Intravenous Solution Wastage in Hospital Pharmacy at Baptist Memorial Hospital-North Mississippi (Oxford)

Introduction: IV solution wastage refers to IV medications made for a patient that remain unused by that patient for a variety of reasons, and have subsequently expired, or for other reasons cannot be used for another patient (recycled), and therefore must be disposed of. This problem is widespread across hospital pharmacies in the U.S. and the world. BMH-NM (Oxford) pharmacy utilizes many waste reduction strategies but has never monitored its IV solution wastage. Therefore, the objective of this study was to identify the number of IV solutions wasted in a month and the subsequent financial loss in terms of drug cost, and categorize the wastage by drug name and drug class. Methods: This study was conducted using a cross-sectional, observational, prospective study design to quantify the amount of IV solution wastage that occurred at BMH-NM (Oxford). For 30 days in March, 2017, the researcher collected data from wasted IV solutions set aside by pharmacy technicians and calculated the drug cost. For each wastage indicator (number of bags and drug cost), the top 10 drugs and drug classes were ranked, and descriptive statistics were conducted to further visualize the impact. Results: From March 1, 2017, to March 30, 2017, the BMH-NM (Oxford) pharmacy wasted 285 bags of IV solution, resulting in a financial loss of $4025.66 in drug cost. There were 46 different types of drugs from 28 different drug classes. Conclusion: The financial loss from a single month of IV solution wastage was significant for a 217-bed rural hospital. A variety of drugs and drug classes were identified as targets for waste reduction. Potential causes for wastage were drug-specific, and both volume and cost of waste need to be considered for reducing overall IV solution wastage

Additive manufacturing techniques and their biomedical applications

Additive manufacturing (AM), also known as three-dimensional (3D) printing, is gaining increasing attention in medical fields, especially in dental and implant areas. Because AM technologies have many advantages in comparison with traditional technologies, such as the ability to manufacture patient-specific complex components, high material utilization, support of tissue growth, and a unique customized service for individual patients, AM is considered to have a large potential market in medical fields. This brief review presents the recent progress of 3D-printed ­biomedical materials for bone applications, mainly for metallic materials, including multifunctional alloys with high strength and low Young’s modulus, shape memory alloys, and their 3D fabrication by AM technologies. It describes the potential of 3D printing techniques in precision medicine and community health

Less disagreement, better forecasts: adjusted risk measures in the energy futures market

This paper develops a generic adjustment framework to improve in the market risk forecasts of diverse risk forecasting models, which indicates the degree to which risk is under- and overestimated. In the context of the energy commodity market, a market in which tail risk management is of crucial importance, the empirical analysis shows that after this adjustment framework is applied, the forecasting performance of various risk models generally improves, as verified by a battery of backtesting methods. Additionally, our method also lessens the risk model disagreement among post-adjusted risk forecasts

Vibration model of a multi-supported guide bar and analysis on the effect of supports location

Two methods (equivalent force method and segmental mode assuming method) of calculating the natural frequencies and mode shapes of a free-free-multi-supported beam subjected to an axial load is found, considering the structure characteristic of the guide bar, which has long length but small section, and supported by many bearings. The calculation shows that these two methods are convenient for computer programing and have the same results in obtaining the natural frequencies and mode shapes of a free-free-multi-supported beam subjected to an axial load, solving the problem that the vibration function of this kind of beam is hard to deal with because it cannot be simplified with the boundary condition of two ends. Then the segmental mode assuming method is used to analyze the impact of the support location on the natural frequencies and mode shapes of the guide bar. The relation graphs of the natural frequencies with support location, as well as the support locations where the natural frequencies reached the maximum and the minimum are found, providing a reference for the support location selection for the guide bar. The changing curves of the mode shapes with support location are plotted, which show that the bending deformation is homogeneous when the length of each segment is approximately equal, avoiding the phenomenon that bending stresses concentrates at the large-amplitude segments and cause breakage while less stress exists in small-amplitude segments and hinder the exploiting of their performance, providing a reference for the structure design of the guide bar

Dynamical Analysis of Carrier-Track Contact Model in a Braiding Machine

As vibrations caused by the coupling of carriers and tracks could affect the performance of braiding machines a lot, it is necessary to establish the carrier-track contact model and investigate its dynamic characteristics. Therefore, a dynamic model of carrier-track contact model has been developed. Based on the Hertz\u27s law and Newton\u27s law, the dynamical equations of carriers were established. The influence of contact related parameters to the carriers\u27 dynamic characteristics were discussed. Besides, a comparison of contact parameters with different contact models was presented. The results show that although carriers keep a low contact speed, collisions still exist during carriers transferring between tracks. To avoid/decrease collisions and shocks, some methods were proposed, e.g. controlling the angular velocity of horn gears variable, changing the contact surface to have a higher coefficient of restitution and reducing the vibration of frame and tracks, which could be helpful to the design of braiding machines

Calculation of oxygen diffusion coefficients in oxide films formed on low-temperature annealed Zr alloys and their related corrosion behavior

The growth of oxide film, which results from the inward oxygen diffusion from a corrosive environment, is a critical consideration for the corrosion resistance of zirconium alloys. This work calculates the oxygen diffusion coefficients in the oxide films formed on zirconium alloys annealed at 400~500 °C and investigates the related corrosion behavior. The annealed samples have a close size for the second-phase particles but a distinctive hardness, indicating the difference in substrate conditions. The weight gain of all samples highly follows parabolic laws. The weight gain of the sample annealed at 400 °C has the fastest increase rate at the very beginning of the corrosion test, but its oxide film has the slowest growth rate as the corrosion proceeds. By contrast, the sample annealed at 500 °C shows the lowest weight gain but the highest corrosion rate constant. Such a corrosion behavior is attributed to the amount of defects existing in the oxide film formed on the annealed samples; fewer defects would provide a lower fraction of short-circuit diffusion in total diffusion, resulting in a lower diffusion coefficient of oxygen in the oxide film, thereby producing better corrosion resistance. This is consistent with the calculated diffusion coefficients of oxygen in the oxide films: 3.252 × 10−11 cm2/s, 3.464 × 10−11 cm2/s and 3.740 × 10−11 cm2/s for the samples annealed at 400 °C, 450 °C, and 500 °C, respectively

Human leukocyte antigen I and levels of expression of antigen-presenting element proteins plays a role in triple negative breast cancer

Purpose: To determine the protein expression levels of leukocyte antigen I and antigen-presenting element (APM) genes, and to study their relationship with triple negative breast cancer (TNBC) in patients from Uyghur and Han, China.Methods: Immunohistochemistry was used to determine the expression levels of 10 proteins (HLA-A (Human Leukocyte Antigens-A), HLA-B, HLA-C, TAP1 (Transporter associated with Antigen Processing-1), TAP2, calreticulin, calnexin, ERp57 (Endoplasmic reticulum resident protein 57), ERAP1 (Type 1 tumor necrosis factor receptor shedding aminopeptidase regulator) and tapasin) in TNBC and non-TNBC tissue specimens, and 26 benign lesions (fibrous adenoma) specimens from 120 Uygur and Han women.Results: Immunohistochemical analysis showed that the positive expressions of HLA-A, HLA-B, TAP2, Erp57, ERAP1, calnexin and calreticulin in breast cancer tissues were significantly lower than those in breast fibroma tissues (p < 0.05). Among the 86 TNBC patients, there were 35 cases of tapasin- (40.70 %), 26 cases of tapasin+ (30.30 %), and 25 cases of tapasin++ (29.10 %). Among the 34 non-TNBC patients, there were 25 cases of tapsin- (73.50 %), 7 cases of tapasin+ (20.60 %) and 2 cases of tapasin ++ (5.9 %). The positive expression of tapasin in TNBC patients was significantly higher than that in non-TNBC patients (p < 0.05).Conclusion: Down-regulation of transcriptional expression or loss of protein expression of HLA-I and APM genes is closely related to the progression of breast cancer, and is therefore, a potential molecular marker for screening tumors.Keywords: Triple negative breast cancer, Antigen presenting element, Human leukocyte antigen (HLA

Asymmetric impacts of technology innovation and environmental quality on tourism development in emerging economies

Tourism development contributes to higher economic output and is highly integrated with environmental quality and associated technologies. Although many studies explore the impact of tourism on carbon emissions; however, little is known regarding the effects of environmental pollution and technology innovation on tourism growth. Therefore, this study examines the impact of technology innovation and environmental pollution on inbound tourism in emerging economies. In doing so, we employ a recently developed panel quantiles regression and found that technology innovation and economic growth stimulate inbound tourism while increasing emissions limit tourist arrivals. These effects are not equally observed across all quantiles. Particularly, the impact of technology innovation is highest at higher quantiles, while the impact of the emissions is highest at lower quantiles. These results suggest that inbound tourism is asymmetrically affected by technology innovation and environmental quality of host destinations. Hence, emerging economies should encourage sustainable tourism by integrating green technologies and minimizing ecological hazards