Care Network Coordination for Chemotherapy at Home: A Case Study

International audienceThis paper deals with a system of chemotherapy at home which is managed by a Home Care Services (HCS) structure. The main role of this HCS structure is to coordinate care actors for a smooth organization of chemotherapy at home. In this work, we model a real system of chemotherapy at home managed by a HCS structure, and simulate its behaviour. The objective is to evaluate the relevance of such a system for current activities of the HCS structure, and to propose solutions for improving the optimal coordination of the care network for chemotherapy at home

Use of path algebra tools for a unified description of a large class of pull control policies

International audienceMany pull policies can be found in the literature for controlling multistage production/inventory systems. In this paper, we present a framework that enables us to describe the dynamics of a large class of pull control policies, using the same set of canonical functions. The class of policies we consider here include well known pull policies, like kanban, CONWIP, basestock, generalized kanban, extended kanban, but also many other hybrid policies, and their extensions to systems producing batches. Each of these policies is characterized by the values of some parameters. These parameters values are calculated thanks to a computational algorithm that relies on the use of path algebra tools, especially (min,+) algebra tools. This canonical formulation allows to identify under which values of the control parameters, two different policies have the same dynamics behavior. It also enables to derive methods for evaluating and comparing the performance of several pull control policies, as we illustrate it in the paper

Aide au pilotage de la chaîne de prise en charge de la chimiothérapie à domicile

Le sujet de thèse s intéresse à la chimiothérapie à domicile qui est l effet combiné de l augmentation des patients atteints du cancer et du succès de l hospitalisation à domicile. Nous proposons à travers ce mémoire de thèse des solutions appropriées au pilotage de la chaîne de prise en charge de la chimiothérapie à domicile permettant d évaluer et d améliorer la performance de celle-ci. La première partie présente le contexte socio-économique de la chimiothérapie à domicile, ainsi que les contraintes réglementaires et organisationnelles pour sa mise en œuvre. La deuxième partie précise les spécificités d une chaîne de prise en charge de la chimiothérapie à domicile et les problématiques liées à cette chaîne basée sur une revue de la littérature. La troisième partie se focalise sur la modélisation des processus de prise en charge de la chimiothérapie à domicile à partir d un important travail de terrain. Un modèle générique de la chimiothérapie à domicile est dégagé du travail de modélisation qui constitue le fondement d une proposition de classification des pratiques de la chimiothérapie à domicile. Un diagnostic individuel et comparatif des différentes familles d approches sont également présentés dans cette partie. La quatrième partie présente les différentes applications développées pour évaluer et améliorer la performance de la chaîne de prise en charge de la chimiothérapie à domicile. En conclusion, cette thèse apporte une première contribution à la généralisation de la pratique de la chimiothérapie à domicile et au développement d outils d aide aux pilotages destinés à l amélioration de sa réalisationThis thesis deals with chemotherapy at home which is the fruit of increasing cancer patients and successful development of home care services. We present in this thesis appropriate solutions to evaluate and improve management performance of chemotherapy at home network. The first part concerns the socioeconomic context of chemotherapy at home, as well as its legal and organizational constraints. The second part outlines specificities and related issues of chemotherapy at home based on a literature review. The third part focuses on chemotherapy at home process modeling depending on an important field work. A generic model of chemotherapy at home is abstracted, which is the basis of a chemotherapy at home practices classification that we proposed. An individual analysis and a comparative analysis of chemotherapy at home approaches are also proposed in this part. The fourth part presents different solutions that we developed to evaluate and improve the management performance of chemotherapy at home network. In conclusion, this thesis provides an initial contribution to promote chemotherapy at home practices and to develop management support tools for its implementationST ETIENNE-Bib. électronique (422189901) / SudocSudocFranceF

Bindarit inhibits human coronary artery smooth muscle cell proliferation, migration and phenotypic switching

Bindarit, a selective inhibitor of monocyte chemotactic proteins (MCPs) synthesis, reduces neointimal formation in animal models of vascular injury and recently has been shown to inhibit in-stent late loss in a placebo-controlled phase II clinical trial. However, the mechanisms underlying the efficacy of bindarit in controlling neointimal formation/restenosis have not been fully elucidated. Therefore, we investigated the effect of bindarit on human coronary smooth muscle cells activation, drawing attention to the phenotypic modulation process, focusing on contractile proteins expression as well as proliferation and migration. The expression of contractile proteins was evaluated by western blot analysis on cultured human coronary smooth muscle cells stimulated with TNF-α (30 ng/mL) or fetal bovine serum (5%). Bindarit (100-300 µM) reduced the embryonic form of smooth muscle myosin heavy chain while increased smooth muscle α-actin and calponin in both TNF-α- and fetal bovine serum-stimulated cells. These effects were associated with the inhibition of human coronary smooth muscle cell proliferation/migration and both MCP-1 and MCP-3 production. The effect of bindarit on smooth muscle cells phenotypic switching was confirmed in vivo in the rat balloon angioplasty model. Bindarit (200 mg/Kg/day) significantly reduced the expression of the embryonic form of smooth muscle myosin heavy chain, and increased smooth muscle α-actin and calponin in the rat carodid arteries subjected to endothelial denudation. Our results demonstrate that bindarit induces the differentiated state of human coronary smooth muscle cells, suggesting a novel underlying mechanisms by which this drug inhibits neointimal formation

FactoryBricks: a New Learning Platform for Smart Manufacturing Systems

Manufacturing industries are facing radical changes under the technological acceleration of Industry 4.0. The manufacturing workforce is not ready for such disruptions due to the lack of vertical skills on digital technologies. Production planning and control of manufacturing systems is often an experience-based art. Further, the companies need of offering training paths for long-life learning of their employees finds several obstacles in the availability of skilled trainers and the trainee’s low engagement with traditional learning models. This paper presents how the FactoryBricks project aims at overcoming the aforementioned issues. The project delivers effective training courses to enable the uptake of industrial technologies and smart manufacturing systems for professionals, either executives or technicians. Beside digital learning contents, the learners are offered an interaction with lab-scale models of production systems built with modular components such as LEGO®. The courses are designed in a modular way, and aim to teach manufacturing concepts in three main topics: (1) the physical system and its dynamics, (2) the physical-digital data connections for smart online analytics, and (3) the exploitation of digital models for production. The paper also presents the results of the prototypical implementation of the project

The efficacy and the safety of eltrombopag in pediatric patients with severe aplastic anemia: a systematic review

BackgroundAcquired aplastic anemia (AAA) in pediatric patients is a rare disorder characterized by hypocellular bone marrow and pancytopenia. Eltrombopag, an oral thrombopoietin receptor agonist, provides a hematologic improvement in adults with severe aplastic anemia (SAA) refractory to immunosuppressive therapy (IST). The association of ELT and IST was approved by the US Food and Drug Administration (FDA) for adults and children ≥2 years of age as a first-line treatment for SAA. However, the effects of ELT on pediatric patients with SAA remain controversial and limited.Methods and findingsWe conducted a systematic review of the most recent literature from Pubmed, Web of Science, and Embase, published up to 20th December 2022, in order to evaluate the available evidence on the efficacy and safety of ELT added to IST for the treatment of SAA in the pediatric population.ConclusionEltrombopag added to the IST has shown a good safety profile, without manifestations of excessive toxic effects, although not all the results obtained from our studies support the addition of ELT to the IST in the first-line treatment of children with SAA.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022325859

Pharmacological and molecular docking assessment of cryptotanshinone as natural-derived analgesic compound

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Chapitre 3 : Méthodes d'aide à la décision pour une gestion efficiente des flux dans les services de stérilisation de dispositifs médicaux

National audienceLes activités médicales (examens, interventions chirurgicales…) nécessitent l’utilisation d’instruments, que l’on appelle dispositifs médicaux (DM), réutilisables et qu’il faut stériliser entre deux utilisations. Dans les établissements hospitaliers, ce sont les services de stérilisation qui se chargent de stériliser et de conditionner ces DM. Cette activité de stérilisation s’avère à la fois coûteuse et stratégique car c’est sur elle que repose le fonctionnement des blocs opératoires et autres services des établissements hospitaliers. Ce chapitre est consacré à la présentation de quelques exemples de travaux, réalisés au laboratoire G-SCOP, montrant l’apport des sciences de l’ingénieur, et plus particulièrement du génie industriel, pour l’étude et l’amélioration de l’organisation de la production de dispositifs médicaux stériles en milieu hospitalier. Nous montrons comment la modélisation, l’évaluation de performances, l’optimisation mathématique et l’analyse de risques peuvent contribuer à rendre la gestion des services de stérilisation plus efficiente

A panorama of scientific methods to make healthcare production systems more efficient in terms of organization: Keynote

This talk will present the stakes of flow management in the health domain, as well as the specificities of healthcare production systems compared to manufacturing systems.We will see some examples of work, carried out in the G-SCOP laboratory, showing the contribution of engineering sciences, and more particularly of industrial engineering, for the study and the improvement of the organization of various healthcare production systems. This talk will thus show how modeling, performance evaluation, mathematical optimization, and risk analysis can contribute to making the management of healthcare production systems more efficient