and made observations in relation to key themes. RESULTS: Median total number of changes across the eleven trials was 71 (range 40-155) and median number of changes per study week was 0.48 (range 0.32-1.34). The most common change type was modification (median 39, range 20-90), followed by additions (median 32, range 18-55), then deletions (median 7, range 1-12). In our sample, changes were more common in the first half of the trial's lifespan, regardless of its overall duration. Trials which saw continuous changes seemed more likely to be external pilots or trials in areas where the trial team was either less experienced overall or within the particular therapeutic area. CONCLUSIONS: Researchers should plan trials with the expectation that clinical trial databases will require changes within the life of the trial, particularly in the early stages or with a less experienced trial team. More research is required to understand potential differences between clinical trial units and database types.

A "twelve-section ultrasonic screening and diagnosis method" and management system for screening and treating neonatal congenital heart disease at the grassroots level in Tang County, Hebei Province, China.

BACKGROUND: To explore a method for screening and diagnosing neonatal congenital heart disease (CHD) applicable to grassroots level, evaluate the prevalence of CHD, and establish a hierarchical management system for CHD screening and treatment at the grassroots level. METHODS: A total of 24,253 newborns born in Tang County between January 2016 and December 2020 were consecutively enrolled and screened by trained primary physicians via the "twelve-section ultrasonic screening and diagnosis method" (referred to as the "twelve-section method"). Specialized staff from the CHD Screening and Diagnosis Center of Hebei Children's Hospital regularly visited the local area for definite diagnosis of CHD in newborns who screened positive. Newborns with CHD were managed according to the hierarchical management system. RESULTS: The centre confirmed that, except for 2 newborns with patent ductus arteriosus missed in the diagnosis of ventricular septal defect combined with severe pulmonary hypertension, newborns with other isolated or concomitant simple CHDs were identified at the grassroots level. The sensitivity, specificity and diagnostic coincidence rate of the twelve-section method for screening complex CHD were 92%, 99.6% and 84%, respectively. A total of 301 children with CHD were identified. The overall CHD prevalence was 12.4‰. According to the hierarchical management system, 113 patients with simple CHD recovered spontaneously during local follow-up, 48 patients continued local follow-up, 106 patients were referred to the centre for surgery (including 17 patients with severe CHD and 89 patients with progressive CHD), 1 patient died without surgery, and 8 patients were lost to follow-up. Eighteen patients with complex CHD were directly referred to the centre for surgery, 3 patients died without surgery, and 4 patients were lost to follow-up. Most patients who received early intervention achieved satisfactory results. The mortality rate of CHD was approximately 28.86 per 100,000 children. CONCLUSIONS: The "twelve-section method" is suitable for screening neonatal CHD at the grassroots level. The establishment of a hierarchical management system for CHD screening and treatment is conducive to the scientific management of CHD, which has important clinical and social significance for early detection, early intervention, reduction in mortality and improvement of the prognosis of complex and severe CHDs.

Technology use among the nation's medical examiner and coroner offices: Data from the 2018 Census of Medical Examiner and Coroner Offices.

Technology uses among medical examiner and coroner (MEC) offices in the United States are not well characterized, yet technology is essential to job-performing duties. Resources, operational infrastructure, and MECs' policies and procedures that affect technology use should be better understood. MEC offices need access to technologies like internet, case management systems (CMSs), databases, and advanced imaging to perform their basic duties. A current state of the technologies MEC offices use to complete a death investigation is presented by analyzing data from the 2018 Census of Medical Examiner and Coroner Offices. This analysis shows the New England division reported the most internet and CMS access. Many offices reported limited access to, and low participation in, databases for assessing and sharing case data. Offices serving populations >250,000 have more access to the internet, CMSs, databases, and advanced imaging. Although MEC office technology use has improved over time, it is still disparate.

A prototype pond water management system (dissolved oxygen, pH and temperature) for giant freshwater prawn farming in Pak Phanang, Southern Thailand.

Significant income was promised by giant freshwater prawn farming, which served as a key occupation for farmers. However, challenges were faced by traditional methods, including difficulties in selling prawns of incorrect sizes, limited market demand, low prices, and the risk of waterborne diseases. In pond-raised environments, these prawns were prone to diseases due to deteriorating environmental conditions, particularly poor pond bottoms, resulting in unsuitable water quality and vulnerability in prawn growth. Consequently, the application of water management technology in the prawn ponds becomes crucial to address these issues. This research aims to develop a prototype for a smart water management system, designed to regulate the water quality that significantly impacts the growth of Pak Phanang giant freshwater prawns within a pond. The equipment and tools utilized comprise ponds, water treatment systems, and smart water quality control systems. The investigation resulted in favorable findings, obtaining a total of 270 river prawns, each measuring an average length of 10-12 cm and weighing between 24 and 30 g. After a rearing period of 120 days in this system, 252 river prawns were successfully harvested, exhibiting a survival rate of 93.3 %. These prawns measured 20-25 cm in length and weighed between 190 and 268 g each, while remaining free from diseases. The results demonstrate that the developed system effectively manages water quality throughout the culture process, offering a valuable model to address the challenges faced by giant freshwater prawn farmers. The prawns obtained are of marketable size, and disease-free, enhancing the farmers' credibility with long-term benefits in the consumer market, in addition to their income generation potential.

Design and implementation of student management system of integrated programmable device programming system.

With the continuous growth and development of society, the reform of higher education is gradually taking shape, and colleges and universities are taking more and more responsibilities in promoting education. The main element of university management is the student management system, which is very important to the development of the university. Under the objective environment of colleges and universities seeking to expand the scale of running schools and rapid economic and social development, the current student management system has been unable to meet the various needs of contemporary students. The integration of programmable device programming systems offers a student management system distinct advantages in terms of reliability, flexibility, and user-friendly operation. This study focuses on developing an effective and affordable student management system by incorporating a programmable device programming system. To evaluate the system's performance, this paper suggests the utilization of a BP neural network, renowned for its high nonlinear approximation capabilities and effectiveness in handling complex nonlinear functional relationships. The experimental findings highlight a significant contribution, demonstrating that the system achieved a throughput of 180 times per second, with a maximum CPU utilization of 99%. Notably, the system's stability exceeded 95%, contrasting sharply with the traditional student management system's stability at a mere 65%. These results underscore the substantial contribution of the proposed system, showcasing its enhanced stability compared to conventional student management systems.

Quality management system in forensic science: An African perspective.

Critical issues in forensic science quality management have emerged in recent decades. The debate on accrediting quality management systems of forensic laboratories is relevant to the African context. Neuteboom, Ross, Bugeja, Willis, Roux, and Lothridge (2022) have conducted a comprehensive survey exploring critical issues in their article "Quality Management in Forensic Science: A Closer Inspection." Their work is a crucial foundation for our discussion, urging the African forensic community to engage in more in-depth conversations. This letter briefly describes the survey, discussing embracing the Sydney Declaration (SD) for Forensic Sciences and issues of quality management systems comprising standards, accreditation, and potential regulation, and highlights the issue of cognitive competency from an African perspective. This underscores the urgent need for critical dialogue, emphasizing that the time for action is now, and urges practitioners, particularly in Africa, to enhance quality management systems to deliver superior forensic products.

Social network analysis for medical narcotics in South Korea: focusing on patients and healthcare organizations.

BACKGROUND: Medical narcotics must be administered under medical supervision because of their potential for misuse and abuse, leading to more dangerous and addictive substances. The control of medical narcotics requires close monitoring to ensure that they remain safe and effective. This study proposes a methodology that can effectively identify the overprescription of medical narcotics in hospitals and patients. METHODS: Social network analysis (SNA) was applied to prescription networks for medical narcotics. Prescription data were obtained from the Narcotics Information Management System in South Korea, which contains all data on narcotic usage nationwide. Two-mode networks comprising hospitals and patients were constructed based on prescription data from 2019 to 2021 for the three most significant narcotics: appetite suppressants, zolpidem, and propofol. Two-mode networks were then converted into one-mode networks for hospitals. Network structures and characteristics were analyzed to identify hospitals suspected of overprescribing. RESULTS: The SNA identified hospitals that overprescribed medical narcotics. Patients suspected of experiencing narcotic addiction seek treatment in such hospitals. The structure of the network was different for the three narcotics. While appetite suppressants and propofol networks had a more centralized structure, zolpidem networks showed a less centralized but more fragmented structure. During the analysis, two types of hospitals caught our attention: one with a high degree, meaning that potential abusers have frequently visited the hospital, and the other with a high weighted degree, meaning that the hospital may overprescribe. For appetite suppressants, these two types of hospitals matched 84.6%, compared with 30.0% for propofol. In all three narcotics, clinics accounted for the largest share of the network. Patients using appetite suppressants were most likely to visit multiple locations, whereas those using zolpidem and propofol tended to form communities around their neighborhoods. CONCLUSIONS: The significance of this study lies in its analysis of nationwide narcotic use reports and the differences observed across different types of narcotics. The social network structure between hospitals and patients varies depending on the composition of the medical narcotics. Therefore, these characteristics should be considered when controlling medication with narcotics. The results of this study provide guidelines for controlling narcotic use in other countries.

Reliability and Detectability of Emergency Management Systems in Smart Cities under Common Cause Failures.

Urban areas are undergoing significant changes with the rise of smart cities, with technology transforming how cities develop through enhanced connectivity and data-driven services. However, these advancements also bring new challenges, especially in dealing with urban emergencies that can disrupt city life and infrastructure. The emergency management systems have become crucial elements for enabling cities to better handle urban emergencies, although ensuring the reliability and detectability of such system remains critical. This article introduces a new method to perform reliability and detectability assessments. By using Fault Tree Markov chain models, this article evaluates their performance under extreme conditions, providing valuable insights for designing and operating urban emergency systems. These analyses fill a gap in the existing research, offering a comprehensive understanding of emergency management systems functionality in complex urban settings.

Dynamics of Carbon and Soil Enzyme Activities under Arabica Coffee Intercropped with Brachiaria decumbens in the Brazilian Cerrado.

The change in land use in the Brazilian Cerrado modifies the dynamics of soil organic matter (SOM) and, consequently, carbon (C) stocks and their fractions and soil enzyme activities. This study evaluated the effect of brachiaria (Brachiaria decumbens Stapf.) intercropped with Arabica coffee (Coffea arabica L.) on the stock and fractions of soil carbon and enzyme activities. The experiment was arranged in a completely randomized block design with three replications and treatments in a factorial design. The first factor consisted of coffee with or without intercropped brachiaria, the second of Arabica coffee cultivars ('I.P.R.103' and 'I.P.R.99') and the third factor of the point of soil sampling (under the canopy (UC) and in inter-rows (I)). Soil was sampled in layers of 0-10, 10-20, 20-30, 30-40, 40-60 and 60-80 cm. Soil from the 0-10 cm layer was also used to analyze enzymatic activity. Significant effects of coffee intercropped with brachiaria were confirmed for particulate organic carbon (POC), with highest contents in the 0-10 and 20-30 cm layers (9.62 and 6.48 g kg-1, respectively), and for soil enzymes (280.83 and 180.3 µg p-nitrophenol g-1 for arylsulfatase and ß-glucosidase, respectively).

The use of energy management ISO 50001 to increase the effectiveness of water treatment plants: An application study on the Zai water treatment plant.

This study sought to determine the impact of implementing the energy management system ISO 50001 on the Zai Water Treatment Plant's energy efficiency performance and demonstrate how this implementation affected the cost and rate of energy consumption. The proposed study model contained three dependent variables-energy consumption, energy efficiency, and the cost of energy consumption. It also contained an independent variable-the energy management system ISO 50001. All these variables were used to develop various questions to help accomplish the study's goals. Planning was done by selecting pumping stations, selecting the most energy-consuming type of pump, and finally, choosing a pump maintenance project to improve energy performance. The researcher used the case of the Zai water pumping station as an example where the ISO 50001 energy management system was applied along with the stages of the Deming Cycle of management. Four pumping units from the Zai water pumping station served as the research sample for the study. •Find the impact of implementing the ISO 50001 energy management system on the energy efficiency performance of the Zai water treatment plant.•The effects of implementing ISO 50001 energy management system on cost and energy consumption at the Zai water treatment plant.•What effect does the ISO 50001 energy management system affect the Zai Water Treatment Plant's energy efficiency? After applying the ISO 50001 energy management system, several conclusions were drawn. Energy costs and consumption rates in the pumping units dropped while the energy efficiency in the chosen pumping units increased.