Using discrete-event simulation in strategic capacity planning for an outpatient physical therapy service

This study uses a simulation model as a tool for strategic capacity planning for an outpatient physical therapy clinic in Taipei, Taiwan. The clinic provides a wide range of physical treatments, with 6 full-time therapists in each session. We constructed a discrete-event simulation model to study the dynamics of patient mixes with realistic treatment plans, and to estimate the practical capacity of the physical therapy room. The changes in time-related and space-related performance measurements were used to evaluate the impact of various strategies on the capacity of the clinic. The simulation results confirmed that the clinic is extremely patient-oriented, with a bottleneck occurring at the traction units for Intermittent Pelvic Traction (IPT), with usage at 58.9 %. Sensitivity analysis showed that attending to more patients would significantly increase the number of patients staying for overtime sessions. We found that pooling the therapists produced beneficial results. The average waiting time per patient could be reduced by 45 % when we pooled 2 therapists. We found that treating up to 12 new patients per session had no significantly negative impact on returning patients. Moreover, we found that the average waiting time for new patients decreased if they were given priority over returning patients when called by the therapists.     

Rapid pseudo-H&E imaging using a fluorescence-inbuilt optical coherence microscopic imaging system

A technique using Linnik-based optical coherence microscopy (OCM), with built-in fluorescence microscopy (FM), is demonstrated here to describe cellular-level morphology for fresh porcine and biobank tissue specimens. The proposed method utilizes color-coding to generate digital pseudo-H&E (p-H&E) images. Using the same camera, colocalized FM images are merged with corresponding morphological OCM images using a 24-bit RGB composition process to generate position-matched p-H&E images. From receipt of dissected fresh tissue piece to generation of stitched images, the total processing time is <15 min for a 1-cm² specimen, which is on average two times faster than frozen-section H&E process for fatty or water-rich fresh tissue specimens. This technique was successfully used to scan human and animal fresh tissue pieces, demonstrating its applicability for both biobank and veterinary purposes. We provide an in-depth comparison between p-H&E and human frozen-section H&E images acquired from the same metastatic sentinel lymph node slice (∼10 µm thick), and show the differences, like elastic fibers of a tiny blood vessel and cytoplasm of tumor cells. This optical sectioning technique provides histopathologists with a convenient assessment method that outputs large-field H&E-like images of fresh tissue pieces without requiring any physical embedment.     

Nanocomposite membranes of polybenzimidazole and amine-functionalized carbon nanofibers for high temperature proton exchange membrane fuel cells

Carbon nanofibers functionalized with aminobenzoyl groups (CNF–aminobenzoyl) were prepared via direct Friedel–Crafts acylation in polyphosphoric acid. The functionalization of CNFs was characterized using XPS, FTIR, TGA, and Raman analyses. Hexafluoroisopropylidene-containing polybenzimidazole (6FPBI) composite membranes containing pristine CNFs or CNF–aminobenzoyl were prepared using solvent-assisted dispersion and solvent-casting methods. In this work, the influence of the incorporation of functionalized CNFs on several physicochemical properties of the 6FPBI nanocomposite membranes, including their thermal stability, mechanical strength, and acid doping level, was studied. The results showed that CNF–aminobenzoyl provided better mechanical reinforcement for the nanocomposite membrane, compared to pristine CNF. The SEM observation confirmed the good compatibility between the CNF–aminobenzoyl fillers and the 6FPBI matrix. For the 0.3 wt% CNF–aminobenzoyl/6FPBI composite membrane, the tensile stress was increased by 12% to be 78.9 MPa (as compared to the 6FPBI membrane), the acid doping level was improved to 12.0, and the proton conductivity at 160 °C was measured above 0.2 S cm⁻¹. Furthermore, the fuel cell performance of the membrane electrolyte assembly (MEA) for each nanocomposite membrane was evaluated. The maximum power density at 160 °C was found up to 461 mW cm⁻² for the MEA based on the 0.3 wt% CNF–aminobenzoyl/6FPBI composite membrane.

Carbon nanofibers functionalized with aminobenzoyl groups (CNF–aminobenzoyl) were prepared via direct Friedel–Crafts acylation in polyphosphoric acid.     

pH‐Responsive Hydrogel With an Anti‐Glycation Agent for Modulating Experimental Periodontitis

Background: Stimulus‐responsive devices have emerged as a novel approach for local drug delivery. This study investigates the feasibility of a novel chitosan‐based, pH‐responsive hydrogel loaded with N‐phenacylthiazolium bromide (PTB), which cleaves the crosslinks of advanced glycation end products on the extracellular matrix. Methods: A chitosan‐based hydrogel loaded with PTB was fabricated, and the in vitro release profile was evaluated within pH 5.5 to 7.4. BALB/cJ mice and Sprague‐Dawley rats were used to evaluate the effects during the induction and recovery phases of periodontitis, respectively, and animals in each phase were divided into four groups: 1) no periodontitis induction; 2) ligature‐induced experimental periodontitis (group PR); 3) experimental periodontitis plus hydrogel without PTB (group PH); and 4) experimental periodontitis plus hydrogel with PTB (group PP). The therapeutic effects were evaluated by microcomputed tomographic imaging of periodontal bone level (PBL) loss and histomorphometry for inflammatory cell infiltration and collagen density. Results: PTB was released faster at pH 5.5 to 6.5 and consistently slower at pH 7.4. In the induction phase, PBL and inflammatory cell infiltration were significantly reduced in group PP relative to group PR, and the loss of collagen matrix was significantly reduced relative to that observed in group PH. In the recovery phase, PBL and inflammatory cell infiltration were significantly reduced, and significantly greater collagen deposition was noted in group PP relative to groups PR and PH at 4 and 14 days after silk removal. Conclusion: Chitosan‐based, pH‐responsive hydrogels loaded with PTB can retard the initiation of and facilitate the recovery from experimental periodontitis.     

Finite Element Analysis on Initial Crack Site of Porous Structure Fabricated by Electron Beam Additive Manufacturing

Ti6Al4V specimens with porous structures can be fabricated by additive manufacturing to obtain the desired Young’s modulus. Their mechanical strength and deformation behavior can be evaluated using finite element analysis (FEA), with various models and simulation methodologies described in the existing literature. Most studies focused on the evaluation accuracy of the mechanical strength and deformation behavior using complex models. This study presents a simple elastic model for brittle specimens followed by an electron beam additive manufacturing (EBAM) process to predict the initial crack site and threshold of applied stress related to the failure of cubic unit lattice structures. Six cubic lattice specimens with different porosities were fabricated by EBAM, and compression tests were performed and compared to the FEA results. In this study, two different types of deformation behavior were observed in the specimens with low and high porosities. The adopted elastic model and the threshold of applied stress calculated via FEA showed good capabilities for predicting the initial crack sites of these specimens. The methodology presented in this study should provide a simple yet accurate method to predict the fracture initiation of porous structure parts.     

Apocynin attenuates lipopolysaccharide-induced lung injury in an isolated and perfused rat lung model

Apocynin (Apo) suppresses the generation of reactive oxygen species that are implicated in lipopolysaccharide (LPS)-induced lung injury (LPSLI). We thus hypothesized that Apo may attenuate LPSLI. In addition, we explored the cellular and molecular mechanisms of Apo treatment in LPSLI. Lipopolysaccharide-induced lung injury was induced by intratracheal instillation of 10 mg/kg LPS in isolated and perfused rat lung model. Apocynin was administered in the perfusate at 15 min before LPS was administered. Hemodynamics, lung injury indices, inflammatory responses, and activation of apoptotic pathways were assessed. There was an increase in lung vascular permeability associated with lung weight gain after LPS exposure. The levels of interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), macrophage inflammatory protein 2, H2O2, and albumin increased in the bronchoalveolar lavage fluid. Adhesion molecule of neutrophil (CD31) was upregulated. The expression of TNF-α, IL-1β, glutathione, myeloperoxidase, JNK, P38, caspase 3, p-AKT, and plasminogen activator inhibitor 1 in lung tissue was greater in the LPS groups when compared with the control group. Upregulation and activation of nuclear factor κB occurred along with increased histopathologic lung injury score in LPSLI. The Apo attenuated these inflammatory responses including the levels of CD31, H2O2, TNF-α, IL-1β, myeloperoxidase, P38, and nuclear factor κB along with downregulation of apoptosis as reflected by caspase 3 and p-AKT. In addition, Apo attenuated the increase in lung weight, bronchoalveolar lavage fluid albumin content, and the histopathologic lung injury score. In conclusion, LPSLI is associated with increased inflammatory responses, apoptosis, and coagulation. The administration of Apo attenuates LPSLI through downregulation of the inflammatory responses and apoptosis.