Determination of optimal post-warranty variable maintenance period for repairable second-hand product based on mean residual life

Due to the increased transactions of second-hand products in the market, the optimization of maintenance strategy for the second-hand product has become very important issue to attract a great attention from many researchers of late. This paper proposes a new post-warranty strategy with a variable self-maintenance period for the second-hand product, assuming that the product is replaced by another one on the first failure following a fixed length of post-warranty self-maintenance period. During the non-renewing warranty period, the product is subject to preventive maintenance periodically at a prorated cost while only minimal repair is implemented at each failure by the dealer. The main goal of this study is to determine an optimal length of post-warranty self-maintenance period which minimizes the expected cost rate per unit time during the product’s life cycle from the user’s perspective. This approach considers not only the periodic preventive maintenance during the warranty period, but also the remaining life distribution of the product after the warranty expires, which is the significant difference of this work from many existing maintenance policies. For this purpose, we formulate the expected length of life cycle and evaluate the expected total cost incurred during the life cycle of the second-had product which is purchased at the age of [Formula: see text] The existence of the optimal self-maintenance period is proved analytically under mild conditions and the proposed maintenance model is compared with an existing model with regard to the expected cost rate. Finally, assuming that the life distribution of the product follows a Weibull distribution, the effect of relevant parameters on the optimal self-maintenance period is analyzed numerically.

Changes in Circulating Metabolites during Weight Loss and Weight Loss Maintenance in Relation to Cardiometabolic Risk

(1) Background: There is a substantial lack of knowledge of the biochemical mechanisms by which weight loss and weight regain exert their beneficial and adverse effects, respectively, on cardiometabolic outcomes. We examined associations between changes in circulating metabolites and changes in cardiometabolic risk factors during diet-induced weight loss and weight loss maintenance. (2) Methods: This prospective analysis of data from the Satiety Innovation (SATIN) study involved adults living with overweight and obesity (mean age=47.5). One hundred sixty-two subjects achieving ≥8% weight loss during an initial 8-week low-calorie diet (LCD) were included in a 12-week weight loss maintenance period. Circulating metabolites (m=123) were profiled using a targeted multiplatform approach. Data were analyzed using multivariate linear regression models. (3) Results: Decreases in the concentrations of several phosphatidylcholines (PCs), sphingomyelins (SMs), and valine were consistently associated with decreases in total (TChol) and low-density lipoprotein cholesterol (LDL-C) levels during the LCD. Increases in PCs and SMs were significantly associated with increases in TChol and LDL-C during the weight loss maintenance period. Decreases and increases in PCs during LCD and maintenance period, respectively, were associated with decreases in the levels of triglycerides. (4) Conclusions: The results of this study suggest that decreases in circulating PCs and SMs during weight loss and the subsequent weight loss maintenance period may decrease the cardiovascular risk through impacting TChol and LDL-C.

Abstract 10475: Heat Loss Augmented by Extracorporeal Circulation is Associated with Overcooling in Cardiac Arrest Survivors Who Underwent Targeted Temperature Management

Introduction: Extracorporeal circuit-based salvage therapy can affect targeted temperature management (TTM) in comatose out-of-hospital cardiac arrest (OHCA) survivors. We investigated the association of patients with extracorporeal device with TTM and neurological outcome. Methods: We performed a retrospective analysis using prospectively collected data from adult comatose OHCA survivors who underwent TTM between October 2015 and December 2020. We defined patients with ECMO and/or CRRT as the extracorporeal group. We calculated the cooling rate during the induction period; the minimum, maximum, and mean time-weighted core temperatures (TWCT), and the standard deviation (SD) of the core temperature and water temperature during the maintenance period based on the temperature measured every minute. We defined the sum of TWCT more and less than 33°C as positive and negative TWCT, respectively. The primary outcome was a poor neurological outcome, defined as cerebral performance category 3-5. We used propensity score (PS) matching to adjust the characteristics of patients who required an extracorporeal circuit device. Results: Of the 223 included patients, 140 (62.8%) patients had poor neurological outcome and 40 (17.9%) patients were categorized into the extracorporeal group. The extracorporeal group had a rapid cooling rate (2.08°C/h [1.13-3.73] vs. 1.24°C/h [0.77-1.79]; p < 0.001). The extracorporeal group had lower mean core temperature; higher core temperature SD; lower positive TWCT; higher negative TWCT; and higher maximum, minimum, and mean water temperature than the no-extracorporeal group. In PS matched cohort, the extracorporeal group had a lower minimum core temperature, lower mean core temperature, higher core temperature SD, higher negative TWCT, higher maximum water temperature, and higher mean water temperature. The neurological outcomes were not different between the two groups, in either the whole or PS-matched cohort. Conclusions: The extracorporeal group achieved the target temperature earlier. The core temperature distribution during the maintenance period was further skewed below 33°C in the extracorporeal group. The extracorporeal group had similar neurological outcomes to the no-extracorporeal group.

Supplementation of Gamal leaves flour (Gliricidia sepium) in commercial feed on the growth of Nirwana tilapia (Oreochromis niloticus) fingerlings

This study aimed to examine the effect of Gamal leaves flour supplementation in commercial feed on the growth of Nirwana tilapia (Oreochromis niloticus) fingerlings. The experimental design used was a non-factorial completely randomized design consisting of four treatments and four replications. The treatments studied included commercial feed without supplementation of Gamal leaves flour as a control (P0), commercial feed with supplementation of Gamal leaves flour 10% kg−1 feed (P1), commercial feed with supplementation of Gamal leaves flour 15% kg−1 feed (P2), and commercial feed with supplementation of Gamal leaves flour 20% kg−1 feed (P3). Nirwana tilapia fingerlings were stocked at a density of 1 fish L−1. Nirwana tilapia fingerlings size ranges from 2-3 cm. Nirwana tilapia fingerlings maintenance period lasts for 40 days. The Annova test showed that the treatment gave a significant effect on the weight gain, length gain, daily growth rate, and feed conversion ratio (P < 0,05), but did not give a significant effect on the survival rate of Nirwana tilapia fingerlings (P > 0,05). The best dose to increase the growth of Nirwana tilapia fingerlings was commercial feed with supplementation of Gamal leaves flour 10% kg−1 feed.

Research on Quantitative Analysis Method of Combined Maintenance Task

In this paper, the delay time theory is used to establish the mathematical model of the combination of monitoring and periodic replacement tasks, and the impact of maintenance period of monitoring and periodic replacement is discussed. Through the optimization solution, the optimal cycle of combined maintenance tasks is obtained to minimize the maintenance cost while ensuring the reliability. Finally, an example is given to demonstrate the feasibility of this method.

Masculinization of betta fish (Betta sp) using cow testic flour through Artemia Immersion

Betta fish (Betta sp) is a freshwater ornamental fish during the pandemic that is very popular with the public. However, people tend to prefer male betta fish than female fish. To deal with the large number of requests, a sex reversal technique is carried out which applies hormonal engineering to change female to male sexual characters (masculinization) using natural ingredients, namely cow testicle flour. The purpose of this study was to analyze the dose of bovine testicular flour hormone on the process of oral male betta fish larvae. This research was conducted in Moncongloe Village, Maros Regency, from July to September 2021. The production of beef testicle flour was carried out in the Chemical Engineering laboratory, Ujung Pandang State Polytechnic. Betta fish seeds were kept each in an aquarium measuring 20 cm x 14 cm x 20 cm as many as 12 pieces. Soaking artemia with beef testicle flour with a predetermined dose of 60 mg L-1, 80 mg L-1 and 100 mg L-1, the duration of immersion is 24 hours. This study used a one-factor completely randomized design (CRD). The results obtained were the highest percentage of male genitalia at a dose of 100 mg L-1 with a percentage of 66.7%. The survival rate of betta fish during the maintenance period with different doses of cow testicles obtained data ranging from 80-100%.

Cost per responder for risankizumab vs secukinumab in patients with moderate-to-severe plaque psoriasis in Italy

Purpose: The objective of this analysis was to compare the cost per responder between risankizumab and secukinumab among patients with moderate-to-severe plaque psoriasis in Italy. Methods: The clinical efficacy was assessed based on IMMerge study of published efficacy data as measured by Psoriasis Area and Severity Index response (PASI 90 and PASI 100) for risankizumab and secukinumab. The treatment cost was based on the number of administrations dispensed in the first (induction plus maintenance period) and the second (maintenance period only) year of treatment and the ex-factory price of each treatment. The cost per responder was adopted as a cost-effectiveness indicator. Results: Independently of the PASI response (PASI 90 and PASI 100) used and the year of treatment considered, the cost per responder was consistently lower for risankizumab compared to secukinumab in all clinical measures. For example, considering the first-year costs and PASI 100, the cost per responder for risankizumab was € 24,506.83 compared to € 38,000.00 for secukinumab. The differences in the cost per responder between risankizumab and secukinumab increased when higher PASI response levels were considered. Conclusion: This economic evaluation suggested that the cost per responder is consistently lower for risankizumab compared to secukinumab from the perspective of the Italian National Health Service in the treatment of moderate-to-severe plaque psoriasis.

Efficacy, Safety, and Durability of Long-Acting Cabotegravir and Rilpivirine in Adults With HIV-1 Infection: ~5-Year Results From the LATTE-2 Study

Background In the LATTE-2 phase IIb study, long-acting (LA) injectable cabotegravir + rilpivirine dosed every 8 weeks (Q8W) or 4 weeks (Q4W) demonstrated comparable efficacy with daily oral antiretroviral therapy (ART) through 96 weeks in ART-naive adults with HIV-1. Here we report efficacy, tolerability, and safety of cabotegravir + rilpivirine LA over ~5 years. Methods After 20 weeks of oral cabotegravir + abacavir/lamivudine, participants were randomized to cabotegravir + rilpivirine LA Q8W or Q4W or continue oral ART through the 96-week maintenance period. In the extension period through Week 256, participants continued their current LA regimen (randomized Q8W/Q4W groups) or switched from oral ART to Q8W or Q4W LA therapy (extension-switch groups). Endpoints assessed included proportion of participants with HIV-1 RNA &lt;50 copies/mL (Snapshot algorithm) and adverse events (AEs). Results At Week 256, 186 (81%) of 230 participants in randomized Q8W/Q4W groups and 41 (93%) of 44 participants in extension-switch groups had HIV-1 RNA &lt;50 copies/mL. No protocol-defined virologic failures occurred after Week 48. Injection-site reactions infrequently resulted in discontinuation (4 [2%] and 1 [2%] participants in randomized Q8W/Q4W and extension-switch groups, respectively). Three participants in randomized Q8W/Q4W groups experienced drug-related serious AEs, including 1 fatal serious AE (Q4W group); none occurred in extension-switch groups. Of 25 participants with AEs leading to withdrawal, 20 were in the randomized Q4W group; no AE leading to withdrawal occurred in &gt;1 participant. Conclusions Cabotegravir + rilpivirine LA exhibited long-term efficacy and tolerability, demonstrating its durability as maintenance therapy for HIV-1 infection (ClinicalTrials.gov, NCT02120352).

Health Informatics Study of Related Complications Relating to Upper Arm Implantable Intravenous Infusion Port in Breast Cancer Patients

Objective: In order to explore the clinical application effect of the upper arm venous infusion port, analyze the prevention and treatment effect of catheter rupture of the upper arm venous infusion port, and conduct a series of studies on postoperative related complications, as well as analyze the prevention and treatment of catheter rupture of the upper arm venous infusion port effect using chest radiography and computed tomography. Methods: We collected clinical data of 98 patients implanted in the upper arm venous infusion port in the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine and Hangzhou Shulan Hospital from January to December 2017, divided the 98 patients into two groups, and gave 49 patients in group A Based on the patient’s basic intervention, 49 patients in group B were given prevention and treatment intervention of catheter rupture, and the intervention effects of the two groups were compared. Consult the nursing records during the hospitalization and maintenance period after the implantation of the upper arm vein infusion port, summarize the complications, analyze the causes, and discuss the formulation of feasible nursing countermea-sures. Results: 98 patients were followed up for 5-16 months, with a median follow-up time of 10 months. Within 2 weeks after implantation of the upper arm vein infusion port and during discharge maintenance, the incidence of complications was 24.49% (24/98), 8.16% (8/98), the difference in the incidence of complications between the two time periods was statistically significant (P < 0.05). Among them, common complications include incision bleeding at the port body, poor healing of the incision, local swelling, obstruction of catheter withdrawal, extravasation of transfusion at the port body, catheter blockage, catheter displacement, and catheter-related thrombosis. There was a difference in the incidence of catheter rupture, catheter rupture time, and patient satisfaction after intervention between the two groups of intravenous implantation patients (P < 0.05), which was statistically significant. Conclusions: Complications within 2 weeks after implantation of the upper arm venous infusion port are significantly higher than the maintenance period. Among them, infusion extravasation, catheter-related thrombosis, catheter blockage, and catheter displacement at the port body are serious complications that directly affect the use of the upper arm infusion port . The prevention and treatment of catheter rupture for patients who have used implanted intravenous infusion ports for a long time has significant effects, which can reduce the occurrence of catheter rupture and ensure the safety of patients’ lives and health.