Search

Ke Wang, Xuelu Wang, Chenying Xu, Lina Bai Operating Room, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, People’s Republic of ChinaCorrespondence: Xuelu Wang; Chenying Xu, Operating Room, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, 2699 West Gaoke Road, Pudong New Area, Shanghai, People’s Republic of China, 200092, Email wangxuelu@51mch.com; xuchenying@51mch.comObjective: Reasonable surgical scheduling management is crucial to optimize the utilization rate of operating room. This study aims to understand the context, frontier and hot spots of surgical scheduling management research, in order to provide reference for surgical scheduling optimization.Methods: Literature on operation scheduling management collected in Web of Science core collection database was searched from the database establishment to June 21, 2023. HisCite Pro 2.1 software was used to analyze the publication time, countries, research institutions, journals, authors, keywords and highly cited papers.Results: A total of 1383 literatures were included, and research institutions in the United States, Canada and other countries played a leading role in this field. Among them, the combination of machine algorithm and system model optimization to improve the accuracy of surgical duration prediction is the future research focus in this field.Conclusion: Improving operation efficiency is one of the key issues in operating room management. Managers should find the best operation scheduling plan from a more detailed and comprehensive perspective to improve operation efficiency.Keywords: surgery, schedule, manage

Delays in construction projects are common and persistent. Frequent disputes also make work time inefficient and result in significant cost increases. Therefore, it is necessary to study or investigate events that are useful as a solution to delay claims and have the potential to be used in litigation. This research has been conducted to maximize reliable data sources. The Source Validation Protocol guides the process for ensuring the validity of the source data based on the Forensic Schedule Analysis methodology. According to the Critical Path Method (CPM) schedule analysis, the construction time of the Rusunawa Building (Rent Simple Flat) of the Health Polytechnic of the Ministry of Health Yogyakarta is 73.2 weeks or 511 calendar days. The 2 data source validation protocols, including Validation of Baseline Schedule Selection, Validation and Rectification, and Validation of As-Built Schedule Sources, Reconstruction, and Validation, greatly influenced the project delays.

Abstract Rationale The effectiveness of immunisation with pneumococcal conjugate vaccine (PCV) has been demonstrated in many countries. However, the global impact of PCV is limited by its cost, which has prevented its introduction in some countries. Reducing the cost of PCV programmes will facilitate further vaccine introductions and improve the sustainability of PCV in low-income countries when they transition from subsidised vaccine supply. We are conducting a large, population-level, cluster-randomised field trial (PVS) of an alternative reduced-dose schedule of PCV compared to the standard schedule. We are also conducting a nested sub-study at the individual level to investigate the immunogenicity of the two schedules and their effects on pneumococcal carriage acquisition (PVS-AcqImm). Methods and design PVS-AcqImm is a prospective, cluster-randomised trial of an alternative schedule of one dose of PCV scheduled at age 6 weeks with a booster dose at age 9 months compared to the standard of three primary doses scheduled at 6, 10, and 14 weeks of age. Sub-groups within the alternative schedule group receive yellow fever vaccine separately or co-administered with PCV at 9 months of age. The primary endpoints are (a) concentrations of vaccine-type anti-pneumococcal IgG at 18 months of age, (b) proportions with yellow fever neutralising antibody titre ≥ 1:8 4 weeks after separate or co-administration of PCV and yellow fever vaccines, and (c) rate of nasopharyngeal vaccine-type pneumococcal acquisition from 10–14 months of age. Participants and field staff are not masked to group allocation while measurement of the laboratory endpoints is masked. Approximately equal numbers of participants are resident in each of 28 randomly allocated geographic clusters (14 clusters in each group); 784 enrolled for acquisition measurements and 336 for immunogenicity measurements. Purpose This statistical analysis plan (SAP) describes the PVS-AcqImm cohort and follow-up criteria to be used in different analyses. The SAP defines the endpoints and describes how adherence to the interventions will be presented. We describe the approach to analyses and how we will account for the effect of clustering. Defining the SAP prior to the conduct of analysis will avoid bias in analyses that may arise from prior knowledge of trial findings. Trial registration ISRCTN, ISRCTN7282161328. Registered on 28 November 2019. https://www.isrctn.com/ISRCTN72821613 . Protocol: MRCG SCC number 1670, LSHTM Ref 17683. Current protocol version: 6.0, 24 May 2021. Version: 1.0 (5 April 2023); SAP revisions—none.

This article describes the process of creating a Telegram bot that would automatically send class schedules for full-time/part-time students on a daily basis. A feature of Telegram bots is - simplicity of use and minimization of resources, which greatly simplifies its creation and interaction with it. Purpose – create a convenient environment in which the student can easily get the information he or she needs, spending a minimum amount of time. The method or methodology of the work: the article deals with the way in which by appointing the academic department as the administrator, there will be access to fill the database. Students, when starting the Telegram bot, once will need to specify the form of study and the group. To implement it, the following are used a SQLite database and the Python programming language are used in the implementation. Result: developed a tool that automates the student will be aware of his schedule, and for the educational part it is easier to create a schedule for each group. Scope of the results: the data stored in the database is reasonable to use to obtain information in the academic life.

Effectively managing the delivery of Ready Mixed Concrete (RMC) for diverse construction projects poses a significant challenge for concrete batch plant supervisors. The formulation of an efficient schedule for dispatching concrete truck mixers is paramount, requiring a delicate balance between practicality and adaptability. The concrete batch plant administrator must establish a productive timetable that aligns activities at the concrete batch facility and construction sites. RMC delivery requests inundate the ready mixed concrete batch plant during specific operational hours, necessitating swift decision-making by the concrete batch plant administrator to create a dispatching schedule that meets the varied requirements of different construction projects. The dispatching schedule time for all batch plants is primarily influenced by the dispatcher administrator's experience and preferences. For instance, a ready mixed concrete batch plant administrator may opt to dispatch as many truck mixers as possible to the busiest construction project. However, while the batch plant waits for the RMC trucks to arrive, this strategy may cause truck congestion at the project site. Clearly, an effective dispatching schedule is crucial for enhancing the overall system efficiency of construction projects and batch plants. This paper initially presents various optimization methods and subsequently analyses the ready mixed concrete system and its transportation strategy, delineating the factors impacting the dispatching schedule. The study then introduces a systematic model employing simulation processes and Genetic Algorithms to optimize the dispatching schedule while minimizing the waiting time of RMC truck mixers at construction projects. The goal of this optimisation is to meet the needs for RMC delivery from various building projects while minimising the impact on casting processes. Ultimately, concrete batch plant administrators will find assistance in organising and managing the dispatching procedure from an automated software that was created utilising the C-sharp programming language and included all pertinent modules. Three cases from the available research were examined, and field data from the DECOM batching facility was applied over the course of three working days to evaluate the software's effectiveness.

Effectively managing the delivery of Ready Mixed Concrete (RMC) for diverse construction projects poses a significant challenge for concrete batch plant supervisors. The formulation of an efficient schedule for dispatching concrete truck mixers is paramount, requiring a delicate balance between practicality and adaptability. The concrete batch plant administrator must establish a productive timetable that aligns activities at the concrete batch facility and construction sites. RMC delivery requests inundate the ready mixed concrete batch plant during specific operational hours, necessitating swift decision-making by the concrete batch plant administrator to create a dispatching schedule that meets the varied requirements of different construction projects. The dispatching schedule time for all batch plants is primarily influenced by the dispatcher administrator's experience and preferences. For instance, a ready mixed concrete batch plant administrator may opt to dispatch as many truck mixers as possible to the busiest construction project. However, while the batch plant waits for the RMC trucks to arrive, this strategy may cause truck congestion at the project site. Clearly, an effective dispatching schedule is crucial for enhancing the overall system efficiency of construction projects and batch plants. This paper initially presents various optimization methods and subsequently analyses the ready mixed concrete system and its transportation strategy, delineating the factors impacting the dispatching schedule. The study then introduces a systematic model employing simulation processes and Genetic Algorithms to optimize the dispatching schedule while minimizing the waiting time of RMC truck mixers at construction projects. The goal of this optimisation is to meet the needs for RMC delivery from various building projects while minimising the impact on casting processes. Ultimately, concrete batch plant administrators will find assistance in organising and managing the dispatching procedure from an automated software that was created utilising the C-sharp programming language and included all pertinent modules. Three cases from the available research were examined, and field data from the DECOM batching facility was applied over the course of three working days to evaluate the software's effectiveness.

Aim: This descriptive study was conducted to analyze the existing situation and nurses' perspectives on work schedules. Method: The study sample consisted of 207 nurses who worked at 23 state hospitals. The data were collected with a 40-item questionnaire developed by the researchers. Descriptive statistics, Kruskal-Wallis, Mann-Whitney U, chi-square, and Spearman's correlation tests were used for data analysis. Results: The mean numbers of beds, nurses, daily hospitalized patients, and patients in the unit on the last shift were 24.23 (SD=15.01), 14.79 (SD=10.48), 9.16 (SD=8.2), and 12.10 (SD=10.28), respectively. Of the nurses, 49% had a rotating shift, 54.8% were dissatisfied with the shift system, and nurse scheduling was mostly prepared on paper by the clinic's responsible nurses and then loaded onto a computer. Conclusion: Fair and objective criteria and software should be used to prepare schedules with mostly fixed shifts and convenient work hours, without wasting time on manual scheduling. These results indicate factors that need to be taken into consideration in the preparation of nurses' work schedules and workforce planning.

In the article, the activities of Armenian schools in Iran in the second half of the 19th century and the first half of the 20th century, and the teaching of the Persian in those schools are addressed. The purpose of the study is to examine the teaching of Persian in Armenian schools․ For conducting the research historical and comparative-historical methods have been used․ In the second half of the 19th century and at the beginning of the 20th century the Armenian schools of Iran were influenced by the Armenian schools of the Caucasus. They often brought educational literature from Tbilisi to Iran and sometimes invited teachers from there. Along with foreign languages, Persian was also taught at Armenian schools in Iran. During the years of the constitutional movement, the classes of Persian language became more widespread in Armenian schools. During the reign of Reza Shah, the management of all schools in the country came under the control of the state, and the teaching of Persian became mandatory in all schools. Thus, in the second half of the 19th century the teaching of Persian facilitated the integration of students into economic and social life, but after educational reforms and standardization of school curriculum, the teaching of Persian gradually became mandatory and standardized in all Armenian schools of Iran.

Modeling and numerical analysis of the design of building structures, their technology, organization and management methods of construction processes are the subject of the work of many scientists in Poland. Schedule designers try to best reflect the reality of construction projects with the available methods, although this procedure is not always successful. One of the scheduling methods is the Time Coupling Methods (TCM), which can be refined using the predictive durations of the Multivariate Method of Statistical Models (MMSM) construction processes and standard deviations. A new scheduling method in the probabilistic approach was developed – Probabilistic Time Couplings Method I (PTCM I). At PTCM I, work is organized in such a way as to maintain the continuity of work of employees, as downtime of workers is disadvantageous and costly. The total duration of the new investment was forecasted and compared with the other methods of scheduling and with real time after its completion. The results clearly show that the developed methodology can be successfully used in scheduling construction works.

ABSTRACTPreventing perinatal transmission is important for hepatitis B (HepB) elimination. We conducted a retrospective cohort study to assess the interval between HepB birth-dose (HepB-BD) to second-dose (HepB-SD) vaccination on perinatal transmission. Among 39,313 infants born to HepB s-antigen (HBsAg)-positive mothers from a Korean national database 38,411 (97.7%) had completed timely immunophylaxis with HepB-BD 41,572 (99.8%) with hepatitis B immune globulin, and 1027 (2.6%) were HBsAg-positive at ≥ 9 months. Maternal factors (i.e. HepB e-antigen status, age, or nationality) were associated with an increased risk of infection whereas short gestational length decreased it. The HepB-BD – HepB-SD interval (

AbstractThe preparation of urban development plans and their implementation for urban development in the Global South are often not treated as projects, despite the time, cost and other resource implications. Urban development plan preparation and implementation often overrun their schedule, and cost and at times become uncertain. So, an argument has emerged that plan preparation and implementation should be managed by the use of project management principles. Thus, the objective of the study was to explore the challenges in the preparation of urban plans and their implementation and how project management as an anti-planning measure can improve efficiency in these aspects. A Delphi research method involving surveys among urban planning and project management professionals and experts was used. Findings suggest that the preparation of plans and implementation suffer from several challenges under the conventional process. However, project management can become an anti-planning measure and enable the preparation of plans and implementation efficiently. As advocated by anti-planning, it can enable keeping a journal of the occurrences regularly which would allow diagnosis of the challenges and to take appropriate remedial interventions. Practically, it can enable controlling the schedule, cost, and resources and eliminate uncertainty in urban planning and implementation.

Complex construction projects require appropriate planning that allows for time and cost optimization, maximization of the use of available resources and appropriate investment control. Scheduling is a complicated process, due to the uncertainties and risks associated with construction works, the paper describes the development of the scheduling method traditionally used in Poland, based on data from KNR catalogs, by using the RiskyProject Professional program. In the RiskyProject Professional program, the risk and uncertainty with reference to a specific construction project were modeled, and the calculation results were compared with the real time of the project implementation. The conclusions from the work carried out confirm that the SRA (Schedule Risk Analysis) analysis of the base schedule allows for a more faithful representation of the actual conditions of a construction project. The probability of investment realization generated on the basis of the SRA analysis may be assumed at the level of 75÷90%.

This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of a chronological step which leads to the phase or status change in the project management. The main purpose of the research is the wedding event in the start to the end of the activities and the event is represented by a node in the network. Systematization of the literary sources and approaches for solving the problem that an event is a specific instant of time which makes the start or end of an activity and event consumes neither time nor resources. It indicates that an activity is the actual performance of the task and requires time and resources for its completion. The relevance of this scientific problem decision is that project management is a tool of functional areas. Investigation of the topic a systematic procedure to implement a weeding event in the paper is carried out in the following logical sequence on project management: Methodological tools of the research methods were a couple of years of research. The object of research is the chosen company that carried out the processes of a wedding project at Toronto Metropolitan University, Canada, because namely they derived this event as a project. The paper presents the results of an empirical analysis on mathematical calculations which showed that were perfect in graphically. The research empirically confirms and theoretically proves that it is the work required to complete a couple of specific tasks: determine your event goals and objectives, visualize the event, draw up a budget, develop a timeline, put the plan into action, double-check the project plan, evaluate the event. The results of the research can be useful for a wedding event cycle consists of five stages: plan, organize measure, analyze and share.

The 12th HPV Prevention and Control meeting was held on June 2–3, 2022, in Antwerp, Belgium. This technical meeting focused on several topics. This report summarises the discussions and lessons learned on two topics: an update on one-dose HPV vaccination studies and humoral immune responses upon HPV vaccination. Long-term follow-up studies from Costa Rica (eleven years) and India (ten years) report stable levels of antibodies after a single HPV vaccination. High vaccine effectiveness against incident persistent HPV 16/18 infection was seen in India (95.4%, 85.0–99.9) ten years postvaccination and in Kenya (97.5%, 81.7–99.7) eighteen months postvaccination, an important observation in a setting with a higher HPV prevalence. The potential impact of HPV vaccination using a one-dose schedule in India was modelled and showed that implementation of one-dose schedule can contribute towards achieving WHO Cervical Cancer elimination goals. These data support the WHO SAGE recommendations for adopting a one-dose schedule for females aged 9–20 years. Immunobridging studies were discussed during the meeting. General agreement was reached that when thoughtfully applied, they can support and accelerate the expanded use of HPV vaccine with new vaccine schedules, age cohorts, or vaccine formulations. Internationally standardised measurements of HPV immune responses important for the progress of HPV vaccinology field. Humoral immune responses upon HPV vaccination plateau at 24 months regardless of number of doses, therefore, data should be analysed after at least 24 months of follow-up to bridge studies accurately.

With the development of AI technology, the parameters and calculation overhead of advanced models have increased exponentially, resulting in the existing low-end GPU(Graphic Processing Unit) being unable to meet the computing power required for model operation. In order to speed up the inference speed in edge scenarios, various manufacturers have launched NPU(Neural Processor Unit), a special chip for neural networks, which can improve the overall inference efficiency and reduce energy consumption through a certain loss of precision. However, in the current common edge-side solutions, the problem of CPU+GPU+NPU co-processing is not well considered. At the same time, edge-side devices are more easily affected by the ambient temperature. In this paper, CPU+GPU+NPU is used to jointly process edge-side inference tasks, and we first established a heterogeneous device temperature perception model based on the ambient temperature of the edge device, then proposed a TAS(temperature-aware schedule) algorithm to control the running speed of the heterogeneous device, and then proposed a task scheduling algorithm for the heterogeneous device, namely TASTS(TAS-based task schedule). At the same time, we also use a hungarian matching algorithm to optimize the final result. This paper finally verified several models in real edge environment, found that it can improve the performance by 20-50% compared with conventional methods under temperature constraints.

Given the increasing need of avionics communications and ship electromechanical communications for reliability and real-time transmission, current scheduling schemes waste bandwidth resources. They increase delay because of the low concurrency and the inefficiency of data transmissions in FC-AE-1553 multi-level switching networks. In this study, we first analyze the characteristics of different tasks in the field of avionics communication and establish the FC-AE-1553 network model. We then propose a multi-task hybrid scheduling scheme that includes a static scheduling scheme based on the flow and common divisors of the periods to improve the utilization of bandwidth while ensuring the periodic transmission of deterministic tasks. Further, we exhibit a dynamic bandwidth allocation scheme based on flow and credit ranking to increase throughput and fairness while decreasing the delay of burst tasks. Specifically, to ensure the periodic transmission of deterministic tasks, we divide the transmission time slots according to the common divisor of the period and schedule them in ascending order of period and flow. We update the weights of the credit ranking and flow online, and schedule them in descending order of weight size. The experimental results show that our schemes improve the bandwidth utilization of deterministic tasks by 10% and can balance the throughput and delay of the network. By improving the bandwidth utilization of deterministic tasks, we can provide a better quality of service for burst tasks. When the network can balance its throughput and delay, this shows that the network is efficient and stable.

Abstract Rationale The effectiveness of universal immunisation with pneumococcal conjugate vaccine (PCV) has been evident in many countries. However, the global impact of PCV is limited by its cost, which has prevented its introduction in several countries. Reducing the cost of PCV programmes may facilitate vaccine introduction in some countries and improve the sustainability of PCV in EPIs in low-income countries when they transition away from subsidised vaccine supply. Methods and design PVS is a real-world field trial of an alternative schedule of one dose of PCV scheduled at age 6 weeks with a booster dose at age 9 months (i.e. the alternative ‘1+1’ schedule) compared to the standard schedule of three primary doses scheduled at 6, 10, and 14 weeks of age (i.e. the standard ‘3+0’ schedule). Delivery of the interventions began in late 2019 in 68 geographic clusters and will continue for 4 years. The primary endpoint is the prevalence of nasopharyngeal vaccine-type pneumococcal carriage in children aged 2–260 weeks with clinical pneumonia in year 4. Secondary endpoints are the prevalence of vaccine-type pneumococcal carriage among all ages in year 4 and the incidence of radiological pneumonia in children enrolled to receive the interventions. Additional disease and carriage endpoints are included. Purpose This statistical analysis plan (SAP) describes the cohorts and populations, and follow-up criteria, to be used in different analyses. The SAP defines the endpoints and describes how adherence to the interventions will be presented. We describe how analyses will account for the effect of clustering and stratified randomisation. The SAP defines the approach to non-inferiority and other analyses. Defining the SAP early in the trial will avoid bias in analyses that may arise from prior knowledge of trial findings.

The organizational and administrative document created in the company, its official and numerical strength are all fixed. Personnel schedule as a type of document is a list of positions in an organization indicating their number and salaries. Its purpose is to normalize the number of employees of the company and the ratio of professionals. Since the personnel schedule is not only an enterprise, but also a primary accounting document, its form is consolidated and included in the album of consolidated forms of primary accounting documents for labor accounting and its payment. In this paper, an intelligent personnel schedule management analysis was proposed for normalized number of employees in internal labor activities. Internal labor regulations are approved by the employer and placed in a visible place, and all employees of the company must be familiar with them. The personnel table is a long-term document, however, if necessary, changes and additions can be made to it. Corrections and additions are made on the order of the head of the organization or a person authorized by him. Based on the staff schedule, the personnel service conducts selection of personnel for vacant posts, creates a reserve for promotion and arranges advanced training for personnel.

This paper proposes a wireless network traffic prediction model based on long-term and short-term memory cyclic neural networks. Through simulation experiments, the throughput prediction of 5G wireless networks using different scheduling algorithms for many different types of services is studied. The results verify that the long short-term memory prediction model has acceptable prediction accuracy and algorithm training speed, meets the needs of wireless network traffic prediction, and has a good application prospect.

Background: Diphtheria cases reported in Central Vietnam since 2013 were mainly in children aged 6-15 years, which may reflect an immunity gap. There is little information on population immunity against diphtheria in countries without a school-entry booster dose. We aimed to measure the age-stratified seroprevalence of anti-diphtheria toxoid antibodies, quantify the change in antibody levels in individuals over time, and estimate the length of protective immunity after vaccination in well-vaccinated communities in Vietnam.Methods: An age-stratified seroprevalence survey among individuals aged 0-55 years was conducted at Nha Trang, Vietnam. The same participants were followed up after two years to quantify the change in antibody levels. IgG was measured using ELISA. The length of protective immunity after vaccination was estimated using a mixed-effect linear regression model with random intercept.Results: Overall seroprevalence was 26% (95%CI:20-32%). Age-stratified seroprevalence was 68% (95%CI:4-11%), 7% (95%CI:4-11%), 12% (95%CI:7-19%), 33% (95%CI:27-40%), and 28% (95%CI:17-43%) among those aged ≤5, 6-15,16-25, 26-35, and 36-55 years, respectively. The antibody levels declined by 47% (95%CI:31-59%) over two years, and the predicted duration of vaccine-derived protective immunity after receiving four doses was 4.3 years (95%CI:3.5–5.3) among participants aged six years or younger.Conclusion: Given the low seroprevalence and short period of vaccine protection, a school-entry booster dose (5-7 years) is recommended in Vietnam.

Manufacturing companies face a significant challenge when developing their master production schedule, navigating unforeseen disruptions during daily operations. Moreover, fluctuations in demand pose a substantial risk to scheduling and are the main cause of instability and uncertainty in the system. To address these challenges, employing flexible systems to mitigate uncertainty without incurring additional costs and generate sustainable responses in industrial applications is crucial. This paper proposes a product-driven system to complement the master production plan generated by a mathematical model. This system incorporates intelligent agents that make production decisions with a function capable of reducing uncertainty without significantly increasing production costs. The agents modify or determine the forecasted production quantities for each cycle or period. In the case study conducted, a master production plan was established for 12 products over a one-year time horizon. The proposed solution achieved an 11.42% reduction in uncertainty, albeit with a 2.39% cost increase.

Abstract Background Pneumococcal conjugate vaccines (PCVs) effectively prevent pneumococcal disease, but the global impact of pneumococcal vaccination is hampered by its cost. The evaluation of reduced dose schedules of PCV includes measurement of effects on immunogenicity and carriage acquisition compared to standard schedules. The relevance and feasibility of trials of reduced dose schedules is greatest in middle- and low-income countries, such as The Gambia, where the introduction of PCV resulted in good disease control but where transmission of vaccine-type pneumococci persists. We designed a large cluster-randomised field trial of an alternative reduced dose schedule of PCV compared to the standard schedule, the PVS trial. We will also conduct a sub-study to evaluate the individual-level effect of the two schedules on carriage acquisition, immunogenicity, and co-administration of PCV with yellow fever vaccine, the PVS-AcqImm trial. Methods PVS-AcqImm is a prospective, cluster-randomised trial of one dose of PCV scheduled at age 6 weeks with a booster dose at age 9 months (i.e. alternative ‘1+1’ schedule) compared to three primary doses scheduled at 6, 10, and 14 weeks of age (i.e. standard ‘3+0’ schedule). Sub-groups within the alternative schedule group will receive yellow fever vaccine separately or co-administered with PCV at 9 months of age. The primary endpoints are (a) rate of nasopharyngeal vaccine-type pneumococcal acquisition from 9 to 14 months of age, (b) geometric mean concentration of vaccine-type pneumococcal IgG at 18 months of age, and (c) proportions with yellow fever neutralising antibody titre ≥8 four weeks after administration of yellow fever vaccine. Participants and field staff will not be masked to group allocation while the measurement of laboratory endpoints will be masked. Approximately equal numbers of participants will be resident in each of 28 geographic clusters (14 clusters in alternative and standard schedule groups); 784 enrolled for acquisition measurements and 336 for immunogenicity measurements. Discussion Analysis will account for potential non-independence of measurements by cluster and so interpretation of effects will be at the individual level (i.e. a population of individuals). PVS-AcqImm will evaluate whether acquisition of vaccine-type pneumococci is reduced by the alternative compared to the standard schedule, which is required if the alternative schedule is to be effective. Likewise, evidence of superior immune response at 18 months of age and safety of PCV co-administration with yellow fever vaccine will support decision-making regarding the use of the alternative 1+1 schedule. Acquisition and immunogenicity outcomes will be essential for the interpretation of the results of the large field trial comparing the two schedules. Trial registration International Standard Randomised Controlled Trial Number 72821613 .

Abstract Background Administration of single-agent docetaxel in a weekly schedule may offer similar efficacy, with a more favorable toxicity profile, compared to a three-weekly schedule in patients with metastatic breast cancer. Methods The original search of Medline, Embase, and Scopus was performed in September 2018 and references were updated with additional searches up to January 2021. Two reviewers independently screened the identified literature based on a predefined set of criteria. Randomized controlled trials investigating the use of weekly versus three-weekly docetaxel in metastatic breast cancer patients were included. Results Four randomized controlled trials (N = 459 patients) were included in the final analyses. No significant differences were found in terms of objective response rate (risk ratio (RR) 0.75, 95% confidence interval (CI): 0.54 – 1.05), progression-free survival (hazard ratio (HR) 0.95, 95% CI: 0.71 – 1.26) or overall survival (HR 0.95, 95% CI: 0.70 – 1.29) between weekly and three-weekly docetaxel, respectively. Weekly docetaxel was associated with a significantly lower risk of grade 3/4 neutropenia (RR 0.16, 95% CI: 0.10 – 0.27), febrile neutropenia (RR 0.21, 95% CI: 0.08 – 0.55), and neuropathy (RR 0.29, 95% CI: 0.11 – 0.78). Although the risk of epiphora (≥ grade 3/leading to treatment withdrawal, RR 3.62, 95% CI: 1.07–12.22) and onycholysis (≥ grade 2/leading to treatment withdrawal, RR 3.90, 95% CI: 1.34 – 11.32) was increased. Conclusions Weekly docetaxel is associated with a lower risk of neutropenia, febrile neutropenia and neuropathy than the three-weekly docetaxel schedule in metastatic breast cancer patients. However, the risk of onycholysis, epiphora, and treatment discontinuation seems increased with weekly administration. No significant differences in efficacy outcomes were found. Weekly docetaxel might be an alternative for patients at risk for developing neutropenia.

Abstract Background Pneumococcal conjugate vaccines (PCV) effectively prevent pneumococcal disease but the global impact of pneumococcal vaccination is hampered by the cost of PCV. The relevance and feasibility of trials of reduced dose schedules is greatest in middle- and low-income countries, such as The Gambia, where PCV has been introduced with good disease control but where transmission of vaccine-type pneumococci persists. We are conducting a large cluster-randomised, non-inferiority, field trial of an alternative reduced dose schedule of PCV compared to the standard schedule, the PVS trial. Methods PVS is a prospective, cluster-randomised, non-inferiority, real-world field trial of an alternative schedule of one dose of PCV scheduled at age 6 weeks with a booster dose at age 9 months (i.e. the alternative ‘1 + 1’ schedule) compared to the standard schedule of three primary doses scheduled at 6, 10, and 14 weeks of age (i.e. the standard ‘3 + 0’ schedule). The intervention will be delivered for 4 years. The primary endpoint is the population-level prevalence of nasopharyngeal vaccine-type pneumococcal carriage in children aged 2 weeks to 59 months with clinical pneumonia in year 4 of the trial. Participants and field staff are not masked to group allocation while measurement of the laboratory endpoint will be masked. Sixty-eight geographic population clusters have been randomly allocated, in a 1:1 ratio, to each schedule and all resident infants are eligible for enrolment. All resident children less than 5 years of age are under continuous surveillance for clinical safety endpoints measured at 11 health facilities; invasive pneumococcal disease, radiological pneumonia, clinical pneumonia, and hospitalisations. Secondary endpoints include the population-level prevalence of nasopharyngeal vaccine-type pneumococcal carriage in years 2 and 4 and vaccine-type carriage prevalence in unimmunised infants aged 6–12 weeks in year 4. The trial includes components of mathematical modelling, health economics, and health systems research. Discussion Analysis will account for potential non-independence of measurements by cluster, comparing the population-level impact of the two schedules with interpretation at the individual level. The non-inferiority margin is informed by the ‘acceptable loss of effect’ of the alternative compared to the standard schedule. The secondary endpoints will provide substantial evidence to support the interpretation of the primary endpoint. PVS will evaluate the effect of transition from a standard 3+ 0 schedule to an alternative 1 + 1 schedule in a setting of high pneumococcal transmission. The results of PVS will inform global decision-making concerning the use of reduced-dose PCV schedules. Trial registration International Standard Randomised Controlled Trial Number 15056916 . Registered on 15 November 2018.

Рассматривается вопрос построения оптимальной траектории обучения и реализации вебприложения для формирования графика образовательной траектории. Проанализированы понятия «оптимальная траектория» и «индивидуальная образовательная траектория». Отмечается возможность использования электронного портфолио для получения данных обучающегося, его интеграция с электронной информационно-образовательной средой, сохранение работ обучающегося, рецензий и оценок, фиксация хода образовательного процесса, результатов промежуточной аттестации и результатов освоения основной образовательной программы, проведение всех видов занятий, процедур оценки результатов обучения, реализация которых предусмотрена с применением электронного обучения, дистанционных образовательных технологий, которое происходит при поддержке электронной информационно-образовательной среды. Приведен пример различных траекторий студентов одной группы Томского государственного педагогического университета. Отмечена возможность наблюдения за дальнейшим трудоустройством выпускника или студента, что дает возможность определить оптимальную траекторию обучения, которая показывает дальнейшую перспективу роста обучающегося. В результате проведенной работы создано веб-приложение для построения графика оптимальной траектории обучения.

The article discusses the types of urban electric transport used in Belarusian cities, gives a detailed classification and comparison of available vehicles. Various options for increasing the share of environmentally friendly transport through the use of electric buses and trolleybuses are considered, an assessment and a comparative analysis of the options are given. Features of the drivers' work planning and drawing up of the schedule taking into account safety requirements are considered. A methodology for assessing the efficiency of urban passenger transport has been developed, taking into account the development of electric vehicles.

Summary: Background: Oral rotavirus vaccines have lower effectiveness in high child mortality settings. We evaluated the impact of additional dose(s) schedules of rotavirus vaccine on vaccine immunogenicity and reduction in episodes of gastroenteritis. Methods: We searched Medline (via PubMed), Cochrane databases and ClinicalTrials.gov for randomised controlled trials from 1973 to February 2022, evaluating the immunological and clinical impact of additional dose vs standard dose oral rotavirus vaccine schedules. We extracted immunogenicity – proportion of children with evidence of anti-rotavirus IgA seroresponse, and clinical – proportion of children with at least one episode of severe rotavirus gastroenteritis, outcome data and used random effects meta-analysis where appropriate. We assessed the methodological quality of the studies using the Cochrane risk of bias tool. The study protocol was registered in PROSPERO (CRD42021261058). Findings: We screened 536 items and included 7 clinical trials. Our results suggest moderate to high level evidence that an additional dose rotavirus vaccine schedule improves IgA vaccine immune response, including additional doses administered as a booster dose schedule >6 months old; IgA vaccine seroresponse 74·3% additional dose schedule vs 56·1% standard dose schedule RR 1·3 (95%CI, 1·15 – 1·48), and when administered to children who were seronegative at baseline; IgA vaccine seroresponse 48.2% additional dose schedule vs 29.6% standard dose schedule RR 1.86 (95%CI 1.27 to 2.72). Only one study evaluated reduction in gastroenteritis episodes and found little benefit in first year of life, 1·8% vs 2·0% RR 0·88 (95% CI, 0·52 to 1·48), or second year of life, 1·7% vs 2·9% RR 0·62 (95%CI, 0·31 – 1·23). Interpretation: Administering an additional dose of oral rotavirus vaccines is likely to result in an improved vaccine immune response, including when administered as a booster dose to older children. Evidence of an impact on diarrhoeal disease is needed before additional dose rotavirus vaccine schedules can be recommended as vaccine policy. Funding: BM was funded by the National Health and Medical Research Council, the Royal Australasian College of Physicians Paediatrics and Child Health Division, and the Australian Academy of Science.

Background: Chemotherapy plus granulocyte colony-stimulating factor (GCSF) regimen is one of the available approaches to mobilize peripheral blood progenitor cells (PBPCs). It causes thrombocytopenia and delays leukapheresis. This study aimed to evaluate the role of recombinant human thrombopoietin (rhTPO) before mobilization chemotherapy in facilitating leukapheresis in patients with lymphoma. Methods: In this randomized open-label phase 2 trial, patients were randomly assigned in a 1:2 ratio to receive mobilization with rhTPO plus GCSF in combination with chemotherapy (the rhTPO plus GCSF arm) or GCSF alone in combination with chemotherapy (the GCSF alone arm). The recovery of neutrophils and platelets and the amount of platelet transfusion were monitored. Results: Thirty patients were enrolled in this study between March 2016 and August 2018. Patients in the rhTPO plus GCSF arm (n = 10) had similar platelet nadir after mobilization chemotherapy (P=0.878) and similar amount of platelet transfusion (median 0 vs. 1 unit, P=0.735) when compared with the GCSF alone arm (n = 20). On the day of leukapheresis, the median platelet count was 86 × 109/L (range 18–219) among patients who received rhTPO and 73 × 109/L (range 42–197) among those who received GCSF alone (P=0.982). After the use of rhTPO, the incidence of platelet count

The educational industry is the main and most widespread industry. The development of the educational system in our country should not be limited to an increase in the number of educational institutions, it should also be aimed at further development using information systems. To ensure comfortable monitoring of the schedule in universities, a number of important software tools are required that simplify the tracking of the curriculum using modern information systems. Purpose – creating a schedule monitoring system in educational institutions to improve the interaction between students and the educational process. Method or methodology of work. The article describes a project on schedule tracking and interaction with the educational process. Results. A public chatbot in the social network VKontakte has been developed, in which, upon request, a response related to the educational process is issued, corresponding to the user’s request. Scope of the results: the results obtained should be applied to students who have the opportunity to track the list of upcoming training sessions and interact with them conveniently.

We consider the problem of scheduling jobs on a single machine subject to an uncertain breakdown to minimize the flowtime. Assuming the machine is unavailable during the breakdown, the starting time of the breakdown is a random variable s with distribution function D(s) and the terminating time of the breakdown has no any other information; jobs are non-resumable. Under these assumptions and starting from the perspective of statistical optimization, we first establish the scheduling problem HSONRP, which contains deterministic information, stochastic information, and online information and then define the expected competitive ratio of an algorithm to find the optimized solution of the problem HSONRP. In addition, then, we propose and prove certain results on the expected competitive ratio of the SPT rule. In particular, we prove the expected competitive ratio of SPT rule is less than 1+max{pi}2P when s is the uniform distribution on interval (0,P], where pi is the processing time of job i, P=∑i=1npi, and show that it is no more than 54 under a quite loose condition. Meanwhile, we also make some discussions about our studies. What we have performed will enrich and improve the research results on the area of scheduling to minimize flowtime and advance the development of online optimization and stochastic optimization.

Abstract Background Immunotherapy is revolutionising the treatment of patients diagnosed with melanoma and other cancers. The first immune checkpoint inhibitor, ipilimumab (targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4)), showed a survival advantage over standard chemotherapy. Subsequently the anti-programmed cell death protein 1 (PD-1) antibodies, nivolumab and pembrolizumab were shown to be more effective than ipilimumab. Ipilimumab combined with nivolumab gives an incremental gain in overall survival compared with nivolumab alone but increases the risk of severe, potentially life-threatening toxicities. In contrast to ipilimumab monotherapy, anti-PD-1 antibodies are licensed to be continued until disease progression. Follow-up of patients recruited to the first trials evaluating 2 years of pembrolizumab showed that three-quarters of responding patients continue responding after stopping treatment. Suggestive of early response, we hypothesised that continuing anti-PD-1 treatment beyond 1 year in progression-free patients may be unnecessary and so designed the DANTE trial. Methods DANTE is a multicentre, randomised, phase III, non-inferiority trial to evaluate the duration of anti-PD-1 therapy in patients with metastatic (unresectable stage III and stage IV) melanoma. It uses a two-stage recruitment strategy, registering patients before they complete 1 year of first-line anti-PD-1 +/− CTLA-4 therapy and randomising eligible patients who have received 12 months of treatment and are progression-free at 1 year. At randomisation, 1208 patients are assigned (1:1) to either 1) continue anti-PD-1 treatment until disease progression/ unacceptable toxicity/ for at least 2 years in the absence of disease progression/ unacceptable toxicity or 2) to stop treatment. Randomisation stratifies for baseline prognostic factors. The primary outcome is progression-free survival at 3, 6, 9 and 12 months and then, 6-monthly for up to 4-years. Secondary outcomes collected at all timepoints include overall survival, response-rate and duration and safety, with quality of life and cost-effectiveness outcomes collected 3-monthly for up to 18-months. Sub-studies include a qualitative analysis of patient acceptance of randomisation and sample collection to inform future translational studies into response/ toxicity biomarkers. Discussion DANTE is a unique prospective trial investigating the optimal duration of anti-PD-1 therapy in metastatic melanoma patients. Outcomes will inform future use of these high burden drugs. Trial registration ISRCTN15837212 , 31 July 2018.

Acceptance of rotavirus (RV) vaccination may be impacted by several factors including the feasibility of the full schedule administration within the fixed immunization timelines. The human RV vaccine Rotarix (GSK) and the human bovine reassortant vaccine RotaTeq (Merck & Co.) were developed with different posologies (2 doses vs 3 doses respectively), which have both scientific and technical implications. A non-systematic literature review revealed that, in the Italian context, topics such as time to achieve RV protection in children, number of preventable cases and administration time window, compatibility/ease of inclusion in the national vaccination calendar, potential overlaps with the peak of natural history of intussusception and adherence to posology could be impacted by the RV vaccine posology. Results suggest that a shorter schedule would allow for greater flexibility of use as well as a greater documented ease of inclusion in the vaccination calendar, thereby reducing potential direct healthcare costs.

Comprehensive estimates of vaccination coverage and timeliness of vaccine receipt among American Indian/Alaska Native (AI/AN) children in the United States are lacking. This study’s objectives were to quantify vaccination coverage and timeliness, as well as the proportion of children with specific undervaccination patterns, among AI/AN and non-Hispanic White (NHW) children ages 0–24 months in Montana, a large and primarily rural U.S. state. Data from Montana’s immunization information system (IIS) for children born 2015–2017 were used to calculate days undervaccinated for all doses of seven recommended vaccine series. After stratifying by race/ethnicity, up-to-date coverage at key milestone ages and the proportion of children demonstrating specific patterns of undervaccination were reported. Among n = 3,630 AI/AN children, only 23.1% received all recommended vaccine doses on-time (i.e., zero days undervaccinated), compared to 40.4% of n = 18,022 NHW children (chi-square p

Pancreatic ductal adenocarcinoma (PDAC) is among the most lethal cancers, with a 5-year relative survival rate of 5%. The desmoplastic stroma found in the tumor microenvironment of PDAC is suggested to be partly responsible for the resistance to most therapeutic strategies. This review outlines the clinical results obtained with an immune checkpoint inhibitor in PDAC and discusses the rationale to use a combination of chemotherapy and immune checkpoint therapy. Moreover, essential parameters to take into account in designing an efficient combination have been highlighted.

The dynamic-scheduling problem of transmission tasks (DSTT) is an important problem in the daily work of radio and television transmission stations. The transmission effect obtained by the greedy algorithm for task allocation is poor. In the case of more tasks and equipment and smaller time division, the precise algorithm cannot complete the calculation within an effective timeframe. In order to solve this problem, this paper proposes a discrete particle swarm optimization algorithm (DPSO), builds a DSTT mathematical model suitable for the DPSO, solves the problem that particle swarm operations are not easy to describe in discrete problems, and redefines the particle motion strategy and adds random disturbance operation in its probabilistic selection model to ensure the effectiveness of the algorithm. In the comparison experiment, the DPSO achieved much higher success rates than the greedy algorithm (GR) and the improved genetic algorithm (IGA). Finally, in the simulation experiment, the result data show that the accuracy of the DPSO outperforms that of the GR and IGA by up to 3.012295% and 0.11115%, respectively, and the efficiency of the DPSO outperforms that of the IGA by up to 69.246%.

Una carga de trabajo desigualmente distribuida a lo largo de un semestre es uno de los factores cruciales que afectan el desempeño académico de los estudiantes universitarios. Las cargas de trabajo excesivas o distribuidas de forma desigual pueden dañar significativamente los resultados académicos y, lo que es más importante, determinar el enfoque de aprendizaje adoptado por los estudiantes. La coordinación horizontal tiene como objetivo garantizar una distribución racional de la carga de trabajo a lo largo de un semestre académico. Para ello, la Universidad Politécnica de Cartagena (UPCT) utiliza el 'Cronograma Conjunto', donde se agrupan las actividades planificadas por el profesorado para los diferentes cursos de un determinado grupo y semestre. El objetivo principal de este trabajo es el desarrollo de un modelo que permita evaluar la distribución de la carga de trabajo del estudiante a lo largo de un semestre, utilizando la planificación inicial de actividades recuperada por la facultad. Se han empleado varios enfoques para estimar la carga de trabajo del estudiante. Este trabajo se basa en la encuesta semanal de carga de trabajo realizada para varios cursos en una serie de grados de la UPCT, que ha permitido a los autores cuantificar la carga de trabajo del alumno medio para diferentes tipos de actividades, medir las actividades planificadas y simular el tiempo de carga de trabajo. Distribución de una actividad determinada en función del tiempo disponible para su realización. Abstract An unevenly distributed workload along a semester is one of the crucial factors that affect the academic performance of university students. Excess or unevenly distributed workloads may significantly harm the academic results and, importantly, determine the learning approach adopted by the students. The horizontal coordination aims at ensuring a rational workload distribution along an academic semester. To achieve this, Universidad Politécnica de Cartagena (UPCT) uses ‘Joint Chronogram’, where the activities planned by the faculty for the different courses in a given group and semester are put together. The main objective of this work is the development of a model that allows for evaluating the student’s workload distribution along a semester, using the initial planning of activities retrieved by the faculty. Several approaches have been employed for estimating the student’s workload. This work is based on the weekly workload survey conducted for several courses in a number of undergraduate degrees at UPCT, which has allowed the authors for quantifying the average student’s workload for different types of activities, for measuring the planned activities and for simulating the workload time distribution of a given activity as a function of the available time for accomplishment. Once the planned activities are introduced into the chronogram for each course, the model computes and represents graphically an average-student’s workload distribution, which depends on the type of activities and their distribution along the semester. This simulation allows for modifying the time-planning of the most critical activities, in agreement with the faculty, in order to ensure a more even workload distribution.

OBJECTIVES: This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes. METHOD: In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area. RESULTS: Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration. CONCLUSIONS: Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases – eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep – additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.

Alcohol use disorders (AUDs) are more prevalent in men than in women, though AUD diagnoses in women are growing rapidly, making an understanding of sex differences in alcohol-related behaviors increasingly important. The development of AUDs involves the transition from casual, low levels of alcohol drinking to higher, maladaptive levels. The ability of low dose alcohol to drive reward and drug seeking may differ in males and females, and this could underlie differences in susceptibility to AUD. In this study we sought to determine whether a history of chronic, low dose ethanol exposure (0.5 g/kg; i.p.) could drive sucrose reward seeking and motivation, and whether this differed between male and female mice. Adult mice were trained to lever press for a liquid sucrose reward on two reinforcement schedules: a random interval (RI) schedule and a variable ratio (VR) schedule. After training, mice were tested on each of these levers for reward motivation using a progressive ratio test. We found that a history of low dose ethanol exposure increased sucrose reward motivation in male mice, but only on the RI lever and only when exposure occurred proximal to learning. Female mice were more motivated for sucrose on the RI lever than the VR lever regardless of ethanol exposure condition. These findings indicate that training on different reinforcement schedules affects reward motivation. Further, we show that males are more susceptible to the effects of low dose ethanol on sucrose reward motivation than females. These data broaden our understanding of sex differences in reward seeking as a result of ethanol exposure.

This study sought to examine the relationship between project risk avoidance and project execution in the Nigerian oil and gas industry. Specifically, the study examined the relationship between project risk avoidance and four components of project execution (budget, quality, schedule and scope) among 51 oil and gas companies operating in Rivers State, Nigeria. To achieve this objective, 102 managing executives were given questionnaires, with 82 questionnaires correctly filled and returned. Data obtained were analysed using mean scores and Spearman’s rank order correlation analysis. The study found that projects risk avoidance was positively and significantly related to all four components of project execution. The main implication of this finding is that oil and gas companies need to invest heavily in innovative technologies and processes that will enhance their ability to avoid risk, thus improving the quality of projects they execute. Abstrak dalam Bahasa Indonesia.Studi ini berusaha untuk menguji hubungan antara proyek penghindaran risiko dan eksekusi proyek di industri minyak dan gas Nigeria. Secara spesifik, studi tersebut meneliti hubungan antara proyek penghindaran risiko dan empat komponen eksekusi proyek (anggaran, kualitas, jadwal dan ruang lingkup) di antara 51 perusahaan minyak dan gas yang beroperasi di Negara Bagian Rivers, Nigeria. Untuk mencapai tujuan ini, 102 eksekutif pelaksana diberikan kuesioner, dengan 82 kuesioner diisi dan dikembalikan dengan benar. Data yang diperoleh dianalisis menggunakan skor rata-rata dan analisis korelasi urutan peringkat Spearman. Studi tersebut menemukan bahwa penghindaran risiko proyek berhubungan positif dan signifikan dengan keempat komponen pelaksanaan proyek. Implikasi utama dari temuan ini adalah bahwa perusahaan minyak dan gas perlu berinvestasi besar-besaran dalam teknologi dan proses inovatif yang akan meningkatkan kemampuan mereka untuk menghindari risiko, sehingga meningkatkan kualitas proyek yang mereka jalankan.

John Ngo,1 David Parker,2 Mathew Meroney,3 Jasmine Mitchell,2 Oscar Veloz,4 Oliver Lee,5 Katherine A Cunningham,2 Denise Wilkes1 1Department of Anesthesiology and Pain Management, University of Texas Medical Branch, Galveston, TX, USA; 2Center for Addiction Research, University of Texas Medical Branch, Galveston, TX, USA; 3Department of Anesthesiology and Pain Management, University of Florida, Gainesville, FL, USA; 4Department of Anesthesia, Mcgaw Northwestern University Medical Center, Chicago, IL, USA; 5Department of Anesthesia, University of Washington, Seattle, WA, USACorrespondence: Denise WilkesDepartment of Anesthesiology and Pain Management, University of Texas, Medical Branch, 301 University Blvd, Galveston, TX 77555, USATel +1 409-772-1221Fax +1 409-747-0011Email dwilkes@utmb.eduPurpose: To determine the effect of rescheduling on prescription practices in a large academic hospital-based multidisciplinary practice comprising anesthesiologist-trained pain physicians.Patients and Methods: We examined the number of HCP prescriptions written and quantity of tablets prescribed during a 6-month period prior to rescheduling and compared this with a 6-month period 1 year after rescheduling. We also examined the changes in prescription of tramadol and acetaminophen with codeine from one period to the next.Results: Our pain clinic conducted 3,320 office visits during the 6-month period prior to HCP rescheduling and 6,003 office visits in the 6-month period 1 year after rescheduling. The charted data from each of these visits were used for our analysis. The mean number of tablets of HCPs prescribed per patient decreased from 318.48 in the pre-period to 242.27 tablets in the post-period, while the mean number of HCP prescriptions per patient decreased from 2.24 to 1.84. The mean number of acetaminophen with codeine tablets prescribed per patient increased from 3.46 to 15.27 in the pre- and post-period. Similarly, the mean number of tramadol tablets per patient increased from 47.33 to 61.97 in the pre- and post-period. The mean number of acetaminophen with codeine and tramadol prescriptions per patient increased from 0.02 to 0.15 and 0.38 to 0.51 in the pre- and post-period, respectively. In the 6-month post-period, fewer new patients were started on opioids compared to the 6-month pre-period, 16% and 27%, respectively.Conclusion: Our study showed a significant decrease in the mean number of HCP prescriptions written per patient, as well as a decrease in the mean number of HCP tablets prescribed. Pain physicians in our clinic increased the number of prescriptions for the non-HCPs. The number of acetaminophen with codeine and tramadol tablets prescribed significantly increased. Therefore, the rescheduling of HCPs has profoundly impacted practices within this academic pain clinic.Keywords: hydrocodone, tramadol, acetaminophen, schedule, reschedule

Active use of electronic learning devices (ELD) in educational process increases its efficiency and makes knowledge more available to children; but at the same time it creates risks for schoolchildren’s health. Intense visual and information loads can result in schoolchildren being over-exhausted. Our research goal was to give scientific grounds for hygienic optimization of education process (a typical class and a schedule) that would allow preventing apparent exhaustion in schoolchildren studying in a digital environment. To solve the fixed tasks, we applied hygienic, physiological and statistical research techniques. We analyzed factors occurring in school environment and components in education process structure; we examined parameters of body functional state (BFS) on a sampling made up of more than 600 schoolchildren attending 5-9th grades, namely, parameters that characterized their mental and visual working abilities. Results were statistically processed with parametric and non-parametric analysis techniques. Relative risks of unfavorable outcomes in body functional state were calculated as per evidence-based medicine principles depending on how education process was organized (a structure of a class and classes schedules). We developed methodical approaches to hygienically rational organization of a class and schedule provided that school environment was optimal (microclimate, luminance, electromagnetic fields, furniture in rooms, etc.) and electronic learning devices were applied according to age-related regulations. Research results proved that implementation of suggested approaches would make for favorable dynamics of children’s functional state as well as prevention of education-related diseases.

The Campbell Dudek Smith (CDS) method is commonly used by large companies to help them make Flowshop schedules. The purpose of this study is to design a more effective maintenance scheduling sequence in order to increase the amount of production with the most efficient use of time without having to stop production and be able to calculate the productivity of the machine it self. Partial Productivity (PP) analysis is used to determine the level of machine productivity by proving Partial Productivity (PP) after is better than Partial Productivity (PP) before. This research was conducted at PT. X, one of the leading national companies in producing cigarette products such as SKT cigarettes, SKM and SPM. As a result, this study has performed calculations using the Campbell Dudek Smith (CDS) algorithm and calculates the productivity of each iteration using Partial Productivity (PP). The recommended improvement of the engine maintenance scheduling sequence is by applying the scheduling sequence to the 5th iteration, J2-J4-J3-J1-J5.

Aims and Method: This paper aims to review the recent literature regarding factors influencing the frequency and number of sessions during a course of electroconvulsive therapy (ECT) for different psychiatric disorders. We systematically reviewed English-language papers of clinical trials of ECT published since the year 2000 in terms of frequency and number of sessions of ECT. Results: None of the 30 studies meeting our inclusion criteria were specifically designed to study frequency or number of sessions of ECT. A preliminary inference may be drawn regarding the number of sessions from the information available in these papers. For depression, patients receiving brief-pulse ECT needed fewer sessions than those receiving ultra-brief ECT when these were delivered at 8-times the threshold with unilateral electrode placement or at 2.5-times the threshold with bilateral placement. For schizophrenia, those receiving bifrontal ECT and ECT at 4-times the threshold-level stimulus needed fewer sessions than those receiving bitemporal ECT and 2-times the threshold-level stimulus, respectively. There were no clinical trials of the frequency of ECT sessions.Clinical Implications: A s there is a dearth of studies specifically examining frequency and number of ECT sessions, broad recommendations from professional bodies should continue to guide practice.

Abstract Background The combination of nivolumab, a programmed death-1 (PD-1) targeted monoclonal antibody, with the cytotoxic T-lymphocyte antigen-4 (CTLA-4) targeted antibody, ipilimumab, represents a new standard of care in the first-line setting for patients with intermediate- and poor-risk metastatic renal cell carcinoma (mRCC) based on recent phase III data. Combining ipilimumab with nivolumab increases rates of grade 3 and 4 toxicity compared with nivolumab alone, and the optimal scheduling of these agents when used together remains unknown. The aim of the PRISM study is to assess whether less frequent dosing of ipilimumab (12-weekly versus 3-weekly), in combination with nivolumab, is associated with a favourable toxicity profile without adversely impacting efficacy. Methods The PRISM trial is a UK-based, open label, multi-centre, phase II, randomised controlled trial. The trial population consists of patients with untreated locally advanced or metastatic clear cell RCC, and aims to recruit 189 participants. Participants will be randomised on a 2:1 basis in favour of a modified schedule of 4 doses of 12-weekly ipilimumab versus a standard schedule of 4 doses of 3-weekly ipilimumab, both in combination with standard nivolumab. The proportion of participants experiencing a grade 3 or 4 adverse reaction within 12 months forms the primary endpoint of the study, but with 12-month progression free survival a key secondary endpoint. The incidence of all adverse events, discontinuation rates, overall response rate, duration of response, overall survival rates and health related quality of life will also be analysed as secondary endpoints. In addition, the potential of circulating and tissue-based biomarkers as predictors of therapy response will be explored. Discussion The combination of nivolumab with ipilimumab is active in patients with mRCC. Modifying the frequency of ipilimumab dosing may mitigate toxicity rates and positively impact quality of life without compromising efficacy, a hypothesis being explored in other tumour types such as non-small cell lung cancer. The best way to give this combination to patients with mRCC must be similarly established. Trial registration PRISM is registered with ISRCTN (reference ISRCTN95351638, 19/12/2017). Trial status At the time of submission, PRISM is open to recruitment and data collection is ongoing.

Challenges exist in developing work schedules for hospital pharmacy staff due to the need to meet around the clock patient care requirements. Work–life integration and reduced burnout are increasingly important considerations in staff schedules. However, information regarding methods to systematically improve scheduling satisfaction is currently lacking. Hospital pharmacist scheduling surveys were reviewed for solutions in a retreat setting to address growing concerns at our institution. All hospital pharmacists and technicians were surveyed to understand opportunities to improve their schedules. Subsequently, pharmacists participated in a retreat to identify opportunities to share work, prioritize for scheduling improvements, and develop a staffing restructure proposal. Out of 172 pharmacists, 84% completed surveys, whereas 55% of 196 technicians responded. The highest ranked scheduling improvement was a more consistent schedule for both pharmacists and technicians. Several solutions identified during the pharmacist retreat were incorporated into a proposal including decreased weekend staffing frequency (every 3rd to a mix of every 3rd and every 4th), improved scheduling consistency and reduced evenings. Negotiation was among the methods used to identify scheduling solutions. Engagement of frontline staff to lead staffing restructure is expected to ensure success of scheduling changes. Future directions include measuring pharmacist burnout and staff satisfaction before and after change implementation. If successful, the retreat and technician-developed proposal can be used for implementing technician schedule improvements.

Construction projects are often delayed. Their budgets are being exceeded. This is partly because construction project models rarely take human factors into account. The article focuses on the repetitive multi-unit projects that are often found in construction practices. They are an excellent example of construction works for which the optimization of certain processes can bring measurable financial benefits. In particular, the focus was on improving the key investment success indicator, the total cost of a project. This article presents the use of learning and forgetting phenomenon to improve construction schedules. The authors proposed an innovative model of the construction phase and optimized the schedule using a proprietary calculation algorithm using the simulated annealing phenomenon. The method was verified by a series of experiments and showcased by a case study. The results show that the presented methods can improve the construction planning process and better reflect the current construction conditions. The findings may impact residential, infrastructure, industrial, and commercial construction branches.

Introduction: The World Health Organization (WHO) recommends all newborn infants receive the first dose of the hepatitis B vaccine within 24 h of birth irrespective of maternal hepatitis B carrier status. However, the physiological immaturity of the immune system in preterm infants may influence the immune responses to the vaccine particularly in the first few days and weeks of life, and adverse events may occur following vaccination that are not observed in infants born at term. Objectives: To review existing published guidelines surrounding timing of the first dose of the hepatitis B vaccine in preterm infants born to hepatitis B surface antigen negative (HBsAg-negative) mothers. Methods: A search was performed for relevant papers and guidelines published between January 2002 and July 2022 on the Ovid MEDLINE and Embase databases and through targeted searches. Two authors independently reviewed the search results to identify relevant sources, which were then analysed and described through narrative synthesis. Results: Twenty-seven relevant papers and guidelines regarding 15 countries and regions were included. Of these, 13.3% of guidelines, which represented 16.8% of the overall population of 4.1 billion people covered by the identified guidelines, recommended a nationwide birth dose of the hepatitis B vaccine to all preterm infants. In 40.0% of guidelines (77.9% of the overall population), the birth dose was only recommended for infants with a birth weight of more than 2000–2200 g. Another 33.3% of countries and regions (covering 4.4% of the population) recommended no universal birth dose for all infants, including preterm infants, whilst 13.3% (1.0% of the population) had guidelines that varied between jurisdictions and hospitals within their country/region. Conclusions: Existing guidelines surrounding the timing of the first dose of the hepatitis B vaccine in preterm infants vary substantially between countries and regions. Further research comparing the immunogenicity and safety of different hepatitis B vaccine schedules is needed to provide concrete evidence to provide guidance regarding the timing of vaccination against hepatitis B in preterm infants.

The aim of the article is to highlight and analyze the existing and promising automatic train operation systems for underground, with an emphasis on their economic performance. The development of the theory and methodology for improving the country’s transport industry has outlined a list of tasks to study and solve, in particular, improving the quality of servicing passengers, ensuring their safety and comfort, observing on-time train performance, saving capital costs for repairs of the rolling stock and track facilities due to increasing their wear life, saving energy, which, for underground, is mainly achieved by optimizing the movement of trains on the running lines (segments of track between two stations). In the Ukrainian underground, there is a long overdue need to replace the existing train management systems with automatic train operation systems, the main advantage of which is combining all of the listed functions: ensuring safety, observing on-time train performance, saving electricity, extending the service life of the rolling stock (sets of wheels) and track facilities.

Purpose. The paper involves the development of information and algorithmic support for conducting the optimization traction and energy calculations on the railway network for their further use in decision-making systems – systems for efficient management of the transport process. Methodology. The system is based on the graph-analytic system, the model of the train with different types of traction, the methods of optimal control of the train and the fundamental algorithms on the weighted graphs with possible parallel ribs (arcs). In the complex, these components of the system provide finding the tracks on the chart-diagram according to the given criteria, conducting the optimization traction-energy calculations according to different criteria, as well as conducting a comparative analysis of the obtained results. The reliability of the results has been repeatedly checked by available methods for varying complexity of race according to the plan and profile of the course. For this purpose, data obtained as a result of control visits using dynamometric cars were used. Also a comparative analysis of the modes in operation of trains, calculated and received by qualified drivers on different races was conducted. Findings. The problem of efficient operation of various types and modifications of locomotives, involved in the implementation of trains schedules for different purposes and loads is considered. Presentations of direct and inverse optimization, according to various criteria, of the regime tasks on the railway network and variants of their effective solution are given. The analysis of the results of the developed mathematical support and the ideas of implemented algorithms is given. Originality. The paper proposes the establishment of the network optimization problems that arise at the stages of the developing the plan for the formation, construction of traffic schedules, transmission capacity assessment and the calculation of optimal parameters for the composite graphs of motion, etc. The system approach is important to ensure the combination of the developed network structure in the universal terms of the graph theory with the system of actualization of their parameters. Pull and energy efficiency calculations are carried out by combinatorial optimization methods, which ensured the maximum level of automation of the process in solving a large set of direct and inverse regime problems with different optimality criteria. Practical value. The information and algorithmic support for the automation of the process in solving the direct and reverse regime traction-energy problems on the railway network was developed. It was tested in the process of calculating the main components for the formation of traffic schedules, analysis of train driving modes, assessment in choosing the optimal parameters of the track reconstruction for high-speed and new types of trains (locomotives).

The author presents an author's approach to the organization of the process of modeling equipment repair at enterprises of the power complex. The approach is based on the use of a modern network planning tool. It seems that the approach will increase the efficiency of using limited resources of energy companies.