Solving finite production rate model with scrap and multiple shipments using algebraic approach

This paper solves a finite production rate (FPR) model with scrap and multiple shipments using an algebraic method. Classic FPR model assumes a continuous inventory issuing policy to satisfy demand and perfect quality production for all items produced. However, in real life vendor-buyer integrated production-inventory system, multiple shipment policy is practically used in lieu of a continuous issuing policy and generation of defective items during production run is inevitable. In this study, it is assumed that all defective items are scrap and the perfect quality items can only be delivered to customers if the whole lot is quality assured at the end of the production run. A conventional approach for solving the FPR model is the use of differential calculus on the long-run average cost function with the need to prove optimality first. This paper demonstrates that optimal lot size and its overall costs for the aforementioned FPR model can be derived without derivatives. As a result, it enables students or practitioners who have little knowledge of calculus to understand and to handle with ease the real-life FPR model

Solving finite production rate model with scrap and multiple shipments using algebraic approach

This paper solves a finite production rate (FPR) model with scrap and multiple shipments using an algebraic method. Classic FPR model assumes a continuous inventory issuing policy to satisfy demand and perfect quality production for all items produced. However, in real life vendor-buyer integrated production-inventory system, multiple shipment policy is practically used in lieu of a continuous issuing policy and generation of defective items during production run is inevitable. In this study, it is assumed that all defective items are scrap and the perfect quality items can only be delivered to customers if the whole lot is quality assured at the end of the production run. A conventional approach for solving the FPR model is the use of differential calculus on the long-run average cost function with the need to prove optimality first. This paper demonstrates that optimal lot size and its overall costs for the aforementioned FPR model can be derived without derivatives. As a result, it enables students or practitioners who have little knowledge of calculus to understand and to handle with ease the real-life FPR model

Changes in the Nasal Colonization with Methicillin-Resistant Staphylococcus aureus in Children: 2004-2009

BACKGROUND: Staphylococcus aureus is an important cause of infection, particularly in persons colonized with this organism. This study compared the annual prevalence and microbiological characteristics of methicillin-resistant S. aureus (MRSA) nasal colonization in Taiwanese children from 2004 through 2009. Risk factors for MRSA were determined for the overall study period. METHODS: Children from birth to ≤14 years of age presenting for health maintenance visits or attending 1 of 57 kindergartens were recruited. Nasal swabs were obtained, and a questionnaire was administered. The prevalence and microbiological characteristics of MRSA colonization were also calculated for two 3-year periods: 2004-2006 and 2007-2009. RESULTS: Cultures of the anterior nares were positive for S. aureus in 824 (25.8%) of the 3,200 children, and MRSA colonization was found in 371 (11.6%) children. The prevalence of S. aureus colonization decreased from 28.1% in 2004-2006 to 23.3% in 2007-2009 (p<0.01), whereas the prevalence of MRSA colonization increased from 8.1% to 15.1% during this period (p<0.0001). Multivariate analysis revealed that the independent risk factors for MRSA carriage were different for male and female children, and also among age groups. Most MRSA isolates belonged to sequence type 59 (ST59) (86.3%); however, a multiresistant MRSA clone with ST338 background emerged in 2007-2009. Ten (62.5%) of the 16 MRSA isolates expressed the genotypic profile ST338/staphylococcal cassette chromosome mec V(T)/Panton-Valentine leukocidin-positive/staphylococcal enterotoxin B-positive, and differed only in their antimicrobial susceptibility patterns. CONCLUSION: The prevalence of nasal colonization by MRSA increased among healthy Taiwanese children from 2004-2006 to 2007-2009, despite an overall decrease in the prevalence of nasal colonization by S. aureus. A multiresistant MRSA clone characterized as ST338 was identified from these children

[[alternative]]The relationship between intravenous injection pain and fear for hospitalized children

[[abstract]]背景：靜脈注射是住院兒童很難避免的醫療經驗，也是令住院兒童感到最害怕的護理措施，多數住院兒童面對靜脈注射時會表現出高度的害怕與痛苦，可能加深兒童對靜脈注射痛苦的記憶，進而影響兒童日後對醫療照護的態度。研究目的：旨在了解住院兒童靜脈注射疼痛與害怕之相關因素，並進一步探討住院兒童靜脈注射疼痛與害怕之重要預測因子。研究設計：採描述相關性研究設計，以Cheng, Hester, Foster 及Huang （2003）中文籌碼片為測量疼痛及害怕之評估工具。實際收案人數為120人，年齡介於4-18歲。研究結果：住院兒童接受靜脈注射時，其疼痛及害怕的程度屬中度，且年齡越小、沒有靜脈注射經驗、完成靜脈注射耗費時間越長，其疼痛及害怕的程度越高。此外，兒童過去、現在、預期之靜脈注射疼痛程度及害怕程度皆呈顯著正相關（r=.41-.78，p<.05）。以逐步多元迴歸分析，結果顯示:此次靜脈注射害怕程度、此次靜脈注射預期疼痛可預測此次靜脈注射疼痛程度，其解釋變異量為63.4%，另，此次靜脈注射疼痛程度、此次靜脈注射預期害怕程度可預測此次靜脈注射害怕程度，其解釋總變異量為65.6%。此外，此次靜脈注射疼痛程度與此次靜脈注射害怕程度互為彼此之重要預測因子，且個別解釋變異量皆具高度解釋力。結論：此研究結果印證神經基質理論（Neuromatrix Theory）（Melzack,1999；2005），說明除了生理層面外、認知及情感層面亦可能同時影響住院兒童對靜脈注射疼痛的感受，進而反映在疼痛的程度上。建議臨床護理人員可透過認知及情感層面，設計一個讓兒童免於「害怕」靜脈注射的治療環境，降低「靜脈注射」對住院兒童的威脅性，使兒童能預期自己將擁有一個正向的靜脈注射經驗，來緩解兒童對疼痛的感受，進而降低兒童對靜脈注射的疼痛程度，如此，不單能減緩兒童靜脈注射的疼痛，亦能營造良好的護病關係，提升照護品質。關鍵詞：住院兒童、靜脈注射、疼痛、害

New Horizons of Macrophage Immunomodulation in the Healing of Diabetic Foot Ulcers

Diabetic foot ulcers (DFUs) are one of the most costly and troublesome complications of diabetes mellitus. The wound chronicity of DFUs remains the main challenge in the current and future treatment of this condition. Persistent inflammation results in chronic wounds characterized by dysregulation of immune cells, such as M1 macrophages, and impairs the polarization of M2 macrophages and the subsequent healing process of DFUs. The interactive regulation of M1 and M2 macrophages during DFU healing is critical and seems manageable. This review details how cytokines and signalling pathways are co-ordinately regulated to control the functions of M1 and M2 macrophages in normal wound repair. DFUs are defective in the M1-to-M2 transition, which halts the whole wound-healing machinery. Many pre-clinical and clinical innovative approaches, including the application of topical insulin, CCL chemokines, micro RNAs, stem cells, stem-cell-derived exosomes, skin substitutes, antioxidants, and the most recent Phase III-approved ON101 topical cream, have been shown to modulate the activity of M1 and M2 macrophages in DFUs. ON101, the newest clinically approved product in this setting, is designed specifically to down-regulate M1 macrophages and further modulate the wound microenvironment to favour M2 emergence and expansion. Finally, the recent evolution of macrophage modulation therapies and techniques will improve the effectiveness of the treatment of diverse DFUs