Average Car Research Articles

Analysis of Bank Financial Health During and After the COVID-19 Pandemic Using the Camel Method (Study at PT. Bank Rakyat Indonesia (Persero), tbk 2020-2023)

Analysis of Bank Financial Health During and After the COVID-19 Pandemic Using the CAMEL Method (Study at PT. Bank Rakyat Indonesia (Persero), Tbk). This study aims to determine whether PT. Bank Rakyat Indonesia (Persero), Tbk experiences differences in financial health as measured by CAMEL (Capital, Assets, Earnings and Liquidity) between during and after the COVID-19 pandemic. The method used in this analysis is the Descriptive Method with a Quantitative Approach. The data used are the Financial Reports of PT. Bank Rakyat Indonesia (Persero), Tbk for the period 2020 - 2023. and the data analysis technique uses the CAMEL Method. The results of the study show that CAMEL PT. Bank Rakyat Indonesia (Persero), Tbk During and After the COVID-19 Pandemic is declared healthy. Average CAR BRI During COVID-19 23.60% and CAR BRI After COVID-19 23.60%, Average KAP During COVID-19 1.76% and After COVID-19 1.96%, Average NPM During COVID-19 72.45% and After COVID-19 78.64%, Average ROA During COVID-19 2.82% and After COVID-19 3.93% and Average LDR During COVID-19 82.76% and After COVID-19 84.73%. Bank BRI was able to face the economic crisis during COVID-19 and was consistently able to maintain its financial performance well.

Health of Islamic Banks in Indonesia After the Covid-19 Pandemic: Financial Performance Analysis

Introduction: The Covid-19 pandemic has significantly impacted the global financial sector, including Indonesia. This study aims to analyze the health level of Islamic Commercial Banks after the Covid-19 pandemic in Indonesia using the NPF, ROA, and CAR Ratios from January 2020 to June 2024. Research Methods: The research method used is qualitative with a descriptive approach. Result: The study results show that the average NPF ratio of Islamic Commercial Banks in 2020-2024 was 2.44%, indicating that Islamic Commercial Banks are Healthy. The smaller the NPF, the healthier the bank. The average ROA ratio of Islamic Commercial Banks in 2020-2024 was 1.77%, indicating that Islamic Commercial Banks are in a very healthy condition. The greater the ROA, the healthier the bank. The average CAR ratio of Islamic Commercial Banks 2020-2024 of 24.91% shows that Islamic Commercial Banks are in a very healthy condition. The greater the CAR, the healthier the bank. Conclusion: From the study results above, it can be concluded that the health level of Islamic commercial banks in Indonesia after the Covid 19 pandemic is very well maintained. This confirms that Islamic banks in Indonesia have resilience in facing the economic crisis. This provides confidence for stakeholders to continue investing and participating in the Islamic financial ecosystem.

Collecting regional data for public health focusing on diet and sustainability measures using myfood24

There is no regular, routine measurement of food and nutrient intake undertaken regionally in the UK. This makes evaluation of local public health interventions challenging. Consumers want to be more sustainable in what they are eating. Social media penetration in the UK is 90%(1), with ∼47m people using Facebook, a potential route to study recruitment. Nutritional analysis software with accurate underpinning food composition and sustainability data could enable quick and easy large scale data collection. This study aimed to collect diet and sustainability measures using online tools and to test the feasibility of using social media to obtain a large, regionally focused sample in a short time.We undertook a rapid, time limited, regional (Yorkshire and Humber) food and nutrient tracking survey ‘One day: Diet in Yorkshire and Humber’ for use with policy makers(2). A Facebook (FB) boost approach was used to recruit a regional sample of adults. Participants completed a brief online demographic survey and used myfood24® to give a detailed measure of their food intake for the previous day. myfood24® generic and branded databases were used(3) which include sustainability metrics.The FB posts were boosted for 21 days and reached 76.9k individuals. Just under £1,000 was spent on 3 FB boosts and 1,428 participants completed the questionnaire. 673 participants also completed the one-day diet diary. Hull, Barnsley and Doncaster had the highest rates of overweight and obesity in the region. Overall nutrient values recorded were similar to national survey data for older women. Intakes of fibre (mean 18g, SD 11) and iron (mean 9.6mg, SD 5.0) were low. For the first time, measures of sustainability from the diet were calculated from myfood24®.The mean greenhouse gas emissions (GHGE) were 5.9(kg CO2 eq/day) (95% CI 5.6, 6.1); land use 9.0 (m2year/day) (95% CI 7.6, 10.3) and water use 582 (l/day) (95% CI 551, 611). Regression analysis showed that for each additional 100kcal consumed there was a significant increase in GHGE of 0.9 (kg CO2 eq/day) (95% CI 0.8, 1.1). Land and water use were also significantly increased with increasing energy intake. Adjusting for total energy, protein intake was positively associated with all 3 metrics. Carbohydrate was inversely associated with GHGE and land use. However, fat intake was not associated with any of the sustainability measures. Portions of fruit and vegetables consumed were positively associated with water use only.Diet is clearly linked to sustainability. The mean GHGE from diet is equivalent to driving an average car ∼22km/day. We successfully recruited a large sample in a short timeframe using FB. Participants were able to use online tools to report food intakes. This data is relevant to local and national policy makers to monitor and evaluate public health programmes.

Estimation of carbon emissions associated with tibial plateau levelling osteotomies in 10 dogs

ObjectiveTo describe a method of estimating the carbon emissions resulting from 10 clinical canine surgical procedures. Study designProspective observational cohort study. AnimalsA total of 10 adult client-owned dogs presenting to two private referral centres in the UK for tibial plateau levelling osteotomy (TPLO) using either isoflurane or sevoflurane for maintenance of anaesthesia. MethodsSingle-use consumables, pharmaceuticals and waste streams were recorded. Volatile anaesthetic use was calculated based on fresh gas flow (FGF) and vaporizer setting. Travel of owners and staff involved in the procedure was recorded (the latter adjusted by procedure length relative to working day). Energy use was calculated based on the clinics monthly usage adjusted for floor area of rooms used. Overnight hospitalisation, kennelling consumables and a revisit for postoperative radiography were excluded. Carbon accounting was performed using published carbon conversion factors (‘bottom-up analysis’) if available, or conversion factors based on cost (‘top-down’). Data are presented as median (range) and totals per emission category. ResultsCarbon emissions from all cases amounted to 667.2 kgCO2e. In these two clinics, median carbon emissions from a canine TPLO were 63.5 (47.6–93) kgCO2e, which is equivalent to driving 372 km (231 miles) in an average UK passenger car. Travel accounted for 30.1% of carbon emissions. Volatile anaesthetics accounted for 21.4% of carbon emissions, with other pharmaceuticals accounting for 24.0%. Consumables, building energy and waste disposal accounted for 19.7%, 3.9% and 0.9% of carbon emissions, respectively. Conclusions and clinical relevanceLikely carbon hotspots for canine orthopaedic procedures include travel and pharmaceuticals, particularly volatile anaesthetic agents. Carbon reductions should focus on reducing travel emissions, streamlining pharmaceutical use and lower-carbon anaesthetic techniques. Future research should focus on improving carbon accounting methodology and widening the range of cases assessed.

Greenhouse Gas Emissions Due to Unnecessary Antibiotic Prescriptions for Respiratory Diagnoses

Background: Healthcare accounts for 8.5% of total US greenhouse gas emissions (GHGE), with US healthcare the main contributor. Yet little effort has been made to measure healthcare related GHGE. Specifically, GHGE related to unnecessary antibiotic prescriptions is unclear, and to our knowledge, no one has used estimates of GHGE of unnecessary antibiotics as an antibiotic stewardship tool. We aimed to measure GHGE from solid waste associated with unnecessary antibiotic prescriptions for respiratory conditions. Methods: We calculated emissions for an outpatient prescription including the plastic bottle, paper leaflet, and paper bag (photos) based on the weight of each item multiplied by US Environmental Protection Agency (EPA) GHGE factors. Emission factors depend on waste type and treatment method which we assumed to be landfilled. To estimate unnecessary antibiotic prescriptions for respiratory infections, visits from nine University of Utah Health Urgent Care Centers from 2019-2022 were electronically identified and included if they had an ICD-10-CM code for a respiratory diagnosis where antibiotics are not indicated. Waste emissions of the paper and plastic in an individual prescription were then multiplied by the number of unnecessary respiratory antibiotic prescriptions for designated time periods to arrive at total landfilled waste emissions. We used similar methods applied to published 2014 data from CDC to estimate national waste emissions due to unnecessary antibiotic prescriptions for respiratory infections. Finally, we used the EPA’s GHG Equivalencies Calculator to convert emissions into tangible GHGE for providers and patients. Results: A prescription has 32g of paper and 15g of plastic waste. Among 124,461 urgent care visits (Table 1) in 2019-2022, 18,531 (14.9%) received an antibiotic. This equates to 593 kg of paper waste and 278 kg of plastic waste leading to a total landfilled waste emissions of 0.479 MT CO2e/ton. Using the EPA GHG Equivalencies Calculator, this equates to driving an average gasoline-powered car 1,228 miles. There were 14,482,976 unnecessary antibiotic prescriptions (Table 2) in the US for respiratory infections in 2014. Our estimates suggest these prescriptions led to 375.109 CO2e/ton of GHGE, the same as driving 961,610 miles by an average gasoline-powered vehicle. Conclusion: Unnecessary antibiotic prescriptions are associated with substantial GHGE. This estimate demands further evaluation across diagnoses and care delivery sites, and most importantly action. Additionally, the large GHG contribution of unnecessary antibiotics should be used as a stewardship tool to highlight low-value care that is likely contributing to global climate change.

Carbon Reduction Impact from Synchronising PrescriptionS (CRISPS): A pilot study

Abstract Introduction Synchronising the dates of patients’ repeat prescriptions can reduce monthly community pharmacy visits or home deliveries, which may improve patients’ adherence to medicines.[1] It should also reduce carbon dioxide (CO2) emissions associated with avoidable travel, but previous research does not appear to have determined the potential size of this reduction. This pilot study therefore attempted to do so using routinely collected data. Aim To estimate potential carbon savings from synchronising repeat medicines for a sample of patients from one community pharmacy. Methods All patients who had prescriptions dispensed four times per month or more from a single medium-sized (approximately 2,500 items dispensed per month) urban community pharmacy in England were identified from the pharmacy’s home delivery application. The threshold of four deliveries per month was selected to increase the likelihood of this frequency being due to asynchronised prescriptions. Data were collected (August 2023) for deliveries in June 2023 as there were no public holidays or events to affect prescription ordering. Data included patients’ postcode, delivery dates, and using the Patient Medication Record, the pharmacist collecting the data determined acute or one-off prescription items, that neither the patients nor the repeat medicines were new, and where deliveries were made to supply medicines owing. The pharmacy was selected because it efficiently managed stock to minimise items owing. The distance that would have been travelled was calculated as if the medicines had been collected from the pharmacy as a dedicated journey to and from the patient’s home address instead of being delivered. The saving in miles and CO2 emitted for different vehicle types was modelled by assuming that for each patient, all deliveries that were not for acute items or medicines owing could have been reduced to a single delivery if prescriptions had been synchronised. UK Government conversion factors were used to calculate CO2 emissions.[2] Results Data were collected for 59 patients, of whom 7 patients had 8 deliveries, 4 had 7 deliveries, 6 had 6 deliveries, 16 had 5 deliveries and 26 had 4 deliveries. The total number of deliveries to these patients was 269 but would have been 80 deliveries if the repeat prescriptions had been synchronised (70% reduction). The distance travelled would have been reduced from 842 miles to 241 miles (71% reduction). This would have resulted in a 71% reduction in CO2 emissions, although the reduction in volume in kilograms of CO2 emitted would have varied (by an estimated 137 Kg CO2 or 51%) depending on whether e.g., a small diesel car was used or a large petrol car (reduction of 133kg versus 270 kg CO2). An average diesel car was estimated to have reduced CO2 emissions by 163 kg. Conclusion The findings demonstrate that potential carbon savings from medicines synchronisation can be modelled from routinely collected data, but with limited accuracy, especially as patients receiving home deliveries may not be representative of all pharmacy users. Challenges remain in how to measure actual carbon savings of prescription synchronisation and overcoming barriers to widespread implementation of clinically appropriate synchronisation.

Climate footprint of industry-sponsored clinical research: an analysis of a phase-1 randomised clinical study and discussion of opportunities to reduce its impact

ObjectiveThis study aims to calculate the global warming potential, in carbon dioxide (CO2) equivalent emissions, from all in-scope activities involved in a phase-1 clinical study.DesignRetrospective analysis.Data sourceInternal data held by...

Komparasi Tingkat Kesehatan Bank Syariah dan Bank Konvensional dengan Pendekatan Resiko

This research aims to find out how the health level of Sharia Banks and Conventional Banks compares using the Risk-Based Bank Rating (RBBR) method. This research is quantitative research with comparative methods. This research data uses secondary data taken from the Bank Indonesia website. This research data analysis uses comparative quantitative statistics. The total sample is 10 banks consisting of 5 sharia banks and 5 conventional banks. The research results show that there is a significant (real) difference between the average value of credit risk in Islamic banks and conventional banks. There is no significant (real) difference between the average value of liquidity risk in Islamic banks and conventional banks. There is a significant (real) difference between the average ROA value for Islamic banks and conventional banks. There is no significant (real) difference between the average NIM value of Islamic banks and conventional banks. There is a significant (real) difference between the average CAR value for Islamic banks and conventional banks.

Analysis of the mechanism of side impact of cars

Problem. Globally, car crashes are the major cause of death, killing 1.2 million people, and despite improvements in car safety, forecasts indicate that car crash deaths will increase significantly by 2030 due to the increase in the number of cars. Such a trend requires an increase in passive safety in the design of cars. It is also necessary to consider with these factors the most popular segments of SUV cars, which during an accident create more dangerous consequences in the event of a side impact, taking into account the mass and dimensions parameters. Goal. The aim is to conduct an analysis of the side collision mechanism of cars of different mass and dimensional parameters. Taking into account the trends in the sale of cars, identifying the most popular classes of cars in Ukraine both on the new car market and on the second-hand market, to further identify problems in testing cars according to various certification protocols. Methodology. The approaches to solving the tasks used in the work are based on the use of statistical data and comparative analysis of various methodologies and certification protocols. Results. Considering that scientific studies of frontal impact are presented by the scientific community in the broadest form, the study of the side impact of two cars is currently a relevant direction, taking into account the global trend towards the production of cars in the SUV segment, which exceed passenger cars in terms of mass and dimensions. In a road accident with a side impact of a passenger car and an off-road vehicle of the SUV segment, we will get a large difference in the height of the primary impact, which is 250 millimeters. That is, all the energy of the impact to the side of the passenger car falls not on the safety bar, but 250 millimeters higher, which will inevitably lead to fatal injuries to the driver and passenger. Unfortunately, the European NCAP and the US National Highway Traffic Safety Administration use moving barriers that are similar in terms of mass and dimensions to an average passenger car. Originality. The obtained results of the analysis of the mechanism of the car side collision make it possible to evaluate the current trend of the automobile market in terms of passive safety and, in particular, to conduct certification tests for side impact in a new way. Practical value. The obtained results can be recommended when studying the structural features of preparing and conducting crash tests.

Design and Optimization of Flux Switching Motor for Electric Vehicle

This paper proposes the design process of an electric motor for electric vehicle (EV). In this process, considering the technical specifications of an average car, the features of the electric motor are calculated. Then, by calculating the main parameters of the electric motor and choosing some dimensions, the initial values for the optimization of the motor are provided. Optimization is done with the help of genetic algorithm to reduce the torque ripple and increase the torque density of the motor. To reduce the torque ripple, the combination of three torque reduction methods is applied to the rotor. To reduce the iron loss of the machine, simulation is done using oriented ferromagnetic laminations. Finally, the optimization results and its effect on the motor parameters are presented along with the efficiency and losses map of the motor.

Optimal replacement scenarios for an average petrol passenger car using life-cycle assessment

The reduction of the lifetime of vehicles, using scrappage schemes, has been identified as a transformation pathway in the target of reducing the environmental impacts of passenger transport. The energy-efficiency of manufacturing new automobiles needs to be measured in order to achieve environmental benefits when replacing old cars. Thus, the goal of the present study is to establish the environmentally optimal time in which to replace a petrol car, in five substitution scenarios that include a newer version of this car, a diesel car and an electric car. The average occupancy, annual mileage and the energy mix on the market for electricity were addressed in this approach. This research quantifies the GHG emissions from the selected vehicles, with the aim of determining the optimal number of years after which substitution should take place, by way of a novel contribution to the current literature. The results show that the base vehicle can be efficiently replaced after 8.88 years if an electric car is selected as the substitute. However, this period would decrease to 6.55 years if the new vehicle were powered with 100% renewable energy. Moreover, an environmentally optimal replacement could be made at 3.29 years, if the substitute were an electric car run with an average occupancy of 3 passengers and a 100% renewable energy mix. It was also demonstrated that the EURO 5 diesel car could be a replacement option for the base vehicle after 13.65 years, considering GWP impacts exclusively. By contrast, there are no environmental benefits related to diesel cars when considering PM2.5 emissions, hence they are not a feasible environmentally optimal substitution. This article concludes that the substitution could be up to 69.94% sooner if a cleaner energy mix is used to run the replacement car.

Self-removal of catheter after robot-assisted radical prostatectomy: a feasibility study.

Self-removal of urinary catheter as an option after robot-assisted radical prostatectomy (RARP) has never been explored in literature. We report the feasibility and outcome of the first study of this novel concept in our hospital. We conducted a prospective audit of self-TWOC (trial without catheter) in men who underwent consecutive RARP in our centre between April 2022 and September 2022. Men who had self-TWOC filled a questionnaire about the outcomes of self-TWOC. Carbon footprint and carbon offset for each hospital TWOC avoided were calculated. Of the 129 who underwent self-TWOC, 112 filled the questionnaire and were hence included in the final analysis. Self-TWOC was successful in all the 112 (100%) men in the study. 99.1% of men were satisfied with self-TWOC at home. We managed to avoid 79.6 ± 36.72km of travel and 77min of travel time for every self-TWOC. This also saved 85£/patient on clinic expenses and fuel cost savings of 9.87-15.99£ per patient depending on car engine size/type. The carbon footprint calculated was 20kg CO2 assuming average engine sized diesel/petrol cars and 10kg CO2 for an average UK petrol hybrid car. The calculated carbon offset per patient for diesel/petrol cars: 0.32£, petrol hybrid: 0.16£. Self-TWOC for 80-160 patients will save the carbon emissions equivalent to that of a passenger on a London-New York Trans-Atlantic flight. Self-TWOC is safe, affordable and is sustainable to the environment. Widespread acceptance of this practice change will be a small, but steady step towards greener health systems across the world.

Evolution of the brazilian passenger car from 2003 to 2018: technology, price, emissions, market, and policy

This study presents and discusses the evolution of the Brazilian fleet. It is studied the engine and vehicle characteristics (price, registration, engine capacity, maximum power, weight, length, and vehicle segment) from 2003 to 2018, and CO2 emission, urban and road fuel consumption from 2013 to 2018, highlighting changes and its possible reasons. In general, Brazilian cars became cheaper, heavier, and more powerful. Despite the increase in weight and power, the CO2 emission were always inside the government targets. Additionally, it is compared the Brazilian and European average car, and Brazilian cars were cheaper, lighter, shorter, less powerful, and less economical.

How do leveraged buyouts affect industry peers? Analysis of the information and the competition channels

AbstractOur paper provides a contribution to the literature on peer effects in leveraged buyouts and delivers an explanation for the seemingly contradicting findings in the existing literature. We find that the average peer announcement CAR amounts to −1.98%. A buyout may reveal private information about peer value and can also change in the competition within the buyout target industry. Our identification strategy to examine the information and competition channels relies on two quasi‐natural experiments, which generate exogenous variation in the information and competition environments. In addition, we analyze various mechanisms within these two channels by considering the cross‐section of peer CARs and by running additional tests. Our results support the revaluation and the competitive pressure hypotheses.

DS14 Same-day surgery promotes sustainability in dermatology

Abstract The healthcare sector is responsible for 4.4% of global greenhouse gas (GHG) emissions. To limit global temperature rise by 1.5 °C, as called for in the Paris Agreement, GHG emissions will need to be significantly reduced. As climate change has been labelled the greatest threat to global health in the twenty-first century, all healthcare professionals must attempt to promote sustainable practice where possible. The British Society of Dermatological Surgery sustainability guidelines published in 2022 advocate multiple strategies for improving sustainability in skin cancer surgery, including a reduction of activity via prevention measures, low-carbon alternatives, operational resource use and research and innovation. It is recommended that ‘see-and-treat clinics’ should be offered where staff and facilities are available, as one of several methods to lower the carbon footprint of dermatological surgery. We performed a cross-sectional study in a single tertiary dermatology department, focusing on carbon dioxide (CO2) emissions associated with travel to and from skin surgery appointments from 1 January 2022 to 31 December 2022. Our dermatology department is located in an urban area and also receives referrals from rural locations. The distance from the patient’s home to the hospital was calculated in kilometres using Google Maps. Total CO2 emissions were calculated using an online calculator recommended by the Environmental Protection Agency of Ireland and were reported in metric tonnes of CO2. Fuel consumption was based on the average car with unknown fuel. In total, 2358 procedures were performed on 2184 patients, 54% of whom were male (n = 1180). The total distance travelled by patients was 109 787.94 km, averaging 50.27 km per patient (range 1.3–168). This generated 18.74 metric tonnes of CO2 emissions. Eighteen per cent (n = 389) of patients underwent surgical procedures on the same day as their outpatient clinic. Same-day surgery led to a reduction of 35 275 km, averaging 90.68 km per patient (range 1.3–120). This represented a reduction of 6.02 metric tonnes of CO2 emissions. This is equivalent to the CO2 emitted from six transatlantic flights. In our department, absorbable sutures are used, where possible, to reduce unnecessary travel to our department or to a general practice for suture removal. Results for benign lesions are communicated via letter, to minimize return to the clinic. This study highlights the reduction in CO2 emissions associated with same-day dermatological surgery. The limitations of this study include an assumption of travel to and from hospital appointments by car and of travel from the address stated in patient records. Dermatologists should consider the environmental impact of skin surgery and implement sustainable options when service planning.

Analysis of the Performance of Rural Sharia Banks in Indonesia During the Covid-19 Pandemic

Covid-19 has a significant impact on the economy, including the Islamic financial industry in Indonesia. So, research on the performance of Islamic banks, including the performance of Islamic banks in Indonesia is very interesting to study. This study aims to determine the level of performance of BPRS in Indonesia during the Covid-19 pandemic in 2019-2021, based on OJK Circular Letter; SEOJK number 28/SEOJK.03/2019. This study uses qualitative descriptive methodology. The results of the study show that the average CAR ratio of BPRS in 2019-2021 is 23.46 percent, which indicates that BPRS is very healthy. The average NPF ratio of BPRS in 2019-2021 is 7.08 percent, which indicates that BPRS is healthy. And the average ROA ratio of BPRS in 2019-2021 is 2.11 percent, which indicates that BPRS is very healthy. Based on the above research results, the performance of BPRS in Indonesia during the Covid-19 pandemic was exceptional. This means that BPRS in Indonesia can continue to operate intact even under sluggish economic conditions. This shows that the performance of BPRS in Indonesia during the Covid-19 pandemic is in the healthy and stable category. This emphasizes that Islamic banks are resilient in the face of an economic crisis. Therefore, it is expected that bank management should always improve the performance of BPRS by paying attention to the capital aspect, asset quality aspect, income aspect, and liquidity aspect.

Specialised treatment of colorectal cancer in certified cancer centres: Do patients really have to travel further?

In Germany, many cancer patients are treated outside of cancer centres certified by the German Cancer Society (DKG) resulting in underuse of these facilities and inferior oncological treatment. One way to address this issue would be to restructure the healthcare landscape by following the Danish approach that limits cancer treatment to specialized hospitals. Such an approach would have an impact on the travelling times to treatment centers. The present study determines the impact on patient travel times using the example of colorectal cancer. For the present analysis, data from structured quality reports (sQB) and from patients insured with the AOK who underwent resection of the colon or rectum during 2018 were used. In addition, data from the DKG regarding an existing certification of a colorectal cance centre were used. Travel time was defined as the time patients spent in an average car with average traffic from the midpoint of the ZIP code of their residence to the coordinates of the hospital. The coordinates of the hospitals and the midpoints of the ZIP codes were obtained by querying the Google API. Travel times were calculated with a local Open Routing Machine server. The statistical programs R and Stata were used for analyses and cartographic representations. In 2018, nearly half of all patients with colon cancer were treated at the hospital nearest to their place of residence, of whom approximately 40% were treated at a certified colorectal cancer centre. Overall, only about 47% of all treatments took place at a certified colorectal cancer centre. Travel time to the chosen treatment site averaged 20 minutes. It was minimally shorter (18 minutes) if no certified centre was chosen and minimally longer (21 minutes) for those whose treatment took place in a certified colorectal cancer centre. Modeling of redistributions of all patients to certified centres resulted on an average travel time of 29 minutes. Even if treatment were limited to specialized hospitals, treatment close to home would still be guaranteed. Regardless of certification, parallel structures can be identified, especially in metropolitan areas, which indicate a potential for restructuring.

Automated radiosynthesis of [89Zr]Zr-DFOSq-Durvalumab for imaging of PD-L1 expressing tumours in vivo

Objectives89Zr-labelled proteins are gaining importance in clinical research in a variety of diseases. To date, no clinical study has been reported that utilizes an automated approach for radiosynthesis of 89Zr-labelled radiopharmaceuticals. We aim to develop an automated method for the clinical production of 89Zr-labelled proteins and apply this method to Durvalumab, a monoclonal antibody targeting PD-L1 immune-checkpoint protein. PD-L1 expression is poorly understood and can be up-regulated over the course of chemo- and radiotherapy treatment. The ImmunoPET multicentre study aims to examine the dynamics of PD-L1 expression via 89Zr-Durvalumab PET imaging before, during, and after chemoradiotherapy. The developed automated technique will enable reproducible clinical production of [89Zr]Zr-DFOSq-Durvalumab for this study at three different sites. MethodsConjugation of Durvalumab to H3DFOSqOEt was optimized for optimal chelator-to-antibody ratio. Automated radiolabelling of H3DFOSq-Durvalumab with zirconium-89 was optimized on the disposable cassette based iPHASE technologies MultiSyn radiosynthesizer using a modified cassette. Activity losses were tracked using a dose calibrator and minimized by optimizing fluid transfers, reaction buffer, antibody formulation additives and pH. The biological profile of the radiolabelled antibody was confirmed in vivo in PD-L1+ (HCC827) and PD-L1- (A549) murine xenografts. Clinical process validation and quality control were performed at three separate study sites to satisfy clinical release criteria. ResultsH3DFOSq-Durvalumab with an average CAR of 3.02 was obtained. Radiolabelling kinetics in succinate (20 mM, pH 6) were significantly faster when compared to HEPES (0.5 M, pH 7.2) with >90 % conversion observed after 15 min. Residual radioactivity in the 89Zr isotope vial was reduced from 24 % to 0.44 % ± 0.18 % (n = 7) and losses in the reactor vial were reduced from 36 % ± 6 % (n = 4) to 0.82 % ± 0.75 % (n = 4) by including a surfactant in the reaction and formulation buffers. Overall process yield was 75 % ± 6 % (n = 5) and process time was 40 min. Typically, 165 MBq of [89Zr]Zr-DFOSq-Durvalumab with an apparent specific activity of 315 MBq/mg ± 34 MBq/mg (EOS) was obtained in a volume of 3.0 mL. At end-of-synthesis (EOS), radiochemical purity and protein integrity were always >99 % and >96 %, respectively, and dropped to 98 % and 65 % after incubation in human serum for 7 days at 37 °C. Immunoreactive fraction in HEK293/PD-L1 cells was 83.3 ± 9.0 (EOS). Preclinical in vivo data at 144 h p.i. showed excellent SUVmax in PD-L1+ tumour (8.32 ± 0.59) with a tumour-background ratio of 17.17 ± 3.96. [89Zr]Zr-DFOSq-Durvalumab passed all clinical release criteria at each study site and was deemed suitable for administration in a multicentre imaging trial. ConclusionFully automated production of [89Zr]Zr-DFOSq-Durvalumab for clinical use was achieved with minimal exposure to the operator. The cassette-based approach allows for consecutive productions on the same day and offers an alternative to currently used manual protocols. The method should be broadly applicable to other proteins and has the potential for clinical impact considering the growing number of clinical trials investigating 89Zr-labelled antibodies.

Tropospheric formaldehyde levels infer ambient formaldehyde-induced brain diseases and global burden in China, 2013–2019

Although air pollutions cause human diseases, no epidemiological study has investigated the effect of exposure to air pollutants on brain diseases in the general population. Our objective was to examine the association between tropospheric airborne pollutants and human health risk and global burden, especially, attributable to indoor formaldehyde (FA) pollution in China. The data of tropospheric pollutants, such as: CO, NO, O3, PM2.5 or PM10, SO2, and FA in China, 2013–2019, which were derived from the database of satellite remote-sensing, were first calculated and then analyzed them according to satellite cloud pictures. The rate of prevalence, incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of the Chinese population was obtained from the Global Burden of Diseases (GBD 2010). A linear regression analysis was used to evaluate the relationship between tropospheric FA concentrations and GBD indexes of human brain diseases, the numbers of fire plot, the average summer temperature, population density and car sales in China from 2013 to 2019. Our results showed that the levels of tropospheric FA could reflect the degree of indoor air FA pollution on a nationwide scale in China; in particular, only tropospheric FA exhibited a positive correlation with the rates of both prevalence and YLDs in brain diseases including: Alzheimer's disease (AD) and brain cancer, but not in Parkinson's disease and depression. In particular, the spatial-temporal changes in tropospheric FA levels were consistent with the geographical distribution of FA exposure-induced AD and brain cancer in both sex old adults with age (60–89). In addition, summer average temperature, car sales and population density were positively correlated with tropospheric FA levels in China, 2013–2019. Hence, mapping of tropospheric pollutants could be used for air quality monitoring and health risk assessment.

Universal “Plug and Play” Real-Time Entire Automotive Exhaust Effluents, Industry Vents and Flue Gas Emissions Liquefiers: The Game Changer Approach-Phase Two Category

Universal “Plug and Play” Real-Time Entire Automotive Exhaust Effluents, Industry Vents and Flue Gas Emissions Liquefiers: The Game Changer Approach-Phase Two Category