PM Strategy Research Articles

A survey of experts on personalized medicine landscape in European Union and China

IntroductionPersonalized Medicine (PM) is one of the main priorities of the research agenda of the European Commission and the focus of the European Coordination and Support Action titled “Integrating China into the International Consortium for Personalized Medicine” (IC2PerMed). Similar to the European focus, PM is a current priority of the Chinese Government, through dedicated policies and its five-year investment plans. In the context of IC2PerMed, we implemented a survey to understand the state of the art of the implementation of PM related policies in EU and China, and to identify opportunities for future Sino-European collaborations.MethodsThe survey was elaborated by the IC2PerMed consortium and validated by a focus group of experts. The final version, in English and Chinese, was administered online to a pool of accurately selected experts. Participation was anonymous and voluntary. The survey consists of 19 questions in 3 sections: (1) personal information; (2) policy in PM; (3) facilitating and hindering factors for Sino-European collaboration in PM.ResultsForty-seven experts completed the survey, 27 from Europe and 20 from China. Only four participants were aware of the implementation of PM-related policies in their working country. Expert reported that PM areas with greatest policy impact so far were: Big Data and digital solutions; citizen and patient literacy; and translational research. The main obstacles found were the lack of shared investment strategies and the limited application of scientific developments in clinical practice. Aligning European and Chinese efforts, finding common ground across cultural, social, and language barriers, were considered as actions needed to enhance efforts in applying PM strategies internationally.ConclusionTo achieve efficiency and sustainability of health systems, it remains crucial to transform PM into an opportunity for all citizens and patients with the commitment of all the stakeholders involved. The results obtained aim to help define common research and development approaches, standards and priorities and increase collaboration at international level, as well as provide key solutions to enable convergence towards a common PM research, innovation, development and implementation approach between Europe and China.

Lifestyle and Health promotional Guidelines in Irritable Bowel Syndrome Patients from the Viewpoint of Persian Medicine

Introduction: Irritable Bowel Syndrome (IBS) is a chronic disorder. Considering its unknown etiology, the aim of IBS treatment is to control symptoms, and most patients are dissatisfied with current treatments. The World Health Organization (WHO) has emphasized, in its latest announcement in this regard, on the safe and effective use of traditional and complementary medicine in the health structures of countries The aim of the present study was to investigate the lifestyle of IBS patients from the perspective of Persian Medicine. Methods: This is a library study. At first symptoms of IBS were first studied in databases and reference books of classical medicine and their Persian equivalents were extracted from PM sources. Then, we explained the total etiologies that were discussed for the occurrence of the causes, with respect to the principles of health care in PM. finally collected information was categorized and analyzed. Results: Iranian physicians have presented their views on health preservation and disease prevention in the form of the six core principles. The influence of diet and lifestyle, sleep disturbances, eating habits, and physical activity have been found to be effective in causing this disease. Discussion: Many of the guidelines given by PM for preservation and restoration of health are incorporated into lifestylerelated topics. Some of these recommendations and guidelines such as sleep, exercise, regular meals, and treatment of mental disorders have been supported with a number of new studies. Conclusion: Introducing PM strategies to control the symptoms or treatment of IBS may provide researchers with new clues.

Maintenance Operations and its Management in Oil Industry in Kuwait

The maintenance in oil area need to undertake entire shutdowns together with generic refinery turn-around, unit shutdowns on a full accountability foundation and Scaffolding services. The in-house equipment and equipment: the in-house Maintenance workshop facility ought to be completely outfitted with lathe machines, shaping machine, hole spindle lathe machine, horizontal boring machine, radial drilling machine, pipe threading machine, valve lapping machine, mechanical seal lapping machine, welding computing device and all sorts of specialized warmness exchanger re-tubing gear and tools. Maintenance operations in this zone face many troubles in management, price and technical problems. This study aims to study the and count the failures occurred in equipments of Kuwait Oil Company (KOC) in 2019, and study the maintenance strategies used in petroleum industry in the Kuwait state, a maintenance programs or steps will be suggested and investigated in order to improve the maintenance operations. Availability of devices are calculated depending on downtime of the devices at KOC. The data were collected about failures frequency occurred for the KOC company equipments. Most of oil equipments have good availability but in the case of KOC four devices have availability less than 90% which means more failure and downtime, the company adopted a Zero S/D PM Strategy or Philosophy which decreasing failures by 75% and improve the availability of KOC devices. Planning and management of maintenance and monitoring operations in any company decreasing failure frequency of equipments and so downtime of equipments which improves the equipments availability.

Agile maintenance attribute coding and evaluation based decision making in sugar manufacturing plant

The production of sugar in plant consists of procedural steps, each step consisting of various sub-systems. Milling plant is the most important sub-system of a sugar manufacturing plant. The equipment availability in milling plant is a big issue as it has direct bearing on total production cost. Intelligent and effective maintenance planning can decrease total production cost and contribute in achieving strategic goals of sugar manufacturing plant. The objective of this paper is to generate and maintain reliable and exhaustive database of agile maintenance attribute for selection of effective maintenance strategy in milling plant of sugar industry. The database of eighty-eight (88) agile maintenance attributes were formed, out of which twenty-six (26) pertinent attributes relevant to the system under study. PM, PDM, CM, CBM and RCM strategies are selected for prioritization respectively. The proposed framework prioritizes and selects maintenance strategy by fuzzy integrated MADM approach. The fuzzy TOPSIS, fuzzy graphical and fuzzy digraph and matrix approach were used for decision making. The results from analysis were compared for better understanding and effective maintenance strategy selection. Proactive maintenance approaches of PDM RCM and CBM were identified as best alternative by different methods. Further, limitations due to uncertainty and vague expert judgement were eliminated in analysis by integrating fuzzy methodology. The novelty of study is selection of optimum maintenance policy based on agile maintenance attributes using proposed framework. The proposed framework will act as decision support system for efficient planning of maintenance activities using exhaustive database of agile maintenance attributes and selecting effective maintenance strategy.

PP34 A Cost-Utility Analysis Of The Syncope: Pacing Or Recording Trial

Introduction:For patients with bifascicular block and syncope of unknown origin, different American Heart Association guidelines give Class 2A recommendations for two treatments: the implantable loop recorder (ILR) and empiric pacemaker insertion (PM). Equipoise reflected in guidelines may contribute to uncertainty in management and inefficient resource use. The objective of this analysis is to determine the cost-effectiveness of ILR compared to PM in the management of older adults (age>50 years) with bifascicular block and syncope over two years, from the perspective of a Canadian publicly funded health care system, in the Syncope: Pacing or Recording In ThE Later Years (SPRITELY) trial.Methods:Resource utilization data was collected throughout the trial, and unit costs were assigned (2017 Canadian dollars). Utility was measured at baseline and annually with the EQ-5D-3L. Quality adjusted life years (QALYs) were calculated as area-under-the-curve, and adjusted for baseline imbalances in utility. Confidence intervals for the incremental cost effectiveness ratio were generated with non-parametric bootstrapping.Results:Mean cost in participants randomized to PM was CAD 9,759 (USD 7,400), compared to CAD 13,453 (USD 10,200) in participants randomized to ILR. The ILR strategy resulted in 0.020 QALYs more than the PM strategy. The incremental cost effectiveness ratio was CAD 186,553 (95% CI: −831,950–1,191,816) (USD 141,900, 95% CI: −632,740–906,440) per additional QALY. In 1,000 bootstrapped replicates, the cost of the ILR strategy was always greater than that of the PM strategy. At the threshold of CAD 50,000 (USD 38,000) per additional QALY, the probability that the ILR strategy is the cost effective option is 0.504.Conclusions:ILR costs were greater than PM costs, with little difference in QALY outcomes over two-years. Findings are generalizable to patients similar to SPRITELY participants, from the perspective of the Canadian health care system. However, practice pattern variation and payment systems inhibit generalizability to other countries. Future analysis will explore cost and QALY outcomes in countries that participated in the SPRITELY trial.

Pathophysiology and therapeutic strategies for peritoneal recurrence after gastric cancer surgery.

4050 Background: We recently showed that cancer cells, with proliferative and tumorigenic potential, can spill into the peritoneal cavity during curative (R0) gastric cancer (GC) surgery, which is associated with peritoneal recurrence (PM). To elucidate the pathophysiology of PM, the relationship between spilled cancer cells and cancer stem cells was evaluated. Furthermore, to identify a therapeutic strategy for PM, the prognostic impact of hyperthermic intraperitoneal chemotherapy (HIPEC) following GC surgery with spillage of cancer cells was evaluated. Methods: Patients with advanced GC (≥pT2 [MP]) who underwent R0 gastrectomy between 2010 and 2015 were enrolled. Ninety-four consecutive patients with negative results in peritoneal cytology and cancer cell culture (CCC [-]) following peritoneal washing (PW) before GC surgery were included. Spilled cancer cells in PW after GC surgery (PW-Post) were examined to identify any CD44-positive cancer stem-like cells associated with cancer metastasis. Based on the PW-Post CCC results, associations between HIPEC and recurrence-free survival (RFS), or overall survival (OS) were evaluated. HIPEC was performed following GC surgery using CDDP, MMC, and 5-FU in 5 L saline maintained at 42˚C for 30 min. Results: Spilled cancer cells included CD44+ cancer stem-like cells. In 48 patients with PW-Post positive CCC (CCC [+]), the number of patients with pStage I, II, and III were 4, 7, and 15, respectively, in those who received HIPEC (n = 26), and 3, 9, and 10, respectively, in those who did not (n = 22). Among patients with CCC (+), the 5-year peritoneal RFS, hepatic RFS, and lymph node RFS rates were 93.3%, 100%, and 68.5%, respectively, in patients who received HIPEC, and 56.7%, 35.6%, and 66.7%, respectively, in those who did not ( P = 0.008, P = 0.008, and P= 0.24, respectively). Among patients with PW-Post CCC (-), none developed recurrence, regardless of whether they received HIPEC (n = 28) or not (n = 18). Conclusions: The results show that PW-Post CCC is a promising predictive biomarker for recurrence after R0 GC surgery. Adjuvant HIPEC performed with R0 GC surgery showed preventive effects on peritoneal and hepatic recurrence and survival benefits for patients with PW-Post CCC (+).

A model of preventive maintenance for parallel, series, and single-item replacement systems based on statistical analysis

ABSTRACTPreventive maintenance (PM) scheduling of units is addressed as a crucial issue that effects on both economy and reliability of power systems. In this paper, we describe an application of statistical analysis for determining the best PM strategy in the case of parallel, series, and single-item replacement systems. A key aspect of industrial maintenance is the trade-off between cost and time of performing PM operations. The goals of this study is to determine the best time for performing PM operations in each system and also finding the number of spare parts and facilities in single-item replacement and parallel systems respectively so that the average cost per unit time is minimized. In this proposed maintenance strategy, PM operations are regularly performed on the production unit in equal time intervals. Finally, three examples are presented to demonstrate the effectiveness of the proposed models.

The effects of emission control strategies on light-absorbing carbon emissions from a modern heavy-duty diesel engine

Control of atmospheric black carbon (BC) and brown carbon (BrC) has been proposed as an important pathway to climate change mitigation, but sources of BC and BrC are still not well understood. In order to better identify the role of modern heavy-duty diesel engines on the production of BC and BrC, emissions from a heavy-duty diesel engine operating with different emission control strategies were examined using a source dilution sampling system. The effect of a diesel oxidation catalyst (DOC) and diesel particulate filter (DPF) on light-absorbing carbon (LAC) was evaluated at three steady-state engine operation modes: idle, 50% speed and load, and 100% speed and load. LAC was measured with four different engine configurations: engine out, DOC out, DPF out, and engine out with an altered combustion calibration. BC and BrC emission rates were measured with the Aethalometer (AE-31). EC and BC emission rates normalized to the mass of CO2 emitted increased with increasing engine speed and load. Emission rates normalized to brake-specific work did not exhibit similar trends with speed and load, but rather the highest emission rate was measured at idle. EC and OC emissions were reduced by 99% when the DOC and DPF architecture was applied. The application of a DPF was equally effective at removing 99% of the BC fraction of PM, proving to be an important control strategy for both LAC and PM. BC emissions were unexpectedly increased across the DOC, seemingly due to a change aerosol optical properties. Removal of exhaust gas recirculation (EGR) flow due to simulated EGR cooler failure caused a large increase in OC and BrC emission rates at idle, but had limited influence during high load operation. LAC emissions proved to be sensitive to the same control strategies effective at controlling the total mass of diesel PM.Implications: In the context of black carbon emissions, very small emission rates of brown carbon were measured over a range of control technologies and engine operating conditions. During specific idle engine operation without EGR and adjusted fueling conditions, brown carbon can be formed in significant amounts, requiring careful management tactics. Control technologies for particulate matter are very effective for light-absorbing carbon, reducing black carbon emissions to near zero for modern engines equipped with a DPF. Efforts to control atmospheric brown carbon need to focus on other sources other than modern diesel engines, such as biomass burning.

Non-periodic preventive maintenance with reliability thresholds for complex repairable systems

In general, a non-periodic condition-based PM policy with different condition variables is often more effective than a periodic age-based policy for deteriorating complex repairable systems. In this study, system reliability is estimated and used as the condition variable, and three reliability-based PM models are then developed with consideration of different scenarios which can assist in evaluating the maintenance cost for each scenario. The proposed approach provides the optimal reliability thresholds and PM schedules in advance by which the system availability and quality can be ensured and the organizational resources can be well prepared and managed. The results of the sensitivity anlysis indicate that PM activities performed at a high reliability threshold can not only significantly improve the system availability but also efficiently extend the system lifetime, although such a PM strategy is more costly than that for a low reliabiltiy threshold. The optimal reliability threshold increases along with the number of PM activities to prevent future breakdowns caused by severe deterioration, and thus substantially reduces repair costs.

The emergent realities of project praxis in socially complex project environments

PurposeThe purpose of this paper is to present an overview of a completed doctoral action research thesis that moved beyond focussing on the instrumentality of project actuality to explore project praxis as social process.Design/methodology/approachSoft systems methodology is selected as the process of enquiry for the thesis, to explore a perceived complex problematic situation. A conceptual framework is designed to guide thinking to explore the social nature of projects, through acknowledging the interconnected nature of human realities, the pragmatism of knowledge and the emergent nature of cognition.FindingsThe paper reveals the reality of project complexity as being socially derived, necessitating an emergent project management response to the inherent differences created from human plurality. Organisational resilience emerged as dependent upon recognising and successfully managing the evolving cognition that arises from a multiplicity of human and project environmental interconnections.Practical implicationsThe project context plays a significant role in determining project outcomes. Projects, as social process will benefit from a PM strategy that adaptively responds to manage the power and politics inherent in project practice, particularly in contexts involving socially disparate stakeholders.Originality/valueThe research is implemented in a Middle Eastern setting where local cultural constraints add to organisational and project complexity caused by socio‐cultural differences in an expatriate workforce. Portraying projects as “complex adaptive systems” has facilitated a shift in project management thinking from traditional linear, inflexible models, towards approaches which can more ably accommodate for human diversity in project practice.

Making People More Responsible: The Blair Governments' Programme for Changing Citizens' Behaviour

A distinctive feature of the three Blair New Labour governments' domestic policy was the effort to change citizens' behaviour. Variously explained using such slogans as ‘something for something’, ‘responsibility’ and, in combating antisocial behaviour, ‘respect’, behaviour change was presented by the PM's Strategy Unit as an overarching strategic framework for policy. This included conditionality in welfare to work, health promotion campaigns, a ban on smoking in public places, measures to combat antisocial behaviour and enforce school discipline, home–school contracts, community cohesion and neighbourhood renewal programmes, measures to encourage car sharing and use of public transport, and others to promote domestic waste recycling. This article examines how far the two principal explanatory theories available predict that programme's characteristics. It uses a structured data set on the policy instruments, target groups and content of initiatives undertaken by eight central government spending departments. We find that indeed the strong (more coercive) tools are markedly concentrated on initiatives targeting the poor and low-income working strata. The expectations derived from the two theoretical traditions are not strongly supported.

Detecting Abnormal Performance in Event Studies

In this project, the researcher conducted specification and power analyses on four matched-firm (MF) and three portfolio-based (PM) matching strategies used to detect abnormal performance in event studies of securities' performance. The researcher conducted these tests on 180 non-repeating random draws of 50 companies; the study ran from January 1, 1985 to December 31, 2002. The PM strategies generated poorly specified test statistics in all tests. Contrarily, all of the MF approaches produced well-specified and powerful test statistics. In this study, the researcher provides empirical evidence showing that techniques, sometimes overlooked by researchers, namely the matched firm approach based on industry affiliation, seem to have better specification and power outcomes than competing models and that the adjustments to PM strategies seem unnecessary. In this project, the researcher has also highlighted the extreme differences in performance of these seven methods used to detect abnormal performance in event studies.

Determination of optimal preventitive maintenance strategy for serial production lines

A Split System Approach (SSA) based methodology is presented to assist in making optimal Preventive Maintenance decisions for serial production lines. The methodology treats a production line as a complex series system with multiple PM actions over multiple intervals. Both risk and maintenance related costs are factored into the methodology as either deterministic or random variables. This SSA based methodology enables Asset Management (AM) decisions to be optimised considering a variety of factors including failure probability, failure cost, maintenance cost, PM performance, and the type of PM strategy. The application of this new methodology and an evaluation of the effects of these factors on PM decisions are demonstrated using an example. The results of this work show that the performance of a PM strategy can be measured by its Total Expected Cost Index (TECI). The optimal PM interval is dependent on TECI, PM performance and types of PM strategies. These factors are interrelated. Generally it was found that a trade-off between reliability and the number of PM actions needs to be made so that one can minimise Total Expected Cost (TEC) for asset maintenance.

산업단지 내 저층과 고층 아파트의 외기 중 호흡성분진과 일산화탄소 수준

Since low-floor apartments ate vertically closer to patting lots and roadways, it is hypothesized that residents in low-floor apartments may be exposed to elevated ambient levels of motet vehicle emissions compared to residents in high-floor apartments. The present study examined this hypothesis by measuring two motor vehicle source-related pollutants(CO and PM10) in ambient air of high-rise apartment buildings within the boundary of industrial complexes according to atmospheric stability The ambient air concentrations of CO and PM10 were higher for low-floor apartments than for high-floor apartments, regardless of atmospheric stability, The median concentration ratio of the low-floor air to high-floor alt ranged from 1.3 to 2.0, depending upon atmospheric stabilities, seasons and compounds. Moreover, the CO and PM10 concentrations were significantly higher in the winter and in the summer, regardless of the Hoot height. Atmospheric stability also was suggested to be important for the residents' exposure of high-rise apartment buildings to both CO and PM10. The median ratios of surface inversion air to non-surface inversion air ranged from 1.2 to 1.7 and from 1.0 to 1.6 lot PM10 and CO, respectively, depending upon seasons. Conclusively, these parameters(apartment floor height, season, and atmospheric stability) should be considered when evaluating the exposure of residents, living in high-rise apartment buildings, to CO and PM10. Meanwhile, the median PMl0 outdoor concentrations were close to or higher than the Korean annual standards for PM10, and the maximum PM10 concentrations substantially exceeded the Korean PM10 standard, thus suggesting the need for a management strategy for ambient PM 10. Neither the median nor the maximum outdoor CO concentrations, however, were higher than the Korean CO standard.

Room I, 10/17/2000 2: 00 PM - 4: 00 PM (PS) Strategy to Decide Whether to Move the Last Case of the Day in an Operating Room to Another Empty Operating Room to Decrease Overtime Costs

<b>Room I, 10/17/2000 2: 00 PM - 4: 00 PM (PS) Strategy to Decide Whether to Move the Last Case of the Day in an Operating Room to Another Empty Operating Room to Decrease Overtime Costs</b>