Implementation of Clinical Assistants in a Pediatric Oncology Department: an Activity and Clinical Time Release Analysis

Background: There is a high bureaucratic and administrative burden associated with health care tasks (test requesting, visits scheduling, supporting documents provision) that has historically largely fallen on health care professionals, which is one among the factors contributing to low job satisfaction and lower productivity. Incorporating new professional roles that help to better respond to the needs of both patients and professionals can increase the quality and efficiency of service provision. Objective: To evaluate the impact of the clinical assistant’s introduction in the Sant Joan de Déu Barcelona Children’s Hospital’s pediatric oncology department, in terms of displacement of activity loads carried out by this new professional role and the consequent time freed up for physicians. Methodology: Observational and retrospective study using administrative data based on the analysis of the type of activity performed by clinical assistants and the measurement of the time freed up in favor of the physicians, based on in situ timekeeping, to approximate the potential skill mix productivity increase. Results: Since its implementation in the pediatric oncology department, clinical assistants have performed 13,553 requests (69.93% of the total), representing a total saving of 266.83 hours or 6.67 workweeks of 40 hours. They performed 74.25% of outpatient surgical requests in the oncology department, 87.5% of day hospital requests and 54.13% of total requests in the outpatient consultations area. Conclusion: The introduction of clinical assistants in the oncology department could be efficient to the extent that it displaces a good part of the bureaucratic and administrative tasks previously performed by health care professionals. This delegation allows them to work more closely to the maximum of their competences and the physicians to have more time for higher added value clinical tasks. In terms of efficiency, this role change enables to optimize the clinical process, reducing the cost by 56% compared to the conventional model.

Cephradine drug release using electrospun chitosan nanofibers incorporated with halloysite nanoclay

The chitosan/polyvinyl alcohol/halloysite nanoclay (CS/PVA/HNC) loaded with cephradine drug electrospun nanofibers (NFs) were fabricated and characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) techniques. FTIR analysis confirmed the hydrogen bonding between the polymer chain and the developed siloxane linkages. SEM analysis revealed the formation of uniform NFs having beads free and smooth surface with an average diameter in 50–200 nm range. The thermal stability of the NFs was increased by increasing the HNC concentration. The antimicrobial activity was examined against Escherichia coli and staphylococcus strains and the NFs revealed auspicious antimicrobial potential. The drug release was studied at pH 7.4 (in PBS) at 37 °C. The drug release analysis showed that 90% of the drug was released from NFs in 2 h and 40 min. Hence, the prepared NFs could be used as a potential drug carrier and release in a control manner for biomedical application.

Performance of a small indirect-injection Diesel engine with intermetallic thermal barrier coated pistons

A multilayer Intermetallic Thermal Barrier Coating has been developed at the University of Windsor using a Cold Spray method. The coating is composed of layers of SHS717 stainless steel (Fe, Cr, Mo, W, C, Mn, Si & B) and layers of aluminum acting as bond coats. The coating properties match the thermophysical properties of metallic engine components. In this study, initial testing of the intermetallic TBC was conducted on the crown of aluminum pistons tested in a small indirect-injection diesel engine operating at full load and various engine RPMs. Indicated and brake performance metrics were analyzed to determine changes in engine performance characteristics when compared to baseline uncoated engine operation. An apparent heat release analysis was completed to determine the change of heat rejection of the engine operating with the TBCs, as well as an energy balance analysis to determine the improvements in the fuel energy conversion. The results from this analysis indicated that indeed the heat transfer losses were reduced with a concurrent modest gain in engine output.

Controlled Release of Chlorogenic Acid from Polyvinyl Alcohol/Poly(γ-Glutamic Acid) Blended Electrospun Nanofiber Mats with Potential Applications in Diabetic Foot Treatment

This work biosynthesized poly(γ-glutamic acid) (γ-PGA) produced by Bacillus licheniformis ATCC-9945a. This material was utilized to prepare electrospun nanofibers with solutions of 10% polyvinyl alcohol (PVA) (w/v) mixed with γ-PGA at 5 and 10% w/v, intended as a wound dressing for diabetic foot treatment. These solutions were loaded with chlorogenic acid (CGA), an active hypoglycemic agent. Morphological analysis showed a decrease in size of the fibers with the combination of PVA/γ-PGA compared to pure PVA nanofibers, which was attributed to the hydrogen bonding interactions between the glutaraldehyde vapors, γ-PGA, and PVA that permitted nanofiber cross-linking and allowed CGA release. The in vitro release analysis showed that the PVA membranes reached 28% delivery after the first 24 h. Notably, the nanofiber mat with PVA blended with 5% γ-PGA reached 57% delivery, and the PVA nanofiber with 10% γ-PGA reached 66% release after the same amount of time. The rate constant for the release kinetics showed that PVA with 5% γ-PGA had a higher value than that of the other samples, reaching saturation first.

Liqui-Mass Technology as a Novel Tool to Produce Sustained Release Liqui-Tablet Made from Liqui-Pellets

The Liqui-Mass technology (also known as Liqui-Pellet technology) has shown promising results in terms of enhancing the drug release rate of water insoluble drugs in a simplistic approach. However, there is no current study on sustained-release formulation using the Liqui-Mass technology. In this study, an attempt was made to produce a sustained-release Liqui-Tablet for the first time using a matrix-based approach. The non-volatile co-solvent used in the investigation included Tween 80, Tween 20 and Kolliphor EL. The production of sustained-release propranolol hydrochloride Liqui-Tablet was successful, and data from the saturation solubility test and dissolution test did not show much difference among the mentioned non-volatile co-solvent. The best Liqui-Tablet formulation took 24 h for drug release to reach at around 100%. There seemed to be a synergistic retarding drug release effect when a non-volatile co-solvent and Eudragit RS PO were used together. The increase of Eudragit RS PO concentration increased the retardant effect. Kinetic drug release analysis suggests that the best formulation followed the Higuchi model. The flowability of pre-compressed Liqui-Tablet pellets had no issues and its size distribution was narrow. Liqui-Tablet was generally robust and most formulations passed the friability test. The study revealed that Liqui-Mass technology can be employed to sustain drug release.

Mercury Speciation in Natural and Mining-Related Systems

Mercury speciation and the composition of mercury phases in natural and mining-related environments is studied by the thermal release analysis combined with electrothermal atomic absorption spectroscopy (TA-ET-AAS), as well as scanning electron microscopy with energy-dispersive X-ray microanalysis (SEM-EDS). The analyses are applied to laboratory-made samples bearing mercury selenide and to field samples from sites known for relatively high natural or industrially induced Hg background. They are, namely, material from the dispersion train of the Ursk sulfide tailings (Ursk Village, Kemerovo region) and debris precipitated from snow sampled in the Kurai mercury zone (Aktash Village, Gorny Altai). The TA-ET-AAS method works well in discrimination and identification of Hg sulfide and Hg selenide provided that the samples contain sufficient amounts of both compounds, but the sum HgS + HgSe can be determined at any contents of the two compounds. The presence of both mercury sulfide and mercury selenide in the samples has been confirmed by SEM-EDS microanalysis. The temperature ranges for the mercury species (Hg2+; HgS+HgSe mixture; mercury bound with organic matter (Hg-OM), including CH3Hg+) are identical in the laboratory and field samples. Therefore, the suggested approach can ensure fast and reliable detection of Hg phases in rocks exposed to supergene alteration

Characterization of Cleaning Potential of Khokhar-Bala, Punjab (Pakistan) Coal and Simulation-Based Study for Identification of Best Strategy for its Cleaning

This study involves the characterization of Khokhar-Bala coal of Punjab (Pakistan) coal field to establish its particle distribution data for size, density and floatability through sizing, float-sink tests and release analysis. Khokhar Bala coal contains high amounts of unwanted impurities like ash (35.22%) and sulphur (8.38%). Over 93% of its mass consists of +1.00 mm particles, when run-of-mine coal is crushed to 38 mm. Washability curves, degrees of washing and the S-values show that the coarser fractions (-38+25 mm; -25+13.33 mm; -13.33+3.35 mm) are extremely difficult to clean, whereas the cleaning potential is high for size fractions -3.35+1.00 mm (moderately difficult) and -1.00+0.15 mm (relatively easy). Modelling and simulation of several processing configurations indicate that at 16% target ash content, dense medium cyclone treating 38 x 1 mm coal particles will provide the maximum clean yield of 37.39% with sulphur content of 4.80%.