The two-echelon location-routing model with multi-commodity, automated delivery systems and integrating people and freight transportation

PurposeTo evaluate the visual performance, refractive stability, and glistening-free clarity of the Clareon® monofocal intraocular lens (IOL) implanted using the AutonoMe® automated delivery system in a real-world North American setting.Patients and MethodsA prospective, single-arm study was conducted at a single Canadian site involving 46 patients, or 85 eyes, undergoing cataract surgery with Clareon® IOL implantation. Eligible participants were ≥22 years old with best-corrected distance visual acuity (BCDVA) of 0.3 logMAR or worse, targeted for emmetropia, and had <1.0 D of preoperative astigmatism. Exclusion criteria included retinal disease, glaucoma, amblyopia, corneal pathology, and prior intraocular or corneal surgery. Manifest refraction, uncorrected (UDVA), best-corrected (BCDVA), and low-contrast visual acuity (LCVA) were assessed at 1, 3, and 12 months postoperatively. Glistenings were graded using the Miyata scale at 3 and 12 months.ResultsNo statistically significant changes were observed in manifest refraction, UDVA, or BCDVA between 1 and 3 months (p > 0.05). At 3 months, the mean spherical equivalent was +0.09 D, with low residual astigmatism (–0.33 D). Mean logMAR UDVA and BCDVA were 0.13 and 0.02, respectively. LCVA was 0.04 logMAR. No glistenings were observed at either 3 or 12 months in any patient. Refractive and visual outcomes remained stable over time, with no device-related complications reported.ConclusionThe Clareon® IOL demonstrated excellent refractive accuracy, stable visual performance, and sustained optical clarity with no glistenings up to one year postoperatively. Its compatibility with the AutonoMe® delivery system supports its utility as a reliable option for cataract surgery.

An automatic delivery system with mobile depot and multiple drones, HIVE, is proposed. Through this system and a series of embedded devices such as drone automatic launch and recovery device etc., two delivery modes, manual delivery and unmanned delivery, are executed in parallel. To solve the delivery route of this system, Two-Echelon Routing Problem with Mobile Depot and Multiple Drones (2E-RP-MD&#x0026;mD) is investigated. A heuristic algorithm based on the regression is designed according to the route characteristics of the HIVE delivery system. Parameters of mobile depot and drones are standardized referred to the performance of delivery vehicles. Experiments on random instances as well as actual case based on Changsha are carried out to test the performance of the proposed algorithm and prove the delivery efficiency of HIVE automatic delivery system.

Multicenter Evaluation of Biochemical Relapse–Free Survival Outcomes for Intraoperatively Planned Prostate Brachytherapy Using an Automated Delivery System

This paper deals with the integration of freight and passenger public transportation systems. The issues of determining the possibility and potential of combining transport with road transport for the carriage of goods of urban origin are examined. A mathematical model and parameters of the interaction between the operation of a freight tram and a car in a docking station is proposed. The overall scheme of research of using urban public transport for freight deliveries in the delivery system is presented. A detailed analysis of all stages of these schemes has been conducted. The technological features between transportation types and urban public transport for freight deliveries are highlighted. A basic freight transportation system using public transport has been developed. It has been found that it is expedient to attract urban public transport for freight transportation. The analysis of public transport implementation in Bratislava had been made. SWOT analysis was made on the results of this investigation. The results provide credibility for implementation this type of system.

Intra-articular hip joint injections have traditionally relied on the use of image guidance to confirm intra-articular needle placement. Musculoskeletal ultrasound (US) has emerged as a popular tool to aid the clinician in performing intra-articular hip injections. Modern automated injection delivery systems are commercially available and may offer the potential to optimize clinical efficiency while limiting procedural morbidity. The purpose of this study was to compare patient-reported outcomes and clinical efficiency between two US-guided intra-articular hip injection techniques. The hypothesis was that the use of an automated delivery system for US-guided intra-articular hip joint injections would show superiority in clinical efficiency over traditional syringe injections. This study was a level 1 randomized prospective postmarket clinical evaluation. Forty patients were randomly assigned to undergo a single intra-articular corticosteroid injection of the hip using either an automated delivery system (Navigator Delivery System; Carticept Medical, Inc, Alpharetta, GA) or a traditional syringe injection. Enrolled patients were prospectively followed at 1, 6, and 12 weeks after injection. A battery of patient-reported outcomes were collected at baseline and again at 1, 6, and 12 weeks after injection. Preparation times were documented for all injections. Forty patients met inclusion criteria and were enrolled. Twenty patients were randomly assigned to receive US guided intra-articular hip injections using the automated system (group A), and 20 patients were treated with standard syringe injections (group B). Body mass index, smoking history, symptom duration, baseline patient-reported outcomes, and demographic data were similar between groups. Improvements from baseline scores were noted at all time points for all patient-reported outcomes regardless of the injection technique used. However, no significant differences were noted at any time point for any of the patient-reported outcomes based on which injection delivery system was used. Statistically significant differences were noted at 6 and 12 weeks for the subjective global assessment score, which favored the use of the automated delivery system over the standard injection technique (6 weeks, P = .029; 12 weeks, P = .028). Between the two injection procedures, there was no difference in pain experienced by the patient (mean Visual Analog Scale pain score ± SEM: group A, 34.9 ± 6.49; group B, 34.5 ± 5.99; P = .960). Body mass index did not influence pain associated with an intra-articular hip injection (P = .870); however, younger patient age was found to be an independent predictor of increased pain associated with injection (P = .011). Although there were no differences among male or female patients in hip injection pain based on the delivery method, statistically significant differences were encountered between male and female patients, irrespective of treatment assignment (male/female: group A, 25.1/41.4; group B, 26.7/46.1; P= .049). Among patients with a smoking history, large differences were noted for injection pain when data for both groups were pooled, regardless of the delivery method (no history, 30.0 ± 4.86; smoking history, 40.8 ± 9.94). Clinical efficiency (as measured by injection preparation time) was found to be inferior for the automated system compared to traditional syringe injection (P < .0001). Use of an automated delivery system for US-guided intra-articular hip injections did not show superior efficiency or patient comfort over traditional syringe injections. Intra-articular corticosteroid injections led to clinically and statistically significant improvements in pain and function for patients with intra-articular hip pain, irrespective of the delivery method. Smoking history and female sex were independent predictors of increased pain associated with intra-articular hip joint injections.

Urban areas are centres of business and innovation. Freight transport is indispensable for the proper functioning of any modern urban society. Urban areas cannot function without an appropriate freight transport system, due to the need to replenish stocks of food and other goods in retail shops. The complexity of the decisions concerning implementation of measures to improve the movement of goods in the city requires tools designed to support this process. In this context, a research gap and a research problem occur—how to obtain a reliable set of factors for development of sustainable urban freight transport (UFT). The purpose of this article is to introduce the possibility of applying the Analytic Hierarchy Process (AHP) as well as the Decision Making Trial and Evaluation Laboratory Method (DEMATEL) in choosing a set of measures and in analysing the field of distribution logistics, which will help to solve delivery problems and streamline cargo flow in Szczecin, in the context of sustainable development. This paper presents the findings of a survey in which experts evaluate the main coefficients for sustainable freight transport in the city area. Using both AHP and DEMATEL methods, we have concluded that: (i) all coefficients from administrative, financial, technical and promotional measures are highly interconnected; (ii) strategy of freight transport development should take into consideration how these coefficients influence each other; (iii) P2—eco-driving trainings, T4—alternative delivery systems and P1—promotional campaigns for sustainable transport are the most important criteria and should be priorities for investments; (iv) A1—implementation of loading/unloading and transit restrictions—highly influences other coefficients; (v) T2—intelligent route guidance in freight transport is greatly influenced by them.

The anatomical and pharmacological inaccessibility of the inner ear is a major challenge in drug-based treatment of auditory disorders. This also makes pharmacokinetic characterization of new drugs with systemic delivery challenging, because efficacy is coupled with how efficiently a drug can reach its target. Direct delivery of drugs to cochlear fluids bypasses pharmacokinetic barriers and helps to minimize systemic toxicity, but anatomical barriers make administration of multiple doses difficult without an automated delivery system. Such a system may be required for hair-cell regeneration treatments, which will likely require timed delivery of several drugs. To address these challenges, we have developed a micropump for controlled, automated inner-ear drug delivery with the ultimate goal of producing a long-term implantable/wearable delivery system. The current pump is designed to be used with a head mount for guinea pigs in preclinical drug characterization experiments. In this system, we have addressed several microfluidic challenges, including maintaining controlled delivery at safe, low flow rates and delivering drug without increasing the volume of fluid in the cochlea. By integrating a drug reservoir and all fluidic components into the microfluidic structure of the pump, we have made the drug delivery system robust compared to previous systems that utilized separate, tubing-connected components. In this study, we characterized the pump's unique infuse-withdraw and on-demand dosing capabilities on the bench and in guinea pig animal models. For the animal experiments, we used DNQX, a glutamate receptor antagonist, as a physiological indicator of drug delivery. DNQX suppresses compound action potentials (CAPs), so we were able to infer the distribution and spreading of the DNQX over time by measuring the changes in CAPs in response to stimuli at several characteristic frequencies.

PurposeTo investigate refractive stability and characterize corneal incision repair up to 3 months after implantation of a new hydrophobic acrylic intraocular lens (IOL) with hydroxyethylmethacrylate using a new automated IOL delivery system.MethodsThis prospective case series included 50 eyes of 50 patients undergoing phacoemulsification and implantation of the Clareon® CNA0T0 IOL using the AutonoMe® automated delivery system in the Department of Ophthalmology, Keio University School of Medicine. The clinical data were collected from 46 eyes of 46 patients preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. Endothelial-side incision gaping, posterior incision retraction, and Descemet’s membrane detachment were recorded as present or absent using anterior-segment optical coherence tomography postoperatively.ResultsThe uncorrected distance and corrected distance visual acuities improved and stabilized 1 week postoperatively. The anterior chamber depth was stable from 1 week postoperatively. The subjective refraction was stable from 1 day postoperatively. Descemet’s membrane detachments and endothelial-side wound gaping were seen in 19 (41.3%) eyes and 34 (73.9%) eyes 1 day postoperatively and decreased gradually. Posterior incision retraction was seen in eight eyes (17.4%) on day 1 and increased to 19 eyes (41.3%) 3 months postoperatively.ConclusionsThe Clareon IOL had excellent refractive stability from day 1 postoperatively. The AutonoMe automated delivery system enables safe IOL implantation through a 2.4-mm corneal incision, although the wound required longer than 1 month to heal postoperatively.

An automated delivery system for cell culture applications would permit studying more complex culture strategies and simplify measures taken to expose cells to unstable molecules. We are interested in understanding how intracellular TAT-HOXB4 protein concentration affects hematopoietic stem cell (HSC) fate; however, current manual dosing strategies of this unstable protein are labor intensive and produce wide concentration ranges which may not promote optimal growth. In this study we describe a programmable automated delivery system that was designed to integrate into a clinically relevant, single-use, closed-system bioprocess and facilitate transcription factor delivery studies. The development of a reporter cell assay allowed for kinetic studies to determine the intracellular (1.4 +/- 0.2 h) and extracellular (3.7 +/- 1.8 h and 78 +/- 27 h at 37 degrees C and 4 degrees C, respectively) half-lives of TAT-HOXB4 activity. These kinetic parameters were incorporated into a mathematical model, which was used to predict the dynamic intracellular concentration of TAT-HOXB4 and optimize the delivery of the protein. The automated system was validated for primary cell culture using human peripheral blood patient samples. Significant expansion of human primitive progenitor cells was obtained upon addition of TAT-HOXB4 without user intervention. The delivery system is thus capable of being used as a clinically relevant tool for the exploration and optimization of temporally sensitive stem cell culture systems.

Propofol consumption during total intravenous anesthesia (TIVA) is influenced by patient's gender and females consume greater amount than males. As gender difference on propofol consumption during TIVA has only been assessed with manually titrated or target-controlled infusion, its validation with automated delivery systems, is desirable. This study evaluated effects of gender differences on propofol consumption during automated propofol TIVA administered by closed-loop anesthesia delivery system (CLADS). The enrolled patients (N.=80) were allocated to two groups based on gender- males and females, and all received automated propofol TIVA by CLADS. Cumulative intraoperative propofol consumption (primary outcome variable), anesthesia depth consistency, anesthesia delivery system performance, intraoperative hemodynamics (heart rate, mean blood pressure), recovery from anesthesia (time-to-eye-opening, time-to-tracheal extubation), and postoperative sedation (secondary outcome variables); were analyzed. While no difference was found for propofol consumption during induction (males: 1.5±0.5 mg/kg versus females: 1.4±0.4 mg/kg, P=0.628) and maintenance (males: 4.9±1.3 mg/kg/h versus females: 4.9±0.8 mg/kg/h, P=0.457) based on total body weight, when calculated by lean body weight; females exhibited significantly greater propofol consumption for induction (males: 1.9±0.6 mg/kg versus females: 2.2±0.5 mg/kg, P<0.001) and maintenance (males: 6.4±1.5 mg/kg/h versus females: 7.8±1.3 mg/kg/h, P<0.001). Time to eye-opening (males: 7.2 [5.2, 9.3] minutes versus females: 4.6 [3.1, 6.7] minutes, P<0.001) and the time to tracheal-extubation (males: 8.1 [6.4, 10.5] minutes versus females: 6.4 [4.5, 9.1] minutes, P=0.010) were significantly lower in females. While females consumed greater amount of propofol for induction and maintenance of propofol TIVA, they exhibited faster recovery than males.

Carbon dioxide (CO2) gas is an established alternative to iodine contrast during angiography in patients with risk of postcontrast acute kidney injury and in those with history of iodine contrast allergy. Different CO2 delivery systems during angiography are reported in literature, with automated delivery system being the latest. The aim of this study is to evaluate the safety, efficacy, and learning curve of an automated CO2 injection system with controlled pressures in peripheral arterial interventions and also to study the patients’ tolerance to the system.From January 2018 to October 2019 peripheral arterial interventions were performed in 40 patients (median age-78 years, interquartile range: 69–84 years) using an automated CO2 injection system with customized protocols, with conventional iodine contrast agent used only as a bailout option. The pain and tolerance during the CO2 angiography were evaluated with a visual analog scale at the end of each procedure. The amount of CO2, iodine contrast used, and radiation dose area product for the interventions were also systematically recorded for all procedures. These values were statistically compared in 2 groups, viz first 20 patients where a learning curve was expected vs the rest 20 patients.All procedures were successfully completed without complications. All patients tolerated the CO2 angiography with a median total pain score of 3 (interquartile range: 3–4), with no statistical difference between the groups (P = .529). The 2 groups were statistically comparable in terms of comorbidities and the type of procedures performed (P = .807). The amount of iodine contrast agent used (24.60 ± 6.44 ml vs 32.70 ± 8.70 ml, P = .006) and the radiation dose area product associated were significantly lower in the second group (2160.74 ± 1181.52 μGym2 vs 1531.62 ± 536.47 μGym2, P = .043).Automated CO2 angiography is technically feasible and safe for peripheral arterial interventions and is well tolerated by the patients. With the interventionalist becoming familiar with the technique, better diagnostic accuracy could be obtained using lower volumes of conventional iodine contrast agents and reduction of the radiation dose involved.

Management of technology in service firms

The many advantages of carbon dioxide (CO2) angiography in the investigation of renal arterial disease include an absence of both nephrotoxicity and allergic reactions. An automated delivery system facilitates injection of CO2 whilst ensuring that there is no contamination of the injection with air. We report our initial experience using a prospective study of this delivery system in 47 patients referred for renal angiography, and assess diagnostic image quality and adverse reactions to CO2 angiography using the automated delivery system. The majority (37/47; 79%) of angiograms were of diagnostic quality and there were no significant adverse reactions in response to the CO2 contrast agent.

Purpose – The purpose of the paper is to investigate the enhancement of resource sharing with a state-of-the-art transportation system in a large open distance learning (ODL) institution in South Africa. The University of South Africa (UNISA) is an ODL institution, and it has the largest academic library of its kind in Africa. The University is acknowledged as one of the mega-universities of the world with a student body approaching 400 000. In addition to providing an inter-lending service to this large student body and to 3,000 staff, the UNISA Library is a net-lender within South Africa’s inter-lending and resource sharing network. The Library’s inter-lending service forms part of the request services available to all its clients and to the wider community of participating libraries. Daily, an average of 2000 requests is received for processing, retrieval and delivery. This paper provides a brief overview of how the Library’s request service is managed and will discuss the technologies used to speed up the request process. It focuses on an automated radio frequency identification (RFID) transportation system to be implemented as part of the 21st century, newly redesigned UNISA Library. To ensure the speedy availability of material on the shelves after return, this system automatically transports materials via a Paternoster book lift to the respective levels within the Library. Design/methodology/approach – The methodology used in this investigation encompassed a literature study and a study visit to a library where this automated delivery system had been implemented and information was gained from relevant service suppliers. Findings – The UNISA Library found that it is feasible to use the system in terms of the large number of books to be transported from drop-off points to the respective levels. In accordance with the investigation of the number of trolleys to be pushed daily by staff from one point to another, the installation of an automated system will allow more time for shelf maintenance staff to attend to the processing of requests for material and other important but less urgent duties. This will impact positively on the speed of delivery of requests submitted by ODL clients who cannot visit the libraries together with those submitted by local and international inter-library loan partners who depend on the UNISA Library as a net-lender for material not available in their own collections. This will impact positively on availability of material on the shelves and the speed of delivery of requests for information resources submitted by ODL clients who cannot visit the ODL libraries and inter-library loan partners, nationally and internationally, who depend on the UNISA Library as a net-lender for material not available in their own collections. Originality/value – Because rapid delivery of requested information resources has become very important to ensure just in time information, it is important to implement an internal delivery system to support the inter-lending process. This study is useful for libraries that need to deliver many physical items to a large client body.

The rapid emergence of e-commerce in Vietnam has resulted in significant pressure on freight traffic and the environment, particularly in urban areas. Automated delivery stations (ADSs), also known as smart lockers or parcel lockers, offer a promising solution to improve the sustainability of last-mile delivery systems. However, the adoption of such a sustainable alternative by Vietnamese customers is inadequately understudied. This study primarily aims to investigate factors impacting Vietnamese customers’ acceptance of these automated delivery points. Utilizing structural equation modeling (SEM), a survey following convenience sampling was carried out in Vietnam to assess recent experiences at automated delivery stations. The results showed that innovativeness and location convenience positively influenced consumer intention to use ADS, while perceived time pressure had no impact on consumer intention to use automatic delivery systems. This study provides valuable insights to e-commerce companies to customize their services to match customer preferences, which will optimize last-mile delivery options and thereby promote sustainable practices.