Biomedical Machine Maintenance Scheduling

Tissue banks procure approximately 45,000 tissue donations per year, providing nearly 9,000,000 individuals (about half the population of New York) with life-enhancing and life-saving medical procedures. Proper biobank machine maintenance is imperative to this process. Mandatory forms of maintenance are critical to avoid unexpected malfunctions, which can halt operations and render samples unusable. Each machine has a unique reliability rate within the system; although some can quickly be repaired or replaced, many processes rely on limited machinery where even planned downtime can significantly influence the tissue processing. AlloSource, one of the largest tissue manufacturers in the United States, too often schedules these preventive events unnecessarily or inconveniently, resulting in machines breaking down at inopportune times. In response to these inefficiencies we ask, “What is the best consolidated and standardized equipment maintenance schedule that maximizes monthly maintenance events to ensure increased equipment availability while meeting the demand of the biomedical manufacturing network?” We use an optimization model to consider equipment reliability, downtime, availability, and demand to develop a preventive maintenance schedule. Our model focuses on scheduling the maximum number of events the maintenance crew can conduct each month to ensure vital equipment to the allograft process is available, which provides more opportunities for tissue therapies. In doing so, the maintenance crew is also able to complete more events, driving up annual throughput while driving down equipment downtime.

Nursing professionals’ biosafety in confronting COVID-19

ABSTRACT Objective: To investigate the nursing professionals’ biosecurity in confronting COVID-19. Methods: This is a Survey type study. Nursing professionals were invited via messaging apps, using self-applied data collection forms. The sample selection (n=693) was non-probabilistic. A descriptive data analysis was conducted. Results: considering the biosafety aspects in facing COVID-19, 79.0% of the participants had not received training or considered it insufficient, 69.3% reported the lack of personal protective equipment during work, and 81.8% did not feel safe with the internal flux adaptations for handling COVID-19 cases. Conclusion: Continuous and effective nursing team training and personal protective equipment availability are necessary, as well as internal flow adjustments for attending suspected or confirmed cases.

Service Exchange or Major Overhaul. Which Philosophy to Implement for Gas Turbine

Maintenance costs and machine availability are two of the most important concerns to gas turbine equipment owner. Therefore, a well thought out maintenance program that reduces costs while increasing equipment availability should be instituted. The correct implementation of planned maintenance relying on preventive maintenance optimization through perfect inspection frequency and scope provides direct benefits in the avoidance of forced outages, unscheduled repairs, and downtime. Major overhaul is carried out for each gas turbine every 48,000 firing hours which costs around 1 M USD for each engine and with more than 8 months unavailability for the unit. To increase equipment availability and enhance cost and time efficiency, alternatives approaches were evaluated including Service Exchange of gas turbines. It is found that service exchange is the best option for optimizing time and cost of overhaul of such engines. This paper is written to improve Major Overhaul practice for existing Gas Turbines from ongoing practice of routine major overhaul including engine strip down, inspection and repair to Service Exchange of Gas Generator and Power Turbine every 48,000 firing hours.

Mental Health Consequences of SARS-CoV-2 Pandemic on Long-Term Care Facility Social Care Provider in Poland

During the pandemic long-term care facilities (LTCF) social health providers constantly remain in a dilemma between loyalty to people with dementia and concerns for their own families. All of these factors could contribute to the mental burden, burnout, and increased chance of depression, anxiety and post-traumatic symptoms. In our study we aimed to provide a window on psychopathological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) associated with the exposure of LTCF employees to the risk of the SARS-CoV-2 contagion in Poland. Moreover, we investigated if institutional factors, such as personal protection equipment availability, safety guidelines or access to psychiatric and psychological support at the workplace, contribute to the decrease of psychological distress of the LTCF personnel. The results can serve as ready-made guidelines for mitigating the SARS-CoV-2 impact on dementia care and constitute the basis for further analysis of long-term consequences of this precedential situation.

THE CORRELATION AVAILABILITY NURSES AND EQUIPMENT WITH ACUTE MISSED NURSING CARE AT HOSPITALS

Background: One of the nurse’s roles is to provide nursing care regards of patient safety, consistently and timely. The availability of nurses and equipment can be considered as a primary constraint contributing to acute missed nursing care.Aims: This study aimed to determine the correlation between the availability of nurses and equipment with incidences of acute missed nursing care in medical and surgical wards at hospitals.Methods: This study used quantitative research with a cross sectional approach. This research was conducted at six private hospitals in Malang from October 2020 to November 2020. The population in this study were selected using consecutive sampling, and the study sample consisted of 206 nurses. The acute MISSCARE Survey was used to collect data. The relationship between the availability of the number of nurses and equipment with acute missed nursing care was analyzed by applying SPSS version 26 with the Spearman test.Results: The relationship between the availability of nurses and acute missed nursing care yielded results of ρ = 0.016 (<0.05) and R = -0.168. Equipment availability and acute missed nursing care had values of ρ = 0.026 (<0.05), and R = -0.155. This shows correlation between the availability of the number of nurses and equipment with incidences of acute missed nursing care.Conclusion: The availability of the number of nurses and equipment are the reasons for the incidence of acute missed nursing care. Therefore, nursing managers are needed in managing and allocating the necessary number of nurses and equipment.Keywords: equipment, missed nursing care, nurse

Subsea Well Intervention Readiness in Brazil

The purpose of this study is to assess the subsea well intervention capabilities in Brazil from an operator point of view and how it compares to other regions in the world, in terms of equipment availability, technology and readiness. The object of this assessment will be restricted to the well access systems, given the numerous scenarios that can drive a subsea well intervention. The intent is to identify the main challenges an International Oil Company (IOC) and/or Local Oil Company (LOC) operating in Brazil must overcome in order to keep a robust and realistic contingency plan in case of any well integrity issue. Also, similar challenges are experienced whenever production restoration is needed and/or even opportunities for production enhancement are economically assessed to viable, or not. Last but not least, well access during the last phase of a well lifecycle (plug and abandonment) is also a key element. This will be discussed further in. Until the late 90's, the subsea oil industry in Brazil was restricted to the state-run operator and the supply chain to the business had developed itself around the mindset to maidenly supply a single state-run operator demand. After the market opening and consolidation of the IOC's and LOC's in the subsea market, a lack of local supply of several goods and services started to present itself. Since well access systems are expensive and the base case is that you won't use it unless you have a problem, there's a strong unconscious desire not to worry about it until you really need it. Sharing the same view, service companies tend to enforce the sale of these kits to the operator, rather than focus on a rental solution. Moreover, when service companies provide rental solutions, they are not kept in country and mobilization fees and lead time become a showstopper on many cases. In view of the scenario described above and ways of operation of the Brazilian market IOC's and LOC's a solution will be proposed to mitigate the risk of unavailability and reduce costs based on the sharing economy principles.

Inpatient telehealth experience of limited English proficient patients: a cross-sectional survey and semi-structured interview (Preprint)

BACKGROUND Limited English proficient (LEP) patients are at higher risk of poor health outcomes and are less likely to utilize telehealth compared to English speaking patients. There is no formal evaluation of inpatient telehealth user experience by language preference to date. OBJECTIVE To compare the experience of Spanish and English-speaking patients and families using our inpatient telehealth program (ITP). To evaluate the experience of Spanish interpreters using ITP. METHODS We prospectively administered a survey to English and Spanish speaking patients and families who used our ITP from October 1, 2020 to March 31, 2021. We performed semi-structured interviews of hospital based Spanish interpreters by phone who participated in ITP. RESULTS High satisfaction was reported by both English and Spanish speakers (SD 0.47-1.7, IQR 0-2). Both English and Spanish speaking patients participated in ITP with their primary inpatient care team, subspecialty consultants and other clinicians. Hospital tablets were used more often than personal devices, and only English speaking patients utilized a personal laptop. Patients and families encountered challenges with log-in, team coordination with multiple users and equipment availability. Interpreters encountered challenges with audio and visual quality, communication, safety, and Wi-fi access. CONCLUSIONS There is high satisfaction amongst both English and Spanish speaking patients using our ITP. Use cases are multi-disciplinary and suggest lasting applicability post-pandemic, however significant investment is needed to provide robust infrastructure to support utilization by all patients, but especially integration of interpreter services for LEP patients. CLINICALTRIAL N/A

Comparing LSTM and GRU Models to Predict the Condition of a Pulp Paper Press

The accuracy of a predictive system is critical for predictive maintenance and to support the right decisions at the right times. Statistical models, such as ARIMA and SARIMA, are unable to describe the stochastic nature of the data. Neural networks, such as long short-term memory (LSTM) and the gated recurrent unit (GRU), are good predictors for univariate and multivariate data. The present paper describes a case study where the performances of long short-term memory and gated recurrent units are compared, based on different hyperparameters. In general, gated recurrent units exhibit better performance, based on a case study on pulp paper presses. The final result demonstrates that, to maximize the equipment availability, gated recurrent units, as demonstrated in the paper, are the best options.

A comparison of antigen-based rapid test and RT-PCR test to diagnose COVID-19 and its infectivity

Background. Medical screening and diagnostic cost and equipment availability has been a major obstacle to supposed-to-be extensive tracing, and overall, to the end of COVID-19 pandemic. Even though RT-PCR is the gold diagnostic standard, it is costly, lengthy, and may be unavailable in remote areas. Therefore, antigen-based COVID-19 rapid tests may be a solution to quickly detect and screen communities suspected of contracting COVID-19. Objective. This paper aims to observe how reliable antigen-based COVID-19 rapid tests are compared to RT-PCR testing. Material and methods. An observational cross-sectional study was performed on 101 samples to find the specificity, sensitivity, and accuracy of antigen-based rapid testing compared to RT-PCR testing performed on every individual. Then, a pattern between CT values and duration between onset of symptoms and testing to antigen-based rapid test result was observed to find a cut-off value such that the person may be deemed safe to exit isolation. Outcomes. A cut-off CT value of above 30.04 (p < 0.01) with a sensitivity of 66.7% and specificity of 77.8% (moderate accuracy) obtained from ROC analysis showed negative results on antigen-based rapid tests. The tests showed an overall accuracy of 67.3%, where results between the two tests were consistent. Conclusion. Therefore, an estimated CT value of 30 was moderately proved to be used as a criterion to end isolation and presume the person no longer sheds SARS-CoV-2.