Optimal Safety Research Articles

Demand Driven Material Requirements Planning: An Inventory Optimization Model

When dealing with stochastic multi-state production and distribution systems, determining the appropriate quantity of safety stocks on hand may be tricky. We often limit existing solutions for maximizing safety stock levels while keeping cost, objectives and service level constraints in mind to a subset of multi-stage inventory challenges, such as strictly serial architectures or specialist two-stage production/distribution systems. This may make achieving ideal stock levels while meeting cost objectives and sustaining service levels problematic. This is due to the underlying assumption in these systems that cost and service level are directly proportional to one another. Controlling unpredictability and satisfying customers are inventory management?s most important tasks. DDMRP (Demand-Driven Material Requirements Planning) dynamically adjusts inventories to handle unpredictability and improve customer service. This is done to improve crisis management. This achieves ?demand-driven material requirements planning.? This study presents a DDMRP-specific safety stock calculation. The inclusion of this formula aids in the preservation of mathematical consistency. When dealing with a model based on normal probability distributions, the major focus is discovering and applying the parts necessary for safety stock computation. One of the most well-known fast-moving consumer goods (FMCG) firms in South East Asia is the major focus of a case study to validate the proposed strategy. To build a scientific model, the study adopts a probabilistic strategy. The primary goal of this model is to aid in the process of identifying appropriate levels of safety stock and inventory at the distributor level, which will ultimately allow for a customer fill rate of 99%. A distribution network will be employed to achieve this purpose. The model provides a complete framework for estimating optimum safety stock levels and reorder points while accounting for the stochastic nature of demand and including critical elements. This enables more precise forecasting of future demand. This contributes to better inventory management practices and promotes customer satisfaction.. KEYWORDS :DDRMP, Demand level, Distribution network, Safety Stock Model.

Cost-optimization based target reliabilities for design of structures exposed to fire

Adequacy of structural fire design in uncommon structures is conceptually ensured through cost-benefit analysis where the future costs are balanced against the benefits of safety investment. Cost-benefit analyses, however, are complicated and computationally challenging, and hence impractical for application to individual projects. To address this issue, design guidance proposes target reliability indices for normal design conditions, but no target reliability indices are defined for structural fire design. We revisit the background of the cost-optimization based approach underlying normal design target reliability indices then we extend this approach for the case of fire design of structures. We also propose a modified objective function for cost-optimization which simplifies the evaluation of target reliability indices and reduces the number of assumptions. The optimum safety level is expressed as a function of a new dimensionless variable named “Damage-to-investment indicator” (DII). The cost optimization approach is validated for the target reliability indices for normal design condition. The method is then applied for evaluating DII and the associated optimum reliability indices for fire-exposed structures. Two case studies are presented: (i) a one-way loaded reinforced concrete slab and (ii) a steel column under axial loading. This study thus provides a framework for deriving optimum (target) reliability index for structural fire design which can support the development of rational provisions in codes and standards.

The Acceptance and Use of Digital Technologies for Self-Reporting Medication Safety Events After Care Transitions to Home in Patients With Cancer: Survey Study.

Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in adopting digital technologies and engaging in self-reporting medication safety events during transitions of care have not been fully understood. We aim to assess oncology patients' perceptions of medication and communication safety during care transitions and their willingness to use digital technologies for self-reporting medication safety events and to identify factors associated with their technology acceptance. A cross-sectional survey study was conducted with adult patients with breast, prostate, lung, or colorectal cancer (N=204) who had experienced care transitions from hospitals or clinics to home in the past 1 year. Surveys were conducted via phone, the internet, or email between December 2021 and August 2022. Participants' perceptions of medication and communication safety and perceived usefulness, ease of use, attitude toward use, and intention to use a technology system to report their medication safety events from home were assessed as outcomes. Potential personal, clinical, and psychosocial factors were analyzed for their associations with participants' technology acceptance through bivariate correlation analyses and multiple logistic regressions. Participants reported strong perceptions of medication and communication safety, positively correlated with medication self-management ability and patient activation. Although most participants perceived a medication safety self-reporting system as useful (158/204, 77.5%) and easy to use (157/204, 77%), had a positive attitude toward use (162/204, 79.4%), and were willing to use such a system (129/204, 63.2%), their technology acceptance was associated with their activation levels (odds ratio [OR] 1.83, 95% CI 1.12-2.98), their perceptions of communication safety (OR 1.64, 95% CI 1.08-2.47), and whether they could receive feedback after self-reporting (OR 3.27, 95% CI 1.37-7.78). In general, oncology patients were willing to use digital technologies to report their medication events after care transitions back home because of their high concerns regarding medication safety. As informed and activated patients are more likely to have the knowledge and capability to initiate and engage in self-reporting, developing a patient-centered reporting system to empower patients and their families and facilitate safety health communications will help oncology patients in addressing their medication safety concerns, meeting their care needs, and holding promise to improve the quality of cancer care.

Fire-Spread Characteristics and Evacuation Plan Optimization of Old Style Multi-Story Student Apartments

Fire is a major disaster event that can have a significant effect on public safety and social development. In a college or university, fire can seriously threaten the safety, lives, and property of those there due to the compact layout of apartment buildings and high population density. The ecological safety and sustainable development of buildings are also affected. In this study, PyroSim and Pathfinder software (version 2019) were used to simulate and analyze fire-spreading characteristics based on a multi-story university student apartment building. Additionally, the most effective safe evacuation plan from four fire evacuation drill schemes was identified by analyzing and comparing their performance. Results show that the spreading of fire smoke on different floors is significantly affected by the roof structure and the vertical and horizontal diffusion characteristics of smoke. While the smoke layer at the evacuation stairways has little effect on a safe evacuation, poor visibility due to smoke and ceiling temperatures has a significant effect. Safe evacuation becomes progressively more difficult at different floor levels from the top to the bottom of the building. The optimal safety scheme involves orderly evacuation through two open emergency exits. The number of emergency exits has a significant impact on the evacuation effectiveness. Measures and suggestions have been proposed to deal with apartment fires that address pre-event prevention, emergency loss reduction during the event, and post-event report-back. These proposals form an important theoretical reference for emergency evacuation and student apartment fire safety, providing important guidance for ecological safety protection of buildings and sustainable development.

Impact of Operational Configuration Onboard a Drillship on Main Generator Engine Subcomponents Interval and Maintenance Strategies

Maintenance intervals and approaches for marine equipment have been the subject of numerous studies, focusing on previous failure patterns and associated risks. However, in vessels like drillships, operating under high reliability requirements and possessing significant redundancy, maintenance strategies have a critical impact on overall performance. This study investigates the influence of operational configurations on maintenance intervals and approaches for generator engine subcomponents onboard a drillship. Using data on injector failures onboard drillships, we employ the maintenance concept adjustment and design (MA-CAD) method to analyse and determine maintenance intervals across various operational configurations. Initially, we analyse the failure pattern of fuel injectors and propose a reduction in maintenance intervals through Weibull probability distribution fitting. Additionally, a risk analysis is conducted to assess the impact of operational configurations on risk indices related to fuel injector reliability and safety consequences. Our findings reveal that different operational configurations of the power generation plant can lead to changes in risk indices, shifting injector reliability status from unacceptable to undesirable limits. Consequently, maintenance intervals need to be adjusted as well to ensure optimal performance and safety. Furthermore, considering various engine subcomponents and their reliability under different operational configurations suggests the need for tailored maintenance approaches. This research provides insights into optimising maintenance strategies for drillship, ensuring reliability and safety across diverse operational scenarios.

Anti-inflammatory, antioxidant, and immunomodulatory effects of Berberis vulgaris and its constituent berberine, experimental and clinical, a review.

Berberis vulgaris (B. vulgaris or barberry) is a medicinal plant that has been used for various purposes in traditional medicine. Berberine is one of the main alkaloids isolated from B. vulgaris and other plants. Both B. vulgaris and berberine have shown anti-inflammatory, antioxidant, and immunomodulatory effects in different experimental models and clinical trials. This review aims to summarize the current evidence on the mechanisms and applications of B. vulgaris and berberine in modulating inflammation, oxidative stress, and immune responses. The literature search was performed using PubMed, Scopus, and Google Scholar databases until August 2023. The results indicated that B. vulgaris and berberine could inhibit the production of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), interleukin 6 (IL-6), and interleukin-17 (IL-17), and enhance the expression of anti-inflammatory cytokines, such as interleukin 10 (IL-10) and transforming growth factor-β (TGF-β), in various cell types and tissues. B. vulgaris and berberine can also scavenge free radicals, increase antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx), and reduce lipid peroxidation and DNA damage. B. vulgaris and berberine have been reported to exert beneficial effects in several inflammatory, oxidative, and immune-related diseases, such as diabetes, obesity, cardiovascular diseases, neurodegenerative diseases, autoimmune diseases, allergic diseases, and infections. However, more studies are needed to elucidate the optimal doses, safety profiles, and potential interactions of B. vulgaris and berberine with other drugs or natural compounds.

Identification of Distribution Network Topology and Line Parameter Based on Smart Meter Measurements

Accurate line parameters are the basis for the optimal control and safety analysis of distribution networks. The lack of real-time monitoring equipment in grids has meant that data-driven identification methods have become the main tool to estimate line parameters. However, frequent network reconfigurations increase the uncertainty of distribution network topologies, creating challenges in the data-driven identification of line parameters. In this paper, a line parameter identification method compatible with an uncertain topology is proposed, which simplifies the model complexity of the joint identification of topology and line parameters by removing the unconnected branches through noise reduction. In order to improve the solving accuracy and efficiency of the identification model, a two-stage identification method is proposed. First, the initial values of the topology and line parameters are quickly obtained using a linear power flow model. Then, the identification results are modified iteratively based on the classical power flow model to achieve a more accurate estimation of the grid topology and line parameters. Finally, a simulation analysis based on IEEE 33- and 118-bus distribution systems demonstrated that the proposed method can effectively realize the estimation of topology and line parameters, and is robust with regard to both measurement errors and grid structures.

Spotlight on Leadership: What Nurse Leaders Need to Know About Artificial Intelligence.

Artificial intelligence (AI) is not a new concept. Since the 2022 release of a popular large language model, AI has become readily accessible to the general population, brought transformational shifts in healthcare, and created significant implications for nurse leaders. Specifically, AI has major indications in the area of evidence-based practice. Historically, new evidence takes years to reach the bedside. Nurse leaders are instrumental in closing the research-to-practice gap and, in doing so, promote optimal patient safety and care delivery methods. This article provides an overview of using AI in the context of nursing leadership in healthcare settings, including appropriate case use. In addition, this article covers the ethical challenges of using AI in clinical settings.

A Scoping Review: Is Yoga an Effective Intervention for Erectile Dysfunction and Premature Ejaculation?

There is increasing concern among both healthcare professionals and the general public about the long-term effectiveness and possible adverse effects of medicines used to treat premature ejaculation (PE) and erectile dysfunction (ED). There is also a growing recognition of the advantages of incorporating alternative or traditional approaches into healthcare systems. Yoga is gaining popularity globally and has emerged as a viable adjunct and alternative to add value to patient care and prevention of illnesses, which requires further investigation. This scoping review aimed to explore the effects of yoga as an independent or adjunct intervention in treating ED and PE. In this review study, researchers conducted a systematic literature review from 2000 to 2023 as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases of Scopus, Google Scholar, Web of Science, and PubMed were used for literature searches. Studies published in the English language on male individuals with ED and PE and those with comorbid stress, anxiety, and depression were also included. Studies on these sexual dysfunctions, comorbid with HIV/AIDS, and severe psychiatric conditions, i.e., schizophrenia, bipolar affective disorders, and substance dependence, except alcohol, were excluded. Ten studies out of the 2016 selected articles met the inclusion criteria and were included in the final analysis. The findings of this scoping review revealed that yoga interventions are more effective in managing PE and ED, with a greater emphasis on the former. Yoga is an effective, safe, and affordable approach recommended for managing erectile functions and PE. Men can improve their quality of life and regain confidence in sexual functioning by incorporating yoga into their routines. The study shows the potential benefits of yoga for both conditions, indicating the need for further robust studiesin this area. Researchers advocate practising yoga under professional supervision for optimal safety and guidance.

6-month Formulations of Androgen Deprivation Therapy for Advanced Prostate Cancer: Effectiveness and Rationale for Extended Dosing

Background: Luteinizing hormone-releasing hormone (LHRH) agonists and GnRH antagonists are the most widely used androgen deprivation therapy to achieve castration levels of serum testosterone (T). Adherence to dosing schedules is important to avoid treatment failure. A recent analysis found a high non-adherence rate of 84% for LHRH agonist injections based on dosing schedules used in pivotal trials. Method: Narrative review of LHRH therapy and evaluation of which offers optimal efficacy, safety, and practicality. Results: 6-month LHRH agonist formulations require fewer appointments for injections than shorter-acting formulations. Therefore, the frequency of late/missed doses and overall non-adherence may be reduced compared to options requiring frequent dosing (e.g., oral therapies and shorter-acting injections). This flexibility may be preferable for patients who live in multiple locations throughout the year, live long distances from clinics, and/or lack access to reliable transportation. 6-month formulations may also have cost benefits compared to shorter-acting doses. Despite similar levels of T suppression during the labeled dosing period, individual 6-month LHRH agonist formulations appear to have unique profiles, e.g., 6-month subcutaneous leuprolide acetate (LA) results in lower T escape rates compared to 6-month intramuscular LA, if dosing is late. Conclusion: The efficacy and practicality offered by 6-month LHRH formulations suggest these could reduce opportunities for late injections by requiring fewer office visits and provide greater confidence that efficacy will be maintained should there be extenuating circumstances leading to delays in therapy administration, as experienced during the recent pandemic.

Review of clinical pharmacokinetics and pharmacodynamics of clonidine as an adjunct to opioids in palliative care.

Clonidine is an α-adrenoceptor agonist acting on receptors in the brain and peripheral tissues, leading to a reduction in sympathetic outflow and release of certain neurotransmitters. Clonidine has multiple uses across various medical conditions. One of its uses is as adjuvant to anaesthetic and analgesic agents specially opioids, mostly administered through intravenous and epidural routes. The opioids, effective in cancer pain management, are associated with various side effects such as sedation, pruritus, constipation, nausea, respiratory depression, tolerance and dependence. Combination of clonidine with opioids seems to help to achieve better pain management and less need of opioids. Use of clonidine in palliative care has been less common, but it is gradually gaining recognition for its potential benefits in managing symptoms like cancer pain and agitation. This combination approach has been explored in palliative care settings, including cancer pain and agitation, where patients experience complex and refractory symptoms. It seems to be well tolerated and gives better symptom relief. The available literature on clonidine's use in cancer pain and agitation management, especially in subcutaneous form, is limited and outdated. Therefore, the optimal dosing, safety profile and overall effectiveness of subcutaneous clonidine requires further exploration through prospective research studies.

Whole-body galactose oxidation as a robust functional assay to assess the efficacy of gene-based therapies in a mouse model of Galactosemia

Despite the implementation of life-saving newborn screening programs and a galactose-restricted diet, many patients with Classic Galactosemia develop long-term debilitating neurological deficits and primary ovarian insufficiency. Previously, we showed that administration of human GALT mRNA predominantly expressed in the GalT gene-trapped mouse liver augmented the expression of hepatic GALT activity, which not only decreased galactose-1 phosphate (gal-1P) in the liver, but also peripheral tissues. Since each peripheral tissue requires distinct methods to examine the biomarker and/or GALT effect, this highlights the necessity for alternative strategies to evaluate the overall impact of therapies. In this study, we established that whole-body galactose oxidation (WBGO) as a robust, non-invasive, and specific method to assess the in vivo pharmacokinetic and pharmacodynamic parameters of two experimental gene-based therapies that aimed to restore GALT activity in a mouse model of Galactosemia. While our results illustrated the long-lasting efficacy of AAVrh10-mediated GALT gene transfer, we found that GALT mRNA therapy that target the liver predominantly is sufficient to sustain WBGO. The latter could have important implications in the design of novel targeted therapy to ensure optimal efficacy and safety.

Evaluating Adherence to Therapeutic Drug Monitoring Guidelines for Gentamicin in Neonatal Care: A Retrospective Study at the Maternity and Children's Hospital in Makkah.

In this study, we assess healthcare providers' adherence to therapeutic drug monitoring (TDM) guidelines for gentamicin in neonates. Conducted at the Maternity and Children's Hospital in Makkah, Saudi Arabia, from July 2020 to July 2022, it retrospectively analyzed the compliance of healthcare workers in managing neonates treated with gentamicin. Covering 410 neonates, primarily diagnosed with respiratory distress (56%) and sepsis (32%), the study revealed that while a majority of trough and peak levels conformed to guidelines, substantial deviations were noted in cases of respiratory distress. This underlines the necessity for targeted TDM strategies, particularly in managing respiratory distress in neonates, to ensure optimal treatment efficacy and safety. The findings urge stringent compliance with TDM guidelines, emphasizing personalized approaches in neonatal gentamicin therapy for improved healthcare outcomes.

TRIM56 protects against nonalcoholic fatty liver disease by promoting the degradation of fatty acid synthase.

Nonalcoholic fatty liver disease (NAFLD) encompasses a disease continuum from simple steatosis to nonalcoholic steatohepatitis (NASH). However, there are currently no approved pharmacotherapies for NAFLD, although several drugs are in advanced stages of clinical development. Because of the complex pathophysiology and heterogeneity of NAFLD, the identification of potential therapeutic targets is clinically important. Here, we demonstrated that tripartite motif 56 (TRIM56) protein abundance was markedly downregulated in the livers of individuals with NAFLD and of mice fed a high-fat diet. Hepatocyte-specific ablation of TRIM56 exacerbated the progression of NAFLD, while hepatic TRIM56 overexpression suppressed it. Integrative analyses of interactome and transcriptome profiling revealed a pivotal role of TRIM56 in lipid metabolism and identified the lipogenesis factor fatty acid synthase (FASN) as a direct binding partner of TRIM56. TRIM56 directly interacted with FASN and triggered its K48-linked ubiquitination-dependent degradation. Finally, using artificial intelligence-based virtual screening, we discovered an orally bioavailable small-molecule inhibitor of FASN (named FASstatin) that potentiates TRIM56-mediated FASN ubiquitination. Therapeutic administration of FASstatin improved NAFLD and NASH pathologies in mice with an optimal safety, tolerability, and pharmacokinetics profile. Our findings provide proof of concept that targeting the TRIM56/FASN axis in hepatocytes may offer potential therapeutic avenues to treat NAFLD.

Gut-targeted therapies for type 2 diabetes mellitus: A review.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin resistance. The global prevalence of T2DM has reached epidemic proportions, affecting approximately 463 million adults worldwide in 2019. Current treatments for T2DM include lifestyle modifications, oral antidiabetic agents, and insulin therapy. However, these therapies may carry side effects and fail to achieve optimal glycemic control in some patients. Therefore, there is a growing interest in the role of gut microbiota and more gut-targeted therapies in the management of T2DM. The gut microbiota, which refers to the community of microorganisms that inhabit the human gut, has been shown to play a crucial role in the regulation of glucose metabolism and insulin sensitivity. Alterations in gut microbiota composition and diversity have been observed in T2DM patients, with a reduction in beneficial bacteria and an increase in pathogenic bacteria. This dysbiosis may contribute to the pathogenesis of the disease by promoting inflammation and impairing gut barrier function. Several gut-targeted therapies have been developed to modulate the gut microbiota and improve glycemic control in T2DM. One potential approach is the use of probiotics, which are live microorganisms that confer health benefits to the host when administered in adequate amounts. Several randomized controlled trials have demonstrated that certain probiotics, such as Lactobacillus and Bifidobacterium species, can improve glycemic control and insulin sensitivity in T2DM patients. Mechanisms may include the production of short-chain fatty acids, the improvement of gut barrier function, and the reduction of inflammation. Another gut-targeted therapy is fecal microbiota transplantation (FMT), which involves the transfer of fecal material from a healthy donor to a recipient. FMT has been used successfully in the treatment of Clostridioides difficile infection and is now being investigated as a potential therapy for T2DM. A recent randomized controlled trial showed that FMT from lean donors improved glucose metabolism and insulin sensitivity in T2DM patients with obesity. However, FMT carries potential risks, including transmission of infectious agents and alterations in the recipient's gut microbiota that may be undesirable. In addition to probiotics and FMT, other gut-targeted therapies are being investigated for the management of T2DM, such as prebiotics, synbiotics, and postbiotics. Prebiotics are dietary fibers that promote the growth of beneficial gut bacteria, while synbiotics combine probiotics and prebiotics. Postbiotics refer to the metabolic products of probiotics that may have beneficial effects on the host. The NIH SPARC program, or the Stimulating Peripheral Activity to Relieve Conditions, is a research initiative aimed at developing new therapies for a variety of health conditions, including T2DM. The SPARC program focuses on using electrical stimulation to activate peripheral nerves and organs, in order to regulate glucose levels in the body. The goal of this approach is to develop targeted, non-invasive therapies that can help patients better manage their diabetes. One promising area of research within the SPARC program is the use of electrical stimulation to activate the vagus nerve, which plays an important role in regulating glucose metabolism. Studies have shown that vagus nerve stimulation can improve insulin sensitivity and lower blood glucose levels in patients with T2DM. Gut-targeted therapies, such as probiotics and FMT, have shown potential for improving glycemic control and insulin sensitivity in T2DM patients. However, further research is needed to determine the optimal dose, duration, and safety of these therapies.

The Risk of Hepatitis B Virus Reactivation in Rheumatoid Arthritis Patients Receiving Tocilizumab: A Systematic Review and Meta-Analysis.

Tocilizumab has demonstrated optimal efficacy and safety in patients with rheumatoid arthritis (RA) from clinical trials. However, the risk of hepatitis B virus reactivation (HBVr) in these patients remains uncertain because patients with underlying HBV have been excluded in phase III studies. Systematical reviews were conducted on PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to 21 February 2023. Random-effects meta-analysis was performed to calculate the pooled incidence of HBV reactivation. We included 0 clinical trials and 11 observational studies with a total of 25 HBsAg+ and 322 HBsAg-/anti-HBc+ RA patients. Among the HBsAg+ patients without antiviral prophylaxis, the pooled rate was 69.4% (95% CI, 32.9-91.3), with a median time of 4 months (range, 1-8 months) from tocilizumab initiated. Half of these patients with HBVr experienced hepatitis flare-up but no deaths. HBVr was eliminated with prophylaxis in this population. Among HBsAg-/anti-HBc+ patients, the pooled incidence of reactivation was 3.3% (95% CI, 1.6-6.7), with a median time of 10 months (range, 2-43 months) from tocilizumab initiated. HBVr was not associated with hepatitis flare-up and death. HBsAg-/anti-HBc+ patients without anti-HBs antibodies had a significantly higher risk of HBVr (Odds ratio, 12.20; 95% CI, 1.16-128.06). This systematic review indicated that the risk of HBVr in RA patients with anti-HBs-, HBsAg+, or HBsAg-/anti-HBc+ cannot be ignored but may be avoided. Clinicians should consider implementing appropriate antiviral prophylaxis and monitoring policies for RA patients to avoid unnecessary hepatic side effects from tocilizumab treatment.

A Hybrid Bearing Prognostic Method With Fault Diagnosis and Model Fusion

Accurate bearing fault diagnosis and prognosis (FDP) is critical for optimal maintenance schedules, safety and reliability. The existing methods face some problems and challenges in detecting the starting time for prognosis and using a single model to describe fault dynamics. With these motivations, this paper presents a hybrid bearing FDP framework with fault detection and automatic fault model selection. In the proposed approach, convolutional neural network is used to detect fault and select the appropriate fault dynamic model. To improve the performance, power spectrum of vibration signals are fused with operating conditions to built information maps for fault detection and model selection. After a fault is detected, a Bayesian method is triggered to estimate the fault state and predict the remaining useful life. In the prognosis, Dempster-Shafer theory is employed to fuse prediction results from different models if necessary. The proposed approach is verified with bearings under different operating conditions. Experimental results and comparison studies verify the high accuracy and efficiency of the proposed method.

Analysis of the Performance of Regional III Airport Authority Air Transport Inspector Personnel on Optimizing PT Minimum Service Standard Supervision. Wings Airlines

In order to achieve optimal aviation safety, security, and service, activities of control, supervision, and investigation are necessary by the Air Transport Inspector. Air transport services provided by Air Transport Companies to Scheduled Commercial Air Transport for Economy Class Passengers and domestic flights within the country. Passenger service standards cover aspects such as pre-flight service standards, in-flight service standards, and post-flight service standards. Pre-flight service standards include flight information, ticket reservations, ticket bookings, check-in processes, boarding procedures, handling of delays and flight cancellations, as well as the issuance of boarding passes. The number of inspectors available to conduct supervision is also a factor affecting the results of the Minimal Standard Inspection of these services. This research aims to identify factors that affect the optimization results of Air Transport Inspectors at Wings Air airline. This research method is descriptive with a qualitative approach, and data is collected through observation, interviews, and documentation. The research results indicate that one of the challenges in the supervision of Air Transport Inspectors for Wings Air airline is the insufficient number of Air Transport Inspector personnel, resulting in a lack of direct supervision of airline personnel in various sub-units of airline services.

Knowledge, attitude and practice (KAP) on food-drug interaction (FDI) among pharmacists working in government health facilities in Sabah, Malaysia.

Food-drug interaction (FDI) is prevalent in our day-to-day life. Widely recognised as drug expert, pharmacists are responsible to provide patient education, including on FDI, to ensure optimum safety and efficacy of treatment. Most pharmacists have knowledge and experience regarding FDI to certain extent. However, the level of knowledge, attitude and practice (KAP) towards FDI among pharmacists were yet to elucidated for many countries, including for Malaysia. This study aims to assess pharmacists' KAP on FDI, their inter-association, as well as association with sociodemographic characteristics in Sabah, Malaysia. A cross-sectional study was conducted from 1 to 31 May 2023, using online, self-administered Google Form questionnaire, involving 24 government hospitals and 113 government health clinics in Sabah. A total of 273 (or 35.5%) out of 768 pharmacists responded. Over two-third were female and serving government hospitals (79.6%). Mean score of KAP were 72.5 ± 14.3%, 93.2 ± 8.3% and 56.0 ± 16.7%, respectively, reflected good attitude but moderate knowledge and practice. Knowledge gaps identified include common medications such as paracetamol and metformin.Additionally, 28.2% respondents reported lack of FDI coverage during undergraduate, while merely 17.2% have received formal training on FDI after started working. Although 89.0% respondents agree that informing patients about possible FDIs is their responsibility, only 35.9% of the respondents usually or always practiced this. Such discrepancy maybe attributed to insufficient pharmacists' knowledge on FDI, where pharmacists with good level of knowledge have almost 2 times higher odd for good level of practice, compared to those with poor/moderate knowledge (odds ratio, OR: 1.92; 95% CI 1.02-3.61; p = 0.040) in this study. There are significant training gaps to be filled in. Pharmacist possessing good knowledge is a prerequisite for better pharmacy practice. Adequate education strategies covering FDI should be emphasised for all pharmacy undergraduates and practising pharmacists.

Prosthodontic Research in the Digital Era: Current Trends and Future Prospects

Prosthodontic Research in the Digital Era: Current Trends and Future Prospects