The Study of the Optimal Parameter Settings in a Hospital Supply Chain System in Taiwan

This study proposed the optimal parameter settings for the hospital supply chain system (HSCS) when either the total system cost (TSC) or patient safety level (PSL) (or both simultaneously) was considered as the measure of the HSCS’s performance. Four parameters were considered in the HSCS: safety stock, maximum inventory level, transportation capacity, and the reliability of the HSCS. A full-factor experimental design was used to simulate an HSCS for the purpose of collecting data. The response surface method (RSM) was used to construct the regression model, and a genetic algorithm (GA) was applied to obtain the optimal parameter settings for the HSCS. The results show that the best method of obtaining the optimal parameter settings for the HSCS is the simultaneous consideration of both the TSC and the PSL to measure performance. Also, the results of sensitivity analysis based on the optimal parameter settings were used to derive adjustable strategies for the decision-makers

Haemophilus Aphrophilus Associated Spleen Abscess: An Unusual Presentation of Subacute Endocarditis

The HACEK group of bacteria (Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella spp.), is uncommon pathogens of infective endocarditis, but can cause life-threatening events such as heart failure or formation of lethal emboli. Here we report a 58-year-old Asian man with a past history of congenital valvular heart disease who presented with sudden onset of left flank pain followed by fever with chills for 2 weeks. Abdominal computed tomography (CT) indicated a 1.6 cm abscess in the spleen. Culturing indicated the presence of Haemophilus aphrophilus. We diagnosed the patient with subacute endocarditis complicated with spleen abscess. The patient recovered fully after two weeks antibiotic (Ceftriaxone) treatment. Clinicians should give further attention to infective endocarditis caused by bacteria in the HACEK group in patients with metastatic infection such as spleen abscess with suspected valvular heart disease

Molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis clinical isolates

To evaluate the molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis (MH) clinical strains isolated from urogenital specimens. 15 MH clinical isolates with different phenotypes of resistance to fluoroquinolones antibiotics were screened for mutations in the quinolone resistance-determining regions (QRDRs) of DNA gyrase (gyrA and gyrB) and topoisomerase IV (parC and parE) in comparison with the reference strain PG21, which is susceptible to fluoroquinolones antibiotics. 15 MH isolates with three kinds of quinolone resistance phenotypes were obtained. Thirteen out of these quinolone-resistant isolates were found to carry nucleotide substitutions in either gyrA or parC. There were no alterations in gyrB and no mutations were found in the isolates with a phenotype of resistance to Ofloxacin (OFX), intermediate resistant to Levofloxacin (LVX) and Sparfloxacin (SFX), and those susceptible to all three tested antibiotics. The molecular mechanism of fluoroquinolone resistance in clinical isolates of MH was reported in this study. The single amino acid mutation in ParC of MH may relate to the resistance to OFX and LVX and the high-level resistance to fluoroquinolones for MH is likely associated with mutations in both DNA gyrase and the ParC subunit of topoisomerase IV

Risk Analysis of Cargos Damages for Aquatic Products of Refrigerated Containers: Shipping Operators’ Perspective in Taiwan

As the development of refrigerated container, transportation of aquatic products is growing rapidly in recent years. It is very important to avoid cargos damages for aquatic products of refrigerated containers, while the shipping operators are running this scope of business. Hence, the risk issue of adopting various improvement strategies would be important for the container shipping operators. In the light of this, the main purpose of this paper is to analyze the risks of cargos damages for aquatic products of refrigerated containers based on the container shipping operators’ perspective in Taiwan. We use four risk assessment procedures - risk identification, risk analysis and evaluation, risk strategies, and risk treatment - as the research method in this paper. The risk factors are generated from literature review and experts interviewing. Then, three dimensions with nineteen risk factors are preliminary identified. We used these risk factors to proceed with the empirical study via questionnaires. Three points of empirical results are presented. At first, the top factor of perceived risk as well as of risk severity is ‘container data setting errors.’ Secondly, the top factor of risk frequency is ‘lack of the goods’ pre-cooling themselves.’ Thirdly, three risk factors are classified into the low-risk area, whereas sixteen risk factors are placed on the medium-risk area. There is no risk factor fix on the high-risk area. Furthermore, three risk strategies - risk prevention, risk reduction, and risk transfer - are suggested to adopt by different risk factors

The microtubule-associated protein, EB1, links AIM2 inflammasomes with autophagy-dependent secretion

Inflammasomes are multi-protein complexes that regulate chronic inflammation-associated diseases by inducing interleukin-1 β (IL-1β) secretion. Numerous components involved in inflammasome activation have been identified, but the mechanisms of inflammasome-mediated IL-1β secretion have not yet been fully explored. Here, we demonstrate that end-binding protein 1 (EB1), which is required for activation of AIM2 inflammasome complex, links the AIM2 inflammasome to autophagy-dependent secretion. Imaging studies revealed that AIM2 inflammasomes colocalize with microtubule organizing centers and autophagosomes. Biochemical analyses showed that poly(dA-dT)-activated AIM2 inflammasomes induce autophagy and IL-1β secretion in an LC3-dependent fashion. Furthermore, depletion of EB1 decreases autophagic shedding and intracellular trafficking. Finally, we found that the 5′-AMP activated protein kinase may regulate this EB1-mediated autophagy-based inflammasome-induced secretion of IL-1β. These findings reveal a novel EB1-mediated pathway for the secretion of IL-1β

Bacteriostatic Substrate by Conductivity Method and Electric Spark Discharge Method Combined with Electrospinning for Silver Dressing

This study uses the conductivity method, Electric Spark Discharge Method, and the electrospinning technique to develop a better silver-based antibacterial agent. The preparation process is free of chemical substances and also conforms to the green energy-saving process. The silver iodide was prepared in an iodine agar medium by using the conductivity method. Multiple bacteriostasis experiments showed that the molds grew in the position with iodine of the culture medium after 6 days, as well as in the position with silver iodide after 10 days. The results prove that silver iodide has better bacteriostatic ability than povidone iodine. The nanosilver colloid was prepared in the PVA solution by using the Electric Spark Discharge Method. UV-Vis, Zetasizer, and SEM-EDX analyses proved that the PVA solution contained nanosilver colloid with good suspension stability. Finally, the electrospinning technique was used to spin the PVA solution with nanosilver colloid into the PVA nanofibrous membrane. According to UV-Vis analysis, the absorption peak of this nanofibrous membrane is about 415 nm, meaning this nanofibrous membrane contains nucleate nanosilver colloid, and is very suitable for antiseptic dressing

The effect of pituitrin on postoperative outcomes in patients with pulmonary hypertension undergoing cardiac surgery: a study protocol for a randomized controlled trial

BackgroundThe vasoplegic syndrome is one of the major consequences of cardiac surgery. If pulmonary hypertension is additionally involved with vasoplegic syndrome, circulation management becomes much more complicated. According to previous studies, pituitrin (a substitute for vasopressin, which contains vasopressin and oxytocin) not only constricts systemic circulation vessels and increases systemic circulation pressure but also likely decreases pulmonary artery pressure and pulmonary vascular resistance. The aim of this study is to investigate whether pituitrin is beneficial for the postoperative outcomes in patients with pulmonary hypertension undergoing cardiac surgery.Methods and analysisThe randomized controlled trial will include an intervention group continuously infused with 0.04 U/(kg h) of pituitrin and a control group. Adult patients with pulmonary hypertension undergoing elective cardiac surgery will be included in this study. Patients who meet the conditions and give their consent will be randomly assigned to the intervention group or the control group. The primary outcome is the composite endpoint of all-cause mortality within 30 days after surgery or common complications after cardiac surgery. Secondary outcomes include the incidence of other postoperative complications, length of hospital stay, and so on.DiscussionPituitrin constricts systemic circulation vessels, increases systemic circulation pressure, and may reduce pulmonary artery pressure and pulmonary vascular resistance, which makes it a potentially promising vasopressor during the perioperative period in patients with pulmonary hypertension. Therefore, evidence from randomized controlled trials is necessary to elucidate whether pituitrin influences outcomes in patients with pulmonary hypertension following cardiac surgery