Average Daily Volume Research Articles

Forecasting Daily Radiotherapy Patient Volumes in a Tertiary Hospital Using Autoregressive Integrated Moving Average (ARIMA) Models.

The purpose is to predict the volume of patients treated daily with radiotherapy using the autoregressive integrated moving average (ARIMA) model. In this retrospective study, data from the billing records detailing daily radiotherapy treatment sessions were extracted from the Hospital Information System and analyzed. The study included all patients treated from January 2004 to December 2022. The analysis was divided into two parts: First, the data were summarized using descriptive statistics. Second, time series forecasting with the implementation of an ARIMA model for estimating patient volumes. For the ARIMA modeling process, the Akaike Information Criterion (AIC) was used for classical model optimization. The Mean Absolute Percentage Error (MAPE) was used for evaluating between different models. Residual analysis was performed in each model using the Ljung-Box test, Jarque-Bera test, and heteroskedasticity test to identify autocorrelation, normal distribution, and variances that could undermine the reliability of the model. A total of 895,808 radiotherapy sessions were included in the study. The median number of radiotherapy sessions per day was 181 (150, 205). A clear transition to more modern radiotherapy equipment, particularly the Truebeam accelerator, was observed, indicating a growing dependency on advanced techniques such as volumetric-modulated arc therapy (VMAT), stereotactic body radiation therapy (SBRT), and stereotactic radiosurgery (SRS). The best ARIMA model predicted an increase in demand, projecting an average daily patient volume of 279.40 by 2030. The study highlights the need for advanced forecasting methodologies in healthcare resource planning and emphasizes the importance of considering environmental and external factors for effective and accurate resource allocation strategies.

Development and Application of a Chelating Acid for Water Injection Wells of Chang 6 Reservoir of An-Sai Oilfield

Abstract Ansai oilfield is a typical low permeability, low pressure, low yield and serious heterogeneity oilfield. Chang 6 play of Triassic YanChang Formation is a typical ultra-low permeability reservoir. The average porosity of the reservoir is 10 % ~ 14 %, and the average permeability is (0.2 ~ 4.0) × 10−3 μm2. The absolute content of clay minerals in the reservoir is relatively high, with an average content of 18.61 %. The main components are kaolinite, chlorite, illite and illite/montmorillonite interlayer. Due to the reservoir blockage caused by scaling, water sensitivity and formation particle migration in the process of water injection, high injection pressure and under injection wells is increasing dramatically. In view of the above challenges, a fit-for-purpose acid, which contains organic acids and chelating agents, was developed for injection pressure reduction and injection enhancement. It has the characteristics of strong dissolution, good retarding and corrosion inhibition performance. Corrosion rate is 0.5632 g / (m2·h) for J55 steel in 24h, and the core permeability increases by 74.57 % after acid flooding. It has been applied in field test of 3 wells in Chang 6 layer of Ansai oilfield since March 2024. The average daily injection volume increased by 37.87 %, and the validity period was more than 180 days.

Operative Efficiency in Military Total Joint Arthroplasty Is Superior at an External Resource Sharing Agreement Facility as Compared to a Military Treatment Facility.

Surgeries within the Military Health System (MHS) are often performed by military physicians at External Resource Sharing Agreement (ERSA) hospitals to offload the operative demand at Military Treatment Facilities (MTFs). These agreements allow physicians flexibility in selecting where to treat military service members and other TRICARE beneficiaries. However, there is a paucity of military orthopedic literature comparing ERSA hospitals and MTFs. The objective of this study is to compare operative volume, efficiency, and orthopedic resident operative experience between an ERSA hospital and an MTF in military arthroplasty. A retrospective chart review was conducted for all surgeries performed between October 1, 2022 and July 31, 2023 by three military arthroplasty-trained surgeons at an MTF and two associated ERSA hospitals (denoted as ERSA-A and ERSA-B). Details recorded include spinal time-out time, spinal end time, in-room time, case start time, case stop time, and out-of-room time. These were used to calculate the total time in room (out-of-room time minus in-room time), case time (case stop time minus case start time), extra time in room (total time in room minus case time), and time between cases (in-room time minus out-of-room time of previous case). Lastly, we compared the average daily case volume and operative time between the facilities. Only primary joint replacements with properly documented time stamps were included in the efficiency analysis. Continuous variables were assessed for normality by the Shapiro-Wilk test. Non-normal data are presented as the median and interquartile range (IQR) and were analyzed using the Mann-Whitney U test (for two group comparisons) or the Kruskal-Wallis test (three or more groups) with Dwass-Steel-Chritchlow-Fligner pairwise comparisons. The associations between categorical variables were analyzed using the chi-squared test. Significance was set to P < .05. Statistical analyses were performed using SAS version 9.4 (Statistical Analysis Software, Cary, NC, USA). This study was classified as exempt human subjects research by the authors' institutional review board. Average daily case volume was significantly higher at both ERSA-A (median of 3, IQR 2-4, P < .001) and ERSA-B (median of 2, IQR 2-3, P = .0075) compared to the MTF (median of 2, IQR 1-2). This translated to residents operating for a median of 270 minutes (IQR 170-398, n = 25 OR days) each operative day at ERSA-A compared to 234 minutes (IQR 131-304, n = 91 OR days) when at the MTF, which was not a significant difference (P = .21). Median case time was 26.5 minutes lower (P < .001), extra time in room was 5 minutes lower (P < .001), and time between cases was 67 minutes lower (P < .001) in the ERSA group as compared to the MTF group. Utilizing ERSAs can improve patient throughput and operative efficiency, which in turn enhances orthopedic resident operative experience. These findings suggest that the MHS should seek ways to improve operative efficiency at MTFs. Expanding ERSA contracts to reach a broader portion of TRICARE beneficiaries, including patients over 65 years of age and those with supplemental insurance, who are currently ineligible, should also be explored.

Analisa Kerusakan Jalan Akibat Beban Kendaraan di Gerbang Masuk Kota Jambi Paal 10 – Simpang 4 Paal 10 Kota Jambi

The Palembang - Jambi highway is a very busy route. Along the road at the entrance to Jambi City, Paal 10 - Simpang 4 Paal 10, Jambi City is passed by many vehicles because this road is one of the roads that is open to pass through heavy vehicles carrying loads. This is also one of the causes of rapid damage to flexible road pavement. The aim of this research is to determine the average daily traffic volume of vehicles passing through the asphalt pavement at the entrance gate of Jambi City, Paal 10 - intersection 4 Paal 10, Jambi City, to find out the effect of vehicle load on the level of road damage on the entrance gate of Jambi City. Paal 10 – Simpang 4 Paal 10 Jambi City. This research method uses guidelines from Bina Marga Pd T-14-2003. Average daily traffic data (LHR) on the entrance road to the city of Jambi Paal 10 – intersection 4 Paal 10 Jambi City on Saturday is 6,702 vehicles, on Sunday it is 6650 vehicles and on Monday it is 6719 vehicles. From this data, the total LHR from the vehicle analysis results is 1115 vehicles/hour. and the results of the Truck Factor calculation are 3.775 &gt; 1, where this value shows that the condition of the damage to the road at the entrance to the city of Jambi Paal 10 - intersection 4 Paal 10 Jambi city is due to the excessive load of vehicles passing through it. The excessive load factor that occurs causes 2 types of damage, namely groove distortion with a high level of damage and alligator cracks.

Empirical analysis of liquidity thresholds for crypto assets

This study applies the methodology of the SEC (2018) to empirically determine thresholds for liquidity of crypto assets, utilizing two metrics for assessing liquidity: the Average Daily Volume (ADV) calculated by the number of units of crypto assets traded (ADV#) and by the traded dollar amounts (ADV$). Our findings reveal that the liquidity distribution patterns for both actively and thinly traded National Market System (NMS) stocks, alongside crypto-USD pairs, exhibit comparable trends. Notably, the liquidity threshold distributions remain stable despite the inclusion of crypto assets with very low unit prices; however, the volume of units traded does affect the distribution when ADV$ is used. This research contributes to the accounting field by offering a new approach to determine liquidity benchmarks for crypto assets, potentially guiding the assessment of whether a crypto asset is traded in an active or inactive market for fair value accounting purposes.

Degradation modeling and remaining life prediction of multi-state long-life systems under random environmental influences

Abstract For large-scale systems such as bridges, which have long operating lifetimes, the operating states are usually categorized into multiple levels, and they are also subjected to various random environmental influences during operation. However, due to the significant granularity in the categorization of system states, it is difficult to assess the system state transitions influenced by random environmental factors, which compromises the accuracy of remaining life predictions. In this study, we focus on long-life systems with multiple states and investigate the degradation modeling and remaining life prediction considering the impact of random environmental factors. The system degradation process, based on the semi-Markov process and multi-state modeling, was decomposed into states using the sub-exponential approximation method. A state transition probability model considering exponential environmental influences was constructed. Furthermore, based on the developed model for calculating the distribution of sojourn times in multiple states, a reliability and remaining life prediction model for the system was derived. By taking the bridge deck as a case study, the verification and analysis of remaining life prediction for the bridge deck were conducted under the influences of average daily traffic volume and bridge age. The results indicate that both the average daily traffic volume and bridge age have a significant impact on the degradation of the bridge deck. The relative error of the predicted results considering the above effects falls within the range of 1.77%–12.18%.

Improving access to infusion services: Results of an operational sprint.

e13522 Background: As a large clinical academic cancer center growing from 40,772 unique patients in 2021 to 44,416 patients in 2022, access for patients to begin therapy in the infusion suite was delayed by 3.2 days. In addition to delays in care the center experienced decreased patient satisfaction related to timeliness of scheduling and an inflexible scheduling template that did not allow for the maximization of chair assets. An infusion sprint was launched to address the challenges with the main goal of providing a seamless patient experience while ensuring that all 60 chair assets were maximally utilized. The multi-disciplinary team sought to accomplish this through a disciplined evaluation and intervention program with the goals of increasing access, improving patient satisfaction and growing operating income. Methods: In February 2022, a multi-disciplinary team was assembled to develop and implement a plan to increase access to the infusion suite over a period of 6 months. The team utilized LEAN-Six Sigma principles to characterize current state, desired future state and tactical interventions with metrics. Access data, available infusion appointments and activities occurring in chairs were analyzed with the goal of maximizing utilization. This was accomplished through the development of an active asset management methodology that compared available infusion appointment hours in the schedule to the actual completed hours which allowed the center to determine the growth opportunity within the current chair count. Financial performance was reviewed, and a pilot of an AI-based scheduling platform was launched. Results: Data collected in December 2022 showed that the pilot increased average daily chemotherapy infusion patient volume by 10% and overall volume by 11% over prior fiscal year from October 2021 to September 2022. Daily scheduling escalations manually resolved by leadership decreased 54% between May 2022 and September 2022. Newly created chair utilization methodology showed increased utilization from 62% to 82% in 7 months and patient satisfaction increased from 76.97% to 81.18% for “Timeliness of Scheduling.” These initiatives also resulted in an 18% increase in infusion/pharmacy income from operations from October 2021 to September 2022. All of this was accomplished without adding staff to the workforce or chairs to the infusion suite. Conclusions: A focused, intentional, multi-disciplinary infusion sprint conducted over 6 months resulted in increases of patient access, increased patient satisfaction and revenue. External validity is limited by its one site design with future investigation planned at other sites within the cancer care network to determine if results can be reproduced.

The effects of COVID-19 restrictions on portuguese marine small-scale fisheries: A regional analysis

There is growing evidence of the differential effects the COVID-19 pandemic had on small-scale fisheries across the world, with predominantly decreased landings during the time of restrictions and substantial negative socio-economic impact. We contribute to this evidence with an analysis of a comprehensive dataset of 5 million first sales of seafood transactions by 3715 small-scale fishers catching 351 species in Portugal from 2017 to the end of 2020. The analysis shows that the patterns observed in other countries, overall, apply to Portugal, with a decline in reported catch and number of fishers during the lockdown. However, there were notable regional differences. Most interestingly, two regions with historically very high tourism activity recorded a statistically significant increase in reported average daily catch volume per fishing operator during the lockdown, often for high-value species. We discuss these regional differences and potential explanations, as well as their policy implications.

Rural Hospitals Experienced More Patient Volume Variability Than Urban Hospitals During The COVID-19 Pandemic, 2020-21.

Fluctuations in patient volume during the COVID-19 pandemic may have been particularly concerning for rural hospitals. We examined hospital discharge data from the Healthcare Cost and Utilization Project State Inpatient Databases to compare data from the COVID-19 pandemic period (March 8, 2020-December 31, 2021) with data from the prepandemic period (January 1, 2017-March 7, 2020). Changes in average daily medical volume at rural hospitals showed a dose-response relationship with community COVID-19 burden, ranging from a 13.2percent decrease in patient volume in periods of low transmission to a 16.5percent increase in volume in periods of high transmission. Overall, about 35percent of rural hospitals experienced fluctuations exceeding 20percent (in either direction) in average daily total volume, in contrast to only 13percent of urban hospitals experiencing similar magnitudes of changes. Rural hospitals with a large change in average daily volume were more likely to be smaller, government-owned, and critical access hospitals and to have significantly lower operating margins. Our findings suggest that rural hospitals may have been more vulnerable operationally and financially to volume shifts during the pandemic, which warrants attention because of the potential impact on these hospitals' long-term sustainability.

The Performance Analysis of a Novel Sterilizable Trombe Wall Based on the Combined Effect of Heat and UV Light

A Trombe wall is a widely applied heating system that has a single function. An interesting thing is that both the solar heat and UV light received by a Trombe wall have an air sterilization effect. Here, the air sterilization and thermal performances of a Trombe wall in different cities were investigated based on an established heat and mass transfer model. The main results were as follows: (1) UV dose accumulation and high temperature were the most important factors that affect the UV and thermal sterilization performance, respectively. The Trombe wall had the thermal characteristics of high accumulation of UV doses in the morning and afternoon and a high temperature level at noon, which was a good match with the UV and thermal sterilization process. (2) A typical sterilization process in a Trombe wall was divided into three areas: the UV inactivation area, UV and thermal inactivation area and UV inactivation area. (3) The weather conditions played an important role in the sterilization performance. UV sterilization was dominant in cloudy weather, and thermal sterilization was dominant in sunny weather. (4) In Nanjing, Shanghai, Xining and Guangzhou, the average daily clean air volumes in heating months were 39.4, 33.5, 32.2 and 39.8 m3/m2, respectively. (5) When the wall height increased from 1.5 m to 3.5 m, the average daily clean air volume in heating months increased from 31.7 to 43.6 m3/m2.

Elaboración de un plan de gestión de residuos sólidos para el distrito de Lobitos, Talara

This research focuses on the presentation of a Solid Waste Management Plan for the district of Lobitos, located in Talara - Piura. The main objectives included carrying out a analysis to evaluate the how things stand locally, characterizing daily household garbage in qualitatively terms and quantitatively too (separated at the source), and developing an appropriate alternative management plan. The study was held out in July 2021, covering a total of 69 houses along 8 consecutive days.The results exposed an average of 1 ton of waste per day, with a breakdown of 39% organic waste, 19% unusable waste, 9% plastics, 9% metals, 9% paper and cardboard, 8% hazardous waste (including fishing nets) and, finally, 7% glass. The average daily volume generated was 4,4 m3, with an average density of 31,624 kg/m3.Based on these results and a survey conducted among public cleaning personnel, insufficiencies were recognized that served as a basis for the formulation of action strategies. These strategies are intended to guide the optimization of waste handling in the area, seeking to improve efficiency and sustainability in waste treatment.

Lung Protective Ventilation during Pregnancy: An Observational Cohort Study.

Objectives We sought to describe characteristics of mechanically ventilated pregnant patients, evaluate utilization of low-tidal-volume ventilation (LTVV) and high-tidal-volume ventilation (HTVV) by trimester, and describe maternal and fetal outcomes by ventilation strategy. Study Design This is a retrospective cohort study of pregnant women with mechanical ventilation for greater than 24 hours between July 2012 and August 2020 at a tertiary care academic medical center. We defined LTVV as average daily tidal volume 8 mL/kg of less of predicted body weight, and HTVV as greater than 8 mL/kg. We examined demographic characteristics, maternal and fetal characteristics, and outcomes by ventilation strategy. Results We identified 52 ventilated pregnant women, 43 had LTVV, and 9 had HTVV. Acute respiratory distress syndrome occurred in 73% ( N = 38) of patients, and infection was a common indication for ventilation ( N = 33, 63%). Patients had LTVV more often than HTVV in all trimesters. Obstetric complications occurred frequently, 21% ( N = 11) experienced preeclampsia or eclampsia, and among 43 patients with available delivery data, 60% delivered preterm ( N = 26) and 16% had fetal demise ( N = 7). Conclusion LTVV was utilized more often than HTVV among pregnant women in all trimesters. There was a high prevalence of maternal and fetal morbidity and fetal mortality among our cohort. Key Points Our center utilized low tidal more often than high-tidal-volume ventilation during all trimesters of pregnancy.Prone positioning can be performed at advanced gestations.Infection is a common cause of antepartum ventilation.

Analysis of the Impact of Hydraulic Gates on a Stabilized Tidal Inlet Structure: Mathematical Model and Data Measurements

Tidal inlet structures are engineering projects with associated benefits related to flood control, water quality enhancement, and coastal protection. This study analyzes the performance of hydraulic gates on a stabilized inlet in estuarine systems by developing a simplified hydraulic model that considers inlet and outlet water levels. The proposed model was applied to the stabilized tidal inlet structure in Cartagena de Indias, Colombia. This model offers a practical tool for engineers and designers operating estuarine systems. The analysis focuses on the coastal lagoon of Ciénaga de la Virgen. The proposed model was successfully calibrated using two water sensors, with extreme input and outlet flow rates of approximately 260 m3/s and 110 m3/s, respectively. The average daily output volume in the system is 3,361,000 m3, while the average daily input volume is 3,200,000 m3. Consequently, the manipulation of the opening gates results in a decrease in the estuarine water level, potentially by as much as 25 cm, which local authorities can use to make decisions to reduce extreme water levels during flooding events.

Adsorption of ciprofloxacin from aqueous solution and fresh synthetic urine by graphene oxide: Conventional and statistical physics modeling approaches

This work uses conventional and statistical physics modeling approaches to address ciprofloxacin (CIP) adsorption by graphene oxide (GO) from aqueous solution and fresh synthetic urine. Instrumental techniques such as FTIR, XRD, SEM, TGA, BET, and EDS were employed to characterize the adsorbent material. The adsorption experiments were performed in a typical batch using different initial concentrations of CIP, adsorbent dosage, pH, and temperatures. Besides, the statistical physics approach was employed to investigate the CIP adsorption onto GO. Five models based on mono, double, and multilayers were used to describe the equilibrium isotherms. Steric and energetic parameters such as the number of adsorbed molecules per site, receptor site density, and half-saturation were considered. The kinetic data were adjusted using three conventional models (pseudo 1st order, pseudo 2nd order, and general order). The pH effect and influence of adsorbent dosage on adsorption performance were also investigated and discussed. In addition, adsorption mechanisms hypotheses were proposed based on experimental data and adsorption modeling using a statistical physics approach. Furthermore, the current work reports the removal of CIP at concentrations commonly found in urine considering factors such as fraction excreted in unmetabolized form, daily defined dose, and average daily urine volume excreted. The adsorption capacity values in aqueous medium and fresh synthetic urine were were 354.24 and 291.39 mg g−1, respectively.

Construction and Research of Water Reuse System in Green Intelligent Buildings

This paper discusses the construction and research of water reuse system in green intelligent buildings to improve the efficiency of water resources utilization and promote the sustainable development of the construction industry, which is of great significance for environmental protection and energy saving. In this paper, the design principles, technical parameters and costs of the water reuse system are considered comprehensively. The social and economic benefits are explored through empirical analysis of water reuse systems in different types of buildings. The COD concentration of treated water in the middle water is reduced to below 50mg/L, and the SS concentration is stabilized between 8 ∼ 10mg/L, which is in line with the standard. The actual scale of water production is significant, with an average daily treatment volume of 2548.8816m3 for the university water project, and 28.4478m3 and 431.625m3 for the residential neighborhood and public building, respectively. The average value of the whole life cycle cost prediction is about 39,767,335,000 yuan, and the payback period is 9 years. This study demonstrates the effectiveness and economic feasibility of the water reuse system for green intelligent buildings, which is important for improving water utilization efficiency and environmental sustainability in the construction industry.

Iatrogenic blood loss from phlebotomy during adult extracorporeal membrane oxygenation: A retrospective cohort study.

Adult extracorporeal membrane oxygenation (ECMO) patients are at high risk for allogeneic blood transfusion. Few studies have characterized iatrogenic blood loss from phlebotomy in adult ECMO patients. We hypothesized that iatrogenic phlebotomy would be a significant source of blood loss during ECMO. Adults who had their entire ECMO run at our medical center between 2020 and 2022 were included. Average daily phlebotomy volume and total phlebotomy volume during ECMO were estimated based on the total number of laboratory tests that were processed. In addition, the crude and adjusted association between total phlebotomy volume during ECMO and RBC transfusion during ECMO was evaluated using linear regression and Loess curve analysis. A total of 161 patients who underwent 162 ECMO runs were included. Of the 162 ECMO runs, 88 (54.3%) were veno-arterial and 74 (45.7%) were veno-venous ECMO. Median duration of ECMO was 5 days [25th, 75th percentile = 2, 11]. Median daily phlebotomy volume was 130 mLs [25th, 75th percentile = 94, 170] and median total phlebotomy volume during ECMO was 579 mLs [25th, 75th percentile = 238, 1314]. There was a significant crude and adjusted association between total phlebotomy volume and RBC transfusion during ECMO (beta coefficient = 0.0023 and 0.0024 respectively, both p < .001) based on linear regression analysis. Phlebotomy for laboratory testing is a significant source of blood loss during ECMO in adults. Comprehensive patient blood management for adult ECMO patients should include strategies to reduce laboratory testing and/or phlebotomy volume during ECMO.

Condition Rating Prediction for Highway Bridge Based on Elman Neural Networks and Markov Chains

Bridges are a critical component of transportation infrastructure, playing a vital role in connectivity. The safe operation of bridges demands significant resource and capital investment, particularly as the operation phase is the most extended period in a bridge’s life cycle. Therefore, the efficient allocation of resources and funds is crucial for the maintenance and repair of bridges. This study addresses the need to predict changes in bridge condition over time. The commonly used state-based Markov chain method for bridge condition rating prediction is straightforward but limited by its assumptions of homogeneity and memorylessness. To improve upon this, we propose a novel method that integrates an Elman neural network with a Markov chain to predict the bridge condition rating. Initially, the ReliefF algorithm conducts a sensitivity analysis on bridge features to obtain the importance ranking of these features that affect the bridge condition. Next, six significant features are selected for data classification: bridge age, average daily truck traffic volume, material type, skew angle between bridges and roads, bridge deck structure type, and bridge type. The Elman neural network is then trained to train a prediction model for bridge condition ratings using the classified data, which can predict the condition levels of bridges. The Markov chain’s transition probability matrix is derived using a genetic algorithm to match the deterioration curve predicted by the Elman neural network. This proposed method, when applied to actual bridge data, demonstrates its effectiveness as evidenced by the condition rating of an actual bridge.

Vegetable Price and Supply Forecast based on the Taboo Search Slgorithm

Vegetables, as an indispensable consumer goods in the daily life of consumers, their price and supply have a great impact on the sellers, urban and rural residents and the whole country. In this paper, the sales flow and loss of 251 vegetables in a supermarket within three years are selected as the test data. On the basis of the analysis of the historical sales volume, price and loss data of vegetables, the vegetable price and supply prediction model based on the taboo search algorithm is put forward from the perspective of sellers. First of all, according to the recent sales data, the average daily average sales volume of various single products is obtained, and the varieties that meet the display demand are determined as available varieties, and 36 available varieties are obtained. Further use of 0-1 planning to determine 27-33 available varieties. The linear regression was used to analyze the relationship between the price of each item and obtain the linear regression equation. Significance analysis of the equations showed a high degree of fit. Finally, with the benefit as the objective function, the optimization model is established combined with the above constraints and solved using the taboo search method. The results of the model solution show that under the constraints, the maximum revenue of July 1 is 1787.61 yuan, and the replenishment quantity and pricing of 28 single products sold at this time can be obtained. Finally, the reliability of the model was further tested by using the time-series prediction. This paper can not only effectively predict the price and sales volume of vegetables, but also formulate reasonable vegetable replenishment and pricing strategies for the sellers, but also has important guiding significance for the sales of other commodities.

Research on Vegetable Pricing and Replenishment Strategy Based on TOPSIS Method and Simulated Annealing Algorithm

By mining the relationship between categories and individual products, this paper puts forward enterprise replenishment and pricing strategies under different conditions. First of all, from the 49 kinds of vegetables sold, the TOPSIS method based on entropy weight is used to select the top 20 important items by taking the market demand and excess income as the first-level index, and taking the historical sales rate, average daily sales volume, variance of sales volume, vegetable loss rate and unit profit as the second-level index. Then, based on the concept of complementary and alternative goods, through the Spearman correlation coefficient, and using the weighted correlation coefficient method, select the top 9 items, such as ginger, garlic, millet pepper combination and so on. Using these selected items, taking the profit maximization of fresh merchants as the objective function and the demand of each category as constraints, a 0-1 integer nonlinear programming model is established. Then, the simulated annealing algorithm is used to simulate the planning for 1000000 times, and the pricing strategy and supply plan of the enterprise on July 1st are obtained, and the maximum profit on that day is 2098.17 yuan.

Factors Associated with the Implementation of Pediatric Immunization Services: A Survey of Community Pharmacies.

Pharmacists are well-positioned to help increase pediatric immunization rates. This study assessed the types of pediatric vaccines offered in community pharmacies, compared participant/pharmacy characteristics and participants' perceptions of barriers and pharmacists' role in providing pediatric immunizations between pharmacy-based providers and non-providers, and assessed factors associated with pharmacy-based pediatric immunization provision. A cross-sectional survey was sent to Alabama community pharmacies from February to April 2023, of which 240 responded (20.5% response rate). Measures included whether they offered childhood vaccines in 2022 and the types of vaccines administered, participants' perceptions of pharmacists' role in pediatric immunization, and perceived barriers to providing pharmacy-based pediatric immunizations. Roughly half of pharmacies (50.8%) provided pediatric immunization services with influenza vaccines (91.0%) the most commonly provided vaccines and poliovirus-inactivated vaccines (4.9%) the least. Pharmacies providing pediatric immunization services significantly differed from non-providers. That is, the majority of providers practiced within a grocery or retail store; they were younger and practiced in a pharmacy with higher average daily prescription volume and a higher average pharmacy practice full-time equivalent; and they perceived lower implementation logistics barriers and a lower role of pharmacists regarding pediatric immunization. Multivariable logistic regression analysis indicated that implementation logistics is significantly associated with pharmacies offering pediatric immunization services after controlling for pharmacy/participant characteristics (p = 0.01). Therefore, ameliorating implementation logistics barriers should be considered when devising strategies to promote pediatric immunization services in community pharmacies.