Leveraging RFID in hospitals: patient life cycle and mobility perspectives

The application of Radio Frequency Identification (RFID) to patient care in hospitals and healthcare facilities has only just begun to be accepted. This article develops a set of frameworks based on patient life cycle and time-and-motion perspectives for how RFID can be leveraged atop existing information systems to offer many benefits for patient care and hospital operations. It examines how patients are processed from admission to discharge, and considers where RFID can be applied. From a time-and-motion perspective, it shows how hospitals can apply RFID in three ways: fixed RFID readers interrogate mobile objects; mobile, handheld readers interrogate fixed objects; and mobile, handheld readers interrogate mobile objects. Implemented properly, RFID can significantly aid the medical staff in performing their duties. It can greatly reduce the need for manual entry of records, increase security for both patient and hospital, and reduce errors in administering medication. Hospitals are likely to encounter challenges, however, when integrating the technology into their day-to-day operations. What we present here can help hospital administrators determine where RFID can be deployed to add the most value

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe

Polymer glass/melt transformation kinetics

The formation of a glassy phase upon cooling (vitrification) and the gradual evolution of thermodynamic state of a glassy material towards the equilibrium (physical aging) are kinetically driven processes [1]. According to Onsager regression theory, this fact suggest that they are both governed by at least one molecular mechanism, which is commonly assumed to be the main α relaxation with a super-Arrhenius temperature dependence [2]. Consequently, one could logically infer that the destruction of a glassy phase upon heating (devitrification) and the resurgence of equilibrium of a deep glass that has been heated to a temperature Tdeag greater than the aging temperature Tag (deaging) should both occur within a timescale comparable to the main α process. To obtain a deeper understanding of the underlying molecular mechanisms that govern vitrification/aging and devitrification/deaging phenomena, we employed Differential (DSC) and Flash Scanning Calorimetry (FSC) to study the time-dependent evolution of the glass enthalpic state of amorphous poly-4-chlorostyrene (Polymer Source, Mw 24.000 g/mol, PdI 1,20) across a wide temperature range. The evolution of specific heat capacity (cp) curves with respect to aging and deaging time at 397 K is depicted in figure 1, which highlights the differences in equilibration time (τeq) of the two processes. To conclude, our study indicates that the process of eliminating thermal history in a deeply aged glass occurs at timescales that deviate from the expected values. The magnitude and direction of the deviation depend on the explored temperature range, with the timescales being either faster or slower than the alpha relaxation process. [1] Schmelzer, J. W. P.; Gutzow, I. S. Glasses and the glass transition; Wiley-VCH, Weinheim, 2011. [2] Onsager, L. Reciprocal relations in irreversible processes. I. Phys. Rev., 37, 405, 193

IMPACT OF RFID-TTI TECHNOLOGIES ON THE EFFICIENCY OF PERISHABLE PRODUCTS LOGISTICS

The paper concerns the logistics activities related to perishable products. Perishable products are delivered from the production site to a warehouse by refrigerated truck. Perishable products are accepted or not at the warehouse entrance, according to their detected quality levels; if accepted, they are stored in the warehouse in suitable environmental conditions. Finally, they are delivered by refrigerated truck to the destination. Human errors affect these activities. Perishable products have to be delivered in a suitable quality level to the destination. Because of human errors, sometime products arrive in an unsuitable quality level and therefore, there is a loss for the company. RFID technologies, integrated with time temperature indicators (TTI), allow a prompt detection of abnormal quality loss and the prompt actuation of mitigation actions. In order to evaluate the benefits of different RFID-TTI implementation set-ups, the study defines a methodology that measures the risk of monetary losses. The method is applied to a case study and the results are presented

Tissue Penetration of Antimicrobials in Intensive Care Unit Patients: A Systematic Review—Part II

In patients that are admitted to intensive care units (ICUs), the clinical outcome of severe infections depends on several factors, as well as the early administration of chemotherapies and comorbidities. Antimicrobials may be used in off-label regimens to maximize the probability of therapeutic concentrations within infected tissues and to prevent the selection of resistant clones. Interestingly, the literature clearly shows that the rate of tissue penetration is variable among antibacterial drugs, and the correlation between plasma and tissue concentrations may be inconstant. The present review harvests data about tissue penetration of antibacterial drugs in ICU patients, limiting the search to those drugs that mainly act as protein synthesis inhibitors and disrupting DNA structure and function. As expected, fluoroquinolones, macrolides, linezolid, and tigecycline have an excellent diffusion into epithelial lining fluid. That high penetration is fundamental for the therapy of ventilator and healthcare-associated pneumonia. Some drugs also display a high penetration rate within cerebrospinal fluid, while other agents diffuse into the skin and soft tissues. Further studies are needed to improve our knowledge about drug tissue penetration, especially in the presence of factors that may affect drug pharmacokinetics

Study of the impact of the LHC radiation environments on the Synergistic Displacement Damage and Ionizing Dose Effect on Electronic Components

International audienceBipolar-based components can exhibit a higher (or lower) degradation when exposed to both total ionizing dose (TID) and displacement damage (DD) effects simultaneously than the sum of the two separated effects. This paper investigates the implications of this synergistic effect on the radiation qualification process of large hadron collider’s (LHC’s) electronic equipment. More specifically, the impact of the wide range of DD/TID rate ratios of the LHC’s areas on the synergistic degradation rates is investigated. An analysis of the ratios of a crucial part of the accelerator is performed. A demonstration of the ability of the CHARM mixed-field facility of CERN to perform radiation tests in representative LHC’s ratios is also presented as well as radiation test results of a bipolar integrated circuit exposed to these different ratios are presented. Finally, the impact of this effect on the CERN radiation hardness assurance process is discussed and a simple method is proposed to qualify component against such effects