OBJECTIVE: Referring to the application of the NEH (Nawaz-Enscore-Ham) algorithm in flow shop scheduling, this paper proposes an optimization method of hospital medical consumables discrete scheduling based on the extended NEH algorithm, in order to obtain the optimal medical consumables discrete scheduling scheme and achieve the optimization of medical consumables discrete scheduling. METHODS: Thoroughly analyze the scheduling needs of medical consumables in hospitals, predict the demand for medical consumables in each department. Construct a discrete scheduling optimization model for medical consumables and determine the constraint conditions for building the model (residual coefficient matrix, efficiency constraint matrix, and time window function). Then, solve the discrete scheduling optimization model for medical consumables based on the extended NEH algorithm. RESULTS: By comparison the data before and after the experiment, it is found that the discrete scheduling time and cost of medical consumables in experimental departments have decreased to varying degrees, and all the differences are statistically significant ( P<0.05). CONCLUSION Through experiments, it is known that the optimized medical consumables discrete scheduling scheme proposed meets the requirements of discrete scheduling time and cost, providing a better solution for hospital medical consumables discrete scheduling.
Algorithms ; Materials Management, Hospital ; Appointments and Schedules

Introduction: Frequent diabetes medication therapy adherence clinic (DMTAC) appointments may lead to more rapid glycaemic control. This study aimed to evaluate the association between appointment intervals and glycaemic control (haemoglobin A1c [HbA1c] level) along with blood pressure (BP) and lipid profile (LP) during DMTAC appointments. Methods: This study retrospectively reviewed all recorded baseline and completed DMTAC data, including HbA1c level, LP and BP, of 318 eligible participants from 29 DMTACs across Perak. The participants were divided into shorter appointment interval (SAI) (≤30 days) and longer appointment interval (LAI) groups. Results: The majority of the baseline socio-demographic and clinical characteristics did not significantly differ between the SAI and LAI groups (p>0.05). Ischaemic heart disease (Odds ratio, OR=3.457; 95% CI=1.354–8.826; p=0.009) and hypertension (OR=0.521; 95% CI=0.276–0.992; p=0.044) were significantly associated with the appointment intervals. Upon completion of eight DMTAC visits, the HbA1c and FBS levels and DBP significantly improved (p<0.05). However, the mean HbA1c level (1.35±2.18% vs 0.87±2.11%, p=0.548), FBS level (1.25±4.82mmol/L vs 2.29±6.23mmol/L, p=0.538), SBP (3.28±21.82mmHg vs 3.65±18.35mmHg, p=0.343) and LDL level (0.09±0.98mmol/L vs 0.07±1.13mmol/L, p=0.246) did not significantly differ between the SAI and LAI groups. Conclusion Longer DMTAC appointment intervals had similar improvement in glycaemic controls, blood pressure and lipid profiles as compared to shorter appointment intervals. A longer interval can be scheduled for lower-risk patients to optimise the use of human resources and minimise costs.
Appointments and Schedules ; Diabetes ; Pharmacists

PURPOSE: This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea.MATERIALS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis.RESULTS: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001).CONCLUSION: WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.
Appointments and Schedules ; Arthritis ; Cohort Studies ; Cross-Sectional Studies ; Extremities ; Humans ; Korea ; Ontario ; Osteoarthritis, Knee ; Osteoporosis ; Quality of Life ; Sarcopenia ; World Health Organization

Graves' ophthalmopathy (GO) is an autoimmune disease associated with orbital inflammation and fibrosis which can result in lid retraction, soft tissue swelling, and proptosis. Treatment should rely on a thorough assessment of the activity and severity of GO. Control of risk factors for GO progression and topical treatments for dry eye are recommended for all patients. In mild GO, a careful observation is usually sufficient. In moderate-to-severe and active GO, high-dose intravenous glucocorticoids can be considered an initial treatment. The most common schedule for intravenous glucocorticoids is a cumulative dose of 4.5 g of methylprednisolone, divided into 12 weekly infusions (6 weekly infusions of 0.5 g, followed by 6 weekly infusions of 0.25 g). Orbital radiation has been shown to be an effective secondary treatment in patients with active GO unresponsive to intravenous glucocorticoids. Rehabilitative surgery is needed in patients with GO when the disease is associated with a significant impact on quality of life or visual function after the disease has been inactive for at least 6 months.
Appointments and Schedules ; Autoimmune Diseases ; Exophthalmos ; Fibrosis ; Glucocorticoids ; Humans ; Inflammation ; Methylprednisolone ; Orbit ; Quality of Life ; Risk Factors

PURPOSE: This study was conducted using the theory of planned behavior to analyze factors influencing mothers' intention to vaccinate their children against hepatitis A (HA). METHODS: This descriptive study used a questionnaire. The participants were 100 mothers with children under 19 years. The collected data were analyzed by the t-test, analysis of variance, and the Mann-Whitney U test. The Pearson's correlation was used to test the correlations among variables. Stepwise multiple regression was used to identify factors related to HA vaccination intention. RESULTS: The attitude of mothers with children under 19 to HA vaccination were quite positive (6.2 of 7), and their perceived behavioral control (5.73 of 7), subjective norm (5.54 of 7), and vaccination intention (5.96 of 7) were relatively high. Attitude toward HA vaccination was the strongest influencing factor, followed by subjective norm. The explanatory power of attitude and subjective norm for HA vaccination was 84%. CONCLUSION: HA vaccination is very important for preventing HA. Mothers' positive attitudes toward HA vaccination were an important factor influencing their children's HA vaccination. Providing education on the benefits of HA vaccination and the vaccination schedule may foster positive attitude toward vaccination.
Appointments and Schedules ; Child ; Education ; Hepatitis A* ; Hepatitis* ; Humans ; Intention* ; Mothers ; Vaccination

Rivaroxaban, a factor Xa inhibitor, is one of the newly developed direct oral anticoagulants (DOAC). In recent times, it has been increasingly used in the prevention of pulmonary embolism in patients undergoing orthopedic surgery. This report describes a case of epidural hematoma in an elderly patient who underwent combined spinal epidural anesthesia for total knee arthroplasty; the patient received rivaroxaban postoperatively for 7 days to prevent pulmonary embolism. Additionally, the epidural hematomas developed on the 5th postoperative day but the patient recovered well with conservative treatment. Although rivaroxaban has a low need for monitoring and is easily administered, the guidelines should be carefully checked for the postoperative administration schedule in patients undergoing regional anesthesia. In addition, rivaroxaban should be used with caution, especially in elderly patients.
Aged ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anticoagulants ; Appointments and Schedules ; Arthroplasty, Replacement, Knee* ; Factor Xa ; Hematoma* ; Hematoma, Epidural, Spinal ; Humans ; Orthopedics ; Pulmonary Embolism ; Rivaroxaban*

OBJECTIVE: To critically compare the benefits and risks of labor induction versus spontaneous labor in uncomplicated nulliparous women at 39 or more weeks of gestation. METHODS: We conducted a retrospective, observational study of 237 nulliparous women who were at 39 or more weeks of a singleton pregnancy with vertex presentation and intact membranes. We compared maternal outcomes including the Cesarean section rate and neonatal outcomes in the induced labor and spontaneous labor groups. RESULTS: Among the 237 women, 199 delivered vaginally (84.0%). The spontaneous labor group and induced labor group had a similar incidence of Cesarean delivery (17.7% vs. 12.3%, P=0.300). The length of stay and blood loss during delivery were also similar between the groups (4.3±1.5 vs. 3.9±1.5 days and 1.9±1.3 vs. 1.8±1.0 mg/sL, respectively; all P > 0.05). Regarding neonatal outcomes, the rate of meconium-stained amniotic fluid, Apgar score < 7 at 5 minutes, and intubation rate were similar between the groups (18.9% vs. 24.7%, 7.9% vs. 4.1%, and 6.1% vs. 4.4%, respectively, all P > 0.05). Only the neonatal intensive care unit admission rate was significantly lower in the induction group than in the spontaneous labor group (28.0% vs. 13.2%, P=0.001). CONCLUSION: Maternal adverse outcomes of labor induction at 39 weeks of gestation were similar to those in a spontaneous labor group in uncomplicated nulliparous women. Neonatal adverse events were also similar between the groups. It may be acceptable to schedule labor induction as long as 7 days before the estimated date, even when the indication is only relative.
Amniotic Fluid ; Apgar Score ; Appointments and Schedules ; Cesarean Section ; Delivery, Obstetric ; Female ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Intubation ; Labor, Induced ; Length of Stay ; Membranes ; Observational Study* ; Postpartum Period ; Pregnancy ; Retrospective Studies* ; Risk Assessment*

BACKGROUND: Recently, a new automated chemistry analyzer, Atellica CH930 (Siemens, Germany), was introduced. It automatically measures internal quality control (QC) materials according to a pre-determined schedule. For this purpose, the instrument has space for storage of QC materials. We evaluated the analytical performance of chemistry items by using the Atellica system. METHODS: The precision of 29 items was evaluated with three levels of QC materials with two storage methods. We stored the QC materials in the dedicated storage space in the instrument during the precision evaluation period. In addition, we aliquoted and stored the materials in the refrigerator, and then loaded the material in a timely manner. Linearity, carry-over, and agreement with current methods were also evaluated. RESULTS: The within-laboratory coefficient of variation (CV) of most items, except for total CO2 (tCO2), was within 5.0% in both QC storage methods without significant differences in CV between storage methods. The CV of tCO2 was 5.2%, 5.8%, and 5.1% at three different levels when the QC materials were stored in a dedicated space in the instrument. The linearity was acceptable, showing <5% nonlinearity. Although good agreement was observed for most items, some items, such as calcium, total bilirubin, aspartate transaminase, and chloride, showed unequivalent results. CONCLUSIONS: Atellica CH930 showed acceptable precision, linearity, and agreement in routine chemistry items. The automatic QC function using the storage device has no problem with stability or precision. It can reduce the manual process, allowing technicians to focus on reviewing the QC results and reporting reliable results.
Appointments and Schedules ; Aspartate Aminotransferases ; Bilirubin ; Calcium ; Chemistry ; Quality Control

OBJECTIVE: To compare adolescents with non-suicidal self-injury behavior and tattoos [NSSI (T+)] with another group with non-suicidal self-injury behavior without tattoos [NSSI (T−)]. METHODS: Adolescents (n=438) 42.6% males from the community (M=12.3, SD=1.3), completed the Self-Injury Schedule. RESULTS: The lifetime prevalence of tattoos performed with the purpose to feel pain was 1.8%. Compared to the NSSI (T−) group, the NSSI (T+) group was significantly more likely to meet the DSM-5 frequency criteria of 5 self-injury events in 1 year, practice more than one method of self-injury, and topography, more suicidal intentionality, more negative thoughts and affective emotions before, during, and after self-injury and more academic and social dysfunction. CONCLUSION: Adolescents from the community who practice tattooing to feel pain, show a distinct phenotype of NSSI. Health professionals and pediatricians should assess tattooing characteristics such as intention (to feel pain), frequency, and presence of non-suicidal self-injury behavior and suicide intentionality.
Adolescent ; Appointments and Schedules ; Health Occupations ; Humans ; Intention ; Male ; Methods ; Phenotype ; Prevalence ; Suicide ; Tattooing

Despite recent innovation in treatment techniques and subsequently improved outcomes, the majority of glioblastoma (GBL) have relapses, especially in locoregional areas. Local re-irradiation (re-RT) has been established as a feasible option for recurrent GBL of all ages with safety, tolerability, and effectiveness both in survival and quality of life regardless of fractionation schedule. To keep adverse effects under acceptable range, cumulative dose limit in equivalent dose at 2 Gy fractions by the linear-quadratic model at α/β = 2 for normal brain tissue (EQD2) with narrow margin should be observed and single/hypofractionated re-RT should be undertaken very carefully to recurrent tumor with large volume or adjacent to the brainstem. Promising outcome of re-operation (re-Op) plus re-RT (re-Op/RT) need to be validated and result from re-RT with temozolomide/bevacizumab (TMZ/BV) or new strategy is expected. Development of new-concept prognostic scoring or risk group is required to select patients properly and make use of predictive biomarkers such as O(6)-methylguanine-DNA methyltransferase (MGMT) promotor methylation that influence outcomes of re-RT, re-Op/RT, or re-RT with TMZ/BV.
Appointments and Schedules ; Biomarkers ; Brain ; Brain Stem ; Glioblastoma ; Humans ; Methylation ; O(6)-Methylguanine-DNA Methyltransferase ; Quality of Life ; Re-Irradiation ; Recurrence