U.S. Navy Surface Ship depot-level maintenance periods of performance were studied to develop a method for predicting maintenance durations. The need for the method has been highlighted by Navy leadership in recent media posts describing unacceptable maintenance delays and this research provides practitioners and decisionmakers with a reliable estimating tool. This study helps by putting forth a method that defines the rate of work accomplishment based on relevant variables. Using ordinary least squares models, this research revealed that the size of the contract obligation and the amount of shipyard work occurring simultaneously in the market are key variables in determining depot maintenance durations. With the knowledge found here, the next logical step is an optimization model for each U.S. Navy surface ship homeport.

Long-acting injectable antipsychotics (LAIs) offer many benefits to patients with schizophrenia spectrum disorder (SSD). They are used with very different frequencies due to questions of eligibility or patients’ and prescribers’ attitudes towards LAI use. We assessed the prescribing rates of LAIs in a large academic psychiatric hospital with public service mandate in Switzerland and compared them with other countries and health care systems. To our knowledge this study is the first to investigate the inpatient LAI-use in Europe. Medical records of all patients diagnosed with SSD discharged from the Clinic of Adult Psychiatry of the University Hospital of Psychiatry Zurich over a 12-month period from January to December 2019 were evaluated regarding the prescribed antipsychotics at the time of discharge. The rates of use of LAIs among all patients and among patients receiving LAI eligible antipsychotic substances were assessed retrospectively. We assessed records of 885 patients with SSD. Among all cases 13.9% received an LAI. Among patients who received antipsychotic medication that was eligible for LAI use 28.3% (n=434) received an agent as LAI. These included paliperidone palmitate (69.9%), aripiprazole monohydrate (14.6%), risperidone (4.9%) and first-generation LAIs (9.8%). Compared to international frequencies of LAI administration, the prescription rate of LAIs in SSD patients was low. Further studies will evaluate patient- and prescriber-related reasons for this low rate.

Bus operators around the world are facing the transformation of their fleets from fossil-fuelled to electric buses. Two technologies prevail: Depot charging and opportunity charging at terminal stops. Total cost of ownership (TCO) is an important metric for the decision between the two technologies, however, most TCO studies for electric bus systems rely on generalised route data and simplifying assumptions that may not reflect local conditions. In particular, the need to re-schedule vehicle operations to satisfy electric buses’ range and charging time constraints is commonly disregarded. We present a simulation tool based on discrete-event simulation to determine the vehicle, charging infrastructure, energy and staff demand required to electrify real-world bus networks. These results are then passed to a TCO model. A greedy scheduling algorithm is developed to plan vehicle schedules suitable for electric buses. Scheduling and simulation are coupled with a genetic algorithm to determine cost-optimised charging locations for opportunity charging. A case study is carried out in which we analyse the electrification of a metropolitan bus network consisting of 39 lines with 4748 passenger trips per day. The results generally favour opportunity charging over depot charging in terms of TCO, however, under some circumstances, the technologies are on par. This emphasises the need for detailed analysis of the local bus network in order to make an informed procurement decision.

Currently the bimatoprost implant (DURYSTA) is approved for a single administration secondary to concern for progressive corneal endothelial cell (CEC) loss with intracameral administration. In order to better understand the cause of CEC loss and other adverse events (AEs) with intracameral administration, multimodal imaging of the implant utilizing optical coherence topography (OCT), robotic ultrasound and bio microscopy video recording was utilized. Inherently the anterior chamber is a non-confined space. In certain examples the implant assumed a round and spotted structure as it picked up iris pigment as it migrated around the anterior chamber. Accordingly, we explored delivery of the implant in the middle segment behind the iris and in front of the pseudophakic lens. We then evaluated the suitability of various imaging modalities to assess the implant in this location. For middle segment administration, the ArcScan Insight 100 robotic ultrasound provided resolution and repeatability sufficient to monitor the implant behind the iris. This preliminary study hypothesizes that DURYSTA migration in the anterior chamber is the main source of AEs. Through use of a confined location, the middle segment, the implant is unlikely to migrate and cause CEC loss while also delivering drug closer to its site of action, the ciliary body. Further efforts are underway to understand the suitability of the middle segment for serial DURYSTA administration to maximize intraocular pressure lowering while minimizing AEs.