Sample records for control chart based

  1. Enhanced Cumulative Sum Charts for Monitoring Process Dispersion

    PubMed Central

    Abujiya, Mu’azu Ramat; Riaz, Muhammad; Lee, Muhammad Hisyam

    2015-01-01

    The cumulative sum (CUSUM) control chart is widely used in industry for the detection of small and moderate shifts in process location and dispersion. For efficient monitoring of process variability, we present several CUSUM control charts for monitoring changes in standard deviation of a normal process. The newly developed control charts based on well-structured sampling techniques - extreme ranked set sampling, extreme double ranked set sampling and double extreme ranked set sampling, have significantly enhanced CUSUM chart ability to detect a wide range of shifts in process variability. The relative performances of the proposed CUSUM scale charts are evaluated in terms of the average run length (ARL) and standard deviation of run length, for point shift in variability. Moreover, for overall performance, we implore the use of the average ratio ARL and average extra quadratic loss. A comparison of the proposed CUSUM control charts with the classical CUSUM R chart, the classical CUSUM S chart, the fast initial response (FIR) CUSUM R chart, the FIR CUSUM S chart, the ranked set sampling (RSS) based CUSUM R chart and the RSS based CUSUM S chart, among others, are presented. An illustrative example using real dataset is given to demonstrate the practicability of the application of the proposed schemes. PMID:25901356

  2. Dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses.

    PubMed

    Zhang, Xiang; Loda, Justin B; Woodall, William H

    2017-07-20

    For a patient who has survived a surgery, there could be several levels of recovery. Thus, it is reasonable to consider more than two outcomes when monitoring surgical outcome quality. The risk-adjusted cumulative sum (CUSUM) chart based on multiresponses has been developed for monitoring a surgical process with three or more outcomes. However, there is a significant effect of varying risk distributions on the in-control performance of the chart when constant control limits are applied. To overcome this disadvantage, we apply the dynamic probability control limits to the risk-adjusted CUSUM charts for multiresponses. The simulation results demonstrate that the in-control performance of the charts with dynamic probability control limits can be controlled for different patient populations because these limits are determined for each specific sequence of patients. Thus, the use of dynamic probability control limits for risk-adjusted CUSUM charts based on multiresponses allows each chart to be designed for the corresponding patient sequence of a surgeon or a hospital and therefore does not require estimating or monitoring the patients' risk distribution. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  3. An Assessment of Statistical Process Control-Based Approaches for Charting Student Evaluation Scores

    ERIC Educational Resources Information Center

    Ding, Xin; Wardell, Don; Verma, Rohit

    2006-01-01

    We compare three control charts for monitoring data from student evaluations of teaching (SET) with the goal of improving student satisfaction with teaching performance. The two charts that we propose are a modified "p" chart and a z-score chart. We show that these charts overcome some of the shortcomings of the more traditional charts…

  4. Using Statistical Process Control to Make Data-Based Clinical Decisions.

    ERIC Educational Resources Information Center

    Pfadt, Al; Wheeler, Donald J.

    1995-01-01

    Statistical process control (SPC), which employs simple statistical tools and problem-solving techniques such as histograms, control charts, flow charts, and Pareto charts to implement continual product improvement procedures, can be incorporated into human service organizations. Examples illustrate use of SPC procedures to analyze behavioral data…

  5. The effectiveness of robust RMCD control chart as outliers’ detector

    NASA Astrophysics Data System (ADS)

    Darmanto; Astutik, Suci

    2017-12-01

    A well-known control chart to monitor a multivariate process is Hotelling’s T 2 which its parameters are estimated classically, very sensitive and also marred by masking and swamping of outliers data effect. To overcome these situation, robust estimators are strongly recommended. One of robust estimators is re-weighted minimum covariance determinant (RMCD) which has robust characteristics as same as MCD. In this paper, the effectiveness term is accuracy of the RMCD control chart in detecting outliers as real outliers. In other word, how effectively this control chart can identify and remove masking and swamping effects of outliers. We assessed the effectiveness the robust control chart based on simulation by considering different scenarios: n sample sizes, proportion of outliers, number of p quality characteristics. We found that in some scenarios, this RMCD robust control chart works effectively.

  6. Monitoring the Level of Students' GPAs over Time

    ERIC Educational Resources Information Center

    Bakir, Saad T.; McNeal, Bob

    2010-01-01

    A nonparametric (or distribution-free) statistical quality control chart is used to monitor the cumulative grade point averages (GPAs) of students over time. The chart is designed to detect any statistically significant positive or negative shifts in student GPAs from a desired target level. This nonparametric control chart is based on the…

  7. Image registration assessment in radiotherapy image guidance based on control chart monitoring.

    PubMed

    Xia, Wenyao; Breen, Stephen L

    2018-04-01

    Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

  8. Intelligent Process Abnormal Patterns Recognition and Diagnosis Based on Fuzzy Logic.

    PubMed

    Hou, Shi-Wang; Feng, Shunxiao; Wang, Hui

    2016-01-01

    Locating the assignable causes by use of the abnormal patterns of control chart is a widely used technology for manufacturing quality control. If there are uncertainties about the occurrence degree of abnormal patterns, the diagnosis process is impossible to be carried out. Considering four common abnormal control chart patterns, this paper proposed a characteristic numbers based recognition method point by point to quantify the occurrence degree of abnormal patterns under uncertain conditions and a fuzzy inference system based on fuzzy logic to calculate the contribution degree of assignable causes with fuzzy abnormal patterns. Application case results show that the proposed approach can give a ranked causes list under fuzzy control chart abnormal patterns and support the abnormity eliminating.

  9. Dynamic probability control limits for risk-adjusted Bernoulli CUSUM charts.

    PubMed

    Zhang, Xiang; Woodall, William H

    2015-11-10

    The risk-adjusted Bernoulli cumulative sum (CUSUM) chart developed by Steiner et al. (2000) is an increasingly popular tool for monitoring clinical and surgical performance. In practice, however, the use of a fixed control limit for the chart leads to a quite variable in-control average run length performance for patient populations with different risk score distributions. To overcome this problem, we determine simulation-based dynamic probability control limits (DPCLs) patient-by-patient for the risk-adjusted Bernoulli CUSUM charts. By maintaining the probability of a false alarm at a constant level conditional on no false alarm for previous observations, our risk-adjusted CUSUM charts with DPCLs have consistent in-control performance at the desired level with approximately geometrically distributed run lengths. Our simulation results demonstrate that our method does not rely on any information or assumptions about the patients' risk distributions. The use of DPCLs for risk-adjusted Bernoulli CUSUM charts allows each chart to be designed for the corresponding particular sequence of patients for a surgeon or hospital. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Toward a New Brewing Control Chart for the 21st Century.

    PubMed

    Melrose, John; Roman-Corrochano, Borja; Montoya-Guerra, Marcela; Bakalis, Serafim

    2018-04-23

    This paper describes new results from a base model of brewing from a bed of packed coffee grains. The model solves for the diffusion of soluble species out of a distribution of particles into the flow through the bed pore space. It requires a limited set of input parameters. It gives a simple picture of the basic physics of coffee brewing and sets out a set of reduced variables for this process. The importance of bed extraction efficiency is elucidated. A coffee brewing control chart has been widely used to describe the region of ideal coffee brewing for some 50 years. A new chart is needed, however, one that connects actual brewing conditions (weight, flow rate, brew time, grind, etc.) to the yield and strength of brews. The paper shows a new approach to brewing control charts, including brew time and bed extraction efficiency as control parameters. Using the base model, an example chart will be given for a particular grind ratio of coarse to fine particles, and an "espresso regime" will be picked out. From such a chart yield, volume and strength of a brew can be read off at will.

  11. Development and assessment of a fiber-optic liquid level sensor with long-period fiber grating and Shewhart control charts

    NASA Astrophysics Data System (ADS)

    Wang, Jian-Neng; Jan, Chen-Han; Tang, Jaw-Luen; Wu, Wei-Te; Chen, Der-Cheng; Chen, Chien-Hsing; Syu, Jial-Yan; Luo, Ching-Ying

    2011-12-01

    This paper presents the development and assessment of a liquid level sensor using long-period fiber grating (LPFG) technology and Shewhart control charts. The 22-mm LPFGs were fabricated with the point-by-point CO2 laser engraving method. This sensor was designed in such a way that it could be moved up and down with a position controller. The experimental section covered LPFG position sensing test, liquid level detection capacity and reliability measurements, and sensing resolution evaluation. LPFG position sensing test was studied and confirmed by the resonance wavelength shifts which were significantly generated when 75% of the LPFG was immersed in water. There were ten groups of different liquid level capacity testing and each group underwent ten repeated measurements. Based on Shewhart control charts including an X-bar chart, s chart, and R chart, the results showed all measurands within the upper and lower control limits. This sensor was reliable and the liquid level could be measured at least 1000 mm. The transmission loss versus the percent of immersion of the LPFG sensor for water and green tea was used to study the sensing resolution. The findings show the LPFG-based liquid sensor had at least 1000-mm level measurement capacity and about 2-mm resolution.

  12. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

    PubMed Central

    2012-01-01

    Background Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. Methods A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. Results ICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. Conclusion We recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system. PMID:22587736

  13. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques.

    PubMed

    Chien, Tsair-Wei; Chou, Ming-Ting; Wang, Wen-Chung; Tsai, Li-Shu; Lin, Weir-Sen

    2012-05-15

    Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan's year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. ICCs were generated for Taiwan's year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. We recommend using the ICC to annually assess a nation's year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  14. A Simple Approach for Monitoring Business Service Time Variation

    PubMed Central

    2014-01-01

    Control charts are effective tools for signal detection in both manufacturing processes and service processes. Much of the data in service industries comes from processes having nonnormal or unknown distributions. The commonly used Shewhart variable control charts, which depend heavily on the normality assumption, are not appropriately used here. In this paper, we propose a new asymmetric EWMA variance chart (EWMA-AV chart) and an asymmetric EWMA mean chart (EWMA-AM chart) based on two simple statistics to monitor process variance and mean shifts simultaneously. Further, we explore the sampling properties of the new monitoring statistics and calculate the average run lengths when using both the EWMA-AV chart and the EWMA-AM chart. The performance of the EWMA-AV and EWMA-AM charts and that of some existing variance and mean charts are compared. A numerical example involving nonnormal service times from the service system of a bank branch in Taiwan is used to illustrate the applications of the EWMA-AV and EWMA-AM charts and to compare them with the existing variance (or standard deviation) and mean charts. The proposed EWMA-AV chart and EWMA-AM charts show superior detection performance compared to the existing variance and mean charts. The EWMA-AV chart and EWMA-AM chart are thus recommended. PMID:24895647

  15. A simple approach for monitoring business service time variation.

    PubMed

    Yang, Su-Fen; Arnold, Barry C

    2014-01-01

    Control charts are effective tools for signal detection in both manufacturing processes and service processes. Much of the data in service industries comes from processes having nonnormal or unknown distributions. The commonly used Shewhart variable control charts, which depend heavily on the normality assumption, are not appropriately used here. In this paper, we propose a new asymmetric EWMA variance chart (EWMA-AV chart) and an asymmetric EWMA mean chart (EWMA-AM chart) based on two simple statistics to monitor process variance and mean shifts simultaneously. Further, we explore the sampling properties of the new monitoring statistics and calculate the average run lengths when using both the EWMA-AV chart and the EWMA-AM chart. The performance of the EWMA-AV and EWMA-AM charts and that of some existing variance and mean charts are compared. A numerical example involving nonnormal service times from the service system of a bank branch in Taiwan is used to illustrate the applications of the EWMA-AV and EWMA-AM charts and to compare them with the existing variance (or standard deviation) and mean charts. The proposed EWMA-AV chart and EWMA-AM charts show superior detection performance compared to the existing variance and mean charts. The EWMA-AV chart and EWMA-AM chart are thus recommended.

  16. Comparison of Grand Median and Cumulative Sum Control Charts on Shuttlecock Weight Variable in CV Marjoko Kompas dan Domas

    NASA Astrophysics Data System (ADS)

    Musdalifah, N.; Handajani, S. S.; Zukhronah, E.

    2017-06-01

    Competition between the homoneous companies cause the company have to keep production quality. To cover this problem, the company controls the production with statistical quality control using control chart. Shewhart control chart is used to normal distributed data. The production data is often non-normal distribution and occured small process shift. Grand median control chart is a control chart for non-normal distributed data, while cumulative sum (cusum) control chart is a sensitive control chart to detect small process shift. The purpose of this research is to compare grand median and cusum control charts on shuttlecock weight variable in CV Marjoko Kompas dan Domas by generating data as the actual distribution. The generated data is used to simulate multiplier of standard deviation on grand median and cusum control charts. Simulation is done to get average run lenght (ARL) 370. Grand median control chart detects ten points that out of control, while cusum control chart detects a point out of control. It can be concluded that grand median control chart is better than cusum control chart.

  17. Analysis of extreme rainfall events using attributes control charts in temporal rainfall processes

    NASA Astrophysics Data System (ADS)

    Villeta, María; Valencia, Jose Luis; Saá-Requejo, Antonio; María Tarquis, Ana

    2015-04-01

    The impacts of most intense rainfall events on agriculture and insurance industry can be very severe. This research focuses in the analysis of extreme rainfall events throughout the use of attributes control charts, which constitutes a usual tool in Statistical Process Control (SPC) but unusual in climate studios. Here, series of daily precipitations for the years 1931-2009 within a Spanish region are analyzed, based on a new type of attributes control chart that takes into account the autocorrelation between the extreme rainfall events. The aim is to conclude if there exist or not evidence of a change in the extreme rainfall model of the considered series. After adjusting seasonally the precipitation series and considering the data of the first 30 years, a frequency-based criterion allowed fixing specification limits in order to discriminate between extreme observed rainfall days and normal observed rainfall days. The autocorrelation amongst maximum precipitation is taken into account by a New Binomial Markov Extended Process obtained for each rainfall series. These modelling of the extreme rainfall processes provide a way to generate the attributes control charts for the annual fraction of rainfall extreme days. The extreme rainfall processes along the rest of the years under study can then be monitored by such attributes control charts. The results of the application of this methodology show evidence of change in the model of extreme rainfall events in some of the analyzed precipitation series. This suggests that the attributes control charts proposed for the analysis of the most intense precipitation events will be of practical interest to agriculture and insurance sectors in next future.

  18. Modified Exponential Weighted Moving Average (EWMA) Control Chart on Autocorrelation Data

    NASA Astrophysics Data System (ADS)

    Herdiani, Erna Tri; Fandrilla, Geysa; Sunusi, Nurtiti

    2018-03-01

    In general, observations of the statistical process control are assumed to be mutually independence. However, this assumption is often violated in practice. Consequently, statistical process controls were developed for interrelated processes, including Shewhart, Cumulative Sum (CUSUM), and exponentially weighted moving average (EWMA) control charts in the data that were autocorrelation. One researcher stated that this chart is not suitable if the same control limits are used in the case of independent variables. For this reason, it is necessary to apply the time series model in building the control chart. A classical control chart for independent variables is usually applied to residual processes. This procedure is permitted provided that residuals are independent. In 1978, Shewhart modification for the autoregressive process was introduced by using the distance between the sample mean and the target value compared to the standard deviation of the autocorrelation process. In this paper we will examine the mean of EWMA for autocorrelation process derived from Montgomery and Patel. Performance to be investigated was investigated by examining Average Run Length (ARL) based on the Markov Chain Method.

  19. New S control chart using skewness correction method for monitoring process dispersion of skewed distributions

    NASA Astrophysics Data System (ADS)

    Atta, Abdu; Yahaya, Sharipah; Zain, Zakiyah; Ahmed, Zalikha

    2017-11-01

    Control chart is established as one of the most powerful tools in Statistical Process Control (SPC) and is widely used in industries. The conventional control charts rely on normality assumption, which is not always the case for industrial data. This paper proposes a new S control chart for monitoring process dispersion using skewness correction method for skewed distributions, named as SC-S control chart. Its performance in terms of false alarm rate is compared with various existing control charts for monitoring process dispersion, such as scaled weighted variance S chart (SWV-S); skewness correction R chart (SC-R); weighted variance R chart (WV-R); weighted variance S chart (WV-S); and standard S chart (STD-S). Comparison with exact S control chart with regards to the probability of out-of-control detections is also accomplished. The Weibull and gamma distributions adopted in this study are assessed along with the normal distribution. Simulation study shows that the proposed SC-S control chart provides good performance of in-control probabilities (Type I error) in almost all the skewness levels and sample sizes, n. In the case of probability of detection shift the proposed SC-S chart is closer to the exact S control chart than the existing charts for skewed distributions, except for the SC-R control chart. In general, the performance of the proposed SC-S control chart is better than all the existing control charts for monitoring process dispersion in the cases of Type I error and probability of detection shift.

  20. Monitoring Poisson observations using combined applications of Shewhart and EWMA charts

    NASA Astrophysics Data System (ADS)

    Abujiya, Mu'azu Ramat

    2017-11-01

    The Shewhart and exponentially weighted moving average (EWMA) charts for nonconformities are the most widely used procedures of choice for monitoring Poisson observations in modern industries. Individually, the Shewhart EWMA charts are only sensitive to large and small shifts, respectively. To enhance the detection abilities of the two schemes in monitoring all kinds of shifts in Poisson count data, this study examines the performance of combined applications of the Shewhart, and EWMA Poisson control charts. Furthermore, the study proposes modifications based on well-structured statistical data collection technique, ranked set sampling (RSS), to detect shifts in the mean of a Poisson process more quickly. The relative performance of the proposed Shewhart-EWMA Poisson location charts is evaluated in terms of the average run length (ARL), standard deviation of the run length (SDRL), median run length (MRL), average ratio ARL (ARARL), average extra quadratic loss (AEQL) and performance comparison index (PCI). Consequently, all the new Poisson control charts based on RSS method are generally more superior than most of the existing schemes for monitoring Poisson processes. The use of these combined Shewhart-EWMA Poisson charts is illustrated with an example to demonstrate the practical implementation of the design procedure.

  1. Using Statistical Process Control to Drive Improvement in Neonatal Care: A Practical Introduction to Control Charts.

    PubMed

    Gupta, Munish; Kaplan, Heather C

    2017-09-01

    Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. A graphics-oriented personal computer-based microscope charting system for neuroanatomical and neurochemical studies.

    PubMed

    Tourtellotte, W G; Lawrence, D T; Getting, P A; Van Hoesen, G W

    1989-07-01

    This report describes a computerized microscope charting system based on the IBM personal computer or compatible. Stepping motors are used to control the movement of the microscope stage and to encode its position by hand manipulation of a joystick. Tissue section contours and the location of cells labeled with various compounds are stored by the computer, plotted at any magnification and manipulated into composites created from several charted sections. The system has many advantages: (1) it is based on an industry standardized computer that is affordable and familiar; (2) compact and commercially available stepping motor microprocessors control the stage movement. These controllers increase reliability, simplify implementation, and increase efficiency by relieving the computer of time consuming control tasks; (3) the system has an interactive graphics interface allowing the operator to view the image during data collection. Regions of the graphics display can be enlarged during the charting process to provide higher resolution and increased accuracy; (4) finally, the digitized data are stored at 0.5 micron resolution and can be routed directly to a multi-pen plotter or exported to a computer-aided design (CAD) program to generate a publication-quality montage composed of several computerized chartings. The system provides a useful tool for the acquisition and qualitative analysis of data representing stained cells or chemical markers in tissue. The modular design, together with data storage at high resolution, allows for potential analytical enhancements involving planimetric, stereologic and 3-D serial section reconstruction.

  3. Evaluation of extreme temperature events in northern Spain based on process control charts

    NASA Astrophysics Data System (ADS)

    Villeta, M.; Valencia, J. L.; Saá, A.; Tarquis, A. M.

    2018-02-01

    Extreme climate events have recently attracted the attention of a growing number of researchers because these events impose a large cost on agriculture and associated insurance planning. This study focuses on extreme temperature events and proposes a new method for their evaluation based on statistical process control tools, which are unusual in climate studies. A series of minimum and maximum daily temperatures for 12 geographical areas of a Spanish region between 1931 and 2009 were evaluated by applying statistical process control charts to statistically test whether evidence existed for an increase or a decrease of extreme temperature events. Specification limits were determined for each geographical area and used to define four types of extreme anomalies: lower and upper extremes for the minimum and maximum anomalies. A new binomial Markov extended process that considers the autocorrelation between extreme temperature events was generated for each geographical area and extreme anomaly type to establish the attribute control charts for the annual fraction of extreme days and to monitor the occurrence of annual extreme days. This method was used to assess the significance of changes and trends of extreme temperature events in the analysed region. The results demonstrate the effectiveness of an attribute control chart for evaluating extreme temperature events. For example, the evaluation of extreme maximum temperature events using the proposed statistical process control charts was consistent with the evidence of an increase in maximum temperatures during the last decades of the last century.

  4. Crude versus case-mix-adjusted control charts for safety monitoring in thyroid surgery.

    PubMed

    Duclos, Antoine; Voirin, Nicolas; Touzet, Sandrine; Soardo, Pietro; Schott, Anne-Marie; Colin, Cyrille; Peix, Jean-Louis; Lifante, Jean-Christophe

    2010-12-01

    Patient-safety monitoring based on health-outcome indicators can lead to misinterpretation of changes in case mix. This study aimed to compare the detection of indicator variations between crude and case-mix-adjusted control charts using data from thyroid surgeries. The study population included each patient who underwent thyroid surgery in a teaching hospital from January 2006 to May 2008. Patient safety was monitored according to two indicators, which are immediately recognisable postoperative complications: recurrent laryngeal nerve palsy and hypocalcaemia. Each indicator was plotted monthly on a p-control chart using exact limits. The weighted κ statistic was calculated to measure the agreement between crude and case-mix-adjusted control charts. We evaluated the outcomes of 1405 thyroidectomies. The overall proportions of immediate recurrent laryngeal nerve palsy and hypocalcaemia were 7.4% and 20.5%, respectively. The proportion of agreement in the detection of indicator variations between the crude and case-mix-adjusted p-charts was 95% (95% CI 85% to 99%). The strength of the agreement was κ = 0.76 (95% CI 0.54 to 0.98). The single special cause of variation that occurred was only detected by the case-mix-adjusted p-chart. There was good agreement in the detection of indicator variations between crude and case-mix-adjusted p-charts. The joint use of crude and adjusted charts seems to be a reasonable approach to increase the accuracy of interpretation of variations in outcome indicators.

  5. Collection of process data after cardiac surgery: initial implementation with a Java-based intranet applet.

    PubMed

    Ratcliffe, M B; Khan, J H; Magee, K M; McElhinney, D B; Hubner, C

    2000-06-01

    Using a Java-based intranet program (applet), we collected postoperative process data after coronary artery bypass grafting. A Java-based applet was developed and deployed on a hospital intranet. Briefly, the nurse entered patient process data using a point and click interface. The applet generated a nursing note, and process data were saved in a Microsoft Access database. In 10 patients, this method was validated by comparison with a retrospective chart review. In 45 consecutive patients, weekly control charts were generated from the data. When aberrations from the pathway occurred, feedback was initiated to restore the goals of the critical pathway. The intranet process data collection method was verified by a manual chart review with 98% sensitivity. The control charts for time to extubation, intensive care unit stay, and hospital stay showed a deviation from critical pathway goals after the first 20 patients. Feedback modulation was associated with a return to critical pathway goals. Java-based applets are inexpensive and can collect accurate postoperative process data, identify critical pathway deviations, and allow timely feedback of process data.

  6. Proving the Usefulness of Demonstrations: Using M&M's to Develop Attribute Control Charts

    ERIC Educational Resources Information Center

    Fish, Lynn A.; Braunscheidel, Michael J.

    2012-01-01

    Experiential-based mini-demonstrations are useful to facilitate student learning on a wide variety of topics. The purpose of this teaching brief is two-fold: (1) it outlines a useful mini-demonstration to teach attribute control charting when the sample size is unknown, and (2) adds additional proof that experiential methods positively impact upon…

  7. Design and application of process control charting methodologies to gamma irradiation practices

    NASA Astrophysics Data System (ADS)

    Saylor, M. C.; Connaghan, J. P.; Yeadon, S. C.; Herring, C. M.; Jordan, T. M.

    2002-12-01

    The relationship between the contract irradiation facility and the customer has historically been based upon a "PASS/FAIL" approach with little or no quality metrics used to gage the control of the irradiation process. Application of process control charts, designed in coordination with mathematical simulation of routine radiation processing, can provide a basis for understanding irradiation events. By using tools that simulate the physical rules associated with the irradiation process, end-users can explore process-related boundaries and the effects of process changes. Consequently, the relationship between contractor and customer can evolve based on the derived knowledge. The resulting level of mutual understanding of the irradiation process and its resultant control benefits both the customer and contract operation, and provides necessary assurances to regulators. In this article we examine the complementary nature of theoretical (point kernel) and experimental (dosimetric) process evaluation, and the resulting by-product of improved understanding, communication and control generated through the implementation of effective process control charting strategies.

  8. Statistical process control using optimized neural networks: a case study.

    PubMed

    Addeh, Jalil; Ebrahimzadeh, Ata; Azarbad, Milad; Ranaee, Vahid

    2014-09-01

    The most common statistical process control (SPC) tools employed for monitoring process changes are control charts. A control chart demonstrates that the process has altered by generating an out-of-control signal. This study investigates the design of an accurate system for the control chart patterns (CCPs) recognition in two aspects. First, an efficient system is introduced that includes two main modules: feature extraction module and classifier module. In the feature extraction module, a proper set of shape features and statistical feature are proposed as the efficient characteristics of the patterns. In the classifier module, several neural networks, such as multilayer perceptron, probabilistic neural network and radial basis function are investigated. Based on an experimental study, the best classifier is chosen in order to recognize the CCPs. Second, a hybrid heuristic recognition system is introduced based on cuckoo optimization algorithm (COA) algorithm to improve the generalization performance of the classifier. The simulation results show that the proposed algorithm has high recognition accuracy. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  9. User Guide for Unmanned Aerial System (UAS) Operations on the National Ranges

    DTIC Science & Technology

    2007-11-01

    WARFARE CENTER WEAPONS DIVISION, PT. MUGU NAVAL AIR WARFARE CENTER WEAPONS DIVISION, CHINA LAKE NAVAL AIR WARFARE CENTER AIRCRAFT DIVISION, PATUXENT...with IFR Instrument Flight Rules MRTFB Major Range and Test Facility Base NAS National Airspace System NM nautical mile NTIA National...sectional charts, Instrument Flight Rules ( IFR ) enroute charts, and terminal area charts. The floor and ceiling, operating hours, and controlling

  10. Automatic exposure control systems designed to maintain constant image noise: effects on computed tomography dose and noise relative to clinically accepted technique charts.

    PubMed

    Favazza, Christopher P; Yu, Lifeng; Leng, Shuai; Kofler, James M; McCollough, Cynthia H

    2015-01-01

    To compare computed tomography dose and noise arising from use of an automatic exposure control (AEC) system designed to maintain constant image noise as patient size varies with clinically accepted technique charts and AEC systems designed to vary image noise. A model was developed to describe tube current modulation as a function of patient thickness. Relative dose and noise values were calculated as patient width varied for AEC settings designed to yield constant or variable noise levels and were compared to empirically derived values used by our clinical practice. Phantom experiments were performed in which tube current was measured as a function of thickness using a constant-noise-based AEC system and the results were compared with clinical technique charts. For 12-, 20-, 28-, 44-, and 50-cm patient widths, the requirement of constant noise across patient size yielded relative doses of 5%, 14%, 38%, 260%, and 549% and relative noises of 435%, 267%, 163%, 61%, and 42%, respectively, as compared with our clinically used technique chart settings at each respective width. Experimental measurements showed that a constant noise-based AEC system yielded 175% relative noise for a 30-cm phantom and 206% relative dose for a 40-cm phantom compared with our clinical technique chart. Automatic exposure control systems that prescribe constant noise as patient size varies can yield excessive noise in small patients and excessive dose in obese patients compared with clinically accepted technique charts. Use of noise-level technique charts and tube current limits can mitigate these effects.

  11. Process control charts in infection prevention: Make it simple to make it happen.

    PubMed

    Wiemken, Timothy L; Furmanek, Stephen P; Carrico, Ruth M; Mattingly, William A; Persaud, Annuradha K; Guinn, Brian E; Kelley, Robert R; Ramirez, Julio A

    2017-03-01

    Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. The objectives of this report are to outline the development of the application and demonstrate application using simulated data. We used Research Electronic Data Capture (REDCap Consortium, Vanderbilt University, Nashville, TN), R (R Foundation for Statistical Computing, Vienna, Austria), and R Studio Shiny (R Foundation for Statistical Computing) to create an open source data collection system with automated process control chart generation. We used simulated data to test and visualize both in-control and out-of-control processes for commonly used metrics in IPC programs. The R code for implementing the control charts and Shiny application can be found on our Web site (https://github.com/ul-research-support/spcapp). Screen captures of the workflow and simulated data indicating both common cause and special cause variation are provided. Process control charts can be easily developed based on individual facility needs using freely available software. Through providing our work free to all interested parties, we hope that others will be able to harness the power and ease of use of the application for improving the quality of care and patient safety in their facilities. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. 29 CFR 801.21 - Adverse employment action under security service and controlled substance exemptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... current employee or prospective employee based solely on the analysis of a polygraph test chart or the refusal to take a polygraph test. (b) Analysis of a polygraph test chart or refusal to take a polygraph..., job performance, etc. may be used as a basis for employment decisions. Employment decisions based on...

  13. Statistical process control charts for attribute data involving very large sample sizes: a review of problems and solutions.

    PubMed

    Mohammed, Mohammed A; Panesar, Jagdeep S; Laney, David B; Wilson, Richard

    2013-04-01

    The use of statistical process control (SPC) charts in healthcare is increasing. The primary purpose of SPC is to distinguish between common-cause variation which is attributable to the underlying process, and special-cause variation which is extrinsic to the underlying process. This is important because improvement under common-cause variation requires action on the process, whereas special-cause variation merits an investigation to first find the cause. Nonetheless, when dealing with attribute or count data (eg, number of emergency admissions) involving very large sample sizes, traditional SPC charts often produce tight control limits with most of the data points appearing outside the control limits. This can give a false impression of common and special-cause variation, and potentially misguide the user into taking the wrong actions. Given the growing availability of large datasets from routinely collected databases in healthcare, there is a need to present a review of this problem (which arises because traditional attribute charts only consider within-subgroup variation) and its solutions (which consider within and between-subgroup variation), which involve the use of the well-established measurements chart and the more recently developed attribute charts based on Laney's innovative approach. We close by making some suggestions for practice.

  14. On the reliability of Shewhart-type control charts for multivariate process variability

    NASA Astrophysics Data System (ADS)

    Djauhari, Maman A.; Salleh, Rohayu Mohd; Zolkeply, Zunnaaim; Li, Lee Siaw

    2017-05-01

    We show that in the current practice of multivariate process variability monitoring, the reliability of Shewhart-type control charts cannot be measured except when the sub-group size n tends to infinity. However, the requirement of large n is meaningless not only in manufacturing industry where n is small but also in service industry where n is moderate. In this paper, we introduce a new definition of control limits in the two most appreciated control charts in the literature, i.e., the improved generalized variance chart (IGV-chart) and vector variance chart (VV-chart). With the new definition of control limits, the reliability of the control charts can be determined. Some important properties of new control limits will be derived and the computational technique of probability of false alarm will be delivered.

  15. Automatic Exposure Control Systems Designed to Maintain Constant Image Noise: Effects on Computed Tomography Dose and Noise Relative to Clinically Accepted Technique Charts

    PubMed Central

    Favazza, Christopher P.; Yu, Lifeng; Leng, Shuai; Kofler, James M.; McCollough, Cynthia H.

    2015-01-01

    Objective To compare computed tomography dose and noise arising from use of an automatic exposure control (AEC) system designed to maintain constant image noise as patient size varies with clinically accepted technique charts and AEC systems designed to vary image noise. Materials and Methods A model was developed to describe tube current modulation as a function of patient thickness. Relative dose and noise values were calculated as patient width varied for AEC settings designed to yield constant or variable noise levels and were compared to empirically derived values used by our clinical practice. Phantom experiments were performed in which tube current was measured as a function of thickness using a constant-noise-based AEC system and the results were compared with clinical technique charts. Results For 12-, 20-, 28-, 44-, and 50-cm patient widths, the requirement of constant noise across patient size yielded relative doses of 5%, 14%, 38%, 260%, and 549% and relative noises of 435%, 267%, 163%, 61%, and 42%, respectively, as compared with our clinically used technique chart settings at each respective width. Experimental measurements showed that a constant noise–based AEC system yielded 175% relative noise for a 30-cm phantom and 206% relative dose for a 40-cm phantom compared with our clinical technique chart. Conclusions Automatic exposure control systems that prescribe constant noise as patient size varies can yield excessive noise in small patients and excessive dose in obese patients compared with clinically accepted technique charts. Use of noise-level technique charts and tube current limits can mitigate these effects. PMID:25938214

  16. An Approach of Registration between Remote Sensing Image and Electronic Chart Based on Coastal Line

    NASA Astrophysics Data System (ADS)

    Li, Ying; Yu, Shuiming; Li, Chuanlong

    Remote sensing plays an important role marine oil spill emergency. In order to implement a timely and effective countermeasure, it is important to provide exact position of oil spills. Therefore it is necessary to match remote sensing image and electronic chart properly. Variance ordinarily exists between oil spill image and electronic chart, although geometric correction is applied to remote sensing image. It is difficult to find the steady control points on sea to make exact rectification of remote sensing image. An improved relaxation algorithm was developed for finding the control points along the coastline since oil spills occurs generally near the coast. A conversion function is created with the least square, and remote sensing image can be registered with the vector map based on this function. SAR image was used as the remote sensing data and shape format map as the electronic chart data. The results show that this approach can guarantee the precision of the registration, which is essential for oil spill monitoring.

  17. Quality and Efficiency Improvement Tools for Every Radiologist.

    PubMed

    Kudla, Alexei U; Brook, Olga R

    2018-06-01

    In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  18. Application of machine learning and expert systems to Statistical Process Control (SPC) chart interpretation

    NASA Technical Reports Server (NTRS)

    Shewhart, Mark

    1991-01-01

    Statistical Process Control (SPC) charts are one of several tools used in quality control. Other tools include flow charts, histograms, cause and effect diagrams, check sheets, Pareto diagrams, graphs, and scatter diagrams. A control chart is simply a graph which indicates process variation over time. The purpose of drawing a control chart is to detect any changes in the process signalled by abnormal points or patterns on the graph. The Artificial Intelligence Support Center (AISC) of the Acquisition Logistics Division has developed a hybrid machine learning expert system prototype which automates the process of constructing and interpreting control charts.

  19. The use of control charts by laypeople and hospital decision-makers for guiding decision making.

    PubMed

    Schmidtke, K A; Watson, D G; Vlaev, I

    2017-07-01

    Graphs presenting healthcare data are increasingly available to support laypeople and hospital staff's decision making. When making these decisions, hospital staff should consider the role of chance-that is, random variation. Given random variation, decision-makers must distinguish signals (sometimes called special-cause data) from noise (common-cause data). Unfortunately, many graphs do not facilitate the statistical reasoning necessary to make such distinctions. Control charts are a less commonly used type of graph that support statistical thinking by including reference lines that separate data more likely to be signals from those more likely to be noise. The current work demonstrates for whom (laypeople and hospital staff) and when (treatment and investigative decisions) control charts strengthen data-driven decision making. We present two experiments that compare people's use of control and non-control charts to make decisions between hospitals (funnel charts vs. league tables) and to monitor changes across time (run charts with control lines vs. run charts without control lines). As expected, participants more accurately identified the outlying data using a control chart than using a non-control chart, but their ability to then apply that information to more complicated questions (e.g., where should I go for treatment?, and should I investigate?) was limited. The discussion highlights some common concerns about using control charts in hospital settings.

  20. Using statistical process control to make data-based clinical decisions.

    PubMed

    Pfadt, A; Wheeler, D J

    1995-01-01

    Applied behavior analysis is based on an investigation of variability due to interrelationships among antecedents, behavior, and consequences. This permits testable hypotheses about the causes of behavior as well as for the course of treatment to be evaluated empirically. Such information provides corrective feedback for making data-based clinical decisions. This paper considers how a different approach to the analysis of variability based on the writings of Walter Shewart and W. Edwards Deming in the area of industrial quality control helps to achieve similar objectives. Statistical process control (SPC) was developed to implement a process of continual product improvement while achieving compliance with production standards and other requirements for promoting customer satisfaction. SPC involves the use of simple statistical tools, such as histograms and control charts, as well as problem-solving techniques, such as flow charts, cause-and-effect diagrams, and Pareto charts, to implement Deming's management philosophy. These data-analytic procedures can be incorporated into a human service organization to help to achieve its stated objectives in a manner that leads to continuous improvement in the functioning of the clients who are its customers. Examples are provided to illustrate how SPC procedures can be used to analyze behavioral data. Issues related to the application of these tools for making data-based clinical decisions and for creating an organizational climate that promotes their routine use in applied settings are also considered.

  1. Methods for computational disease surveillance in infection prevention and control: Statistical process control versus Twitter's anomaly and breakout detection algorithms.

    PubMed

    Wiemken, Timothy L; Furmanek, Stephen P; Mattingly, William A; Wright, Marc-Oliver; Persaud, Annuradha K; Guinn, Brian E; Carrico, Ruth M; Arnold, Forest W; Ramirez, Julio A

    2018-02-01

    Although not all health care-associated infections (HAIs) are preventable, reducing HAIs through targeted intervention is key to a successful infection prevention program. To identify areas in need of targeted intervention, robust statistical methods must be used when analyzing surveillance data. The objective of this study was to compare and contrast statistical process control (SPC) charts with Twitter's anomaly and breakout detection algorithms. SPC and anomaly/breakout detection (ABD) charts were created for vancomycin-resistant Enterococcus, Acinetobacter baumannii, catheter-associated urinary tract infection, and central line-associated bloodstream infection data. Both SPC and ABD charts detected similar data points as anomalous/out of control on most charts. The vancomycin-resistant Enterococcus ABD chart detected an extra anomalous point that appeared to be higher than the same time period in prior years. Using a small subset of the central line-associated bloodstream infection data, the ABD chart was able to detect anomalies where the SPC chart was not. SPC charts and ABD charts both performed well, although ABD charts appeared to work better in the context of seasonal variation and autocorrelation. Because they account for common statistical issues in HAI data, ABD charts may be useful for practitioners for analysis of HAI surveillance data. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. SU-C-BRD-03: Analysis of Accelerator Generated Text Logs for Preemptive Maintenance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Able, CM; Baydush, AH; Nguyen, C

    2014-06-15

    Purpose: To develop a model to analyze medical accelerator generated parameter and performance data that will provide an early warning of performance degradation and impending component failure. Methods: A robust 6 MV VMAT quality assurance treatment delivery was used to test the constancy of accelerator performance. The generated text log files were decoded and analyzed using statistical process control (SPC) methodology. The text file data is a single snapshot of energy specific and overall systems parameters. A total of 36 system parameters were monitored which include RF generation, electron gun control, energy control, beam uniformity control, DC voltage generation, andmore » cooling systems. The parameters were analyzed using Individual and Moving Range (I/MR) charts. The chart limits were calculated using a hybrid technique that included the use of the standard 3σ limits and the parameter/system specification. Synthetic errors/changes were introduced to determine the initial effectiveness of I/MR charts in detecting relevant changes in operating parameters. The magnitude of the synthetic errors/changes was based on: the value of 1 standard deviation from the mean operating parameter of 483 TB systems, a small fraction (≤ 5%) of the operating range, or a fraction of the minor fault deviation. Results: There were 34 parameters in which synthetic errors were introduced. There were 2 parameters (radial position steering coil, and positive 24V DC) in which the errors did not exceed the limit of the I/MR chart. The I chart limit was exceeded for all of the remaining parameters (94.2%). The MR chart limit was exceeded in 29 of the 32 parameters (85.3%) in which the I chart limit was exceeded. Conclusion: Statistical process control I/MR evaluation of text log file parameters may be effective in providing an early warning of performance degradation or component failure for digital medical accelerator systems. Research is Supported by Varian Medical Systems, Inc.« less

  3. A web-based information system for management and analysis of patient data after refractive eye surgery.

    PubMed

    Zuberbuhler, Bruno; Galloway, Peter; Reddy, Aravind; Saldana, Manuel; Gale, Richard

    2007-12-01

    The aim was to develop a software tool for refractive surgeons using a standard user-friendly web-based interface, providing the user with a secure environment to protect large volumes of patient data. The software application was named "Internet-based refractive analysis" (IBRA), and was programmed with the computer languages PHP, HTML and JavaScript, attached to the opensource MySQL database. IBRA facilitated internationally accepted presentation methods including the stability chart, the predictability chart and the safety chart; it was able to perform vector analysis for the course of a single patient or for group data. With the integrated nomogram calculation, treatment could be customised to reduce the postoperative refractive error. Multicenter functions permitted quality-control comparisons between different surgeons and laser units.

  4. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    PubMed

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (p<0.001). Since 2010, the quarterly rate of severe PPH has not exceeded the upper control limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. An ex ante control chart for project monitoring using earned duration management observations

    NASA Astrophysics Data System (ADS)

    Mortaji, Seyed Taha Hossein; Noori, Siamak; Noorossana, Rassoul; Bagherpour, Morteza

    2017-12-01

    In the past few years, there has been an increasing interest in developing project control systems. The primary purpose of such systems is to indicate whether the actual performance is consistent with the baseline and to produce a signal in the case of non-compliance. Recently, researchers have shown an increased interest in monitoring project's performance indicators, by plotting them on the Shewhart-type control charts over time. However, these control charts are fundamentally designed for processes and ignore project-specific dynamics, which can lead to weak results and misleading interpretations. By paying close attention to the project baseline schedule and using statistical foundations, this paper proposes a new ex ante control chart which discriminates between acceptable (as-planned) and non-acceptable (not-as-planned) variations of the project's schedule performance. Such control chart enables project managers to set more realistic thresholds leading to a better decision making for taking corrective and/or preventive actions. For the sake of clarity, an illustrative example has been presented to show how the ex ante control chart is constructed in practice. Furthermore, an experimental investigation has been set up to analyze the performance of the proposed control chart. As expected, the results confirm that, when a project starts to deflect significantly from the project's baseline schedule, the ex ante control chart shows a respectable ability to detect and report right signals while avoiding false alarms.

  6. Control chart pattern recognition using RBF neural network with new training algorithm and practical features.

    PubMed

    Addeh, Abdoljalil; Khormali, Aminollah; Golilarz, Noorbakhsh Amiri

    2018-05-04

    The control chart patterns are the most commonly used statistical process control (SPC) tools to monitor process changes. When a control chart produces an out-of-control signal, this means that the process has been changed. In this study, a new method based on optimized radial basis function neural network (RBFNN) is proposed for control chart patterns (CCPs) recognition. The proposed method consists of four main modules: feature extraction, feature selection, classification and learning algorithm. In the feature extraction module, shape and statistical features are used. Recently, various shape and statistical features have been presented for the CCPs recognition. In the feature selection module, the association rules (AR) method has been employed to select the best set of the shape and statistical features. In the classifier section, RBFNN is used and finally, in RBFNN, learning algorithm has a high impact on the network performance. Therefore, a new learning algorithm based on the bees algorithm has been used in the learning module. Most studies have considered only six patterns: Normal, Cyclic, Increasing Trend, Decreasing Trend, Upward Shift and Downward Shift. Since three patterns namely Normal, Stratification, and Systematic are very similar to each other and distinguishing them is very difficult, in most studies Stratification and Systematic have not been considered. Regarding to the continuous monitoring and control over the production process and the exact type detection of the problem encountered during the production process, eight patterns have been investigated in this study. The proposed method is tested on a dataset containing 1600 samples (200 samples from each pattern) and the results showed that the proposed method has a very good performance. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

  7. Synthetic-Type Control Charts for Time-Between-Events Monitoring

    PubMed Central

    Yen, Fang Yen; Chong, Khoo Michael Boon; Ha, Lee Ming

    2013-01-01

    This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts. PMID:23755231

  8. 'Correction:'Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement

    PubMed Central

    Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

    2007-01-01

    Background The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%–72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components – neurological, vascular and skin foot exam – increased over time (6% to 24%, p < 0.001). Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial. PMID:17662124

  9. Peer chart audits: a tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement.

    PubMed

    Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

    2007-07-27

    The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%-72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components - neurological, vascular and skin foot exam - increased over time (6% to 24%, p < 0.001). Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

  10. Control chart applications in healthcare: a literature review

    NASA Astrophysics Data System (ADS)

    Suman, Gaurav; Prajapati, DeoRaj

    2018-05-01

    The concept of Statistical process control (SPC) was given by the physicist Walter Shewhart in order to improve the industrial manufacturing. The SPC was firstly applied in laboratory and after then shifted to patient level in hospitals. As there is more involvement of human in healthcare, the chances of errors are also more. SPC i.e., control chart can help in determining the source of errors by identifying the special and common causes of variations. This paper presents the review of literature on the application of SPC and control chart in healthcare sector. Forty articles are selected out of 142 potentially relevant searched studies. Selected studies are categorised into eight departments. Literature survey shows that most of work on control chart applications in healthcare is carried out in Surgery, Emergency and Epidemiology departments. US, UK and Australia are the main customers where maximum amount of work was done. The US is the country where control chart in healthcare sector have been used at regular interval. This shows the gap of deploying control chart in different departments and different countries as well. The CUSUM and EWMA chart came into picture in healthcare sector after 2008 and are used at regular interval.

  11. 75 FR 1020 - Amendments to the Export Administration Regulations (EAR) Based Upon the Accession of Albania and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ...--Commerce Country Chart [Reason for control] Countries Chemical & biological Nuclear National Security Missile Regional Stability Firearms Crime control Anti-terrorism weapons nonproliferation Tech convention...

  12. Performance of Bootstrap MCEWMA: Study case of Sukuk Musyarakah data

    NASA Astrophysics Data System (ADS)

    Safiih, L. Muhamad; Hila, Z. Nurul

    2014-07-01

    Sukuk Musyarakah is one of several instruments of Islamic bond investment in Malaysia, where the form of this sukuk is actually based on restructuring the conventional bond to become a Syariah compliant bond. The Syariah compliant is based on prohibition of any influence of usury, benefit or fixed return. Despite of prohibition, daily returns of sukuk are non-fixed return and in statistic, the data of sukuk returns are said to be a time series data which is dependent and autocorrelation distributed. This kind of data is a crucial problem whether in statistical and financing field. Returns of sukuk can be statistically viewed by its volatility, whether it has high volatility that describing the dramatically change of price and categorized it as risky bond or else. However, this crucial problem doesn't get serious attention among researcher compared to conventional bond. In this study, MCEWMA chart in Statistical Process Control (SPC) is mainly used to monitor autocorrelated data and its application on daily returns of securities investment data has gained widespread attention among statistician. However, this chart has always been influence by inaccurate estimation, whether on base model or its limit, due to produce large error and high of probability of signalling out-of-control process for false alarm study. To overcome this problem, a bootstrap approach used in this study, by hybridise it on MCEWMA base model to construct a new chart, i.e. Bootstrap MCEWMA (BMCEWMA) chart. The hybrid model, BMCEWMA, will be applied to daily returns of sukuk Musyarakah for Rantau Abang Capital Bhd. The performance of BMCEWMA base model showed that its more effective compare to real model, MCEWMA based on smaller error estimation, shorter the confidence interval and smaller false alarm. In other word, hybrid chart reduce the variability which shown by smaller error and false alarm. It concludes that the application of BMCEWMA is better than MCEWMA.

  13. Plan delivery quality assurance for CyberKnife: Statistical process control analysis of 350 film-based patient-specific QAs.

    PubMed

    Bellec, J; Delaby, N; Jouyaux, F; Perdrieux, M; Bouvier, J; Sorel, S; Henry, O; Lafond, C

    2017-07-01

    Robotic radiosurgery requires plan delivery quality assurance (DQA) but there has never been a published comprehensive analysis of a patient-specific DQA process in a clinic. We proposed to evaluate 350 consecutive film-based patient-specific DQAs using statistical process control. We evaluated the performance of the process to propose achievable tolerance criteria for DQA validation and we sought to identify suboptimal DQA using control charts. DQAs were performed on a CyberKnife-M6 using Gafchromic-EBT3 films. The signal-to-dose conversion was performed using a multichannel-correction and a scanning protocol that combined measurement and calibration in a single scan. The DQA analysis comprised a gamma-index analysis at 3%/1.5mm and a separate evaluation of spatial and dosimetric accuracy of the plan delivery. Each parameter was plotted on a control chart and control limits were calculated. A capability index (Cpm) was calculated to evaluate the ability of the process to produce results within specifications. The analysis of capability showed that a gamma pass rate of 85% at 3%/1.5mm was highly achievable as acceptance criteria for DQA validation using a film-based protocol (Cpm>1.33). 3.4% of DQA were outside a control limit of 88% for gamma pass-rate. The analysis of the out-of-control DQA helped identify a dosimetric error in our institute for a specific treatment type. We have defined initial tolerance criteria for DQA validations. We have shown that the implementation of a film-based patient-specific DQA protocol with the use of control charts is an effective method to improve patient treatment safety on CyberKnife. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Evaluation of Shiryaev-Roberts procedure for on-line environmental radiation monitoring.

    PubMed

    Watson, Mara M; Seliman, Ayman F; Bliznyuk, Valery N; DeVol, Timothy A

    2018-04-30

    Water can become contaminated as a result of a leak from a nuclear facility, such as a waste facility, or from clandestine nuclear activity. Low-level on-line radiation monitoring is needed to detect these events in real time. A Bayesian control chart method, Shiryaev-Roberts (SR) procedure, was compared with classical methods, 3-σ and cumulative sum (CUSUM), for quantifying an accumulating signal from an extractive scintillating resin flow-cell detection system. Solutions containing 0.10-5.0 Bq/L of 99 Tc, as T99cO 4 - were pumped through a flow cell packed with extractive scintillating resin used in conjunction with a Beta-RAM Model 5 HPLC detector. While T99cO 4 - accumulated on the resin, time series data were collected. Control chart methods were applied to the data using statistical algorithms developed in MATLAB. SR charts were constructed using Poisson (Poisson SR) and Gaussian (Gaussian SR) probability distributions of count data to estimate the likelihood ratio. Poisson and Gaussian SR charts required less volume of radioactive solution at a fixed concentration to exceed the control limit in most cases than 3-σ and CUSUM control charts, particularly solutions with lower activity. SR is thus the ideal control chart for low-level on-line radiation monitoring. Once the control limit was exceeded, activity concentrations were estimated from the SR control chart using the control chart slope on a semi-logarithmic plot. A linear regression fit was applied to averaged slope data for five activity concentration groupings for Poisson and Gaussian SR control charts. A correlation coefficient (R 2 ) of 0.77 for Poisson SR and 0.90 for Gaussian SR suggest this method will adequately estimate activity concentration for an unknown solution. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Applying Statistical Process Control to Clinical Data: An Illustration.

    ERIC Educational Resources Information Center

    Pfadt, Al; And Others

    1992-01-01

    Principles of statistical process control are applied to a clinical setting through the use of control charts to detect changes, as part of treatment planning and clinical decision-making processes. The logic of control chart analysis is derived from principles of statistical inference. Sample charts offer examples of evaluating baselines and…

  16. Improving blood pressure control in diabetes: limitations of a clinical reminder in influencing physician behavior.

    PubMed

    Sanders, Karen M; Satyvavolu, Anuradha

    2002-01-01

    Hypertension should be aggressively treated, especially in diabetic patients. But studies of physician prescribing habits reveal that physicians often delay making medication changes or initiating antihypertensive therapy. A chart-based reminder was designed to improve physician medication prescribing in this clinical situation. A randomized controlled trial was conducted at the Veterans Affairs Medical Center in Richmond, Virginia. Patients with diabetes and hypertension were selected. A highly visible chart reminder was applied to the front of outpatient charts in the intervention group practice. A chart review was conducted to assess physician-directed medication changes. A successful outcome was defined as any antihypertensive medication increase or addition at that same visit. Physicians were more likely to intensify antihypertensive medication as the blood pressure increased regardless of the reminder. Overall, only 33% of visits resulted in a medication change, even though 93% of patients had elevations over target blood pressure at the follow-up visit. Physicians in the intervention and control groups made changes to medication at similar rates (chi 2 = 0.621, p = .511). In this study, a chart reminder failed to improve physician compliance with the clinical guideline for hypertension management in diabetics, Sixth Report of the Joint National Committee on the Detection, Evaluation, Prevention and Treatment of High Blood Pressure. To inform the design of effective intervention strategies, further research should explore specific barriers to guideline adherence in this clinical situation.

  17. Optimization and validation of moving average quality control procedures using bias detection curves and moving average validation charts.

    PubMed

    van Rossum, Huub H; Kemperman, Hans

    2017-02-01

    To date, no practical tools are available to obtain optimal settings for moving average (MA) as a continuous analytical quality control instrument. Also, there is no knowledge of the true bias detection properties of applied MA. We describe the use of bias detection curves for MA optimization and MA validation charts for validation of MA. MA optimization was performed on a data set of previously obtained consecutive assay results. Bias introduction and MA bias detection were simulated for multiple MA procedures (combination of truncation limits, calculation algorithms and control limits) and performed for various biases. Bias detection curves were generated by plotting the median number of test results needed for bias detection against the simulated introduced bias. In MA validation charts the minimum, median, and maximum numbers of assay results required for MA bias detection are shown for various bias. Their use was demonstrated for sodium, potassium, and albumin. Bias detection curves allowed optimization of MA settings by graphical comparison of bias detection properties of multiple MA. The optimal MA was selected based on the bias detection characteristics obtained. MA validation charts were generated for selected optimal MA and provided insight into the range of results required for MA bias detection. Bias detection curves and MA validation charts are useful tools for optimization and validation of MA procedures.

  18. Monitoring scale scores over time via quality control charts, model-based approaches, and time series techniques.

    PubMed

    Lee, Yi-Hsuan; von Davier, Alina A

    2013-07-01

    Maintaining a stable score scale over time is critical for all standardized educational assessments. Traditional quality control tools and approaches for assessing scale drift either require special equating designs, or may be too time-consuming to be considered on a regular basis with an operational test that has a short time window between an administration and its score reporting. Thus, the traditional methods are not sufficient to catch unusual testing outcomes in a timely manner. This paper presents a new approach for score monitoring and assessment of scale drift. It involves quality control charts, model-based approaches, and time series techniques to accommodate the following needs of monitoring scale scores: continuous monitoring, adjustment of customary variations, identification of abrupt shifts, and assessment of autocorrelation. Performance of the methodologies is evaluated using manipulated data based on real responses from 71 administrations of a large-scale high-stakes language assessment.

  19. Study on the quality of FRP fishing vessel based on improved Fishbone Chart

    NASA Astrophysics Data System (ADS)

    Sui, J. H.; Yu, Y. F.; Du, Q. F.; Jiang, D. W.

    2018-01-01

    The construction quality of FRP fishing vessels influences their production, use and industry development. In order to explore the factors that affect the construction quality of FRP fishing vessels, key factors affecting the construction quality of FRP fishing vessels are determined based on the quality problems of FRP fishing vessels constructed. The improved Fishbone Chart is used to analyze the eight factors of “human, machine, material, process, environment, inspection, design and information”. Taking the factors that affect the construction quality of FRP fishing vessels as the central target, the eight influencing factors were condensed into five aspects and a composite Fishbone Chart is drawn. The Fishbone Chart is used as the basic model, the influencing factors are sorted, screened and discriminated, and the system model convenient for construction site management and control is established. Finally, the causes of poor construction of FRP fishing vessels are analyzed and discussed, and relevant suggestions are put forward.

  20. Control charts for monitoring accumulating adverse event count frequencies from single and multiple blinded trials.

    PubMed

    Gould, A Lawrence

    2016-12-30

    Conventional practice monitors accumulating information about drug safety in terms of the numbers of adverse events reported from trials in a drug development program. Estimates of between-treatment adverse event risk differences can be obtained readily from unblinded trials with adjustment for differences among trials using conventional statistical methods. Recent regulatory guidelines require monitoring the cumulative frequency of adverse event reports to identify possible between-treatment adverse event risk differences without unblinding ongoing trials. Conventional statistical methods for assessing between-treatment adverse event risks cannot be applied when the trials are blinded. However, CUSUM charts can be used to monitor the accumulation of adverse event occurrences. CUSUM charts for monitoring adverse event occurrence in a Bayesian paradigm are based on assumptions about the process generating the adverse event counts in a trial as expressed by informative prior distributions. This article describes the construction of control charts for monitoring adverse event occurrence based on statistical models for the processes, characterizes their statistical properties, and describes how to construct useful prior distributions. Application of the approach to two adverse events of interest in a real trial gave nearly identical results for binomial and Poisson observed event count likelihoods. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. A method of setting limits for the purpose of quality assurance

    NASA Astrophysics Data System (ADS)

    Sanghangthum, Taweap; Suriyapee, Sivalee; Kim, Gwe-Ya; Pawlicki, Todd

    2013-10-01

    The result from any assurance measurement needs to be checked against some limits for acceptability. There are two types of limits; those that define clinical acceptability (action limits) and those that are meant to serve as a warning that the measurement is close to the action limits (tolerance limits). Currently, there is no standard procedure to set these limits. In this work, we propose an operational procedure to set tolerance limits and action limits. The approach to establish the limits is based on techniques of quality engineering using control charts and a process capability index. The method is different for tolerance limits and action limits with action limits being categorized into those that are specified and unspecified. The procedure is to first ensure process control using the I-MR control charts. Then, the tolerance limits are set equal to the control chart limits on the I chart. Action limits are determined using the Cpm process capability index with the requirements that the process must be in-control. The limits from the proposed procedure are compared to an existing or conventional method. Four examples are investigated: two of volumetric modulated arc therapy (VMAT) point dose quality assurance (QA) and two of routine linear accelerator output QA. The tolerance limits range from about 6% larger to 9% smaller than conventional action limits for VMAT QA cases. For the linac output QA, tolerance limits are about 60% smaller than conventional action limits. The operational procedure describe in this work is based on established quality management tools and will provide a systematic guide to set up tolerance and action limits for different equipment and processes.

  2. Effective solutions for monitoring the electrostatic separation of metal and plastic granular waste from electric and electronic equipment.

    PubMed

    Senouci, Khouira; Medles, Karim; Dascalescu, Lucian

    2013-02-01

    The variability of the quantity and purity of the recovered materials is a serious drawback for the application of electrostatic separation technologies to the recycling of granular wastes. In a series of previous articles we have pointed out how capability and classic control chart concepts could be employed for better mastering the outcome of such processes. In the present work, the multiple exponentially weighted moving average (MEWMA) control chart is introduced and shown to be more effective than the Hotelling T2 chart for monitoring slow varying changes in the electrostatic separation of granular mixtures originating from electric and electronic equipment waste. The operation of the industrial process was simulated by using a laboratory roll-type electrostatic separator and granular samples resulting from shredded electric cable wastes. The 25 tests carried out during the observation phase enabled the calculation of the upper and lower control limits for the two control charts considered in the present study. The 11 additional tests that simulated the monitoring phase pointed out that the MEWMA chart is more effective than Hotelling's T(2) chart in detecting slow varying changes in the outcome of a process. As the reverse is true in the case of abrupt alterations of monitored process performances, simultaneous usage of the two control charts is strongly recommended. While this study focused on a specific electrostatic separation process, using the MEWMA chart together with the well known Hotelling's T(2) chart should be applicable to the statistical control of other complex processes in the field of waste processing.

  3. Enhancing learning using questions, adjunct to science charts

    NASA Astrophysics Data System (ADS)

    Holliday, William G.; Benson, Garth

    This study supported two hypotheses. First, adjunct questions interacted with a science chart so powerfully that content established as difficult to learn in the pilot and in this study's control groups became easier to learn when charted. Second, students familiar with the chart test before instruction (test exposure) were better prepared to take this test after instruction. This adjunct-question study examined the generalizability of selective-attention and academic-studying hypotheses to a modified science chart medium. About 300 high school students were randomly assigned to four conditions each including a vitamin chart (chart only, test exposure, importance of questions emphasized to students by teachers, and combinational conditions - test exposure and question importance) across 16 biology classrooms. Then these same students were again randomly assigned within each classroom to a control and to four question treatments no questions, questions focusing on easy-to-learn charted content, questions focusing on difficult-to-learn charted content, and a combinational treatment.

  4. Enhancing learning using questions adjunct to science charts

    NASA Astrophysics Data System (ADS)

    Holliday, William G.; Benson, Garth

    This study supported two hypotheses. First, adjunct questions interacted with a science chart so powerfully that content established as difficult to learn in the pilot and in this study's control groups became easier to learn when charted. Second, students familiar with the chart test before instruction (test exposure) were better prepared to take this test after instruction. This adjunct-question study examined the generalizability of selective-attention and academic-studying hypotheses to a modified science chart medium. About 300 high school students were randomly assigned to four conditions each including a vitamin chart (chart only, test exposure, importance of questions emphasized to students by teachers, and combinational conditions--test exposure and question importance) across 16 biology classrooms. Then these same students were again randomly assigned within each classroom to a control and to four question treatments (no questions, questions focusing on easy-to-learn charted content, questions focusing on difficult-to-learn charted content, and a combinational treatment).

  5. Statistical process control: a practical application for hospitals.

    PubMed

    VanderVeen, L M

    1992-01-01

    A six-step plan based on using statistics was designed to improve quality in the central processing and distribution department of a 223-bed hospital in Oakland, CA. This article describes how the plan was implemented sequentially, starting with the crucial first step of obtaining administrative support. The QI project succeeded in overcoming beginners' fear of statistics and in training both managers and staff to use inspection checklists, Pareto charts, cause-and-effect diagrams, and control charts. The best outcome of the program was the increased commitment to quality improvement by the members of the department.

  6. Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals.

    PubMed

    Rasmussen, Thomas Bøjer; Ulrichsen, Sinna Pilgaard; Nørgaard, Mette

    2018-01-01

    Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM) chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes. The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses. We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations. Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals' estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54). In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease. The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most Danish hospitals. Together with descriptive analyses, it was possible to use an alarm from a risk-adjusted CUSUM chart to identify potential performance problems.

  7. An Approach for Implementing a Microcomputer Based Report Origination System in the Ada Programming Language

    DTIC Science & Technology

    1983-03-01

    Decision Tree -------------------- 62 4-E. PACKAGE unitrep Action/Area Selection flow Chart 82 4-7. PACKAGE unitrep Control Flow Chart...the originetor wculd manually draft simple, readable, formatted iressages using "-i predef.ined forms and decision logic trees . This alternative was...Study Analysis DATA CCNTENT ERRORS PERCENT OF ERRORS Character Type 2.1 Calcvlations/Associations 14.3 Message Identification 4.? Value Pisiratch 22.E

  8. [Selecting methods of controls concentration for internal quality control and continuity of control chart between different reagent lots for HBsAg qualitative detection].

    PubMed

    Li, Jin-ming; Zheng, Huai-jing; Wang, Lu-nan; Deng, Wei

    2003-04-01

    To establish a model for one choosing controls with a suitable concentration for internal quality control (IQC) with qualitative ELISA detection, and a consecutive plotting method on Levey-Jennings control chart when reagent kit lot is changed. First, a series of control serum with 0.2, 0.5, 1.0, 2.0 and 5.0ng/ml HBsAg respectively were assessed for within-run and between-run precision according to NCCLs EP5 document. Then, a linear regression equation (y=bx + a) with best correlation coefficient (r > 0.99) was established based on S/CO values of the series of control serum. Finally, one could choose controls with S/CO value calculated from the equation (y = bx + a) minus the product of the S/CO value multiplying three-fold between-run CV to be still more than 1.0 for IQC use. For consecutive plotting on Levey-Jennings control chart when ELISA kit lot was changed, the new lot kits were used to detect the same series of HBsAg control serum as above. Then, a new linear regression equation (y2 = b2x2 + a2) with best correlation coefficient was obtained. The old one (y1 =b1x1 + a1) could be obtained based on the mean values from above precision assessment. The S/CO value of a control serum detected by new lot kit could be changed to that detected by old kit lot based on the factor of y2/y1. Therefore, the plotting on primary Levey-Jennings control chart could be continued. The within-run coefficient of variation CV of the ELISA method for control serum with 0.2, 0.5, 1.0, 2.0 and 5.0ng/ml HBsAg were 11.08%, 9.49%, 9.83%, 9.18% and 7.25%, respectively, and between-run CV were 13.25%, 14.03%, 15.11%, 13.29% and 9.92%. The linear regression equation with best correlation coefficient from a test at random was y = 3.509x + 0.180. The suitable concentration of control serum for IQC could be 0.5ng/ml or 1.0ng/ml. The linear regression equation from the old lot and other two new lots of the ELISA kits were y1 = 3.550(x1) + 0.226, y2 = 3.238(x2) +0.388, and y3 =3.428(x3) + 0.148, respectively. Then, the transferring factors of 0.960 (y2/y1) and 0.908 (y3/y1) were obtained. The results shows that the model established for IQC control serum concentration selecting and for consecutive plotting on control chart when the reagent lot is changed is effective and practical.

  9. Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial

    PubMed Central

    Gidwani, Risha; Nguyen, Cathina; Kofoed, Alexis; Carragee, Catherine; Rydel, Tracy; Nelligan, Ian; Sattler, Amelia; Mahoney, Megan; Lin, Steven

    2017-01-01

    PURPOSE Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency. METHODS We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 year. Scribes drafted all relevant documentation, which was reviewed by the physician before attestation and signing. In encounters without a scribe, the physician performed all charting duties. Our outcomes were physician satisfaction, measured by a 5-item instrument that included physicians’ perceptions of chart quality and chart accuracy; patient satisfaction, measured by a 6-item instrument; and charting efficiency, measured by time to chart close. RESULTS Scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic (OR = 10.75), having enough face time with patients (OR = 3.71), time spent charting (OR = 86.09), chart quality (OR = 7.25), and chart accuracy (OR = 4.61) (all P values <.001). Scribes had no effect on patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours (OR =1.18, P =.028). CONCLUSIONS To our knowledge, we have conducted the first randomized controlled trial of scribes. We found that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy, and charting efficiency without detracting from patient satisfaction. Scribes appear to be a promising strategy to improve health care efficiency and reduce physician burnout. PMID:28893812

  10. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Costa, Mafalda T., E-mail: mafaldatcosta@gmail.com; Carolino, Elisabete, E-mail: lizcarolino@gmail.com; Oliveira, Teresa A., E-mail: teresa.oliveira@uab.pt

    In water supply systems with distribution networkthe most critical aspects of control and Monitoring of water quality, which generates crises system, are the effects of cross-contamination originated by the network typology. The classics of control of quality systems through the application of Shewhart charts are generally difficult to manage in real time due to the high number of charts that must be completed and evaluated. As an alternative to the traditional control systems with Shewhart charts, this study aimed to apply a simplified methodology of a monitoring plan quality parameters in a drinking water distribution, by applying Hotelling’s T{sup 2}more » charts and supplemented with Shewhart charts with Bonferroni limits system, whenever instabilities with processes were detected.« less

  11. Statistical process control charts for monitoring military injuries.

    PubMed

    Schuh, Anna; Canham-Chervak, Michelle; Jones, Bruce H

    2017-12-01

    An essential aspect of an injury prevention process is surveillance, which quantifies and documents injury rates in populations of interest and enables monitoring of injury frequencies, rates and trends. To drive progress towards injury reduction goals, additional tools are needed. Statistical process control charts, a methodology that has not been previously applied to Army injury monitoring, capitalise on existing medical surveillance data to provide information to leadership about injury trends necessary for prevention planning and evaluation. Statistical process control Shewhart u-charts were created for 49 US Army installations using quarterly injury medical encounter rates, 2007-2015, for active duty soldiers obtained from the Defense Medical Surveillance System. Injuries were defined according to established military injury surveillance recommendations. Charts display control limits three standard deviations (SDs) above and below an installation-specific historical average rate determined using 28 data points, 2007-2013. Charts are available in Army strategic management dashboards. From 2007 to 2015, Army injury rates ranged from 1254 to 1494 unique injuries per 1000 person-years. Installation injury rates ranged from 610 to 2312 injuries per 1000 person-years. Control charts identified four installations with injury rates exceeding the upper control limits at least once during 2014-2015, rates at three installations exceeded the lower control limit at least once and 42 installations had rates that fluctuated around the historical mean. Control charts can be used to drive progress towards injury reduction goals by indicating statistically significant increases and decreases in injury rates. Future applications to military subpopulations, other health outcome metrics and chart enhancements are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Breast cancer screening (BCS) chart: a basic and preliminary model for making screening mammography more productive and efficient.

    PubMed

    Poorolajal, Jalal; Akbari, Mohammad Esmaeil; Ziaee, Fatane; Karami, Manoochehr; Ghoncheh, Mahshid

    2017-05-15

    The breast cancer screening (BCS) chart is suggested as a basic and preliminary tool to improve efficiency of screening mammography. We conducted this case-control study in 2016 and enrolled 1422 women aged 30-75 years, including 506 women with breast cancer (cases) and 916 women without breast cancer (controls). We developed the BCS chart using a multiple logistic regression analysis. We combined the risks of breast cancer to predict the individual risk of breast cancer. Then, we stratified and colored the predicted risk probabilities as follows: <05% (green), 05-09% (yellow), 10-14% (orange), 15-19% (red), 20-24% (brown) and ≥25% (black). The BCS chart provides the risk probability of breast cancer, based on age, body mass index, late menopause, having a benign breast disease and a positive family history of breast cancer among the first-degree or the second/third-degree relatives. According to this chart, an individual can be classified in a category of low risk (green), medium risk (yellow and orange), high risk (red and brown) and very high risk (black) for breast cancer. This chart is a flexible and easy to use tool that can detect high-risk subjects and make the screening program more efficient and productive. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. A Tale of Two Methods: Chart and Interview Methods for Identifying Delirium

    PubMed Central

    Saczynski, Jane S.; Kosar, Cyrus M.; Xu, Guoquan; Puelle, Margaret R.; Schmitt, Eva; Jones, Richard N.; Marcantonio, Edward R.; Wong, Bonnie; Isaza, Ilean; Inouye, Sharon K.

    2014-01-01

    Background Interview and chart-based methods for identifying delirium have been validated. However, relative strengths and limitations of each method have not been described, nor has a combined approach (using both interviews and chart), been systematically examined. Objectives To compare chart and interview-based methods for identification of delirium. Design, Setting and Participants Participants were 300 patients aged 70+ undergoing major elective surgery (majority were orthopedic surgery) interviewed daily during hospitalization for delirium using the Confusion Assessment Method (CAM; interview-based method) and whose medical charts were reviewed for delirium using a validated chart-review method (chart-based method). We examined rate of agreement on the two methods and patient characteristics of those identified using each approach. Predictive validity for clinical outcomes (length of stay, postoperative complications, discharge disposition) was compared. In the absence of a gold-standard, predictive value could not be calculated. Results The cumulative incidence of delirium was 23% (n= 68) by the interview-based method, 12% (n=35) by the chart-based method and 27% (n=82) by the combined approach. Overall agreement was 80%; kappa was 0.30. The methods differed in detection of psychomotor features and time of onset. The chart-based method missed delirium in CAM-identified patients laacking features of psychomotor agitation or inappropriate behavior. The CAM-based method missed chart-identified cases occurring during the night shift. The combined method had high predictive validity for all clinical outcomes. Conclusions Interview and chart-based methods have specific strengths for identification of delirium. A combined approach captures the largest number and the broadest range of delirium cases. PMID:24512042

  14. Application of interactive motion charts for displaying liver transplantation data in public websites.

    PubMed

    Santori, G

    2014-09-01

    In the past several years a vast amount of digital information has become available in every field of science, and ideas to apply improved strategies for obtaining a more in-depth knowledge of the data are considered in many areas. Although several American and European organizations show regularly in their public websites the aggregated results of organ donation and transplantation, no tools are provided to engage with the final users and to enable them to handle these data. In this study, a new model of Web-based interactive motion charts was applied to aggregated liver transplantation data obtained from a consecutive 28-year series of liver transplantation performed in a single Italian center. The interactive charts were obtained by combining the Google visualization application programming interface and the googleVis package within the open source statistical environment R. The interactive charts may be embedded into online/offline Web pages and rendered in each common browser. The users may interact with the charts by selecting chart type (bubble, bar, or line chart), x- and y-axis scales (linear or logarithmic), variables, bubble size, color, and even changing opacity of unselected items. Moreover, the charts may dynamically display the trend over time of each continuous/categoric variable, allowing users both to trace how the lines changes over time and to control the animation speed. The interactive motion charts should be used in the public websites that manage aggregated data concerning organ donation and transplantation. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Results of a multicentre randomised controlled trial of statistical process control charts and structured diagnostic tools to reduce ward-acquired meticillin-resistant Staphylococcus aureus: the CHART Project.

    PubMed

    Curran, E; Harper, P; Loveday, H; Gilmour, H; Jones, S; Benneyan, J; Hood, J; Pratt, R

    2008-10-01

    Statistical process control (SPC) charts have previously been advocated for infection control quality improvement. To determine their effectiveness, a multicentre randomised controlled trial was undertaken to explore whether monthly SPC feedback from infection control nurses (ICNs) to healthcare workers of ward-acquired meticillin-resistant Staphylococcus aureus (WA-MRSA) colonisation or infection rates would produce any reductions in incidence. Seventy-five wards in 24 hospitals in the UK were randomised into three arms: (1) wards receiving SPC chart feedback; (2) wards receiving SPC chart feedback in conjunction with structured diagnostic tools; and (3) control wards receiving neither type of feedback. Twenty-five months of pre-intervention WA-MRSA data were compared with 24 months of post-intervention data. Statistically significant and sustained decreases in WA-MRSA rates were identified in all three arms (P<0.001; P=0.015; P<0.001). The mean percentage reduction was 32.3% for wards receiving SPC feedback, 19.6% for wards receiving SPC and diagnostic feedback, and 23.1% for control wards, but with no significant difference between the control and intervention arms (P=0.23). There were significantly more post-intervention 'out-of-control' episodes (P=0.021) in the control arm (averages of 0.60, 0.28, and 0.28 for Control, SPC and SPC+Tools wards, respectively). Participants identified SPC charts as an effective communication tool and valuable for disseminating WA-MRSA data.

  16. A strip chart recorder pattern recognition tool kit for Shuttle operations

    NASA Technical Reports Server (NTRS)

    Hammen, David G.; Moebes, Travis A.; Shelton, Robert O.; Savely, Robert T.

    1993-01-01

    During Space Shuttle operations, Mission Control personnel monitor numerous mission-critical systems such as electrical power; guidance, navigation, and control; and propulsion by means of paper strip chart recorders. For example, electrical power controllers monitor strip chart recorder pen traces to identify onboard electrical equipment activations and deactivations. Recent developments in pattern recognition technologies coupled with new capabilities that distribute real-time Shuttle telemetry data to engineering workstations make it possible to develop computer applications that perform some of the low-level monitoring now performed by controllers. The number of opportunities for such applications suggests a need to build a pattern recognition tool kit to reduce software development effort through software reuse. We are building pattern recognition applications while keeping such a tool kit in mind. We demonstrated the initial prototype application, which identifies electrical equipment activations, during three recent Shuttle flights. This prototype was developed to test the viability of the basic system architecture, to evaluate the performance of several pattern recognition techniques including those based on cross-correlation, neural networks, and statistical methods, to understand the interplay between an advanced automation application and human controllers to enhance utility, and to identify capabilities needed in a more general-purpose tool kit.

  17. The development of IoT based BBT charting and monitoring using ThingSpeak

    NASA Astrophysics Data System (ADS)

    Yazed, Muhammad Syukri Mohd; Mahmud, Farhanahani

    2017-01-01

    Family planning is necessary for individual and couples to manage their desired number of children or spacing timing of their births. Fertility can be planned by using Fertility Awareness Method (FAM) or others like medicine. FAM is a natural family planning method that based on body signs changes during each menstrual cycle in response to the hormones that cause ovulation. This method allows a woman to know their ovulation time using the ovulation chart by plotting body temperature at the exact time every day in the early morning. This method requires a device to measure basal body temperature (BBT) and a chart to plot the temperature every morning, which is a tedious way of charting. Therefore, through this research, a BBT monitoring system has been developed using Arduino Yun Mini and ThingSpeak as the Internet of Things (IoT) platform in order to create a medium of sharing information for fertility monitoring and consultation purposes; where the data management and control can be done conveniently through the internet with secured environment. While the basal body temperature measurement has been done using a fast response time 503 ET-3H NTC thermistor-type temperature sensor from Semitec Corporation and the BBT data are successfully charted and monitored through the ThingSpeak.

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hatton, Matthew; Nankivell, Matthew, E-mail: mn@ctu.mrc.ac.uk; Lyn, Ethan

    Purpose: Recent clinical trials and meta-analyses have shown that both CHART (continuous hyperfractionated accelerated radiation therapy) and induction chemotherapy offer a survival advantage over conventional radical radiotherapy for patients with inoperable non-small cell-lung cancer (NSCLC). This multicenter randomized controlled trial (INCH) was set up to assess the value of giving induction chemotherapy before CHART. Methods and Materials: Patients with histologically confirmed, inoperable, Stage I-III NSCLC were randomized to induction chemotherapy (ICT) (three cycles of cisplatin-based chemotherapy followed by CHART) or CHART alone. Results: Forty-six patients were randomized (23 in each treatment arm) from 9 UK centers. As a result ofmore » poor accrual, the trial was closed in December 2007. Twenty-eight patients were male, 28 had squamous cell histology, 34 were Stage IIIA or IIIB, and all baseline characteristics were well balanced between the two treatment arms. Seventeen (74%) of the 23 ICT patients completed the three cycles of chemotherapy. All 42 (22 CHART + 20 ICT) patients who received CHART completed the prescribed treatment. Median survival was 17 months in the CHART arm and 25 months in the ICT arm (hazard ratio of 0.60 [95% CI 0.31-1.16], p = 0.127). Grade 3 or 4 adverse events (mainly fatigue, dysphagia, breathlessness, and anorexia) were reported for 13 (57%) CHART and 13 (65%) ICT patients. Conclusions: This small randomized trial indicates that ICT followed by CHART is feasible and well tolerated. Despite closing early because of poor accrual, and so failing to show clear evidence of a survival benefit for the additional chemotherapy, the results suggest that CHART, and ICT before CHART, remain important options for the treatment of inoperable NSCLC and deserve further study.« less

  19. Langley Wind Tunnel Data Quality Assurance-Check Standard Results

    NASA Technical Reports Server (NTRS)

    Hemsch, Michael J.; Grubb, John P.; Krieger, William B.; Cler, Daniel L.

    2000-01-01

    A framework for statistical evaluation, control and improvement of wind funnel measurement processes is presented The methodology is adapted from elements of the Measurement Assurance Plans developed by the National Bureau of Standards (now the National Institute of Standards and Technology) for standards and calibration laboratories. The present methodology is based on the notions of statistical quality control (SQC) together with check standard testing and a small number of customer repeat-run sets. The results of check standard and customer repeat-run -sets are analyzed using the statistical control chart-methods of Walter A. Shewhart long familiar to the SQC community. Control chart results are presented for. various measurement processes in five facilities at Langley Research Center. The processes include test section calibration, force and moment measurements with a balance, and instrument calibration.

  20. Economic design of control charts considering process shift distributions

    NASA Astrophysics Data System (ADS)

    Vommi, Vijayababu; Kasarapu, Rukmini V.

    2014-09-01

    Process shift is an important input parameter in the economic design of control charts. Earlier control chart designs considered constant shifts to occur in the mean of the process for a given assignable cause. This assumption has been criticized by many researchers since it may not be realistic to produce a constant shift whenever an assignable cause occurs. To overcome this difficulty, in the present work, a distribution for the shift parameter has been considered instead of a single value for a given assignable cause. Duncan's economic design model for chart has been extended to incorporate the distribution for the process shift parameter. It is proposed to minimize total expected loss-cost to obtain the control chart parameters. Further, three types of process shifts namely, positively skewed, uniform and negatively skewed distributions are considered and the situations where it is appropriate to use the suggested methodology are recommended.

  1. Methods of Statistical Control for Groundwater Quality Indicators

    NASA Astrophysics Data System (ADS)

    Yankovich, E.; Nevidimova, O.; Yankovich, K.

    2016-06-01

    The article describes the results of conducted groundwater quality control. Controlled quality indicators included the following microelements - barium, manganese, iron, mercury, iodine, chromium, strontium, etc. Quality control charts - X-bar chart and R chart - were built. For the upper and the lower threshold limits, maximum permissible concentration of components in water and the lower limit of their biologically significant concentration, respectively, were selected. The charts analysis has shown that the levels of microelements content in water at the area of study are stable. Most elements in the underground water are contained in concentrations, significant for human organisms consuming the water. For example, such elements as Ba, Mn, Fe have concentrations that exceed maximum permissible levels for drinking water.

  2. Quality Control Charts in Large-Scale Assessment Programs

    ERIC Educational Resources Information Center

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying

    2011-01-01

    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  3. Program for Generating Graphs and Charts

    NASA Technical Reports Server (NTRS)

    Ackerson, C. T.

    1986-01-01

    Office Automation Pilot (OAP) Graphics Database system offers IBM personal computer user assistance in producing wide variety of graphs and charts and convenient data-base system, called chart base, for creating and maintaining data associated with graphs and charts. Thirteen different graphics packages available. Access graphics capabilities obtained in similar manner. User chooses creation, revision, or chartbase-maintenance options from initial menu; Enters or modifies data displayed on graphic chart. OAP graphics data-base system written in Microsoft PASCAL.

  4. Considering chance in quality and safety performance measures: an analysis of performance reports by boards in English NHS trusts.

    PubMed

    Schmidtke, Kelly Ann; Poots, Alan J; Carpio, Juan; Vlaev, Ivo; Kandala, Ngianga-Bakwin; Lilford, Richard J

    2017-01-01

    Hospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions. Thirty English NHS trusts were selected at random and their board papers retrieved. Charts depicting quality and safety were identified. Categorical discriminations were then performed to document the methods used to present quality and safety data in board papers, with particular attention given to whether and how the charts depicted the role of chance, that is, by including control lines or error bars. Thirty board papers, containing a total of 1488 charts, were sampled. Only 88 (6%) of these charts depicted the role of chance, and only 17 of the 30 board papers included any charts depicting the role of chance. Of the 88 charts that attempted to represent the role of chance, 16 included error bars and 72 included control lines. Only 6 (8%) of the 72 control charts indicated where the control lines had been set (eg, 2 vs 3 SDs). Hospital board members are expected to consider large amounts of information. Control charts can help board members distinguish signals from noise, but often boards are not using them. We discuss demand-side and supply-side barriers that could be overcome to increase use of control charts in healthcare. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Detecting defective electrical components in heterogeneous infra-red images by spatial control charts

    NASA Astrophysics Data System (ADS)

    Jamshidieini, Bahman; Fazaee, Reza

    2016-05-01

    Distribution network components connect machines and other loads to electrical sources. If resistance or current of any component is more than specified range, its temperature may exceed the operational limit which can cause major problems. Therefore, these defects should be found and eliminated according to their severity. Although infra-red cameras have been used for inspection of electrical components, maintenance prioritization of distribution cubicles is mostly based on personal perception and lack of training data prevents engineers from developing image processing methods. New research on the spatial control chart encouraged us to use statistical approaches instead of the pattern recognition for the image processing. In the present study, a new scanning pattern which can tolerate heavy autocorrelation among adjacent pixels within infra-red image was developed and for the first time combination of kernel smoothing, spatial control charts and local robust regression were used for finding defects within heterogeneous infra-red images of old distribution cubicles. This method does not need training data and this advantage is crucially important when the training data is not available.

  6. Flowcharting with D-charts

    NASA Technical Reports Server (NTRS)

    Meyer, D.

    1985-01-01

    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

  7. Flowcharting with D-charts

    NASA Technical Reports Server (NTRS)

    Meyer, D. D.

    1985-01-01

    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Joviai J73, HAL/S, and Algol are discussed.

  8. Customized versus population-based birth weight charts for the detection of neonatal growth and perinatal morbidity in a cross-sectional study of term neonates.

    PubMed

    Carberry, Angela E; Raynes-Greenow, Camille H; Turner, Robin M; Jeffery, Heather E

    2013-10-15

    Customized birth weight charts that incorporate maternal characteristics are now being adopted into clinical practice. However, there is controversy surrounding the value of these charts in the prediction of growth and perinatal outcomes. The objective of this study was to assess the use of customized charts in predicting growth, defined by body fat percentage, and perinatal morbidity. A total of 581 term (≥37 weeks' gestation) neonates born in Sydney, Australia, in 2010 were included. Body fat percentage measurements were taken by using air displacement plethysmography. Objective composite measurements of perinatal morbidity were used to identify neonates who had poor outcomes; these data were extracted from medical records. The value of customized charts was assessed by calculating positive predictive values, negative predictive values, and odds ratios with 95% confidence intervals. Customized versus population-based charts did not improve the prediction of either low body fat percentage (59% vs. 66% positive predictive value and 87% vs. 89% negative predictive value, respectively) or high body fat percentage (48% vs. 53% positive predictive value and 90% vs. 89% negative predictive value, respectively). Customized charts were not better than population-based charts at predicting perinatal morbidity (for customized charts, odds ratio = 1.02, 95% confidence interval: 1.01, 1.04; for population-based charts, odds ratio = 1.03, 95% confidence interval: 1.01, 1.05) per percentile decrease in birth weight. Customized birth weight charts do not provide significant improvements over population-based charts in predicting neonatal growth and morbidity.

  9. Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.

    PubMed

    Nendaz, Mathieu R; Gut, Anne M; Louis-Simonet, Martine; Perrier, Arnaud; Vu, Nu V

    2011-04-01

    Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

  10. A quality improvement project using statistical process control methods for type 2 diabetes control in a resource-limited setting.

    PubMed

    Flood, David; Douglas, Kate; Goldberg, Vera; Martinez, Boris; Garcia, Pablo; Arbour, MaryCatherine; Rohloff, Peter

    2017-08-01

    Quality improvement (QI) is a key strategy for improving diabetes care in low- and middle-income countries (LMICs). This study reports on a diabetes QI project in rural Guatemala whose primary aim was to improve glycemic control of a panel of adult diabetes patients. Formative research suggested multiple areas for programmatic improvement in ambulatory diabetes care. This project utilized the Model for Improvement and Agile Global Health, our organization's complementary healthcare implementation framework. A bundle of improvement activities were implemented at the home, clinic and institutional level. Control charts of mean hemoglobin A1C (HbA1C) and proportion of patients meeting target HbA1C showed improvement as special cause variation was identified 3 months after the intervention began. Control charts for secondary process measures offered insights into the value of different components of the intervention. Intensity of home-based diabetes education emerged as an important driver of panel glycemic control. Diabetes QI work is feasible in resource-limited settings in LMICs and can improve glycemic control. Statistical process control charts are a promising methodology for use with panels or registries of diabetes patients. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. TU-FG-201-09: Predicting Accelerator Dysfunction

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Able, C; Nguyen, C; Baydush, A

    Purpose: To develop an integrated statistical process control (SPC) framework using digital performance and component data accumulated within the accelerator system that can detect dysfunction prior to unscheduled downtime. Methods: Seven digital accelerators were monitored for twelve to 18 months. The accelerators were operated in a ‘run to failure mode’ with the individual institutions determining when service would be initiated. Institutions were required to submit detailed service reports. Trajectory and text log files resulting from a robust daily VMAT QA delivery were decoded and evaluated using Individual and Moving Range (I/MR) control charts. The SPC evaluation was presented in amore » customized dashboard interface that allows the user to review 525 monitored parameters (480 MLC parameters). Chart limits were calculated using a hybrid technique that includes the standard SPC 3σ limits and an empirical factor based on the parameter/system specification. The individual (I) grand mean values and control limit ranges of the I/MR charts of all accelerators were compared using statistical (ranked analysis of variance (ANOVA)) and graphical analyses to determine consistency of operating parameters. Results: When an alarm or warning was directly connected to field service, process control charts predicted dysfunction consistently on beam generation related parameters (BGP)– RF Driver Voltage, Gun Grid Voltage, and Forward Power (W); beam uniformity parameters – angle and position steering coil currents; and Gantry position accuracy parameter: cross correlation max-value. Control charts for individual MLC – cross correlation max-value/position detected 50% to 60% of MLCs serviced prior to dysfunction or failure. In general, non-random changes were detected 5 to 80 days prior to a service intervention. The ANOVA comparison of BGP determined that each accelerator parameter operated at a distinct value. Conclusion: The SPC framework shows promise. Long term monitoring coordinated with service will be required to definitively determine the effectiveness of the model. Varian Medical System, Inc. provided funding in support of the research presented.« less

  12. Computing exact bundle compliance control charts via probability generating functions.

    PubMed

    Chen, Binchao; Matis, Timothy; Benneyan, James

    2016-06-01

    Compliance to evidenced-base practices, individually and in 'bundles', remains an important focus of healthcare quality improvement for many clinical conditions. The exact probability distribution of composite bundle compliance measures used to develop corresponding control charts and other statistical tests is based on a fairly large convolution whose direct calculation can be computationally prohibitive. Various series expansions and other approximation approaches have been proposed, each with computational and accuracy tradeoffs, especially in the tails. This same probability distribution also arises in other important healthcare applications, such as for risk-adjusted outcomes and bed demand prediction, with the same computational difficulties. As an alternative, we use probability generating functions to rapidly obtain exact results and illustrate the improved accuracy and detection over other methods. Numerical testing across a wide range of applications demonstrates the computational efficiency and accuracy of this approach.

  13. Quality of pancreatic transplant program assessment using a risk-adjusted cumulative sum chart: experience from a single, small center.

    PubMed

    Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J

    2014-10-01

    The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.

  14. Evaluation of Shiryaev-Roberts Procedure for On-line Environmental Radiation Monitoring

    NASA Astrophysics Data System (ADS)

    Watson, Mara Mae

    An on-line radiation monitoring system that simultaneously concentrates and detects radioactivity is needed to detect an accidental leakage from a nuclear waste disposal facility or clandestine nuclear activity. Previous studies have shown that classical control chart methods can be applied to on-line radiation monitoring data to quickly detect these events as they occur; however, Bayesian control chart methods were not included in these studies. This work will evaluate the performance of a Bayesian control chart method, the Shiryaev-Roberts (SR) procedure, compared to classical control chart methods, Shewhart 3-sigma and cumulative sum (CUSUM), for use in on-line radiation monitoring of 99Tc in water using extractive scintillating resin. Measurements were collected by pumping solutions containing 0.1-5 Bq/L of 99Tc, as 99T cO4-, through a flow cell packed with extractive scintillating resin coupled to a Beta-RAM Model 5 HPLC detector. While 99T cO4- accumulated on the resin, simultaneous measurements were acquired in 10-s intervals and then re-binned to 100-s intervals. The Bayesian statistical method, Shiryaev-Roberts procedure, and classical control chart methods, Shewhart 3-sigma and cumulative sum (CUSUM), were applied to the data using statistical algorithms developed in MATLAB RTM. Two SR control charts were constructed using Poisson distributions and Gaussian distributions to estimate the likelihood ratio, and are referred to as Poisson SR and Gaussian SR to indicate the distribution used to calculate the statistic. The Poisson and Gaussian SR methods required as little as 28.9 mL less solution at 5 Bq/L and as much as 170 mL less solution at 0.5 Bq/L to exceed the control limit than the Shewhart 3-sigma method. The Poisson SR method needed as little as 6.20 mL less solution at 5 Bq/L and up to 125 mL less solution at 0.5 Bq/L to exceed the control limit than the CUSUM method. The Gaussian SR and CUSUM method required comparable solution volumes for test solutions containing at least 1.5 Bq/L of 99T c. For activity concentrations less than 1.5 Bq/L, the Gaussian SR method required as much as 40.8 mL less solution at 0.5 Bq/L to exceed the control limit than the CUSUM method. Both SR methods were able to consistently detect test solutions containing 0.1 Bq/L, unlike the Shewhart 3-sigma and CUSUM methods. Although the Poisson SR method required as much as 178 mL less solution to exceed the control limit than the Gaussian SR method, the Gaussian SR false positive of 0% was much lower than the Poisson SR false positive rate of 1.14%. A lower false positive rate made it easier to differentiate between a false positive and an increase in mean count rate caused by activity accumulating on the resin. The SR procedure is thus the ideal tool for low-level on-line radiation monitoring using extractive scintillating resin, because it needed less volume in most cases to detect an upward shift in the mean count rate than the Shewhart 3-sigma and CUSUM methods and consistently detected lower activity concentrations. The desired results for the monitoring scheme, however, need to be considered prior to choosing between the Poisson and Gaussian distribution to estimate the likelihood ratio, because each was advantageous under different circumstances. Once the control limit was exceeded, activity concentrations were estimated from the SR control chart using the slope of the control chart on a semi-logarithmic plot. Five of nine test solutions for the Poisson SR control chart produced concentration estimates within 30% of the actual value, but the worst case was 263.2% different than the actual value. The estimations for the Gaussian SR control chart were much more precise, with six of eight solutions producing estimates within 30%. Although the activity concentrations estimations were only mediocre for the Poisson SR control chart and satisfactory for the Gaussian SR control chart, these results demonstrate that a relationship exists between activity concentration and the SR control chart magnitude that can be exploited to determine the activity concentration from the SR control chart. More complex methods should be investigated to improve activity concentration estimations from the SR control charts.

  15. Teaching Quality Control with Chocolate Chip Cookies

    ERIC Educational Resources Information Center

    Baker, Ardith

    2014-01-01

    Chocolate chip cookies are used to illustrate the importance and effectiveness of control charts in Statistical Process Control. By counting the number of chocolate chips, creating the spreadsheet, calculating the control limits and graphing the control charts, the student becomes actively engaged in the learning process. In addition, examining…

  16. Economic Statistical Design of Integrated X-bar-S Control Chart with Preventive Maintenance and General Failure Distribution

    PubMed Central

    Caballero Morales, Santiago Omar

    2013-01-01

    The application of Preventive Maintenance (PM) and Statistical Process Control (SPC) are important practices to achieve high product quality, small frequency of failures, and cost reduction in a production process. However there are some points that have not been explored in depth about its joint application. First, most SPC is performed with the X-bar control chart which does not fully consider the variability of the production process. Second, many studies of design of control charts consider just the economic aspect while statistical restrictions must be considered to achieve charts with low probabilities of false detection of failures. Third, the effect of PM on processes with different failure probability distributions has not been studied. Hence, this paper covers these points, presenting the Economic Statistical Design (ESD) of joint X-bar-S control charts with a cost model that integrates PM with general failure distribution. Experiments showed statistically significant reductions in costs when PM is performed on processes with high failure rates and reductions in the sampling frequency of units for testing under SPC. PMID:23527082

  17. Statistical process control based chart for information systems security

    NASA Astrophysics Data System (ADS)

    Khan, Mansoor S.; Cui, Lirong

    2015-07-01

    Intrusion detection systems have a highly significant role in securing computer networks and information systems. To assure the reliability and quality of computer networks and information systems, it is highly desirable to develop techniques that detect intrusions into information systems. We put forward the concept of statistical process control (SPC) in computer networks and information systems intrusions. In this article we propose exponentially weighted moving average (EWMA) type quality monitoring scheme. Our proposed scheme has only one parameter which differentiates it from the past versions. We construct the control limits for the proposed scheme and investigate their effectiveness. We provide an industrial example for the sake of clarity for practitioner. We give comparison of the proposed scheme with EWMA schemes and p chart; finally we provide some recommendations for the future work.

  18. Quality control of test iodine in urine by spectrophotometry UV-Vis

    NASA Astrophysics Data System (ADS)

    Huda, Thorikul; Nafisah, Durotun; Kumorowulan, Suryati; Lestari, Sri

    2017-12-01

    A quality control of iodine test in with UV-Vis spectrophotometry has been done. The purpose of this research is to find out whether the test results of samples conducted by Clinical Office of Research and Development Of GAKI (BP2GAKI) laboratory are still controlled, feasible and reliable, and still consistent over time, as indicated by the control chart. Quality control parameters are linearity, precision, accuracy, limit of detection, and limit of quantification. Based on the quality control that has been done, obtained linearity (r)= -0.9974, the detection limit and the limit of quantitation are respectively 2.26 µg/L and 7.54 µg/L, while the accuracy is calculated by %recovery and precision with value % RSD are 97.4161% and 1.7136% respectively. The quality control of iodine test in urine using the control chart shows excellent or stable results for 30 days and no variation of the results is very different for each day.

  19. Using a statistical process control chart during the quality assessment of cancer registry data.

    PubMed

    Myles, Zachary M; German, Robert R; Wilson, Reda J; Wu, Manxia

    2011-01-01

    Statistical process control (SPC) charts may be used to detect acute variations in the data while simultaneously evaluating unforeseen aberrations that may warrant further investigation by the data user. Using cancer stage data captured by the Summary Stage 2000 (SS2000) variable, we sought to present a brief report highlighting the utility of the SPC chart during the quality assessment of cancer registry data. Using a county-level caseload for the diagnosis period of 2001-2004 (n=25,648), we found the overall variation of the SS2000 variable to be in control during diagnosis years of 2001 and 2002, exceeded the lower control limit (LCL) in 2003, and exceeded the upper control limit (UCL) in 2004; in situ/localized stages were in control throughout the diagnosis period, regional stage exceeded UCL in 2004, and distant stage exceeded the LCL in 2001 and the UCL in 2004. Our application of the SPC chart with cancer registry data illustrates that the SPC chart may serve as a readily available and timely tool for identifying areas of concern during the data collection and quality assessment of central cancer registry data.

  20. Charts for Estimating Tail-rotor Contribution to Helicopter Directional Stability and Control in Low-Speed Flight

    NASA Technical Reports Server (NTRS)

    Amer, Kenneth B; Gessow, Alfred

    1955-01-01

    Theoretically derived charts and equations are presented by which tail-rotor design studies of directional trim and control response at low forward speed can be conveniently made. The charts can also be used to obtain the main-rotor stability derivatives of thrust with respect to collective pitch and angle of attack at low forward speeds. The use of the charts and equations for tail-rotor design studies is illustrated. Comparisons between theoretical and experimental results are presented. The charts indicate, and flight tests confirm, that the region of vortex roughness which is familiar for the main rotor is also encountered by the tail rotor and that prolonged operation at the corresponding flight conditions would be difficult.

  1. Construction and validation of logMAR visual acuity charts in seven Indian languages.

    PubMed

    Negiloni, Kalpa; Mazumdar, Deepmala; Neog, Aditya; Das, Biman; Medhi, Jnanankar; Choudhury, Mitalee; George, Ronnie Jacob; Ramani, Krishna Kumar

    2018-05-01

    The evaluation of visual impairment requires the measurement of visual acuity with a validated and standard logMAR visual acuity chart. We aimed to construct and validate new logMAR visual acuity chart in Indian languages (Hindi, Bengali, Telugu, Urdu, Kannada, Malayalam, and Assamese). The commonly used font in each language was chosen as the reference and designed to fit the 5 × 5 grid (Adobe Photoshop). Ten letters (easiest to difficult) around median legibility score calculated for each language based on the results of legibility experiment and differing by 10% were selected. The chart was constructed based on the standard recommendations. The repeatability of charts was tested and also compared with a standard English Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart for validation. A total of 14 rows (1.0 to -0.3 logMAR) with five letters in each line were designed with the range of row legibility between 4.7 and 5.3 for all the language charts. Each chart showed good repeatability, and a maximum difference of four letters was noted. The median difference in visual acuity was 0.16 logMAR for Urdu and Assamese chart compared to ETDRS English chart. Hindi and Malayalam chart had a median difference of 0.12 logMAR. When compared to the English chart a median difference of 0.14 logMAR was noted in Telugu, Kannada, and Bengali chart. The newly developed Indian language visual acuity charts are designed based on the standard recommendations and will help to assess visual impairment in people of these languages across the country.

  2. Preliminary Retrospective Analysis of Daily Tomotherapy Output Constancy Checks Using Statistical Process Control.

    PubMed

    Mezzenga, Emilio; D'Errico, Vincenzo; Sarnelli, Anna; Strigari, Lidia; Menghi, Enrico; Marcocci, Francesco; Bianchini, David; Benassi, Marcello

    2016-01-01

    The purpose of this study was to retrospectively evaluate the results from a Helical TomoTherapy Hi-Art treatment system relating to quality controls based on daily static and dynamic output checks using statistical process control methods. Individual value X-charts, exponentially weighted moving average charts, and process capability and acceptability indices were used to monitor the treatment system performance. Daily output values measured from January 2014 to January 2015 were considered. The results obtained showed that, although the process was in control, there was an out-of-control situation in the principal maintenance intervention for the treatment system. In particular, process capability indices showed a decreasing percentage of points in control which was, however, acceptable according to AAPM TG148 guidelines. Our findings underline the importance of restricting the acceptable range of daily output checks and suggest a future line of investigation for a detailed process control of daily output checks for the Helical TomoTherapy Hi-Art treatment system.

  3. The Conjugate Acid-Base Chart.

    ERIC Educational Resources Information Center

    Treptow, Richard S.

    1986-01-01

    Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)

  4. Using patients' charts to assess medical trainees in the workplace: a systematic review.

    PubMed

    Al-Wassia, Heidi; Al-Wassia, Rolina; Shihata, Shadi; Park, Yoon Soo; Tekian, Ara

    2015-04-01

    The objective of this review is to summarize and critically appraise existing evidence on the use of chart stimulated recall (CSR) and case-based discussion (CBD) as an assessment tool for medical trainees. Medline, Embase, CINAHL, PsycINFO, Educational Resources Information Centre (ERIC), Web of Science, and the Cochrane Central Register of Controlled Trials were searched for original articles on the use of CSR or CBD as an assessment method for trainees in all medical specialties. Four qualitative and three observational non-comparative studies were eligible for this review. The number of patient-chart encounters needed to achieve sufficient reliability varied across studies. None of the included studies evaluated the content validity of the tool. Both trainees and assessors expressed high level of satisfaction with the tool; however, inadequate training, different interpretation of the scoring scales and skills needed to give feedback were addressed as limitations for conducting the assessment. There is still no compelling evidence for the use of patient's chart to evaluate medical trainees in the workplace. A body of evidence that is valid, reliable, and documents the educational effect in support of the use of patients' charts to assess medical trainees is needed.

  5. Flexible Design and Operation of a Smart Charging Microgrid (Briefing Charts)

    DTIC Science & Technology

    2014-04-08

    release; distribution unlimited 13. SUPPLEMENTARY NOTES Briefing Charts for SAE World Congress 2014 14. ABSTRACT A microgrid is a controllable ...UNCLASSIFIED Distribution Statement A: Approved for Public Release Flexible Design and Operation of a Smart Charging Microgrid Annette G... control number. 1. REPORT DATE 08 APR 2014 2. REPORT TYPE Briefing Charts 3. DATES COVERED 08-01-2014 to 09-03-2014 4. TITLE AND SUBTITLE

  6. Robust control charts in industrial production of olive oil

    NASA Astrophysics Data System (ADS)

    Grilo, Luís M.; Mateus, Dina M. R.; Alves, Ana C.; Grilo, Helena L.

    2014-10-01

    Acidity is one of the most important variables in the quality analysis and characterization of olive oil. During the industrial production we use individuals and moving range charts to monitor this variable, which is not always normal distributed. After a brief exploratory data analysis, where we use the bootstrap method, we construct control charts, before and after a Box-Cox transformation, and compare their robustness and performance.

  7. Phase-I monitoring of standard deviations in multistage linear profiles

    NASA Astrophysics Data System (ADS)

    Kalaei, Mahdiyeh; Soleimani, Paria; Niaki, Seyed Taghi Akhavan; Atashgar, Karim

    2018-03-01

    In most modern manufacturing systems, products are often the output of some multistage processes. In these processes, the stages are dependent on each other, where the output quality of each stage depends also on the output quality of the previous stages. This property is called the cascade property. Although there are many studies in multistage process monitoring, there are fewer works on profile monitoring in multistage processes, especially on the variability monitoring of a multistage profile in Phase-I for which no research is found in the literature. In this paper, a new methodology is proposed to monitor the standard deviation involved in a simple linear profile designed in Phase I to monitor multistage processes with the cascade property. To this aim, an autoregressive correlation model between the stages is considered first. Then, the effect of the cascade property on the performances of three types of T 2 control charts in Phase I with shifts in standard deviation is investigated. As we show that this effect is significant, a U statistic is next used to remove the cascade effect, based on which the investigated control charts are modified. Simulation studies reveal good performances of the modified control charts.

  8. Feature Extraction Assessment Study.

    DTIC Science & Technology

    1984-11-01

    base in the form of orthophotos , control manuscripts, . or maps or charts; aids to feature identification such as im- agery (rectified and unrectified...manually delineated (i.e. , drawn by * hand) on a feature manuscript which may be a mylar overlay on an orthophoto or other control base. Once delineated...partition of tiled constant gray level regions, with addi- tive noise in each, it is not clear that any segmentation tech- nique would identify each

  9. Applying Statistical Process Quality Control Methodology to Educational Settings.

    ERIC Educational Resources Information Center

    Blumberg, Carol Joyce

    A subset of Statistical Process Control (SPC) methodology known as Control Charting is introduced. SPC methodology is a collection of graphical and inferential statistics techniques used to study the progress of phenomena over time. The types of control charts covered are the null X (mean), R (Range), X (individual observations), MR (moving…

  10. Quality Control System using Simple Implementation of Seven Tools for Batik Textile Manufacturing

    NASA Astrophysics Data System (ADS)

    Ragil Suryoputro, Muhammad; Sugarindra, Muchamad; Erfaisalsyah, Hendy

    2017-06-01

    In order to produce better products and mitigate defect in products, every company must implement a quality control system. Company will find means to implement a quality control system that is capable and reliable. One of the methods is using the simple implementation of the seven tools in quality control defects. The case studied in this research was the level of disability xyz grey fabric on a shuttle loom 2 on the Batik manufacturing company. The seven tools that include: flowchart, check sheet, histogram, scatter diagram combined with control charts, Pareto diagrams and fishbone diagrams (causal diagram). Check sheet results obtained types of defects in the grey fabric was woven xyz is warp, double warp, the warp break, double warp, empty warp, warp tenuous, ugly edges, thick warp, and rust. Based on the analysis of control chart indicates that the process is out of control. This can be seen in the graph control where there is still a lot of outlier data. Based on a scatter diagram shows a positive correlation between the percentage of disability and the number of production. Based on Pareto diagram, repair needs priority is for the dominant type of defect is warp (44%) and based on double warp value histogram is also the highest with a value of 23635.11 m. In addition, based on the analysis of the factors causing defect by fishbone diagram double warp or other types of defects originating from the materials, methods, machines, measurements, man and environment. Thus the company can take to minimize the prevention and repair of defects and improve product quality.

  11. Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

    PubMed

    Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

    2017-08-01

    Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P < .05) was used to compare pre- and post-intervention scores of each group. A total of 125 pre-intervention and 125 post-intervention reports were evaluated (total 750 assessments). The Cronbach's alpha for the study tool was 0.865. A significant improvement was seen in the cumulative 19-item score (66% versus 73%, P < .001) and the global rating score (59% versus 72%, P < .001) of the intervention group after the CSR. The reports of the control group did not demonstrate any significant improvement. CSR is a feasible workplace-based assessment method for improving reporting skills of the radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  12. 49 CFR 236.718 - Chart, dog.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  13. 49 CFR 236.718 - Chart, dog.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  14. 49 CFR 236.718 - Chart, dog.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  15. 49 CFR 236.718 - Chart, dog.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  16. 49 CFR 236.718 - Chart, dog.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  17. Percentiles of the run-length distribution of the Exponentially Weighted Moving Average (EWMA) median chart

    NASA Astrophysics Data System (ADS)

    Tan, K. L.; Chong, Z. L.; Khoo, M. B. C.; Teoh, W. L.; Teh, S. Y.

    2017-09-01

    Quality control is crucial in a wide variety of fields, as it can help to satisfy customers’ needs and requirements by enhancing and improving the products and services to a superior quality level. The EWMA median chart was proposed as a useful alternative to the EWMA \\bar{X} chart because the median-type chart is robust against contamination, outliers or small deviation from the normality assumption compared to the traditional \\bar{X}-type chart. To provide a complete understanding of the run-length distribution, the percentiles of the run-length distribution should be investigated rather than depending solely on the average run length (ARL) performance measure. This is because interpretation depending on the ARL alone can be misleading, as the process mean shifts change according to the skewness and shape of the run-length distribution, varying from almost symmetric when the magnitude of the mean shift is large, to highly right-skewed when the process is in-control (IC) or slightly out-of-control (OOC). Before computing the percentiles of the run-length distribution, optimal parameters of the EWMA median chart will be obtained by minimizing the OOC ARL, while retaining the IC ARL at a desired value.

  18. CRN5EXP: Expert system for statistical quality control

    NASA Technical Reports Server (NTRS)

    Hentea, Mariana

    1991-01-01

    The purpose of the Expert System CRN5EXP is to assist in checking the quality of the coils at two very important mills: Hot Rolling and Cold Rolling in a steel plant. The system interprets the statistical quality control charts, diagnoses and predicts the quality of the steel. Measurements of process control variables are recorded in a database and sample statistics such as the mean and the range are computed and plotted on a control chart. The chart is analyzed through patterns using the C Language Integrated Production System (CLIPS) and a forward chaining technique to reach a conclusion about the causes of defects and to take management measures for the improvement of the quality control techniques. The Expert System combines the certainty factors associated with the process control variables to predict the quality of the steel. The paper presents the approach to extract data from the database, the reason to combine certainty factors, the architecture and the use of the Expert System. However, the interpretation of control charts patterns requires the human expert's knowledge and lends to Expert Systems rules.

  19. Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study.

    PubMed

    Nasir, Nazrila Hairin; Mohamad, Mohazmi; Lum, Lucy Chai See; Ng, Chirk Jenn

    2017-01-01

    Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever. To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting. This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets < 150 x 109/L). Both groups received a dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake. Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance. This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive tool that may reduce hospitalization and intravenous fluid requirement in suspected dengue patients. A randomized controlled trial with larger sample size is needed to determine this conclusively. International Standard Randomized Controlled Trial Number (ISRCTN) Registry ISRCTN25394628 http://www.isrctn.com/ISRCTN25394628.

  20. How To Better Track Effective School Indicators: The Control Chart Techniques.

    ERIC Educational Resources Information Center

    Coutts, Douglas

    1998-01-01

    Control charts are practical tools to monitor various school indicators (attendance rates, standardized test scores, grades, and graduation rates) by displaying data on the same scale over time. This article shows how principals can calculate the upper natural-process limit, lower natural-process limit, and upper control limit for attendance. (15…

  1. The Uniform Chart of Accounts and Its Use in Management Control.

    DTIC Science & Technology

    1982-10-01

    accounting reports [Ref. 10: p.45]. Horngren [Ref. 5: p. 162] notes that a common complaint of *, managers is that they are unfairly charged with costs ...aids of amsst 0W somir IM WOR M oo Owp U CA Hospital Management Control Uniform Chart of Accounts Performance Measurement Hospital Cost Accounting ...Output Measurement HCU 30. he.T ACT fCamnnus m .. s ado It 09000*Min d IdWOReeO 661 eammeei ~Full implementation of thc Uniform Chart of Accounts (UCA

  2. Driving Force.

    ERIC Educational Resources Information Center

    Rich, Richard A.

    1998-01-01

    Discusses campus parking assessment and planning to meet the increasing demands of colleges and universities while controlling costs and reducing student and staff discontent. Explores advice for expanding parking-lot space and maintaining security. Provides a chart that shows general parking requirements for various groups based on students…

  3. Low Visibility Operations/Surface Movement Guidance and Control System (LVO/SMGCS) Chart Symbology

    DOT National Transportation Integrated Search

    2016-02-01

    This study examined which symbol shapes are considered to be representative of information shown on Low Visibility Operations/Surface Movement Guidance and Control System (LVO/SMGCS) charts, and how useful pilots perceive that information to be. The ...

  4. Discussion on integrated digital chart data model and display platform for pocket navigator system (PNS)

    NASA Astrophysics Data System (ADS)

    Sui, Haigang; Xiao, Jinghuan; Wang, Qi; Li, Qian

    2007-06-01

    PDA (Personal Digital Assistant) is a useful tool for navigation which has many advantages such as its smallness and portability. In the meantime, digital charts have been found a wide application in past ten years, and many users are hoping for giving up the paper chart entirely and using ENC by the law. However, traditional paper chart is a nonreplaced tool for people in hydrographical survey and other application fields, and would coexist with ENC for a long time. How to manage and display integrated chart for traditional paper chart and ENC together in PDA for navigating is still an unsolved problem. Aiming at this, a new integrated spatial data model and display techniques for ENC and paper chart are presented. The core idea of the new algorithm is to build an integrated spatial data model, structure and display environment for both paper chart and ENC. Based on the above algorithms and strategies, an Integrated Electronic Chart Pocket Navigator System named PNS based on PDA was developed. It has been applied in Tianjin Marine Safety Administration Bureau and obtained a good evaluation.

  5. Continuing Medical Education Improves Gastroenterologists' Compliance with Inflammatory Bowel Disease Quality Measures.

    PubMed

    Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Greene, Laurence; Patel, Barry; Higgins, Peter D R

    2016-07-01

    Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists. We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities. Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists' performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure. The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013). QI-focused CME improves community-based gastroenterologists' compliance with IBD quality measures and measures aligned with NQS priorities.

  6. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jassal, K; Sarkar, B; Mohanti, B

    Objective: The study presents the application of a simple concept of statistical process control (SPC) for pre-treatment quality assurance procedure analysis for planar dose measurements performed using 2D-array and a-Si electronic portal imaging device (a-Si EPID). Method: A total of 195 patients of four different anatomical sites: brain (n1=45), head & neck (n2=45), thorax (n3=50) and pelvis (n4=55) were selected for the study. Pre-treatment quality assurance for the clinically acceptable IMRT/VMAT plans was measured with 2D array and a-Si EPID of the accelerator. After the γ-analysis, control charts and the quality index Cpm was evaluated for each cohort. Results: Meanmore » and σ of γ ( 3%/3 mm) were EPID γ %≤1= 99.9% ± 1.15% and array γ %<1 = 99.6% ± 1.06%. Among all plans γ max was consistently lower than for 2D array as compared to a-Si EPID. Fig.1 presents the X-bar control charts for every cohort. Cpm values for a-Si EPID were found to be higher than array, detailed results are presented in table 1. Conclusion: Present study demonstrates the significance of control charts used for quality management purposes in newer radiotherapy clinics. Also, provides a pictorial overview of the clinic performance for the advanced radiotherapy techniques.Higher Cpm values for EPID indicate its higher efficiency than array based measurements.« less

  7. The acquisition, storage, and dissemination of LANDSAT and other LACIE support data

    NASA Technical Reports Server (NTRS)

    Abbotts, L. F.; Nelson, R. M. (Principal Investigator)

    1979-01-01

    Activities performed at the LACIE physical data library are described. These include the researching, acquisition, indexing, maintenance, distribution, tracking, and control of LACIE operational data and documents. Much of the data available can be incorporated into an Earth resources data base. Elements of the data collection that can support future remote sensing programs include: (1) the LANDSAT full-frame image files; (2) the microfilm file of aerial and space photographic and multispectral maps and charts that encompasses a large portion of the Earth's surface; (3) the map/chart collection that includes various scale maps and charts for a good portion of the U.S. and the LACIE area in foreign countries; (4) computer-compatible tapes of good quality LANDSAT scenes; (5) basic remote sensing data, project data, reference material, and associated publications; (6) visual aids to support presentation on remote sensing projects; and (7) research acquisition and handling procedures for managing data.

  8. Spectrum Efficiency Through Dynamic Spectrum Access Techniques (Briefing Charts)

    DTIC Science & Technology

    2014-06-01

    Telemetry Data Sources IP BASED TELEMETRY STATION Flow control • Volume- based • Credit- based • Rate- based Signaling using custom protocols or standards...Responsible for all T&E infrastructure assessment within the Major Range and Test Facility Base (MRTFB) DoD Directive 3200.11 • Administer three...Memorandum Unleashing of the Wireless Broadband Revolution THE WHY: Based on the view that “we are now beginning the next transformation in

  9. Identifying representative symbology for low visibility operations/surface movement guidance and control system (LVO/SMGCS) paper charts

    DOT National Transportation Integrated Search

    2015-05-04

    The Volpe Center developed a questionnaire to examine the representativeness of symbol shapes and the usefulness of information depicted on Low Visibility Operations/Surface Movement Guidance and Control System (LVO/SMGCS) paper charts. One-hundred f...

  10. Statistical Process Control Charts for Measuring and Monitoring Temporal Consistency of Ratings

    ERIC Educational Resources Information Center

    Omar, M. Hafidz

    2010-01-01

    Methods of statistical process control were briefly investigated in the field of educational measurement as early as 1999. However, only the use of a cumulative sum chart was explored. In this article other methods of statistical quality control are introduced and explored. In particular, methods in the form of Shewhart mean and standard deviation…

  11. Inaccurate Dental Charting in an Audit of 1128 General Dental Practice Records.

    PubMed

    Brown, Nathan L; Jephcote, Victoria E L

    2017-03-01

    Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. Clinical relevance: Dental charting forms part of the patient’s dental records, and the GDC requires dentists to maintain complete and accurate dental records.

  12. Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.

    PubMed

    Baker, Arthur W; Haridy, Salah; Salem, Joseph; Ilieş, Iulian; Ergai, Awatef O; Samareh, Aven; Andrianas, Nicholas; Benneyan, James C; Sexton, Daniel J; Anderson, Deverick J

    2017-11-24

    Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013. We compared the results of SPC surveillance to the results of traditional SSI surveillance methods. Then, we analysed the performance of modified SPC charts constructed with different outbreak detection rules, EWMA smoothing factors and baseline SSI rate calculations. Conventional Shewhart and EWMA SPC charts both detected 8 of the 10 SSI outbreaks analysed, in each case prior to the date of traditional detection. Among detected outbreaks, conventional Shewhart chart detection occurred a median of 12 months prior to outbreak onset and 22 months prior to traditional detection. Conventional EWMA chart detection occurred a median of 7 months prior to outbreak onset and 14 months prior to traditional detection. Modified Shewhart and EWMA charts additionally detected several outbreaks earlier than conventional SPC charts. Shewhart and SPC charts had low false-positive rates when used to analyse separate control hospital SSI data. Our findings illustrate the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimise SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Errors in patient specimen collection: application of statistical process control.

    PubMed

    Dzik, Walter Sunny; Beckman, Neil; Selleng, Kathleen; Heddle, Nancy; Szczepiorkowski, Zbigniew; Wendel, Silvano; Murphy, Michael

    2008-10-01

    Errors in the collection and labeling of blood samples for pretransfusion testing increase the risk of transfusion-associated patient morbidity and mortality. Statistical process control (SPC) is a recognized method to monitor the performance of a critical process. An easy-to-use SPC method was tested to determine its feasibility as a tool for monitoring quality in transfusion medicine. SPC control charts were adapted to a spreadsheet presentation. Data tabulating the frequency of mislabeled and miscollected blood samples from 10 hospitals in five countries from 2004 to 2006 were used to demonstrate the method. Control charts were produced to monitor process stability. The participating hospitals found the SPC spreadsheet very suitable to monitor the performance of the sample labeling and collection and applied SPC charts to suit their specific needs. One hospital monitored subcategories of sample error in detail. A large hospital monitored the number of wrong-blood-in-tube (WBIT) events. Four smaller-sized facilities, each following the same policy for sample collection, combined their data on WBIT samples into a single control chart. One hospital used the control chart to monitor the effect of an educational intervention. A simple SPC method is described that can monitor the process of sample collection and labeling in any hospital. SPC could be applied to other critical steps in the transfusion processes as a tool for biovigilance and could be used to develop regional or national performance standards for pretransfusion sample collection. A link is provided to download the spreadsheet for free.

  14. DASHBOARDS & CONTROL CHARTS EXPERIENCES IN IMPROVING SAFETY AT HANFORD WASHINGTON

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    PREVETTE, S.S.

    2006-02-27

    The aim of this paper is to demonstrate the integration of safety methodology, quality tools, leadership, and teamwork at Hanford and their significant positive impact on safe performance of work. Dashboards, Leading Indicators, Control charts, Pareto Charts, Dr. W. Edward Deming's Red Bead Experiment, and Dr. Deming's System of Profound Knowledge have been the principal tools and theory of an integrated management system. Coupled with involved leadership and teamwork, they have led to significant improvements in worker safety and protection, and environmental restoration at one of the nation's largest nuclear cleanup sites.

  15. Charting Early Trajectories of Executive Control with the Shape School

    ERIC Educational Resources Information Center

    Clark, Caron A. C.; Sheffield, Tiffany D.; Chevalier, Nicolas; Nelson, Jennifer Mize; Wiebe, Sandra A.; Espy, Kimberly Andrews

    2013-01-01

    Despite acknowledgement of the importance of executive control for learning and behavior, there is a dearth of research charting its developmental trajectory as it unfolds against the background of children's sociofamilial milieus. Using a prospective, cohort-sequential design, this study describes growth trajectories for inhibitory control…

  16. Operator Influence of Unexploded Ordnance Sensor Technologies

    DTIC Science & Technology

    2007-03-01

    chart display ActiveX control Mscomct2.dll – date/time display ActiveX control Pnpscr.dll – Systran SCRAMNet replicated shared memory device...response value database rgm_p2.dll – Phase 2 shared memory API and implementation Commercial components StripM.ocx – strip chart display ActiveX

  17. Predicting 10-Year Risk of Fatal Cardiovascular Disease in Germany: An Update Based on the SCORE-Deutschland Risk Charts

    PubMed Central

    Rücker, Viktoria; Keil, Ulrich; Fitzgerald, Anthony P; Malzahn, Uwe; Prugger, Christof; Ertl, Georg; Heuschmann, Peter U; Neuhauser, Hannelore

    2016-01-01

    Estimation of absolute risk of cardiovascular disease (CVD), preferably with population-specific risk charts, has become a cornerstone of CVD primary prevention. Regular recalibration of risk charts may be necessary due to decreasing CVD rates and CVD risk factor levels. The SCORE risk charts for fatal CVD risk assessment were first calibrated for Germany with 1998 risk factor level data and 1999 mortality statistics. We present an update of these risk charts based on the SCORE methodology including estimates of relative risks from SCORE, risk factor levels from the German Health Interview and Examination Survey for Adults 2008–11 (DEGS1) and official mortality statistics from 2012. Competing risks methods were applied and estimates were independently validated. Updated risk charts were calculated based on cholesterol, smoking, systolic blood pressure risk factor levels, sex and 5-year age-groups. The absolute 10-year risk estimates of fatal CVD were lower according to the updated risk charts compared to the first calibration for Germany. In a nationwide sample of 3062 adults aged 40–65 years free of major CVD from DEGS1, the mean 10-year risk of fatal CVD estimated by the updated charts was lower by 29% and the estimated proportion of high risk people (10-year risk > = 5%) by 50% compared to the older risk charts. This recalibration shows a need for regular updates of risk charts according to changes in mortality and risk factor levels in order to sustain the identification of people with a high CVD risk. PMID:27612145

  18. 48 CFR 245.102 - Policy.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 245.102-70.) (1) Mapping, charting, and geodesy property. All Government-furnished mapping, charting, and geodesy (MC&G) property is under the control of the Director, National Geospatial Intelligence...

  19. 48 CFR 245.102 - Policy.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 245.102-70.) (1) Mapping, charting, and geodesy property. All Government-furnished mapping, charting, and geodesy (MC&G) property is under the control of the Director, National Geospatial Intelligence...

  20. 48 CFR 245.102 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 245.102-70.) (1) Mapping, charting, and geodesy property. All Government-furnished mapping, charting, and geodesy (MC&G) property is under the control of the Director, National Geospatial Intelligence...

  1. Public Libraries: Responding to Demand.

    ERIC Educational Resources Information Center

    Annichiarico, Mark; And Others

    1993-01-01

    Discussion of problems library wholesalers/distributors face trying to fulfill public libraries' needs while adjusting to a changing industry is based on responses by librarians to a survey on library jobbers. Increased services to libraries, electronic ordering, timeliness, stock management, and quality control are addressed; and a chart of…

  2. 50. DETAIL OF TYPICAL PANELS IN ANALOG RECORD BAY. LEFT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    50. DETAIL OF TYPICAL PANELS IN ANALOG RECORD BAY. LEFT PANEL CONTAINS OSCILLOGRAPH AND CONTROLS. RIGHT PANEL CONTAINS CATHODE RAY TUBE AND INK-TYPE CHART RECORDER. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  3. Design of control system based on SCM music fountain

    NASA Astrophysics Data System (ADS)

    Li, Biqing; Li, Zhao; Jiang, Suping

    2018-06-01

    The design of the design of a microprocessor controlled by simple circuit, introduced this design applied to the components, and draw the main flow chart presentation. System is the use of an external music source, the intensity of the input audio signal lights will affect the light off, the fountain spray of water level will be based on changes in the lantern light off. This design uses a single-chip system is simple, powerful, good reliability and low cost.

  4. 48 CFR 245.102 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY General 245.102 Policy. (1) Mapping, charting, and geodesy property. All Government-furnished mapping, charting, and geodesy (MC&G) property is under the control of...

  5. The business case for pediatric asthma quality improvement in low-income populations: examining a provider-based pay-for-reporting intervention.

    PubMed

    Reiter, Kristin L; Lemos, Kristin Andrews; Williams, Charlotte E; Esposito, Dominick; Greene, Sandra B

    2015-06-01

    To measure the return on investment (ROI) for a pediatric asthma pay-for-reporting intervention initiated by a Medicaid managed care plan in New York State. Practice-level, randomized prospective evaluation. Twenty-five primary care practices providing care to children enrolled in the Monroe Plan for Medical Care (the Monroe Plan). Practices were randomized to either treatment (13 practices, 11 participated) or control (12 practices). For each of its eligible members assigned to a treatment group practice, the Monroe plan paid a low monthly incentive fee to the practice. To receive the incentive, treatment group practices were required to conduct, and report to the Monroe Plan, the results of chart audits on eligible members. Chart audits were conducted by practices every 6 months. After each chart audit, the Monroe Plan provided performance feedback to each practice comparing its adherence to asthma care guidelines with averages from all other treatment group practices. Control practices continued with usual care. Intervention implementation and operating costs and per member, per month claims costs. ROI was measured by net present value (discounted cash flow analysis). The ROI to the Monroe Plan was negative, primarily due to high intervention costs and lack of reductions in spending on emergency department and hospital utilization for children in treatment relative to control practices. A pay-for-reporting, chart audit intervention is unlikely to achieve the meaningful reductions in utilization of high-cost services that would be necessary to produce a financial ROI in 2.5 years. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  6. Energy measurement using flow computers and chromatography

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beeson, J.

    1995-12-01

    Arkla Pipeline Group (APG), along with most transmission companies, went to electronic flow measurement (EFM) to: (1) Increase resolution and accuracy; (2) Real time correction of flow variables; (3) Increase speed in data retrieval; (4) Reduce capital expenditures; and (5) Reduce operation and maintenance expenditures Prior to EFM, mechanical seven day charts were used which yielded 800 pressure and differential pressure readings. EFM yields 1.2-million readings, a 1500 time improvement in resolution and additional flow representation. The total system accuracy of the EFM system is 0.25 % compared with 2 % for the chart system which gives APG improved accuracy.more » A typical APG electronic measurement system includes a microprocessor-based flow computer, a telemetry communications package, and a gas chromatograph. Live relative density (specific gravity), BTU, CO{sub 2}, and N{sub 2} are updated from the chromatograph to the flow computer every six minutes which provides accurate MMBTU computations. Because the gas contract length has changed from years to monthly and from a majority of direct sales to transports both Arkla and its customers wanted access to actual volumes on a much more timely basis than is allowed with charts. The new electronic system allows volumes and other system data to be retrieved continuously, if EFM is on Supervisory Control and Data Acquisition (SCADA) or daily if on dial up telephone. Previously because of chart integration, information was not available for four to six weeks. EFM costs much less than the combined costs of telemetry transmitters, pressure and differential pressure chart recorders, and temperature chart recorder which it replaces. APG will install this equipment on smaller volume stations at a customers expense. APG requires backup measurement on metering facilities this size. It could be another APG flow computer or chart recorder, or the other companies flow computer or chart recorder.« less

  7. On designing a new cumulative sum Wilcoxon signed rank chart for monitoring process location

    PubMed Central

    Nazir, Hafiz Zafar; Tahir, Muhammad; Riaz, Muhammad

    2018-01-01

    In this paper, ranked set sampling is used for developing a non-parametric location chart which is developed on the basis of Wilcoxon signed rank statistic. The average run length and some other characteristics of run length are used as the measures to assess the performance of the proposed scheme. Some selective distributions including Laplace (or double exponential), logistic, normal, contaminated normal and student’s t-distributions are considered to examine the performance of the proposed Wilcoxon signed rank control chart. It has been observed that the proposed scheme shows superior shift detection ability than some of the competing counterpart schemes covered in this study. Moreover, the proposed control chart is also implemented and illustrated with a real data set. PMID:29664919

  8. Best Practices to Achieve the Lowest Uncertainty in Measuring with Respect

    Science.gov Websites

    been sitting in a cabinet from time to time. If control charts are used, then this interval could be 6 packaged cells or module for use in control charts to monitor the test bed and any potential drift in the reference device's calibration. Measure the control sample at least once a week. Plot percentage deviation

  9. 15 CFR 738.3 - Commerce Country Chart structure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... license requirements for most items listed on the CCL. Such license requirements are based on the Reasons... ECCNs, however, impose license requirements either without reference to a reason for control code that... their license requirements in full in their “Reasons for Control” sections or they may refer the reader...

  10. Organization Charts in ARL Libraries. SPEC Kit #170.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    This kit is based on a review of the organization charts of 71 member libraries of the Association of Research Libraries (ARL) gathered in January 1991, compared with an earlier SPEC Kit published in 1986, and contains charts of 29 of the libraries. A summary of the chart analyses presents information about the titles of library directors,…

  11. Using Statistical Process Control Charts to Study Stuttering Frequency Variability during a Single Day

    ERIC Educational Resources Information Center

    Karimi, Hamid; O'Brian, Sue; Onslow, Mark; Jones, Mark; Menzies, Ross; Packman, Ann

    2013-01-01

    Purpose: Stuttering varies between and within speaking situations. In this study, the authors used statistical process control charts with 10 case studies to investigate variability of stuttering frequency. Method: Participants were 10 adults who stutter. The authors counted the percentage of syllables stuttered (%SS) for segments of their speech…

  12. Computer-Presented Organizational/Memory Aids as Instruction for Solving Pico-Fomi Problems.

    ERIC Educational Resources Information Center

    Steinberg, Esther R.; And Others

    1985-01-01

    Describes investigation of effectiveness of computer-presented organizational/memory aids (matrix and verbal charts controlled by computer or learner) as instructional technique for solving Pico-Fomi problems, and the acquisition of deductive inference rules when such aids are present. Results indicate chart use control should be adapted to…

  13. User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study.

    PubMed

    Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

    2017-12-01

    To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  14. The construction of control chart for PM10 functional data

    NASA Astrophysics Data System (ADS)

    Shaadan, Norshahida; Jemain, Abdul Aziz; Deni, Sayang Mohd

    2014-06-01

    In this paper, a statistical procedure to construct a control chart for monitoring air quality (PM10) using functional data is proposed. A set of daily indices that represent the daily PM10 curves were obtained using Functional Principal Component Analysis (FPCA). By means of an iterative charting procedure, a reference data set that represented a stable PM10 process was obtained. The data were then used as a reference for monitoring future data. The application of the procedure was conducted using seven-year (2004-2010) period of recorded data from the Klang air quality monitoring station located in the Klang Valley region of Peninsular Malaysia. The study showed that the control chart provided a useful visualization tool for monitoring air quality and was capable in detecting abnormality in the process system. As in the case of Klang station, the results showed that with reference to 2004-2008, the air quality (PM10) in 2010 was better than that in 2009.

  15. Construction and validation of a Tamil logMAR chart.

    PubMed

    Varadharajan, Srinivasa; Srinivasan, Krithica; Kumaresan, Brindha

    2009-09-01

    To design, construct and validate a new Tamil logMAR visual acuity chart based on current recommendations. Ten Tamil letters of equal legibility were identified experimentally and were used in the chart. Two charts, one internally illuminated and one externally illuminated, were constructed for testing at 4 m distance. The repeatability of the two charts was tested. For validation, the two charts were compared with a standard English logMAR chart (ETDRS). When compared to the ETDRS chart, a difference of 0.06 +/- 0.07 and 0.07 +/- 0.07 logMAR was found for the internally and externally illuminated charts respectively. Limits of agreement between the internally illuminated Tamil logMAR chart and ETDRS chart were found to be (-0.08, 0.19), and (-0.07, 0.20) for the externally illuminated chart. The test - retest results showed a difference of 0.02 +/- 0.04 and 0.02 +/- 0.06 logMAR for the internally and externally illuminated charts respectively. Limits of agreement for repeated measurements for the internally illuminated Tamil logMAR chart were found to be (-0.06, 0.10), and (-0.10, 0.14) for the externally illuminated chart. The newly constructed Tamil logMAR charts have good repeatability. The difference in visual acuity scores between the newly constructed Tamil logMAR chart and the standard English logMAR chart was within acceptable limits. This new chart can be used for measuring visual acuity in the literate Tamil population.

  16. Methods to achieve high interrater reliability in data collection from primary care medical records.

    PubMed

    Liddy, Clare; Wiens, Miriam; Hogg, William

    2011-01-01

    We assessed interrater reliability (IRR) of chart abstractors within a randomized trial of cardiovascular care in primary care. We report our findings, and outline issues and provide recommendations related to determining sample size, frequency of verification, and minimum thresholds for 2 measures of IRR: the κ statistic and percent agreement. We designed a data quality monitoring procedure having 4 parts: use of standardized protocols and forms, extensive training, continuous monitoring of IRR, and a quality improvement feedback mechanism. Four abstractors checked a 5% sample of charts at 3 time points for a predefined set of indicators of the quality of care. We set our quality threshold for IRR at a κ of 0.75, a percent agreement of 95%, or both. Abstractors reabstracted a sample of charts in 16 of 27 primary care practices, checking a total of 132 charts with 38 indicators per chart. The overall κ across all items was 0.91 (95% confidence interval, 0.90-0.92) and the overall percent agreement was 94.3%, signifying excellent agreement between abstractors. We gave feedback to the abstractors to highlight items that had a κ of less than 0.70 or a percent agreement less than 95%. No practice had to have its charts abstracted again because of poor quality. A 5% sampling of charts for quality control using IRR analysis yielded κ and agreement levels that met or exceeded our quality thresholds. Using 3 time points during the chart audit phase allows for early quality control as well as ongoing quality monitoring. Our results can be used as a guide and benchmark for other medical chart review studies in primary care.

  17. Defense Manufacturing Management Guide for Program Managers, Third Edition

    DTIC Science & Technology

    1989-04-01

    Crosby (Quality goals of quality, cost, schedule, mission need, College), Genechi Taguchi (Experimental 5-1 Design), Dr. Kaoru Ishikawa (Cause/Effect...the remaining problems were resolved. 5-7 6. Ishikawa Diagram 7. Control Charts This technique was developed by Dr. In the minds of some quality Kaoru ... Ishikawa , one of the foremost professionals and nonprofesslonals alike, the authorities on quality control in Japan. The control chart is synonymous

  18. Application of capability indices and control charts in the analytical method control strategy.

    PubMed

    Oliva, Alexis; Llabres Martinez, Matías

    2017-08-01

    In this study, we assessed the usefulness of control charts in combination with the process capability indices, C pm and C pk , in the control strategy of an analytical method. The traditional X-chart and moving range chart were used to monitor the analytical method over a 2-year period. The results confirmed that the analytical method is in-control and stable. Different criteria were used to establish the specifications limits (i.e. analyst requirements) for fixed method performance (i.e. method requirements). If the specification limits and control limits are equal in breadth, the method can be considered "capable" (C pm  = 1), but it does not satisfy the minimum method capability requirements proposed by Pearn and Shu (2003). Similar results were obtained using the C pk index. The method capability was also assessed as a function of method performance for fixed analyst requirements. The results indicate that the method does not meet the requirements of the analytical target approach. A real-example data of a SEC with light-scattering detection method was used as a model whereas previously published data were used to illustrate the applicability of the proposed approach. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Using Statistical Process Control Charts to Identify the Steroids Era in Major League Baseball: An Educational Exercise

    ERIC Educational Resources Information Center

    Hill, Stephen E.; Schvaneveldt, Shane J.

    2011-01-01

    This article presents an educational exercise in which statistical process control charts are constructed and used to identify the Steroids Era in American professional baseball. During this period (roughly 1993 until the present), numerous baseball players were alleged or proven to have used banned, performance-enhancing drugs. Also observed…

  20. Low visibility operations/surface movement guidance and control system (LVO/SMGCS) chart usability : an examination of flightcrew position awareness in homogeneous 300 ft/75 m RVR conditions

    DOT National Transportation Integrated Search

    2014-09-01

    Two studies were conducted to identify best practices for the design of Low Visibility Operations/Surface Movement Guidance and Control System (LVO/SMGCS) paper charts and flightcrew use of them in extremely low visibility surface conditions. In the ...

  1. 15 CFR 738.3 - Commerce Country Chart structure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... for Control listed in the Export Control Classification Number (ECCN) that applies to the item. Some... may impose license requirements on the items described in that ECCN. (1) ECCNs 0A983, 5A001.i, 5A980... of each ECCN. (d) Cells. The symbol “X” is used to denote licensing requirements on the Country Chart...

  2. 15 CFR 738.3 - Commerce Country Chart structure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... for Control listed in the Export Control Classification Number (ECCN) that applies to the item. Some... may impose license requirements on the items described in that ECCN. (1) ECCNs 0A983, 5A980, 5D980... of each ECCN. (d) Cells. The symbol “X” is used to denote licensing requirements on the Country Chart...

  3. 15 CFR 738.3 - Commerce Country Chart structure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... for Control listed in the Export Control Classification Number (ECCN) that applies to the item. Some... may impose license requirements on the items described in that ECCN. (1) ECCNs 0A983, 5A980, 5D980... of each ECCN. (d) Cells. The symbol “X” is used to denote licensing requirements on the Country Chart...

  4. The unsuitability of HTML-based colour charts for estimating animal colours--a comment on Berggren and Merilä (2004).

    PubMed

    Stevens, Martin; Cuthill, Innes C

    2005-08-30

    A variety of techniques are used to study the colours of animal signals, including the use of visual matching to colour charts. This paper aims to highlight why they are generally an unsatisfactory tool for the measurement and classification of animal colours and why colour codes based on HTML (really RGB) standards, as advocated in a recent paper, are particularly inappropriate. There are many theoretical arguments against the use of colour charts, not least that human colour vision differs markedly from that of most other animals. However, the focus of this paper is the concern that, even when applied to humans, there is no simple 1:1 mapping from an RGB colour space to the perceived colours in a chart (the results are both printer- and illumination-dependent). We support our criticisms with data from colour matching experiments with humans, involving self-made, printed colour charts. Colour matching experiments with printed charts involving 11 subjects showed that the choices made by individuals were significantly different between charts that had exactly the same RGB values, but were produced from different printers. Furthermore, individual matches tended to vary under different lighting conditions. Spectrophotometry of the colour charts showed that the reflectance spectra of the charts varied greatly between printers and that equal steps in RGB space were often far from equal in terms of reflectance on the printed charts. In addition to outlining theoretical criticisms of the use of colour charts, our empirical results show that: individuals vary in their perception of colours, that different printers produce strikingly different results when reproducing what should be the same chart, and that the characteristics of the light irradiating the surface do affect colour perception. Therefore, we urge great caution in the use of colour charts to study animal colour signals. They should be used only as a last resort and in full knowledge of their limitations, with specially produced charts made to high industry standards.

  5. Using an electronic medical record to improve communication within a prenatal care network.

    PubMed

    Bernstein, Peter S; Farinelli, Christine; Merkatz, Irwin R

    2005-03-01

    In 2002, the Institute of Medicine called for the introduction of information technologies in health care settings to improve quality of care. We conducted a review of hospital charts of women who delivered before and after the implementation of an intranet-based computerized prenatal record in an inner-city practice. Our objective was to assess whether the use of this record improved communication among the outpatient office, the ultrasonography unit, and the labor floor. The charts of patients who delivered in August 2002 and August 2003 and received their prenatal care at the Comprehensive Family Care Center at Montefiore Medical Center were analyzed. Data collected included the presence of a copy of the prenatal record in the hospital chart, the date of the last documented prenatal visit, and documentation of any prenatal ultrasonograms performed. Forty-three charts in each group were available for review. The prenatal chart was absent in 16% of the charts of patients from August 2002 compared with only 2% in August 2003 charts (P < .05). Among charts with prenatal records available, the median length of time between the last documented prenatal visit and delivery was significantly longer for August 2002 patients compared with August 2003 patients (36 compared with 4 days, respectively, P < .001). All patients received prenatal ultrasonograms, but documentation of the ultrasonogram was missing from 16% of the August 2002 charts compared with none of the August 2003 charts (P = .01). The use of a paperless, hospital intranet-based prenatal chart significantly improves communication among providers.

  6. Modified SPC for short run test and measurement process in multi-stations

    NASA Astrophysics Data System (ADS)

    Koh, C. K.; Chin, J. F.; Kamaruddin, S.

    2018-03-01

    Due to short production runs and measurement error inherent in electronic test and measurement (T&M) processes, continuous quality monitoring through real-time statistical process control (SPC) is challenging. Industry practice allows the installation of guard band using measurement uncertainty to reduce the width of acceptance limit, as an indirect way to compensate the measurement errors. This paper presents a new SPC model combining modified guard band and control charts (\\bar{\\text{Z}} chart and W chart) for short runs in T&M process in multi-stations. The proposed model standardizes the observed value with measurement target (T) and rationed measurement uncertainty (U). S-factor (S f) is introduced to the control limits to improve the sensitivity in detecting small shifts. The model was embedded in automated quality control system and verified with a case study in real industry.

  7. Reference Charts for Height and Weight of School Children from West Malaysia in Comparison with the United States Centers for Disease Control and Prevention

    PubMed Central

    Bong, YB; Shariff, AA; Majid, AM; Merican, AF

    2012-01-01

    Background: Reference charts are widely used in healthcare as a screening tool. This study aimed to produce reference growth charts for school children from West Malaysia in comparison with the United States Centers for Disease Control and Prevention (CDC) chart. Methods: A total of 14,360 school children ranging from 7 to 17 years old from six states in West Malaysia were collected. A two-stage stratified random sampling technique was used to recruit the subjects. Curves were adjusted using Cole’s LMS method. The LOWESS method was used to smooth the data. Results: The means and standard deviations for height and weight for both genders are presented. The results showed good agreement with growth patterns in other countries, i.e., males tend to be taller and heavier than females for most age groups. Height and weight of females reached a plateau at 17 years of age; however, males were still growing at this age. The growth charts for West Malaysian school children were compared with the CDC 2000 growth charts for school children in the United States. Conclusion: The height and weight for males and females at the start of school-going ages were almost similar. The comparison between the growth charts from this study and the CDC 2000 growth charts indicated that the growth patterns of West Malaysian school children have improved, although the height and weight of American school children were higher than those for West Malaysian school children. PMID:23113132

  8. Multivariate statistical process control of a continuous pharmaceutical twin-screw granulation and fluid bed drying process.

    PubMed

    Silva, A F; Sarraguça, M C; Fonteyne, M; Vercruysse, J; De Leersnyder, F; Vanhoorne, V; Bostijn, N; Verstraeten, M; Vervaet, C; Remon, J P; De Beer, T; Lopes, J A

    2017-08-07

    A multivariate statistical process control (MSPC) strategy was developed for the monitoring of the ConsiGma™-25 continuous tablet manufacturing line. Thirty-five logged variables encompassing three major units, being a twin screw high shear granulator, a fluid bed dryer and a product control unit, were used to monitor the process. The MSPC strategy was based on principal component analysis of data acquired under normal operating conditions using a series of four process runs. Runs with imposed disturbances in the dryer air flow and temperature, in the granulator barrel temperature, speed and liquid mass flow and in the powder dosing unit mass flow were utilized to evaluate the model's monitoring performance. The impact of the imposed deviations to the process continuity was also evaluated using Hotelling's T 2 and Q residuals statistics control charts. The influence of the individual process variables was assessed by analyzing contribution plots at specific time points. Results show that the imposed disturbances were all detected in both control charts. Overall, the MSPC strategy was successfully developed and applied. Additionally, deviations not associated with the imposed changes were detected, mainly in the granulator barrel temperature control. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Real-Time Reliability Verification for UAV Flight Control System Supporting Airworthiness Certification.

    PubMed

    Xu, Haiyang; Wang, Ping

    2016-01-01

    In order to verify the real-time reliability of unmanned aerial vehicle (UAV) flight control system and comply with the airworthiness certification standard, we proposed a model-based integration framework for modeling and verification of time property. Combining with the advantages of MARTE, this framework uses class diagram to create the static model of software system, and utilizes state chart to create the dynamic model. In term of the defined transformation rules, the MARTE model could be transformed to formal integrated model, and the different part of the model could also be verified by using existing formal tools. For the real-time specifications of software system, we also proposed a generating algorithm for temporal logic formula, which could automatically extract real-time property from time-sensitive live sequence chart (TLSC). Finally, we modeled the simplified flight control system of UAV to check its real-time property. The results showed that the framework could be used to create the system model, as well as precisely analyze and verify the real-time reliability of UAV flight control system.

  10. Real-Time Reliability Verification for UAV Flight Control System Supporting Airworthiness Certification

    PubMed Central

    Xu, Haiyang; Wang, Ping

    2016-01-01

    In order to verify the real-time reliability of unmanned aerial vehicle (UAV) flight control system and comply with the airworthiness certification standard, we proposed a model-based integration framework for modeling and verification of time property. Combining with the advantages of MARTE, this framework uses class diagram to create the static model of software system, and utilizes state chart to create the dynamic model. In term of the defined transformation rules, the MARTE model could be transformed to formal integrated model, and the different part of the model could also be verified by using existing formal tools. For the real-time specifications of software system, we also proposed a generating algorithm for temporal logic formula, which could automatically extract real-time property from time-sensitive live sequence chart (TLSC). Finally, we modeled the simplified flight control system of UAV to check its real-time property. The results showed that the framework could be used to create the system model, as well as precisely analyze and verify the real-time reliability of UAV flight control system. PMID:27918594

  11. Decision Support Systems: Applications in Statistics and Hypothesis Testing.

    ERIC Educational Resources Information Center

    Olsen, Christopher R.; Bozeman, William C.

    1988-01-01

    Discussion of the selection of appropriate statistical procedures by educators highlights a study conducted to investigate the effectiveness of decision aids in facilitating the use of appropriate statistics. Experimental groups and a control group using a printed flow chart, a computer-based decision aid, and a standard text are described. (11…

  12. Capital Budgeting Decisions with Post-Audit Information

    DTIC Science & Technology

    1990-06-08

    estimates that were used during project selection. In similar fashion, this research introduces the equivalent sample size concept that permits the... equivalent sample size is extended to include the user’s prior beliefs. 4. For a management tool, the concepts for Cash Flow Control Charts are...Acoxxting Research , vol. 7, no. 2, Autumn 1969, pp. 215-244. [9] Gaynor, Edwin W., "Use of Control Charts in Cost Control ", National Association of Cost

  13. Promoting evidence-based childhood fever management through a peer education programme based on the theory of planned behaviour.

    PubMed

    Edwards, Helen; Walsh, Anne; Courtney, Mary; Monaghan, Sarah; Wilson, Jenny; Young, Jeanine

    2007-10-01

    This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management. Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms. A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme. All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions. Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not. The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management. The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.

  14. Charts and approximate formulas for the estimation of aeroelastic effects of the lateral control of swept and unswept wings

    NASA Technical Reports Server (NTRS)

    Foss, Kenneth A; Diederich, Franklin W

    1953-01-01

    Charts and approximate formulas are presented for the estimation of static aeroelastic effects on the spanwise lift distribution, rolling-moment coefficient, and rate of roll due to the deflection of ailerons on swept and unswept wings at subsonic and supersonic speeds. Some design considerations brought out by the results of this report are discussed. This report treats the lateral-control case in a manner similar to that employed in NACA Report 1140 for the symmetric-flight case, and is intended to be used in conjunction with NACA Report 1140 and the charts and formulas presented therein.

  15. Mobile app reading speed test.

    PubMed

    Kingsnorth, Alec; Wolffsohn, James S

    2015-04-01

    To validate the accuracy and repeatability of a mobile app reading speed test compared with the traditional paper version. Twenty-one subjects wearing their full refractive correction glasses read 14 sentences of decreasing print size between 1.0 and -0.1 logMAR, each consisting of 14 words (Radner reading speed test) at 40 cm with a paper-based chart and twice on iPad charts. Time duration was recorded with a stop watch for the paper chart and on the App itself for the mobile chart allowing critical print size (CPS) and optimal reading speed (ORS) to be derived objectively. The ORS was higher for the mobile app charts (194±29 wpm; 195±25 wpm) compared with the paper chart (166±20 wpm; F=57.000, p<0.001). The CPS was lower for the mobile app charts (0.17±0.20 logMAR; 0.18±0.17 logMAR) compared with the paper chart (0.25±0.17 logMAR; F=5.406, p=0.009). The mobile app test had a mean difference repeatability of 0.30±22.5 wpm, r=0.917 for ORS, and a CPS of 0.0±0.2 logMAR, r=0.769. Repeatability of the app reading speed test is as good (ORS) or better (CPS) than previous studies on the paper test. While the results are not interchangeable with paper-based charts, mobile app tablet-based tests of reading speed are reliable and rapid to perform, with the potential to capture functional visual ability in research studies and clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants.

    PubMed

    Fenton, Tanis R; Kim, Jae H

    2013-04-20

    The aim of this study was to revise the 2003 Fenton Preterm Growth Chart, specifically to: a) harmonize the preterm growth chart with the new World Health Organization (WHO) Growth Standard, b) smooth the data between the preterm and WHO estimates, informed by the Preterm Multicentre Growth (PreM Growth) study while maintaining data integrity from 22 to 36 and at 50 weeks, and to c) re-scale the chart x-axis to actual age (rather than completed weeks) to support growth monitoring. Systematic review, meta-analysis, and growth chart development. We systematically searched published and unpublished literature to find population-based preterm size at birth measurement (weight, length, and/or head circumference) references, from developed countries with: Corrected gestational ages through infant assessment and/or statistical correction; Data percentiles as low as 24 weeks gestational age or lower; Sample with greater than 500 infants less than 30 weeks. Growth curves for males and females were produced using cubic splines to 50 weeks post menstrual age. LMS parameters (skew, median, and standard deviation) were calculated. Six large population-based surveys of size at preterm birth representing 3,986,456 births (34,639 births < 30 weeks) from countries Germany, United States, Italy, Australia, Scotland, and Canada were combined in meta-analyses. Smooth growth chart curves were developed, while ensuring close agreement with the data between 24 and 36 weeks and at 50 weeks. The revised sex-specific actual-age growth charts are based on the recommended growth goal for preterm infants, the fetus, followed by the term infant. These preterm growth charts, with the disjunction between these datasets smoothing informed by the international PreM Growth study, may support an improved transition of preterm infant growth monitoring to the WHO growth charts.

  17. Counseling African Americans to Control Hypertension (CAATCH) Trial: A Multi-level Intervention to Improve Blood Pressure Control in Hypertensive African Americans

    PubMed Central

    Ogedegbe, Gbenga; Tobin, Jonathan N.; Fernandez, Senaida; Gerin, William; Diaz-Gloster, Marleny; Cassells, Andrea; Khalida, Chamanara; Pickering, Thomas; Schoenthaler, Antoinette; Ravenell, Joseph

    2009-01-01

    Background Despite strong evidence of effective interventions targeted at blood pressure (BP) control, there is little evidence on the translation of these approaches to routine clinical practice in care of hypertensive African Americans. The goal of this study is to evaluate the effectiveness of a multi-level, multi-component, evidence-based intervention compared to usual care in improving BP control among hypertensive African Americans who receive care in Community Health Centers (CHCs). The primary outcomes are BP control rate at 12 months; and maintenance of intervention one year after the trial. The secondary outcomes are within-patient change in BP from baseline to 12 months and cost effectiveness of the intervention. Methods and Results Counseling African Americans to Control Hypertension (CAATCH) is a group randomized clinical trial with two conditions: Intervention Condition (IC) and Usual Care (UC). Thirty CHCs were randomly assigned equally to the IC group (N=15) or the UC group (N=15). The intervention is comprised of three components targeted at patients (interactive computerized hypertension education; home BP monitoring; and monthly behavioral counseling on lifestyle modification) and two components targeted at physicians (monthly case rounds based on JNC-7 guidelines; chart audit and provision of feedback on clinical performance and patients’ home BP readings). All outcomes are assessed at quarterly study visits for one year. Chart review is conducted at 24 months to evaluate maintenance of intervention effects and sustainability of the intervention. Conclusions Poor BP control is one of the major reasons for the mortality gap between African Americans and whites. Findings from this study, if successful, will provide salient information needed for translation and dissemination of evidence-based interventions targeted at BP control into clinical practice for this high-risk population. PMID:20031845

  18. Reliability of a standardized test in Swedish for evaluation of reading performance in healthy eyes. Interchart and test-retest analyses.

    PubMed

    Thaung, Jörgen; Olseke, Kjell; Ahl, Johan; Sjöstrand, Johan

    2014-09-01

    The purpose of our study was to establish a practical and quick test for assessing reading performance and to statistically analyse interchart and test-retest reliability of a new standardized Swedish reading chart system consisting of three charts constructed according to the principles available in the literature. Twenty-four subjects with healthy eyes, mean age 65 ± 10 years, were tested binocularly and the reading performance evaluated as reading acuity, critical print size and maximum reading speed. The test charts all consist of 12 short text sentences with a print size ranging from 0.9 to -0.2 logMAR in approximate steps of 0.1 logMAR. Two testing sessions, in two different groups (C1 and C2), were under strict control of luminance and lighting environment. Reading performance tests with chart T1, T2 and T3 were used for evaluation of interchart reliability and test data from a second session 1 month or more apart for the test-retest analysis. The testing of reading performance in adult observers with short sentences of continuous text was quick and practical. The agreement between the tests obtained with the three different test charts was high both within the same test session and at retest. This new Swedish variant of a standardized reading system based on short sentences and logarithmic progression of print size provides reliable measurements of reading performance and preliminary norms in an age group around 65 years. The reading test with three independent reading charts can be useful for clinical studies of reading ability before and after treatment. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Cumulative sum control charts for assessing performance in arterial surgery.

    PubMed

    Beiles, C Barry; Morton, Anthony P

    2004-03-01

    The Melbourne Vascular Surgical Association (Melbourne, Australia) undertakes surveillance of mortality following aortic aneurysm surgery, patency at discharge following infrainguinal bypass and stroke and death following carotid endarterectomy. Quality improvement protocol employing the Deming cycle requires that the system for performing surgery first be analysed and optimized. Then process and outcome data are collected and these data require careful analysis. There must be a mechanism so that the causes of unsatisfactory outcomes can be determined and a good feedback mechanism must exist so that good performance is acknowledged and unsatisfactory performance corrected. A simple method for analysing these data that detects changes in average outcome rates is available using cumulative sum statistical control charts. Data have been analysed both retrospectively from 1999 to 2001, and prospectively during 2002 using cumulative sum control methods. A pathway to deal with control chart signals has been developed. The standard of arterial surgery in Victoria, Australia, is high. In one case a safe and satisfactory outcome was achieved by following the pathway developed by the audit committee. Cumulative sum control charts are a simple and effective tool for the identification of variations in performance standards in arterial surgery. The establishment of a pathway to manage problem performance is a vital part of audit activity.

  20. STS-26 long duration simulation in JSC Mission Control Center (MCC) Bldg 30

    NASA Technical Reports Server (NTRS)

    1988-01-01

    STS-26 long duration simulation is conducted in JSC Mission Control Center (MCC) Bldg 30 Flight Control Room (FCR). Front row of consoles with Propulsion Engineer (PROP) and Guidance, Navigation, and Control Systems Engineer (GNC) are visible in the foreground. CBS television camera personnel record front visual displays (orbital chart and data) for '48 Hours' program to be broadcast at a later date. The integrated simulation involved communicating with crewmembers stationed in the fixed based (FB) shuttle mission simulator (SMS) located in JSC Mission Simulation and Training Facility Bldg 5.

  1. Sticker charts: a method for improving adherence to treatment of chronic diseases in children.

    PubMed

    Luersen, Kara; Davis, Scott A; Kaplan, Sebastian G; Abel, Troy D; Winchester, Woodrow W; Feldman, Steven R

    2012-01-01

    Poor adherence is a common problem and may be an underlying cause of poor clinical outcomes. In pediatric populations, positive reinforcement techniques such as sticker charts may increase motivation to adhere to treatment regimens. To review the use of sticker charts to improve adherence in children with chronic disease, Medline and PsycINFO searches were conducted using the key words "positive reinforcement OR behavior therapy" and "adherence OR patient compliance" and "child." Randomized controlled retrospective cohort or single-subject-design studies were selected. Studies reporting adherence to the medical treatment of chronic disease in children using positive reinforcement techniques were included in the analysis. The systematic search was supplemented by identifying additional studies identified through the reference lists and authors of the initial articles found. Positive reinforcement techniques such as sticker charts increase adherence to medical treatment regimens. In several studies, this effect was maintained for months after the initial intervention. Better adherence correlated with better clinical outcomes in some, but not all, studies. Few studies examining the use of sticker charts were identified. Although single-subject-design studies are useful in establishing the effect of a behavioral intervention, larger randomized controlled trials would help determine the precise efficacy of sticker chart interventions. Adherence to medical treatments in children can be increased using sticker charts or other positive reinforcement techniques. This may be an effective means to encourage children with atopic dermatitis to apply their medications and improve clinical outcomes. © 2012 Wiley Periodicals, Inc.

  2. Estimation of degree of sea ice ridging based on dual-polarized C-band SAR data

    NASA Astrophysics Data System (ADS)

    Gegiuc, Alexandru; Similä, Markku; Karvonen, Juha; Lensu, Mikko; Mäkynen, Marko; Vainio, Jouni

    2018-01-01

    For ship navigation in the Baltic Sea ice, parameters such as ice edge, ice concentration, ice thickness and degree of ridging are usually reported daily in manually prepared ice charts. These charts provide icebreakers with essential information for route optimization and fuel calculations. However, manual ice charting requires long analysis times, and detailed analysis of large areas (e.g. Arctic Ocean) is not feasible. Here, we propose a method for automatic estimation of the degree of ice ridging in the Baltic Sea region, based on RADARSAT-2 C-band dual-polarized (HH/HV channels) SAR texture features and sea ice concentration information extracted from Finnish ice charts. The SAR images were first segmented and then several texture features were extracted for each segment. Using the random forest method, we classified them into four classes of ridging intensity and compared them to the reference data extracted from the digitized ice charts. The overall agreement between the ice-chart-based degree of ice ridging and the automated results varied monthly, being 83, 63 and 81 % in January, February and March 2013, respectively. The correspondence between the degree of ice ridging reported in the ice charts and the actual ridge density was validated with data collected during a field campaign in March 2011. In principle the method can be applied to the seasonal sea ice regime in the Arctic Ocean.

  3. Systems approach provides management control of complex programs

    NASA Technical Reports Server (NTRS)

    Dudek, E. F., Jr.; Mc Carthy, J. F., Jr.

    1970-01-01

    Integrated program management process provides management visual assistance through three interrelated charts - system model that identifies each function to be performed, matrix that identifies personnel responsibilities for these functions, process chart that breaks down the functions into discrete tasks.

  4. Determination of Tide Heights from Airborne Bathymetric Data

    DTIC Science & Technology

    1989-12-01

    MEASUREMENT ERROR, A FORTRAN FUNCTION ............................. 60 v D. THE MEASUREMENT ERROR .......................... 61 E. THE REFERENCE PLANE ...soundings made to a chart datum. The chart datum is a "tide based" plane which usually corresponds to some mean of the low waters for the local tidal...regime. A low water plane is used so depths published on a nautical chart are shown in their least favorable aspect. If the chart datum is very

  5. The unsuitability of html-based colour charts for estimating animal colours – a comment on Berggren and Merilä (2004)

    PubMed Central

    Stevens, Martin; Cuthill, Innes C

    2005-01-01

    Background A variety of techniques are used to study the colours of animal signals, including the use of visual matching to colour charts. This paper aims to highlight why they are generally an unsatisfactory tool for the measurement and classification of animal colours and why colour codes based on HTML (really RGB) standards, as advocated in a recent paper, are particularly inappropriate. There are many theoretical arguments against the use of colour charts, not least that human colour vision differs markedly from that of most other animals. However, the focus of this paper is the concern that, even when applied to humans, there is no simple 1:1 mapping from an RGB colour space to the perceived colours in a chart (the results are both printer- and illumination-dependent). We support our criticisms with data from colour matching experiments with humans, involving self-made, printed colour charts. Results Colour matching experiments with printed charts involving 11 subjects showed that the choices made by individuals were significantly different between charts that had exactly the same RGB values, but were produced from different printers. Furthermore, individual matches tended to vary under different lighting conditions. Spectrophotometry of the colour charts showed that the reflectance spectra of the charts varied greatly between printers and that equal steps in RGB space were often far from equal in terms of reflectance on the printed charts. Conclusion In addition to outlining theoretical criticisms of the use of colour charts, our empirical results show that: individuals vary in their perception of colours, that different printers produce strikingly different results when reproducing what should be the same chart, and that the characteristics of the light irradiating the surface do affect colour perception. Therefore, we urge great caution in the use of colour charts to study animal colour signals. They should be used only as a last resort and in full knowledge of their limitations, with specially produced charts made to high industry standards. PMID:16131394

  6. Control Chart on Semi Analytical Weighting

    NASA Astrophysics Data System (ADS)

    Miranda, G. S.; Oliveira, C. C.; Silva, T. B. S. C.; Stellato, T. B.; Monteiro, L. R.; Marques, J. R.; Faustino, M. G.; Soares, S. M. V.; Ulrich, J. C.; Pires, M. A. F.; Cotrim, M. E. B.

    2018-03-01

    Semi-analytical balance verification intends to assess the balance performance using graphs that illustrate measurement dispersion, trough time, and to demonstrate measurements were performed in a reliable manner. This study presents internal quality control of a semi-analytical balance (GEHAKA BG400) using control charts. From 2013 to 2016, 2 weight standards were monitored before any balance operation. This work intended to evaluate if any significant difference or bias were presented on weighting procedure over time, to check the generated data reliability. This work also exemplifies how control intervals are established.

  7. The Effect of Various Media Scaffolding on Increasing Understanding of Students' Geometry Concepts

    ERIC Educational Resources Information Center

    Sutiarso, Sugeng; Coesamin, M.; Nurhanurawati

    2018-01-01

    This study is a quasi-experimental research with pretest-posttest control group design, which aims to determine (1) the tendency of students in using various media scaffolding based on gender, and (2) effect of media scaffolding on increasing understanding of students' geometry concepts. Media scaffolding used this study is chart, props, and…

  8. Batch statistical process control of a fluid bed granulation process using in-line spatial filter velocimetry and product temperature measurements.

    PubMed

    Burggraeve, A; Van den Kerkhof, T; Hellings, M; Remon, J P; Vervaet, C; De Beer, T

    2011-04-18

    Fluid bed granulation is a batch process, which is characterized by the processing of raw materials for a predefined period of time, consisting of a fixed spraying phase and a subsequent drying period. The present study shows the multivariate statistical modeling and control of a fluid bed granulation process based on in-line particle size distribution (PSD) measurements (using spatial filter velocimetry) combined with continuous product temperature registration using a partial least squares (PLS) approach. Via the continuous in-line monitoring of the PSD and product temperature during granulation of various reference batches, a statistical batch model was developed allowing the real-time evaluation and acceptance or rejection of future batches. Continuously monitored PSD and product temperature process data of 10 reference batches (X-data) were used to develop a reference batch PLS model, regressing the X-data versus the batch process time (Y-data). Two PLS components captured 98.8% of the variation in the X-data block. Score control charts in which the average batch trajectory and upper and lower control limits are displayed were developed. Next, these control charts were used to monitor 4 new test batches in real-time and to immediately detect any deviations from the expected batch trajectory. By real-time evaluation of new batches using the developed control charts and by computation of contribution plots of deviating process behavior at a certain time point, batch losses or reprocessing can be prevented. Immediately after batch completion, all PSD and product temperature information (i.e., a batch progress fingerprint) was used to estimate some granule properties (density and flowability) at an early stage, which can improve batch release time. Individual PLS models relating the computed scores (X) of the reference PLS model (based on the 10 reference batches) and the density, respectively, flowabililty as Y-matrix, were developed. The scores of the 4 test batches were used to examine the predictive ability of the model. Copyright © 2011 Elsevier B.V. All rights reserved.

  9. Building information for systematic improvement of the prevention of hospital-acquired pressure ulcers with statistical process control charts and regression.

    PubMed

    Padula, William V; Mishra, Manish K; Weaver, Christopher D; Yilmaz, Taygan; Splaine, Mark E

    2012-06-01

    To demonstrate complementary results of regression and statistical process control (SPC) chart analyses for hospital-acquired pressure ulcers (HAPUs), and identify possible links between changes and opportunities for improvement between hospital microsystems and macrosystems. Ordinary least squares and panel data regression of retrospective hospital billing data, and SPC charts of prospective patient records for a US tertiary-care facility (2004-2007). A prospective cohort of hospital inpatients at risk for HAPUs was the study population. There were 337 HAPU incidences hospital wide among 43 844 inpatients. A probit regression model predicted the correlation of age, gender and length of stay on HAPU incidence (pseudo R(2)=0.096). Panel data analysis determined that for each additional day in the hospital, there was a 0.28% increase in the likelihood of HAPU incidence. A p-chart of HAPU incidence showed a mean incidence rate of 1.17% remaining in statistical control. A t-chart showed the average time between events for the last 25 HAPUs was 13.25 days. There was one 57-day period between two incidences during the observation period. A p-chart addressing Braden scale assessments showed that 40.5% of all patients were risk stratified for HAPUs upon admission. SPC charts complement standard regression analysis. SPC amplifies patient outcomes at the microsystem level and is useful for guiding quality improvement. Macrosystems should monitor effective quality improvement initiatives in microsystems and aid the spread of successful initiatives to other microsystems, followed by system-wide analysis with regression. Although HAPU incidence in this study is below the national mean, there is still room to improve HAPU incidence in this hospital setting since 0% incidence is theoretically achievable. Further assessment of pressure ulcer incidence could illustrate improvement in the quality of care and prevent HAPUs.

  10. Estimating the Occupational Morbidity for Migrant and Seasonal Farmworkers in New York State: a Comparison of Two Methods

    PubMed Central

    Earle-Richardson, Giulia B.; Brower, Melissa A.; Jones, Amanda M.; May, John J.; Jenkins, Paul L.

    2008-01-01

    Purpose To compare occupational morbidity estimates for migrant and seasonal farmworkers obtained from survey methods versus chart review methods, and to estimate the proportion of morbidity treated at federally recognized migrant health centers (MHCs) in a highly agricultural region of New York. Methods Researchers simultaneously conducted: a) an occupational injury and illness survey among agricultural workers; b) MHC chart review; and c) hospital emergency room (ER) chart reviews. Results Of the 24 injuries reported by 550 survey subjects, 54.2% received treatment MHCs 16.7% at ERs, 16.7% at some other facility, and 12.5% were untreated. For injuries treated at MHCs or ERs, the incidence density based on survey methods was 29.3 injuries per 10,000 worker-weeks versus 27.4 by chart review. The standardized morbidity ratio (SMR) for this comparison was 1.07 (95% CI = 0.65 – 1.77). Conclusion Survey data indicate that 71% of agricultural injury and illness can be captured with MHC and ER chart review. MHC and ER incidence density estimates show strong correspondence between the two methods. A chart review-based surveillance system, in conjunction with a correction factor based on periodic worker surveys, would provide a cost-effective estimate of the occupational illness and injury rate in this population. PMID:18063238

  11. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases.

    PubMed

    Arimura, Eiko; Matsumoto, Chota; Nomoto, Hiroki; Hashimoto, Shigeki; Takada, Sonoko; Okuyama, Sachiko; Shimomura, Yoshikazu

    2011-01-05

    To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP). The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases.

  12. Focus on Adoption.

    ERIC Educational Resources Information Center

    Child Welfare Information Services, Inc., New York, NY.

    This report consists of three charts which present data on adoption patterns in New York City in the year 1976. The report is based on quarterly Child Welfare Information Service (CWIS) reports developed by Dave Fanshel and John Grundy. Each chart is accompanied by a brief explanatory text, and a summary of the findings. The charts present data on…

  13. Use of an optokinetic chart stimulation intervention for restoration of voluntary movement, postural control and mobility in acute stroke patients and one post intensive care polyneuropathy patient: A case series.

    PubMed

    Chitambira, Benjamin

    2011-01-01

    The objective of this case series is to report on the use of an optokinetic chart stimulation intervention to restore voluntary movement, postural control and mobility in acute stroke patients and one post intensive care polyneuropathy patient. An optokinetic chart was moved in front of the patient: from side to side, up and down and finally forwards and backwards. Specific active-assisted exercises of affected shoulder anti-gravity muscles were also carried out. Except for strokes involving basal ganglia, parietal and temporal lobes simultaneously, optokinetic stimulation was effective in restoring voluntary movements, postural control and mobility. In single lobe strokes and those that do not involve simultaneous extensive damage to the basal ganglia, parietal and temporal lobes optokinetics may be one of the neuro-modulation techniques that use cranial nerve circuits of key movement and postural control input organs to enhance neural plasticity. Extensive temporal- parietal strokes may need longer periods of rehabilitation. Further research using a combination of vestibular interventions may provide an effective intervention for severely disabling extensive temporal-parietal strokes. Further studies with this optokinetic chart intervention are also recommended for chronic stroke patients.

  14. Color-coding and human factors engineering to improve patient safety characteristics of paper-based emergency department clinical documentation.

    PubMed

    Kobayashi, Leo; Boss, Robert M; Gibbs, Frantz J; Goldlust, Eric; Hennedy, Michelle M; Monti, James E; Siegel, Nathan A

    2011-01-01

    Investigators studied an emergency department (ED) physical chart system and identified inconsistent, small font labeling; a single-color scheme; and an absence of human factors engineering (HFE) cues. A case study and description of the methodology with which surrogate measures of chart-related patient safety were studied and subsequently used to reduce latent hazards are presented. Medical records present a challenge to patient safety in EDs. Application of HFE can improve specific aspects of existing medical chart organization systems as they pertain to patient safety in acute care environments. During 10 random audits over 5 consecutive days (573 data points), 56 (9.8%) chart binders (range 0.0-23%) were found to be either misplaced or improperly positioned relative to other chart binders; 12 (21%) were in the critical care area. HFE principles were applied to develop an experimental chart binder system with alternating color-based chart groupings, simple and prominent identifiers, and embedded visual cues. Post-intervention audits revealed significant reductions in chart binder location problems overall (p < 0.01), for Urgent Care A and B pods (6.4% to 1.2%; p < 0.05), Fast Track C pod (19.3% to 0.0%; p < 0.05) and Behavioral/Substance Abuse D pod (15.7% to 0.0%; p < 0.05) areas of the ED. The critical care room area did not display an improvement (11.4% to 13.2%; p = 0.40). Application of HFE methods may aid the development, assessment, and modification of acute care clinical environments through evidence-based design methodologies and contribute to safe patient care delivery.

  15. Monitoring of International Space Station Telemetry Using Shewhart Control Charts

    NASA Technical Reports Server (NTRS)

    Fitch, Jeffery T.; Simon, Alan L.; Gouveia, John A.; Hillin, Andrew M.; Hernandez, Steve A.

    2012-01-01

    Shewhart control charts have been established as an expedient method for analyzing dynamic, trending data in order to identify anomalous subsystem performance as soon as such performance would exceed a statistically established baseline. Additionally, this leading indicator tool integrates a selection methodology that reduces false positive indications, optimizes true leading indicator events, minimizes computer processor unit duty cycles, and addresses human factor concerns (i.e., the potential for flight-controller data overload). This innovation leverages statistical process control, and provides a relatively simple way to allow flight controllers to focus their attention on subtle system changes that could lead to dramatic off-nominal system performance. Finally, this capability improves response time to potential hardware damage and/or crew injury, thereby improving space flight safety. Shewhart control charts require normalized data. However, the telemetry from the ISS Early External Thermal Control System (EETCS) was not normally distributed. A method for normalizing the data was implemented, as was a means of selecting data windows, the number of standard deviations (Sigma Level), the number of consecutive points out of limits (Sequence), and direction (increasing or decreasing trend data). By varying these options, and treating them like dial settings, the number of nuisance alerts and leading indicators were optimized. The goal was to capture all leading indicators while minimizing the number of nuisances. Lean Six Sigma (L6S) design of experiment methodologies were employed. To optimize the results, Perl programming language was used to automate the massive amounts of telemetry data, control chart plots, and the data analysis.

  16. Smart Aeronautical Chart Management System Design

    NASA Astrophysics Data System (ADS)

    Pakdil, M. E.; Celik, R. N.; Kaya, Ö.; Konak, Y. C.; Guney, C.

    2015-10-01

    Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc.) to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO's Annex 4 and Annex 15, cartographic representation and page layout differs in each state's publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID) charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  17. Browser-Based Application for Telemetry Monitoring of Robotic Assets

    NASA Technical Reports Server (NTRS)

    Breed, Kelly S.; Powell, Mark W.; Shams, Khawaja S.; Petras, Richard D.

    2010-01-01

    AEGSE Virtuoso Charting is an application that enables animated, real-time charting of telemetry streams of data from a rover. These automatically scaled charts are completely interactive, and allow users to choose the variables that they want to monitor. The charts can process data from streams with many variables. This application allows for the simultaneous viewing of up to four individually configured charts on a small touch-screen laptop. The charting application has been tested and found to be extremely robust during long operations. It was left running overnight, with incoming telemetry at 100 Hz, and it did not experience any signs of lost functionality or memory leaks. This robustness is critical for an application that will be used to support vital tests for the Mars Science Laboratory rover. The charting component also provides an interactive interface that allows the engineers to decide how many charts they want on their screen, and which attributes should be plotted on each chart. The application is optimized to make the charts on display take up as much of the available space as possible to maximize the use of the screen real estate. Engineers are also able to plot multiple attributes on the same chart, which enables them to observe the correlation between various attributes.

  18. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants

    PubMed Central

    2013-01-01

    Background The aim of this study was to revise the 2003 Fenton Preterm Growth Chart, specifically to: a) harmonize the preterm growth chart with the new World Health Organization (WHO) Growth Standard, b) smooth the data between the preterm and WHO estimates, informed by the Preterm Multicentre Growth (PreM Growth) study while maintaining data integrity from 22 to 36 and at 50 weeks, and to c) re-scale the chart x-axis to actual age (rather than completed weeks) to support growth monitoring. Methods Systematic review, meta-analysis, and growth chart development. We systematically searched published and unpublished literature to find population-based preterm size at birth measurement (weight, length, and/or head circumference) references, from developed countries with: Corrected gestational ages through infant assessment and/or statistical correction; Data percentiles as low as 24 weeks gestational age or lower; Sample with greater than 500 infants less than 30 weeks. Growth curves for males and females were produced using cubic splines to 50 weeks post menstrual age. LMS parameters (skew, median, and standard deviation) were calculated. Results Six large population-based surveys of size at preterm birth representing 3,986,456 births (34,639 births < 30 weeks) from countries Germany, United States, Italy, Australia, Scotland, and Canada were combined in meta-analyses. Smooth growth chart curves were developed, while ensuring close agreement with the data between 24 and 36 weeks and at 50 weeks. Conclusions The revised sex-specific actual-age growth charts are based on the recommended growth goal for preterm infants, the fetus, followed by the term infant. These preterm growth charts, with the disjunction between these datasets smoothing informed by the international PreM Growth study, may support an improved transition of preterm infant growth monitoring to the WHO growth charts. PMID:23601190

  19. Auditing the nutrition content of patient charts: one hospital's perspective.

    PubMed

    Skopelianos, S

    1993-01-01

    Chart audits are traditionally based on patient charts categorized by disease. An alternate approach, using categorization by four types of nutrition care intervention, has been developed by University Hospital. This paper describes the process followed, criteria developed and the results of two complete chart audits. It was shown that nutrition profile forms improved documentation. Overall norms increased significantly from 81.5% to 90% (p < .05). Discussion centres on the evolutionary process from quality assurance to continuous quality improvement.

  20. Does daily nurse staffing match ward workload variability? Three hospitals' experiences.

    PubMed

    Gabbay, Uri; Bukchin, Michael

    2009-01-01

    Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity. The real challenge will be to develop planning systems and implement corrective interventions such as dynamic and flexible daily staffing, which will face difficulties and barriers. The paper fulfils the need for workforce utilization evaluation. A simple method using available data for daily staffing appropriateness evaluation, which is easy to implement and operate, is presented. The statistical process control method enables intra-ward evaluation, while standardization by converting crude into relative measures enables inter-ward analysis. The staffing indicator definitions enable performance evaluation. This original study uses statistical process control to develop simple standardization methods and applies straightforward statistical tools. This method is not limited to crude measures, rather it uses weighted workload measures such as nursing acuity or weighted nurse level (i.e. grade/band).

  1. Electronic growth charts: watching our patients grow.

    PubMed

    Murphy, Cynthia A; Carstens, Kimberly; Villamayor, Precy

    2005-01-01

    Pediatric Growth Charts have been used in the pediatric community since 1977. The first growth charts were developed by the National Center for Health Statistics as a clinical tool for health care professionals. The growth charts, revised in 2000, by the Center for Disease Control consists of a series of percentile curves for selected body measurements in children [1]. Capitalizing on the benefits of our Electronic Medical Record (EMR), and as a byproduct of nursing electronic documentation of routine heights, weights, and frontal occipital circumferences, our system plots the routine measurements without additional intervention by the staff. Clinicians can view the graphs online or generate printed reports as needed during routine examination for outpatient or hospitalized care. This abstract outlines the background, design process, programming rules utilized to plot growth curves, and the evaluation of the electronic CDC growth charts in our organization.

  2. Evaluation of audit-based performance measures for dental care plans.

    PubMed

    Bader, J D; Shugars, D A; White, B A; Rindal, D B

    1999-01-01

    Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult.

  3. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children.

    PubMed

    Khadilkar, Vaman; Yadav, Sangeeta; Agrawal, K K; Tamboli, Suchit; Banerjee, Monidipa; Cherian, Alice; Goyal, Jagdish P; Khadilkar, Anuradha; Kumaravel, V; Mohan, V; Narayanappa, D; Ray, I; Yewale, Vijay

    2015-01-01

    The need to revise Indian Academy of Pediatrics (IAP) growth charts for 5- to 18-year-old Indian children and adolescents was felt as India is in nutrition transition and previous IAP charts are based on data which are over two decades old. The Growth Chart Committee was formed by IAP in January 2014 to design revised growth charts. Consultative meeting was held in November 2014 in Mumbai. Studies performed on Indian children's growth, nutritional assessment and anthropometry from upper and middle socioeconomic classes in last decade were identified. Committee contacted 13 study groups; total number of children in the age group of 5 to 18 years were 87022 (54086 boys). Data from fourteen cities (Agartala, Ahmadabad, Chandigarh, Chennai, Delhi, Hyderabad, Kochi, Kolkata, Madurai, Mumbai, Mysore, Pune, Raipur and Surat) in India were collated. Data of children with weight for height Z scores >2 SD were removed from analyses. Data on 33148 children (18170 males, 14978 females) were used to construct growth charts using Cole's LMS method. To construct revised IAP growth charts for 5-18 year old Indian children based on collated national data from published studies performed on apparently healthy children and adolescents in the last 10 years. The IAP growth chart committee recommends these revised growth charts for height, weight and body mass index (BMI) for assessment of growth of 5-18 year old Indian children to replace the previous IAP charts; rest of the recommendations for monitoring height and weight remain as per the IAP guidelines published in 2007. To define overweight and obesity in children from 5-18 years of age, adult equivalent of 23 and 27 cut-offs presented in BMI charts may be used. IAP recommends use of WHO standards for growth assessment of children below 5 years of age.

  4. Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

    PubMed

    Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

    2018-02-09

    Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P < 0.01). Chart design did support neither clinical authorization of individual insulin prescription (10%), nor insulin administration confirmed by nurses' signature (25%), nor treatment of hypoglycemia (0%), which resulted in a reduced documentation and treatment quality in clinical practice 7%, 30%, 25%, respectively. A multitude of charts with variable design characteristics and structural deficits were in use across the inpatient wards. More than half of the inpatients had a chart displaying a medication error. Lack of structure quality features of the charts had an impact on documentation and treatment quality. Based on identified deficits and international standards, a new insulin chart was developed to overcome these quality hurdles.

  5. Harmonic regression based multi-temporal cloud filtering algorithm for Landsat 8

    NASA Astrophysics Data System (ADS)

    Joshi, P.

    2015-12-01

    Landsat data archive though rich is seen to have missing dates and periods owing to the weather irregularities and inconsistent coverage. The satellite images are further subject to cloud cover effects resulting in erroneous analysis and observations of ground features. In earlier studies the change detection algorithm using statistical control charts on harmonic residuals of multi-temporal Landsat 5 data have been shown to detect few prominent remnant clouds [Brooks, Evan B., et al, 2014]. So, in this work we build on this harmonic regression approach to detect and filter clouds using a multi-temporal series of Landsat 8 images. Firstly, we compute the harmonic coefficients using the fitting models on annual training data. This time series of residuals is further subjected to Shewhart X-bar control charts which signal the deviations of cloud points from the fitted multi-temporal fourier curve. For the process with standard deviation σ we found the second and third order harmonic regression with a x-bar chart control limit [Lσ] ranging between [0.5σ < Lσ < σ] as most efficient in detecting clouds. By implementing second order harmonic regression with successive x-bar chart control limits of L and 0.5 L on the NDVI, NDSI and haze optimized transformation (HOT), and utilizing the seasonal physical properties of these parameters, we have designed a novel multi-temporal algorithm for filtering clouds from Landsat 8 images. The method is applied to Virginia and Alabama in Landsat8 UTM zones 17 and 16 respectively. Our algorithm efficiently filters all types of cloud cover with an overall accuracy greater than 90%. As a result of the multi-temporal operation and the ability to recreate the multi-temporal database of images using only the coefficients of the fourier regression, our algorithm is largely storage and time efficient. The results show a good potential for this multi-temporal approach for cloud detection as a timely and targeted solution for the Landsat 8 research community, catering to the need for innovative processing solutions in the infant stage of the satellite.

  6. Extra projection data identification method for fast-continuous-rotation industrial cone-beam CT.

    PubMed

    Yang, Min; Duan, Shengling; Duan, Jinghui; Wang, Xiaolong; Li, Xingdong; Meng, Fanyong; Zhang, Jianhai

    2013-01-01

    Fast-continuous-rotation is an effective measure to improve the scanning speed and decrease the radiation dose for cone-beam CT. However, because of acceleration and deceleration of the motor, as well as the response lag of the scanning control terminals to the host PC, uneven-distributed and redundant projections are inevitably created, which seriously decrease the quality of the reconstruction images. In this paper, we first analyzed the aspects of the theoretical sequence chart of the fast-continuous-rotation mode. Then, an optimized sequence chart was proposed by extending the rotation angle span to ensure the effective 2π-span projections were situated in the stable rotation stage. In order to match the rotation angle with the projection image accurately, structure similarity (SSIM) index was used as a control parameter for extraction of the effective projection sequence which was exactly the complete projection data for image reconstruction. The experimental results showed that SSIM based method had a high accuracy of projection view locating and was easy to realize.

  7. Digital adaptive controllers for VTOL vehicles. Volume 2: Software documentation

    NASA Technical Reports Server (NTRS)

    Hartmann, G. L.; Stein, G.; Pratt, S. G.

    1979-01-01

    The VTOL approach and landing test (VALT) adaptive software is documented. Two self-adaptive algorithms, one based on an implicit model reference design and the other on an explicit parameter estimation technique were evaluated. The organization of the software, user options, and a nominal set of input data are presented along with a flow chart and program listing of each algorithm.

  8. The Use of Conjugate Charts in Transfer Reactions: A Unified Approach

    ERIC Educational Resources Information Center

    Allnutt, Michael I.

    2007-01-01

    Redox reactions can be conveniently discussed in terms of the relative strengths of the oxidant, the reductant, and their conjugates; a conjugate chart is a most convenient and useful way of doing this. A similar chart for acids and bases is proposed, which can be applied in the same manner. (Contains 7 figures and 2 tables.)

  9. A Control Chart Approach for Representing and Mining Data Streams with Shape Based Similarity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Omitaomu, Olufemi A

    The mining of data streams for online condition monitoring is a challenging task in several domains including (electric) power grid system, intelligent manufacturing, and consumer science. Considering a power grid application in which thousands of sensors, called the phasor measurement units, are deployed on the power grid network to continuously collect streams of digital data for real-time situational awareness and system management. Depending on design, each sensor could stream between ten and sixty data samples per second. The myriad of sensory data captured could convey deeper insights about sequence of events in real-time and before major damages are done. However,more » the timely processing and analysis of these high-velocity and high-volume data streams is a challenge. Hence, a new data processing and transformation approach, based on the concept of control charts, for representing sequence of data streams from sensors is proposed. In addition, an application of the proposed approach for enhancing data mining tasks such as clustering using real-world power grid data streams is presented. The results indicate that the proposed approach is very efficient for data streams storage and manipulation.« less

  10. Practice-based learning for improvement: the pursuit of clinical excellence.

    PubMed

    Staker, L V

    2000-10-01

    Physicians often seem to be paralyzed waiting for a health plan, a health maintenance organization, or an integrated health care system to bring about change or improvement in health care. But small changes in individual practices (microsystems) can have a profound impact on outcomes in an organization (microsystem). With simple graphical measurement tools, physicians can teach patients to measure and empower themselves to learn to improve both their health and their health care. At the same time, physicians can learn a great deal from their patient population data. When these measurement tools and a well-known and widely accepted method for clinical practice improvement called rapid cycle testing were used in a population of patients with diabetes, the average fasting blood sugar changed from 187 to 110 and the average hemoglobin A1c from 10.5 to 7.2. This article shows that measurement using specification charts and control charts in patient care can have a profound impact on patients, physicians, and organizations. Understanding these principles and using time-sequence measurement with graphical data feedback, physicians can engage in practice-based learning and can participate in improvement in the microsystems over which they have control.

  11. Practical Software Measurement: Measuring for Process Management and Improvement,

    DTIC Science & Technology

    1997-04-01

    Ishikawa , Kaoru . Guide to Quality Control, Second Revised Edition. White Plains, N.Y.: UNIPUB-Kraus International Publications, 1986. CMU/SEI-97...begin, you may want to assemble a group of people who work within the process to brainstorm possible reasons for the unusual behavior. Ishikawa charts...control limits and center line. • Cause-and-effect diagrams (also know as Ishikawa charts) allow you to probe for, map, and prioritize a set of factors

  12. A Study on Predictive Analytics Application to Ship Machinery Maintenance

    DTIC Science & Technology

    2013-09-01

    Looking at the nature of the time series forecasting method , it would be better applied to offline analysis . The application for real- time online...other system attributes in future. Two techniques of statistical analysis , mainly time series models and cumulative sum control charts, are discussed in...statistical tool employed for the two techniques of statistical analysis . Both time series forecasting as well as CUSUM control charts are shown to be

  13. Age and Sex Differences in Controlled Force Exertion Measured by a Computing Bar Chart Target-Pursuit System

    ERIC Educational Resources Information Center

    Nagasawa, Yoshinori; Demura, Shinichi

    2009-01-01

    This study aimed to examine the age and sex differences in controlled force exertion measured by the bar chart display in 207 males (age 42.1 [plus or minus] 19.8 years) and 249 females (age 41.7 [plus or minus] 19.1 years) aged 15 to 86 years. The subjects matched their submaximal grip strength to changing demand values, which appeared as a…

  14. A methodology for post-EIS (environmental impact statement) monitoring

    USGS Publications Warehouse

    Marcus, Linda Graves

    1979-01-01

    A methodology for monitoring the impacts predicted in environmental impact statements (EIS's) was developed using the EIS on phosphate development in southeastern Idaho as a case study. A monitoring system based on this methodology: (1) coordinates a comprehensive, intergovernmental monitoring effort; (2) documents the major impacts that result, thereby improving the accuracy of impact predictions in future EIS's; (3) helps agencies control impacts by warning them when critical impact levels are reached and by providing feedback on the success of mitigating measures; and (4) limits monitoring data to the essential information that agencies need to carry out their regulatory and environmental protection responsibilities. The methodology is presented as flow charts accompanied by tables that describe the objectives, tasks, and products for each work element in the flow chart.

  15. Do parents understand growth charts? A national, Internet-based survey.

    PubMed

    Ben-Joseph, Elana Pearl; Dowshen, Steven A; Izenberg, Neil

    2009-10-01

    The objective of this study was to assess parental knowledge and understanding of growth charts. An online survey was conducted with 1000 parents selected to be demographically representative of the US population. Questions explored awareness of, knowledge of, and attitudes toward growth monitoring, as well as the ability to interpret growth chart data. Seventy-nine percent of parents surveyed claimed to have seen a growth chart before, with the majority thinking that they understood it well. Sixty-four percent of parents thought it was important to be shown growth charts to see how their child was growing, and 40% expressed the need to see their child's growth chart as confirmation of their health care provider's verbal interpretation. However, when provided with multiple-choice questions and answers, only 64% could identify a child's weight when shown a plotted point on a growth chart. Ninety-six percent had heard of the term "percentile," but only 68% identified the percentile of the plotted point, and only 56% could identify the definition of percentile. Up to 77% interpreted incorrectly charts containing height/weight measurements in tandem. Although growth charts are used frequently as visual aids to educate parents about their children's growth, many parents cannot comprehend the data. This finding is significant because many parents prefer to be shown growth charts by their health care provider, and many parents report recording their children's measurements on growth charts at home.

  16. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tan, J; Pompos, A; Jiang, S

    Purpose: To put forth an innovative clinical paradigm for weekly chart checking so that treatment status is periodically checked accurately and efficiently. This study also aims to help optimize the chart checking clinical workflow in a busy radiation therapy clinic. Methods: It is mandated by the Texas Administrative code to check patient charts of radiation therapy once a week or every five fractions, however it varies drastically among institutions in terms of when and how it is done. Some do it every day, but a lot of efforts are wasted on opening ineligible charts; some do it on a fixedmore » day but the distribution of intervals between subsequent checks is not optimal. To establish an optimal chart checking procedure, a new paradigm was developed to achieve 1) charts are checked more accurately and more efficiently; 2) charts are checked on optimal days without any miss; 3) workload is evened out throughout a week when multiple physicists are involved. All active charts will be accessed by querying the R&V system. Priority is assigned to each chart based on the number of days before the next due date followed by sorting and workload distribution steps. New charts are also taken into account when distributing the workload so it is reasonably even throughout the week. Results: Our clinical workflow became more streamlined and smooth. In addition, charts get checked in a more timely fashion so that errors would get caught earlier should they occur. Conclusion: We developed a new weekly chart checking diagram. It helps physicists check charts in a timely manner, saves their time in busy clinics, and consequently reduces possible errors.« less

  17. Health Indicators: A Tool for Program Review

    ERIC Educational Resources Information Center

    Abou-Sayf, Frank K.

    2006-01-01

    A visual tool used to evaluate instructional program performance has been designed by the University of Hawaii Community College system. The tool combines features from traffic lights, blood-chemistry test reports, and industry production control charts, and is labeled the Program Health-Indicator Chart. The tool was designed to minimize the labor…

  18. Tools for Measuring and Improving Performance.

    ERIC Educational Resources Information Center

    Jurow, Susan

    1993-01-01

    Explains the need for meaningful performance measures in libraries and the Total Quality Management (TQM) approach to data collection. Five tools representing different stages of a TQM inquiry are covered (i.e., the Shewhart Cycle, flowcharts, cause-and-effect diagrams, Pareto charts, and control charts), and benchmarking is addressed. (Contains…

  19. Assessing Educational Processes Using Total-Quality-Management Measurement Tools.

    ERIC Educational Resources Information Center

    Macchia, Peter, Jr.

    1993-01-01

    Discussion of the use of Total Quality Management (TQM) assessment tools in educational settings highlights and gives examples of fishbone diagrams, or cause and effect charts; Pareto diagrams; control charts; histograms and check sheets; scatter diagrams; and flowcharts. Variation and quality are discussed in terms of continuous process…

  20. Quality Control of High-Dose-Rate Brachytherapy: Treatment Delivery Analysis Using Statistical Process Control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Able, Charles M., E-mail: cable@wfubmc.edu; Bright, Megan; Frizzell, Bart

    Purpose: Statistical process control (SPC) is a quality control method used to ensure that a process is well controlled and operates with little variation. This study determined whether SPC was a viable technique for evaluating the proper operation of a high-dose-rate (HDR) brachytherapy treatment delivery system. Methods and Materials: A surrogate prostate patient was developed using Vyse ordnance gelatin. A total of 10 metal oxide semiconductor field-effect transistors (MOSFETs) were placed from prostate base to apex. Computed tomography guidance was used to accurately position the first detector in each train at the base. The plan consisted of 12 needles withmore » 129 dwell positions delivering a prescribed peripheral dose of 200 cGy. Sixteen accurate treatment trials were delivered as planned. Subsequently, a number of treatments were delivered with errors introduced, including wrong patient, wrong source calibration, wrong connection sequence, single needle displaced inferiorly 5 mm, and entire implant displaced 2 mm and 4 mm inferiorly. Two process behavior charts (PBC), an individual and a moving range chart, were developed for each dosimeter location. Results: There were 4 false positives resulting from 160 measurements from 16 accurately delivered treatments. For the inaccurately delivered treatments, the PBC indicated that measurements made at the periphery and apex (regions of high-dose gradient) were much more sensitive to treatment delivery errors. All errors introduced were correctly identified by either the individual or the moving range PBC in the apex region. Measurements at the urethra and base were less sensitive to errors. Conclusions: SPC is a viable method for assessing the quality of HDR treatment delivery. Further development is necessary to determine the most effective dose sampling, to ensure reproducible evaluation of treatment delivery accuracy.« less

  1. Tactile Acuity Charts: A Reliable Measure of Spatial Acuity

    PubMed Central

    Bruns, Patrick; Camargo, Carlos J.; Campanella, Humberto; Esteve, Jaume; Dinse, Hubert R.; Röder, Brigitte

    2014-01-01

    For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds. PMID:24504346

  2. Composition and Thermodynamic Properties of Air in Chemical Equilibrium

    NASA Technical Reports Server (NTRS)

    Moeckel, W E; Weston, Kenneth C

    1958-01-01

    Charts have been prepared relating the thermodynamic properties of air in chemical equilibrium for temperatures to 15,000 degrees k and for pressures 10(-5) to 10 (plus 4) atmospheres. Also included are charts showing the composition of air, the isentropic exponent, and the speed of sound. These charts are based on thermodynamic data calculated by the National Bureau of Standards.

  3. Centile charts for birthweight for gestational age for Scottish singleton births

    PubMed Central

    Bonellie, Sandra; Chalmers, James; Gray, Ron; Greer, Ian; Jarvis, Stephen; Williams, Claire

    2008-01-01

    Background Centile charts of birthweight for gestational age are used to identify low birthweight babies. The charts currently used in Scotland are based on data from the 1970s and require updating given changes in birthweight and in the measurement of gestational age since then. Methods Routinely collected data of 100,133 singleton births occurring in Scotland from 1998–2003 were used to construct new centile charts using the LMS method. Results Centile charts for birthweight for sex and parity groupings were constructed for singleton birth and compared to existing charts used in Scottish hospitals. Conclusion Mean birthweight has been shown to have increased over recent decades. The differences shown between the new and currently used centiles confirm the need for more up-to-date centiles for birthweight for gestational age. PMID:18298810

  4. The NASA Langley Research Center 0.3-meter transonic cryogenic tunnel T-P/Re-M controller manual

    NASA Technical Reports Server (NTRS)

    Balakrishna, S.; Kilgore, W. Allen

    1989-01-01

    A new microcomputer based controller for the 0.3-m Transonic Cryogenic Tunnel (TCT) has been commissioned in 1988 and has reliably operated for more than a year. The tunnel stagnation pressure, gas stagnation temperature, tunnel wall structural temperature and flow Mach number are precisely controlled by the new controller in a stable manner. The tunnel control hardware, software, and the flow chart to assist in calibration of the sensors, actuators, and the controller real time functions are described. The software installation details are also presented. The report serves as the maintenance and trouble shooting manual for the 0.3-m TCT controller.

  5. Predictors of Start of Different Antidepressants in Patient Charts among Patients with Depression

    PubMed Central

    Kim, Hyungjin Myra; Zivin, Kara; Choe, Hae Mi; Stano, Clare M.; Ganoczy, Dara; Walters, Heather; Valenstein, Marcia

    2016-01-01

    Background In usual psychiatric care, antidepressant treatments are selected based on physician and patient preferences rather than being randomly allocated, resulting in spurious associations between these treatments and outcome studies. Objectives To identify factors recorded in electronic medical chart progress notes predictive of antidepressant selection among patients who had received a depression diagnosis. Methods This retrospective study sample consisted of 556 randomly selected Veterans Health Administration (VHA) patients diagnosed with depression from April 1, 1999 to September 30, 2004, stratified by the antidepressant agent, geographic region, gender, and year of depression cohort entry. Predictors were obtained from administrative data, and additional variables were abstracted from electronic medical chart notes in the year prior to the start of the antidepressant in five categories: clinical symptoms and diagnoses, substance use, life stressors, behavioral/ideation measures (e.g., suicide attempts), and treatments received. Multinomial logistic regression analysis was used to assess the predictors associated with different antidepressant prescribing, and adjusted relative risk ratios (RRR) are reported. Results Of the administrative data-based variables, gender, age, illicit drug abuse or dependence, and number of psychiatric medications in prior year were significantly associated with antidepressant selection. After adjusting for administrative data-based variables, sleep problems (RRR = 2.47) or marital issues (RRR = 2.64) identified in the charts were significantly associated with prescribing mirtazapine rather than sertraline; however, no other chart-based variables showed a significant association or an association with a large magnitude. Conclusion Some chart data-based variables were predictive of antidepressant selection, but we neither found many nor found them highly predictive of antidepressant selection in patients treated for depression. PMID:25943003

  6. Facility versus unit level reporting of quality indicators in nursing homes when performance monitoring is the goal

    PubMed Central

    Norton, Peter G; Murray, Michael; Doupe, Malcolm B; Cummings, Greta G; Poss, Jeff W; Squires, Janet E; Teare, Gary F; Estabrooks, Carole A

    2014-01-01

    Objectives To demonstrate the benefit of defining operational management units in nursing homes and computing quality indicators on these units as well as on the whole facility. Design Calculation of adjusted Resident Assessment Instrument – Minimum Data Set 2.0 (RAI–MDS 2.0) quality indicators for: PRU05 (prevalence of residents with a stage 2–4 pressure ulcer), PAI0X (prevalence of residents with pain) and DRG01 (prevalence of residents receiving an antipsychotic with no diagnosis of psychosis), for quarterly assessments between 2007 and 2011 at unit and facility levels. Comparisons of these risk-adjusted quality indicators using statistical process control (control charts). Setting A representative sample of 30 urban nursing homes in the three Canadian Prairie Provinces. Measurements Explicit decision rules were developed and tested to determine whether the control charts demonstrated improving, worsening, unchanging or unclassifiable trends over the time period. Unit and facility performance were compared. Results In 48.9% of the units studied, unit control chart performance indicated different changes in quality over the reporting period than did the facility chart. Examples are provided to illustrate that these differences lead to quite different quality interventions. Conclusions Our results demonstrate the necessity of considering facility-level and unit-level measurement when calculating quality indicators derived from the RAI–MDS 2.0 data, and quite probably from any RAI measures. PMID:24523428

  7. Two Student Self-Management Techniques Applied to Data-Based Program Modification.

    ERIC Educational Resources Information Center

    Wesson, Caren

    Two student self-management techniques, student charting and student selection of instructional activities, were applied to ongoing data-based program modification. Forty-two elementary school resource room students were assigned randomly (within teacher) to one of three treatment conditions: Teacher Chart-Teacher Select Instructional Activities…

  8. Prompting a consumer behavior for pollution control1

    PubMed Central

    Geller, E. Scott; Farris, John C.; Post, David S.

    1973-01-01

    A field application of behavior modification studied the relative effectiveness of different prompting procedures for increasing the probability that customers entering a grocery store would select their soft drinks in returnable rather than nonreturnable containers. Six different 2-hr experimental conditions during which bottle purchases were recorded were (1) No Prompt (i.e., control), (2) one student gave incoming customers a handbill urging the purchase of soft drinks in returnable bottles, (3) distribution of the handbill by one student and public charting of each customer's bottle purchases by another student, (4) handbill distribution and charting by a five-member group, (5) handbills distributed and purchases charted by three females. The variant prompting techniques were equally effective, and in general increased the percentage of returnable-bottle customers by an average of 25%. PMID:16795418

  9. Prompting a consumer behavior for pollution control.

    PubMed

    Geller, E S; Farris, J C; Post, D S

    1973-01-01

    A field application of behavior modification studied the relative effectiveness of different prompting procedures for increasing the probability that customers entering a grocery store would select their soft drinks in returnable rather than nonreturnable containers. Six different 2-hr experimental conditions during which bottle purchases were recorded were (1) No Prompt (i.e., control), (2) one student gave incoming customers a handbill urging the purchase of soft drinks in returnable bottles, (3) distribution of the handbill by one student and public charting of each customer's bottle purchases by another student, (4) handbill distribution and charting by a five-member group, (5) handbills distributed and purchases charted by three females. The variant prompting techniques were equally effective, and in general increased the percentage of returnable-bottle customers by an average of 25%.

  10. The design and implementation of hydrographical information management system (HIMS)

    NASA Astrophysics Data System (ADS)

    Sui, Haigang; Hua, Li; Wang, Qi; Zhang, Anming

    2005-10-01

    With the development of hydrographical work and information techniques, the large variety of hydrographical information including electronic charts, documents and other materials are widely used, and the traditional management mode and techniques are unsuitable for the development of the Chinese Marine Safety Administration Bureau (CMSAB). How to manage all kinds of hydrographical information has become an important and urgent problem. A lot of advanced techniques including GIS, RS, spatial database management and VR techniques are introduced for solving these problems. Some design principles and key techniques of the HIMS including the mixed mode base on B/S, C/S and stand-alone computer mode, multi-source & multi-scale data organization and management, multi-source data integration and diverse visualization of digital chart, efficient security control strategies are illustrated in detail. Based on the above ideas and strategies, an integrated system named Hydrographical Information Management System (HIMS) was developed. And the HIMS has been applied in the Shanghai Marine Safety Administration Bureau and obtained good evaluation.

  11. Key technology research of HILS based on real-time operating system

    NASA Astrophysics Data System (ADS)

    Wang, Fankai; Lu, Huiming; Liu, Che

    2018-03-01

    In order to solve the problems that the long development cycle of traditional simulation and digital simulation doesn't have the characteristics of real time, this paper designed a HILS(Hardware In the Loop Simulation) system based on the real-time operating platform xPC. This system solved the communication problems between HMI and Simulink models through the MATLAB engine interface, and realized the functions of system setting, offline simulation, model compiling and downloading, etc. Using xPC application interface and integrating the TeeChart ActiveX chart component to realize the monitoring function of real-time target application; Each functional block in the system is encapsulated in the form of DLL, and the data interaction between modules was realized by MySQL database technology. When the HILS system runs, search the address of the online xPC target by means of the Ping command, to establish the Tcp/IP communication between the two machines. The technical effectiveness of the developed system is verified through the typical power station control system.

  12. Integrated G and C Implementation within IDOS: A Simulink Based Reusable Launch Vehicle Simulation

    NASA Technical Reports Server (NTRS)

    Fisher, Joseph E.; Bevacqua, Tim; Lawrence, Douglas A.; Zhu, J. Jim; Mahoney, Michael

    2003-01-01

    The implementation of multiple Integrated Guidance and Control (IG&C) algorithms per flight phase within a vehicle simulation poses a daunting task to coordinate algorithm interactions with the other G&C components and with vehicle subsystems. Currently being developed by Universal Space Lines LLC (USL) under contract from NASA, the Integrated Development and Operations System (IDOS) contains a high fidelity Simulink vehicle simulation, which provides a means to test cutting edge G&C technologies. Combining the modularity of this vehicle simulation and Simulink s built-in primitive blocks provide a quick way to implement algorithms. To add discrete-event functionality to the unfinished IDOS simulation, Vehicle Event Manager (VEM) and Integrated Vehicle Health Monitoring (IVHM) subsystems were created to provide discrete-event and pseudo-health monitoring processing capabilities. Matlab's Stateflow is used to create the IVHM and Event Manager subsystems and to implement a supervisory logic controller referred to as the Auto-commander as part of the IG&C to coordinate the control system adaptation and reconfiguration and to select the control and guidance algorithms for a given flight phase. Manual creation of the Stateflow charts for all of these subsystems is a tedious and time-consuming process. The Stateflow Auto-builder was developed as a Matlab based software tool for the automatic generation of a Stateflow chart from information contained in a database. This paper describes the IG&C, VEM and IVHM implementations in IDOS. In addition, this paper describes the Stateflow Auto-builder.

  13. Major Range and Test Facility Base Summary of Capabilities.

    DTIC Science & Technology

    1983-06-01

    TEST CHART NATIONAL BUREAU OF STANDARDS 1963 A 3,i 4, S °.I i L -. ~ . % o,. ° . - ° . - . .I ¢ PHOTOGRAPH THIS SHEET LEVEL INVENTORY DOCUMENT...NUMBER DOD 3200.11-D 4. TTLE(~dS..tt~t@) S TYPE Of REPORT a PERIO’ COVERED Major Range and Test Facility Base Summary Reference Maerial of Capabilities...Electronic Warfare, Command, Control Communications and Intelligence (C31) Surveillance, Jammers, Radar, Test Facility ZG5 ABETW ACT f~ a "Afie Afr- s 444 eF~f

  14. Age differences between the controlled force exertion measured by a computer-generated sinusoidal and a bar chart display.

    PubMed

    Nagasawa, Yoshinori; Demura, Shinichi; Takahashi, Kenji

    2013-01-01

    It is important to develop an accurate method of measuring controlled force exertion. This study examined the age differences between the controlled force exertion measured by a sinusoidal waveform and a bar chart display. The participants comprised 175 right-handed male adults aged 20-86 years. The participants were divided into three age groups: young (n=53), middle-aged (n=71), and elderly (n=51). They matched the submaximal grip strength exerted by their dominant hand to changing demand values displayed as either a sinusoidal waveform or a bar chart appearing on a personal computer screen. The participants performed the controlled force exertion test three times with a 1-min inter-trial interval using their dominant hand. The dependent variable was the total sum of the percentage values of the differences between the demand value and grip exertion value for more than 25s. The coefficient of variance had almost the same range in all age groups in both displays (CVSW=28.0-36.9, CVBC=29.1-32.6), but the elderly group showed a somewhat higher value with the sinusoidal waveform. Significant correlations were found between the scores with sinusoidal waveform and bar chart displays in the young, middle-aged, and elderly groups (r=0.47-0.68), but the correlations did not differ significantly between the age groups. Scores over 1500% in sinusoidal and bar chart display were found in one and two participants, respectively, in the middle-aged group and in 12% and 16% of the participants, respectively, in the elderly group. Furthermore, among all participants, only 8% of participants in the elderly group scored over 1500% in both displays. Scores over 1500% in both displays are considered to be considerably worse in controlled force exertion than lower scores. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Revised Indian Academy of Pediatrics 2015 growth charts for height, weight and body mass index for 5-18-year-old Indian children.

    PubMed

    Khadilkar, Vaman V; Khadilkar, Anuradha V

    2015-01-01

    Growth chart committee of Indian Academy of Pediatrics (IAP) has revised growth charts for 5-18-year-old Indian children in Jan 2015. The last IAP growth charts (2007) were based on data collected in 1989-92 which is now >2 decades old. India is in an economic and nutrition transition and hence growth pattern of Indian children has changed over last few years. Thus, it was necessary to produce contemporary, updated growth references for Indian children. The new IAP charts were prepared by collating data from nine groups who had published studies in indexed journals on growth from India in the last decade. Growth charts were constructed from a total of 87022 middle and upper socioeconomic class children (m 54086, f 32936) from all five zones of India. Data from middle and upper socioeconomic class children are likely to have higher prevalence of overweight and obesity and hence growth charts produced on such populations are likely to "normalize" obesity. To remove such unhealthy weights form the data, method suggested by World Health Organization was used to produce weight charts. Thus, the new IAP weight charts are much lower than the recently published studies on affluent Indian children. Since Indian's are at a higher risk of obesity-related cardiometabolic complications at lower body mass index (BMI), BMI charts adjusted for 23, and 27 adult equivalent cut-offs as per International obesity task force guidelines were constructed. IAP now recommends use of these new charts to replace the 2007 IAP charts.

  16. 40 CFR 86.343-79 - Chart reading.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 19 2013-07-01 2013-07-01 false Chart reading. 86.343-79 Section 86.343-79 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Emission Regulations for New Gasoline-Fueled and Diesel-Fueled Heavy-Duty...

  17. 40 CFR 86.343-79 - Chart reading.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 19 2012-07-01 2012-07-01 false Chart reading. 86.343-79 Section 86.343-79 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES Emission Regulations for New Gasoline-Fueled and Diesel-Fueled Heavy-Duty...

  18. 77 FR 31408 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ..., Washington, DC 20549-0213. Extension: Rules 17h-1T and 17h-2T, SEC File No. 270-359, OMB Control No. 3235... are approximately twenty-five new respondents per year that must draft an organizational chart... estimates that drafting the required organizational chart requires one hour and establishing a system for...

  19. Proposal for internet-based Digital Dental Chart for personal dental identification in forensics.

    PubMed

    Hanaoka, Yoichi; Ueno, Asao; Tsuzuki, Tamiyuki; Kajiwara, Masahiro; Minaguchi, Kiyoshi; Sato, Yoshinobu

    2007-05-03

    A dental chart is very useful as a standard source of evidence in the personal identification of bodies. However, the kind of dental chart available will often vary as a number of types of odontogram have been developed where the visual representation of dental conditions has relied on hand-drawn representation. We propose the Digital Dental Chart (DDC) as a new style of dental chart, especially for open investigations aimed at establishing the identity of unknown bodies. Each DDC is constructed using actual oral digital images and dental data, and is easy to upload onto an Internet website. The DDC is a more useful forensic resource than the standard types of dental chart in current use as it has several advantages, among which are its ability to carry a large volume of information and reproduce dental conditions clearly and in detail on a cost-effective basis.

  20. Equations and charts for the rapid estimation of hinge-moment and effectiveness parameters for trailing-edge controls having leading and trailing edges swept ahead of the Mach lines

    NASA Technical Reports Server (NTRS)

    Goin, Kennith L

    1951-01-01

    Existing conical-flow solutions have been used to calculate the hinge-moments and effectiveness parameters of trailing-edge controls having leading and trailing edges swept ahead of the Mach lines and having streamwise root and tip chords. Equations and detailed charts are presented for the rapid estimation of these parameters. Also included is an approximate method by which these parameters may be corrected for airfoil-section thickness.

  1. Control Charts When the Observations Are Correlated.

    DTIC Science & Technology

    1987-05-01

    l7 D-AiB6 388 CONTROL CHARTS WHEN THE OBSERVATIONS ARE CORRELATED(J) i/iPITTSBURGH UNIV PA CENTER FOR KULTIVARIATE ANALYSIS P R KRISHNAIAH ET AL MAY... Krishnaiah and B. Q. Miao F-49620-85-C-0008 S. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASK AREA II WORK UNIT NUMBERS... Krishnaiah and B.Q. Miao Center for Multivariate Analysis University of Pittsburgh N DTIC E L 1Zk-, -I- OCT0 11987 Play 1987 Technical Report No. 87-09

  2. The effect of point-of-care personal digital assistant use on resident documentation discrepancies.

    PubMed

    Carroll, Aaron E; Tarczy-Hornoch, Peter; O'Reilly, Eamon; Christakis, Dimitri A

    2004-03-01

    We recently found documentation discrepancies in 60% of resident daily-progress notes with respect to patient weight, medications, or vascular lines. To what extent information systems can decrease such discrepancies is unknown. To determine whether a point-of-care personal digital assistant (PDA)-based patient record and charting system could reduce the number of resident progress-note documentation discrepancies in a neonatal intensive care unit (NICU). We conducted a before-and-after trial in an academic NICU. Our intervention was a PDA-based patient record and charting system used by all NICU resident physicians over the study period. We analyzed all resident daily-progress notes from 40 randomly selected days over 4 months in both the baseline and intervention periods. Using predefined reference standards, we determined the accuracy of recorded information for patient weights, medications, and vascular lines. Logistic and Poisson regression were used in analyses to control for potential confounding factors. A total of 339 progress notes in the baseline period and 432 progress notes in the intervention period were reviewed. When controlling for covariates in the regression, there were significantly fewer documentation discrepancies of patient weights in notes written by using the PDA system (14.4%-4.4% of notes; odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.15-0.56). When using the PDA system, there were no significant changes in the numbers of notes with documentation discrepancies of medications (27.7%-17.1% of notes; OR: 0.63; 95% CI: 0.35-1.13) or vascular lines (33.6%-36.1% of notes; OR: 1.11; 95% CI: 0.66-1.87). The use of our PDA-based point-of-care patient record and charting system showed a modest benefit in reducing the number of documentation discrepancies in resident daily-progress notes. Further study of PDAs in information systems is warranted before they are widely adopted.

  3. Data on the distribution of cancer incidence and death across age and sex groups visualized using multilevel spie charts.

    PubMed

    Feitelson, Dror G

    2016-04-01

    Cancer incidence and death statistics are typically recorded for multiple age and sex brackets, leading to large data tables which are difficult to digest. Effective visualizations of this data would allow practitioners, policy makers, and the general public to comprehend the data more readily and act on it appropriately. We introduce multilevel spie charts to create a combined visualization of cancer incidence and death statistics. Spie charts combine multiple pie charts, where the base pie chart (representing the general population) is used to set the angles of slices, and the superimposed ones use variable radii to portray the cancer data. Spie charts of cancer incidence and death statistics from Israel for 2009-2011 are used as an illustration. These charts clearly show various patterns of how cancer incidence and death distribute across age and sex groups, illustrating (1) absolute numbers and (2) rates per 100,000 population for different age and sex brackets. In addition, drawing separate charts for different cancer types illustrates relative mortality, both (3) across cancer types and (4) mortality relative to incidence. Naturally, this graphical depiction can be used for other diseases as well. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Study of blood pressure and blood sugar levels in adolescence and comparison with body mass index.

    PubMed

    Borade, Ashwin; Kadam, Gauri Shashank; Bhide, Gayatri; Dhongade, Ram

    2011-07-01

    Worldwide prevalence of overweight and obesity is increasing and its consequences prompted the WHO to designate obesity as a global epidemic in 2002. Being overweight is a risk factor for significant illness, especially diabetes and hypertension in adult life. To study the blood pressure and blood sugar levels and lifestyle parameters in adolescence and comparison with body mass index. In a prospective case control study, out of the 1000 screened, a total of 200 adolescents were considered out of which 100 were with high body mass index (BMI) and the other 100 were with normal BMI. Height, weight, BMI, waist hip ratio (WHR), blood pressure (BP), BSL, and associated risk factors like physical activity, fast food consumption, and computer/television watching were measured and screened. 109 (54.5%) males and 91 (45.5%) females were included. Maximum number [90 (45%)] of adolescents screened were in the age group of 17-19 years, while 54 (27%) and 56 (28%) adolescents were in the age group of 10-13 years and 14-16 years, respectively. According to CDC charts 2000, prevalence of overweight was 24% which was double when compared to WHO charts 2007. There was significant difference in prevalence of obesity; according to CDC chart it was 26%, whereas according to WHO chart it was 39%. The difference in blood pressures between cases and controls as per both CDC and WHO charts was found to be statistically significant (P < 0.0001). Positive family history of hypertension has a highly significant correlation (P < 0.001) with BMI. Blood sugar level (BSL) was significantly higher in cases (high BMI) when compared to controls (normal BMI). The comparison of WHR in the study group showed highly significant correlation ( P < 0.0001) between cases and controls. The present study shows highly significant correlation of physical activity ( P < 0.0001) and fast food ( P < 0.05) between cases and controls, whereas there was no significant correlation of computer/television watching ( P > 0.05) with BMI. The adolescents seem to have become heavier owing to environmental influences on growth patterns. So, a consideration should be given to shift the cut-offs for overweight and obesity to higher BMI percentiles if recent growth charts are to be followed. Adolescents with a BMI above the 95 th percentile (obese) are most likely to have obesity-related health risks.

  5. Strategies for increasing house staff management of cholesterol with inpatients.

    PubMed

    Boekeloo, B O; Becker, D M; Levine, D M; Belitsos, P C; Pearson, T A

    1990-01-01

    This study tested the effectiveness of two conceptually different chart audit-based approaches to modifying physicians' clinical practices to conform with quality-assurance standards. The objective was to increase intern utilization of cholesterol management opportunities in the inpatient setting. Using a clinical trial study design, 29 internal medicine interns were randomly assigned to four intervention groups identified by the intervention they received: control, reminder checklists (checklists), patient-specific feedback (feedback), or both interventions (combined). Over a nine-month period, intern management of high blood cholesterol levels in internal medicine inpatients (n = 459) was monitored by postdischarge chart audit. During both a baseline and subsequent intervention period, interns documented significantly more cholesterol management for inpatients with coronary artery disease (CAD) than without CAD. During baseline, 27.3%, 24.3%, 21.7%, 12.4%, 5.4%, and 2.7% of all inpatient charts had intern documentation concerning a low-fat hospital diet, cholesterol history, screening blood cholesterol level assessment, follow-up lipid profile, nutritionist consult, and preventive cardiology consult, respectively. The feedback intervention significantly increased overall intern-documented cholesterol management among inpatients with CAD. The checklists significantly decreased overall intern-documented cholesterol management. Feedback appears to be an effective approach to increasing intern cholesterol management in inpatients.

  6. Implementation of statistical process control for proteomic experiments via LC MS/MS.

    PubMed

    Bereman, Michael S; Johnson, Richard; Bollinger, James; Boss, Yuval; Shulman, Nick; MacLean, Brendan; Hoofnagle, Andrew N; MacCoss, Michael J

    2014-04-01

    Statistical process control (SPC) is a robust set of tools that aids in the visualization, detection, and identification of assignable causes of variation in any process that creates products, services, or information. A tool has been developed termed Statistical Process Control in Proteomics (SProCoP) which implements aspects of SPC (e.g., control charts and Pareto analysis) into the Skyline proteomics software. It monitors five quality control metrics in a shotgun or targeted proteomic workflow. None of these metrics require peptide identification. The source code, written in the R statistical language, runs directly from the Skyline interface, which supports the use of raw data files from several of the mass spectrometry vendors. It provides real time evaluation of the chromatographic performance (e.g., retention time reproducibility, peak asymmetry, and resolution), and mass spectrometric performance (targeted peptide ion intensity and mass measurement accuracy for high resolving power instruments) via control charts. Thresholds are experiment- and instrument-specific and are determined empirically from user-defined quality control standards that enable the separation of random noise and systematic error. Finally, Pareto analysis provides a summary of performance metrics and guides the user to metrics with high variance. The utility of these charts to evaluate proteomic experiments is illustrated in two case studies.

  7. 92. VIEW OF CHART RECORDERS AND PERSONAL COMPUTER LINING NORTHEAST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    92. VIEW OF CHART RECORDERS AND PERSONAL COMPUTER LINING NORTHEAST CORNER OF AUTOPILOT ROOM - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  8. System Study at SUNY College Bookstore/Oswego

    ERIC Educational Resources Information Center

    DeVita, Richard; And Others

    1975-01-01

    A system study of the textbook ordering department is presented including systems flow chart, chart of activities, and description of operations and procedures for utilizing the computer system. Changes based on the study are noted. (JT)

  9. A patient centered care plan in the EHR: improving collaboration and engagement.

    PubMed

    Chunchu, Kavitha; Mauksch, Larry; Charles, Carol; Ross, Valerie; Pauwels, Judith

    2012-09-01

    Patients attempting to manage their chronic conditions require ongoing support in changing and adopting self-management behaviors. However, patient values, health goals, and action plans are not well represented in the electronic health record (EHR) impeding the ability of the team (MA and providers) to provide respectful, ongoing self-management support. We evaluated whether a team approach to using an EHR based patient centered care plan (PCCP) improved collaborative self-management planning. An experimental, prospective cohort study was conducted in a family medicine residency clinic. The experimental group included 7 physicians and a medical assistant who received 2 hr of PCCP training. The control group consisted of 7 physicians and a medical assistant. EHR charts were analyzed for evidence of 8 behavior change elements. Follow-up interviews with experimental group patients and physicians and the medical assistant assessed their experiences. We found that PCCP charts had more documented behavior change elements than control charts in all 8 domains (p < .001). Experimental group physicians valued the PCCP model and suggested ways to improve its use. Patient feedback demonstrated support for the model. A PCCP can help team members to engage patients with chronic illnesses in goal setting and action planning to support self-management. An EHR design that stores patient values, health goals, and action plans may strengthen continuity and quality of care between patients and primary care team members. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  10. Validation of life-charts documented with the personal life-chart app - a self-monitoring tool for bipolar disorder.

    PubMed

    Schärer, Lars O; Krienke, Ute J; Graf, Sandra-Mareike; Meltzer, Katharina; Langosch, Jens M

    2015-03-14

    Long-term monitoring in bipolar affective disorders constitutes an important therapeutic and preventive method. The present study examines the validity of the Personal Life-Chart App (PLC App), in both German and in English. This App is based on the National Institute of Mental Health's Life-Chart Method, the de facto standard for long-term monitoring in the treatment of bipolar disorders. Methods have largely been replicated from 2 previous Life-Chart studies. The participants documented Life-Charts with the PLC App on a daily basis. Clinicians assessed manic and depressive symptoms in clinical interviews using the Inventory of Depressive Symptomatology, clinician-rated (IDS-C) and the Young Mania Rating Scale (YMRS) on a monthly basis on average. Spearman correlations of the total scores of IDS-C and YMRS were calculated with both the Life-Chart functional impairment rating and mood rating documented with the PLC App. 44 subjects used the PLC App in German and 10 subjects used the PLC App in English. 118 clinical interviews from the German sub-sample and 97 from the English sub-sample were analysed separately. The results in both sub-samples are similar to previous Life-Chart validation studies. Again statistically significant high correlations were found between the Life-Chart function rating assigned through the PLC App and well-established observer-rated methods. Again correlations were weaker for the Life-Chart mood rating than for the Life-Chart function impairment. No relevant correlation was found between the Life-chart mood rating and YMRS in the German sub-sample. This study gives further evidence for the validity of the Life-Chart method as a valid tool for the recognition of both manic and depressive episodes. Documenting Life-Charts with the PLC App (English and German) does not seem to impair the validity of patient ratings.

  11. Comparison of Onsite Versus Online Chart Reviews as Part of the American College of Radiation Oncology Accreditation Program.

    PubMed

    Hepel, Jaroslaw T; Heron, Dwight E; Mundt, Arno J; Yashar, Catheryn; Feigenberg, Steven; Koltis, Gordon; Regine, William F; Prasad, Dheerendra; Patel, Shilpen; Sharma, Navesh; Hebert, Mary; Wallis, Norman; Kuettel, Michael

    2017-05-01

    Accreditation based on peer review of professional standards of care is essential in ensuring quality and safety in administration of radiation therapy. Traditionally, medical chart reviews have been performed by a physical onsite visit. The American College of Radiation Oncology Accreditation Program has remodeled its process whereby electronic charts are reviewed remotely. Twenty-eight radiation oncology practices undergoing accreditation had three charts per practice undergo both onsite and online review. Onsite review was performed by a single reviewer for each practice. Online review consisted of one or more disease site-specific reviewers for each practice. Onsite and online reviews were blinded and scored on a 100-point scale on the basis of 20 categories. A score of less than 75 was failing, and a score of 75 to 79 was marginal. Any failed charts underwent rereview by a disease site team leader. Eighty-four charts underwent both onsite and online review. The mean scores were 86.0 and 86.9 points for charts reviewed onsite and online, respectively. Comparison of onsite and online reviews revealed no statistical difference in chart scores ( P = .43). Of charts reviewed, 21% had a marginal (n = 8) or failing (n = 10) score. There was no difference in failing charts ( P = .48) or combined marginal and failing charts ( P = .13) comparing onsite and online reviews. The American College of Radiation Oncology accreditation process of online chart review results in comparable review scores and rate of failing scores compared with traditional on-site review. However, the modern online process holds less potential for bias by using multiple reviewers per practice and allows for greater oversight via disease site team leader rereview.

  12. Statistical transformation and the interpretation of inpatient glucose control data.

    PubMed

    Saulnier, George E; Castro, Janna C; Cook, Curtiss B

    2014-03-01

    To introduce a statistical method of assessing hospital-based non-intensive care unit (non-ICU) inpatient glucose control. Point-of-care blood glucose (POC-BG) data from hospital non-ICUs were extracted for January 1 through December 31, 2011. Glucose data distribution was examined before and after Box-Cox transformations and compared to normality. Different subsets of data were used to establish upper and lower control limits, and exponentially weighted moving average (EWMA) control charts were constructed from June, July, and October data as examples to determine if out-of-control events were identified differently in nontransformed versus transformed data. A total of 36,381 POC-BG values were analyzed. In all 3 monthly test samples, glucose distributions in nontransformed data were skewed but approached a normal distribution once transformed. Interpretation of out-of-control events from EWMA control chart analyses also revealed differences. In the June test data, an out-of-control process was identified at sample 53 with nontransformed data, whereas the transformed data remained in control for the duration of the observed period. Analysis of July data demonstrated an out-of-control process sooner in the transformed (sample 55) than nontransformed (sample 111) data, whereas for October, transformed data remained in control longer than nontransformed data. Statistical transformations increase the normal behavior of inpatient non-ICU glycemic data sets. The decision to transform glucose data could influence the interpretation and conclusions about the status of inpatient glycemic control. Further study is required to determine whether transformed versus nontransformed data influence clinical decisions or evaluation of interventions.

  13. Observation chart design features affect the detection of patient deterioration: a systematic experimental evaluation.

    PubMed

    Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

    2016-01-01

    To systematically evaluate the impact of several design features on chart-users' detection of patient deterioration on observation charts with early-warning scoring-systems. Research has shown that observation chart design affects the speed and accuracy with which abnormal observations are detected. However, little is known about the contribution of individual design features to these effects. A 2 × 2 × 2 × 2 mixed factorial design, with data-recording format (drawn dots vs. written numbers), scoring-system integration (integrated colour-based system vs. non-integrated tabular system) and scoring-row placement (grouped vs. separate) varied within-participants and scores (present vs. absent) varied between-participants by random assignment. 205 novice chart-users, tested between March 2011-March 2014, completed 64 trials where they saw real patient data presented on an observation chart. Each participant saw eight cases (four containing abnormal observations) on each of eight designs (which represented a factorial combination of the within-participants variables). On each trial, they assessed whether any of the observations were physiologically abnormal, or whether all observations were normal. Response times and error rates were recorded for each design. Participants responded faster (scores present and absent) and made fewer errors (scores absent) using drawn-dot (vs. written-number) observations and an integrated colour-based (vs. non-integrated tabular) scoring-system. Participants responded faster using grouped (vs. separate) scoring-rows when scores were absent, but separate scoring-rows when scores were present. Our findings suggest that several individual design features can affect novice chart-users' ability to detect patient deterioration. More broadly, the study further demonstrates the need to evaluate chart designs empirically. © 2015 John Wiley & Sons Ltd.

  14. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    PubMed Central

    Levy, Rebecca; Pantanowitz, Liron; Cloutier, Darlene; Provencher, Jean; McGirr, Joan; Stebbins, Jennifer; Cronin, Suzanne; Wherry, Josh; Fenton, Joseph; Donelan, Eileen; Johari, Vandita; Andrzejewski, Chester

    2010-01-01

    Background: Electronic medical records (EMRs) provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS) involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution's initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting) strategy within the EMR. Methods: A focus group of our hospital's transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium) for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater realered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encount by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also enhance data mining, quality improvement, and biovigilance monitoring activities. PMID:20805955

  15. Guideline implementation in clinical practice: use of statistical process control charts as visual feedback devices.

    PubMed

    Al-Hussein, Fahad A

    2009-01-01

    To use statistical control charts in a series of audits to improve the acceptance and consistant use of guidelines, and reduce the variations in prescription processing in primary health care. A series of audits were done at the main satellite of King Saud Housing Family and Community Medicine Center, National Guard Health Affairs, Riyadh, where three general practitioners and six pharmacists provide outpatient care to about 3000 residents. Audits were carried out every fortnight to calculate the proportion of prescriptions that did not conform to the given guidelines of prescribing and dispensing. Simple random samples of thirty were chosen from a sampling frame of all prescriptions given in the two previous weeks. Thirty six audits were carried out from September 2004 to February 2006. P-charts were constructed around a parametric specification of non-conformities not exceeding 25%. Of the 1081 prescriptions, the most frequent non-conformity was failure to write generic names (35.5%), followed by the failure to record patient's weight (16.4%), pharmacist's name (14.3%), duration of therapy (9.1%), and the use of inappropriate abbreviations (6.0%). Initially, 100% of prescriptions did not conform to the guidelines, but within a period of three months, this came down to 40%. A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

  16. 77 FR 44699 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ..., Washington, DC 20549-0213. Extension: Rules 17h-1T and 17h-2T, SEC File No. 270-359, OMB Control No. 3235... that must draft an organizational chart required under Rule 17h-1T and establish a system for complying with the risk assessment rules. The staff estimates that drafting the required organizational chart...

  17. Approximate relations and charts for low-speed stability derivatives of swept wings

    NASA Technical Reports Server (NTRS)

    Toll, Thomas A; Queijo, M J

    1948-01-01

    Contains derivations, based on a simplified theory, of approximate relations for low-speed stability derivatives of swept wings. Method accounts for the effects and, in most cases, taper ratio. Charts, based on the derived relations, are presented for the stability derivatives of untapered swept wings. Calculated values of the derivatives are compared with experimental results.

  18. The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

    PubMed

    Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

    2001-01-01

    To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

  19. Development and evaluation of a data-adaptive alerting algorithm for univariate temporal biosurveillance data.

    PubMed

    Elbert, Yevgeniy; Burkom, Howard S

    2009-11-20

    This paper discusses further advances in making robust predictions with the Holt-Winters forecasts for a variety of syndromic time series behaviors and introduces a control-chart detection approach based on these forecasts. Using three collections of time series data, we compare biosurveillance alerting methods with quantified measures of forecast agreement, signal sensitivity, and time-to-detect. The study presents practical rules for initialization and parameterization of biosurveillance time series. Several outbreak scenarios are used for detection comparison. We derive an alerting algorithm from forecasts using Holt-Winters-generalized smoothing for prospective application to daily syndromic time series. The derived algorithm is compared with simple control-chart adaptations and to more computationally intensive regression modeling methods. The comparisons are conducted on background data from both authentic and simulated data streams. Both types of background data include time series that vary widely by both mean value and cyclic or seasonal behavior. Plausible, simulated signals are added to the background data for detection performance testing at signal strengths calculated to be neither too easy nor too hard to separate the compared methods. Results show that both the sensitivity and the timeliness of the Holt-Winters-based algorithm proved to be comparable or superior to that of the more traditional prediction methods used for syndromic surveillance.

  20. Managing serious clinical deterioration in a tertiary hospital in Hong Kong: from indicators development to multiple measures in reducing the rates.

    PubMed

    Ho, Jasperine Ka Yee; Lee, Quinnie; Lam, Jaden Chun Ho; Tang, Kam Shing

    2017-06-01

    Timely detection and management of acutely deteriorating patients can save lives. Tuen Mun Hospital (TMH), a 1800-bed acute tertiary hospital serving more than 1.06 million populations in Hong Kong, is exploring to quantitatively monitor serious clinical deterioration (SCD) and uses it to guide patient care improvement initiatives. Literature review on definition and measurement of SCD was conducted. Monthly SCD rates of TMH were first calculated according to the published methodology and benchmarked against those of international centres. A refined composite clinical indicator good for local use was compiled. In the second phase, p-control charts of SCD have been plotted based on cumulative data. TMH's performance was comparable with that of international centres. SCD on p-control charts has been plotting since January 2013. There were peaks in all 4 SCD rates during the winter surge period in 2013-2014. In the third phase, multiple measures have been taking to reduce the SCD rates including targeting the 3 main factors of winter surge situation. We are delighted to observe that the pattern did not repeat in the rate of cardiac arrest without do not attempt cardiopulmonary resuscitation (DNACPR) and rate of death without DNACPR in the same period in 2014-2015. SCD becomes a clinical governance tool to monitor the performance of clinical teams in treating acutely deteriorating patients in TMH. Any abnormal patterns or indications of special cause variations in the control charts would alert leaders to look for root causes of special cause variations and manage accordingly. We hope that this project will extend to corporate level and become a sustainable clinical indicator to guide audits, quality improvement initiatives and strategic planning. © 2016 John Wiley & Sons, Ltd.

  1. Comparison of power curve monitoring methods

    NASA Astrophysics Data System (ADS)

    Cambron, Philippe; Masson, Christian; Tahan, Antoine; Torres, David; Pelletier, Francis

    2017-11-01

    Performance monitoring is an important aspect of operating wind farms. This can be done through the power curve monitoring (PCM) of wind turbines (WT). In the past years, important work has been conducted on PCM. Various methodologies have been proposed, each one with interesting results. However, it is difficult to compare these methods because they have been developed using their respective data sets. The objective of this actual work is to compare some of the proposed PCM methods using common data sets. The metric used to compare the PCM methods is the time needed to detect a change in the power curve. Two power curve models will be covered to establish the effect the model type has on the monitoring outcomes. Each model was tested with two control charts. Other methodologies and metrics proposed in the literature for power curve monitoring such as areas under the power curve and the use of statistical copulas have also been covered. Results demonstrate that model-based PCM methods are more reliable at the detecting a performance change than other methodologies and that the effectiveness of the control chart depends on the types of shift observed.

  2. The Eye Phone Study: reliability and accuracy of assessing Snellen visual acuity using smartphone technology

    PubMed Central

    Perera, C; Chakrabarti, R; Islam, F M A; Crowston, J

    2015-01-01

    Purpose Smartphone-based Snellen visual acuity charts has become popularized; however, their accuracy has not been established. This study aimed to evaluate the equivalence of a smartphone-based visual acuity chart with a standard 6-m Snellen visual acuity (6SVA) chart. Methods First, a review of available Snellen chart applications on iPhone was performed to determine the most accurate application based on optotype size. Subsequently, a prospective comparative study was performed by measuring conventional 6SVA and then iPhone visual acuity using the ‘Snellen' application on an Apple iPhone 4. Results Eleven applications were identified, with accuracy of optotype size ranging from 4.4–39.9%. Eighty-eight patients from general medical and surgical wards in a tertiary hospital took part in the second part of the study. The mean difference in logMAR visual acuity between the two charts was 0.02 logMAR (95% limit of agreement −0.332, 0.372 logMAR). The largest mean difference in logMAR acuity was noted in the subgroup of patients with 6SVA worse than 6/18 (n=5), who had a mean difference of two Snellen visual acuity lines between the charts (0.276 logMAR). Conclusion We did not identify a Snellen visual acuity app at the time of study, which could predict a patients standard Snellen visual acuity within one line. There was considerable variability in the optotype accuracy of apps. Further validation is required for assessment of acuity in patients with severe vision impairment. PMID:25931170

  3. Use of a control chart to monitor diarrhoea admissions: a quality improvement exercise in West Kalimantan Provincial Hospital, Pontianak, Indonesia.

    PubMed

    Purba, M

    1999-09-01

    Data on the number of admissions for diarrhoea each week to the West Kalimantan Provincial Hospital, Pontianak, Indonesia over a 5 year period, 1992-1996, were collected. After cleaning and exclusion of extreme values, transformation was then performed to ensure that the data were free of special cause variation and normally distributed. A control chart was then constructed to provide an 'early warning' system for hospital authorities in order to facilitate the management of the epidemic and to improve patient care.

  4. Management Control Systems in Not-for-Profit Organizations: A Case Study.

    DTIC Science & Technology

    1982-12-01

    UNCLASSIFIED F/G 5/1 NL mhmmhhhhhmhmmum IEIIEEIIIIIEEE EIIIIIIIIIIIIl Diiit 1.1_I220 H- M141116 MICROCOPY RESOLUION4 TEST CHART 14ATIONAL BUREAU Of... test case. C. RESEARCH RET HODS The first phase of the study was a review of current literature on management control procedures and systems in...RESOLUTION TEST CHART NATIONAL BUREAU 0f SIANDARD 96% A I II a U a .1 ii IiU- I! IA i -~ - U I -..................... I I ~ 3 ,’u!nAA~~ -~~j ~; Eu ~ II 8I~ ~B

  5. Power Distribution Analysis For Electrical Usage In Province Area Using Olap (Online Analytical Processing)

    NASA Astrophysics Data System (ADS)

    Samsinar, Riza; Suseno, Jatmiko Endro; Widodo, Catur Edi

    2018-02-01

    The distribution network is the closest power grid to the customer Electric service providers such as PT. PLN. The dispatching center of power grid companies is also the data center of the power grid where gathers great amount of operating information. The valuable information contained in these data means a lot for power grid operating management. The technique of data warehousing online analytical processing has been used to manage and analysis the great capacity of data. Specific methods for online analytics information systems resulting from data warehouse processing with OLAP are chart and query reporting. The information in the form of chart reporting consists of the load distribution chart based on the repetition of time, distribution chart on the area, the substation region chart and the electric load usage chart. The results of the OLAP process show the development of electric load distribution, as well as the analysis of information on the load of electric power consumption and become an alternative in presenting information related to peak load.

  6. Predictive ability and efficacy for shortening door-to-balloon time of a new prehospital electrocardiogram-transmission flow chart in patients with ST-elevation myocardial infarction - Results of the CASSIOPEIA study.

    PubMed

    Sakai, Toshiaki; Nishiyama, Osamu; Onodera, Masayuki; Matsuda, Shigekatsu; Wakisawa, Shinobu; Nakamura, Motoyuki; Morino, Yoshihiro; Itoh, Tomonori

    2018-05-24

    The purposes of this study were to create a new flow-chart of prehospital electrocardiography (ECG)-transmission, evaluate its predictive ability for ST-elevation myocardial infarction (STEMI) and shorten door-to-balloon time (DTBT). The new transmission flow-chart was created using symptoms from previous medical records of STEMI patients. A total of 4090 consecutive patients transferred emergently to our hospital were divided into two groups: those in ambulances with an ECG-transmission device with the new flow-chart (ECGT-FC) and those transferred without an ECG-transmission device (non-ECGT) groups. A STEMI group comprising walk-in patients during the same period was used as a control group. The predictive ability of STEMI and the effectiveness of shortening the DTBT by the new flow-chart of ECG-transmission was evaluated. In the ECGT-FC group, the prevalence of STEMI in the ECG-transmission by the new flow-chart were significantly higher than in the non-ECG-transmission patients (6.71% vs. 0.19%; p<0.001). The sensitivity and specificity of the new ECG-transmission flow-chart were 83.3% and 88.1%, respectively. The median DTBT was significantly shortened (p=0.045) and the prevalence of DTBT<90min was significantly higher in the ECGT-FC group (p=0.018) than the other groups. The sensitivity and specificity of the new flow-chart for ECG-transmission were high. The new flow-chart combined with an ECG-transmission device could detect STEMI efficiently and shorten DTBT. Copyright © 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  7. Examining the Impact of Art-Based Anchor Charts on Academic Achievement in Language Arts

    ERIC Educational Resources Information Center

    Fontanez, Kimberly

    2017-01-01

    The students at 2 middle schools in County SD, NHMS and WMS are not scoring on or above grade level on the information text portion of the English Language Arts (ELA) standardized SC Palmetto Assessment of State Standards (SCPASS) test given annually in South Carolina. The teachers developed and implemented art-based anchor charts to help close…

  8. Charting the Course for Civil Affairs in the New Normal

    DTIC Science & Technology

    2015-07-01

    Select a caveat Unlimited distribution Charting the Course for Civil Affairs in the New Normal Vera Zakem and Emily Mushen July...11  Challenges for Joint CA in the New Normal Environment ............................................ 13  New requirements for ...deliver essential services in preparation for handing full control back to the host nation government. Other independent civil affairs teams worked

  9. Selecting Statistical Quality Control Procedures for Limiting the Impact of Increases in Analytical Random Error on Patient Safety.

    PubMed

    Yago, Martín

    2017-05-01

    QC planning based on risk management concepts can reduce the probability of harming patients due to an undetected out-of-control error condition. It does this by selecting appropriate QC procedures to decrease the number of erroneous results reported. The selection can be easily made by using published nomograms for simple QC rules when the out-of-control condition results in increased systematic error. However, increases in random error also occur frequently and are difficult to detect, which can result in erroneously reported patient results. A statistical model was used to construct charts for the 1 ks and X /χ 2 rules. The charts relate the increase in the number of unacceptable patient results reported due to an increase in random error with the capability of the measurement procedure. They thus allow for QC planning based on the risk of patient harm due to the reporting of erroneous results. 1 ks Rules are simple, all-around rules. Their ability to deal with increases in within-run imprecision is minimally affected by the possible presence of significant, stable, between-run imprecision. X /χ 2 rules perform better when the number of controls analyzed during each QC event is increased to improve QC performance. Using nomograms simplifies the selection of statistical QC procedures to limit the number of erroneous patient results reported due to an increase in analytical random error. The selection largely depends on the presence or absence of stable between-run imprecision. © 2017 American Association for Clinical Chemistry.

  10. Outcomes of Computerized Physician Order Entry in an Electronic Health Record After Implementation in an Outpatient Oncology Setting

    PubMed Central

    Harshberger, Cara A.; Harper, Abigail J.; Carro, George W.; Spath, Wayne E.; Hui, Wendy C.; Lawton, Jessica M.; Brockstein, Bruce E.

    2011-01-01

    Purpose: Computerized physician order entry (CPOE) in electronic health records (EHR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after implementation of an outpatient oncology EHR/ CPOE system in a hospital-based outpatient cancer center within three treatment sites. Methods: This study is a retrospective chart review of 90 patients who received one of the following regimens between 1999 and 2006: FOLFOX, AC, carboplatin + paclitaxel, ABVD, cisplatin + etoposide, R-CHOP, and clinical trials. Documentation completeness scores were assigned to each chart based on the number of documented data points found out of the total data points assessed. EHR/CPOE documentation completeness was compared with completeness of paper charts orders of the same regimens. A user satisfaction survey of the paper chart and EHR/CPOE system was conducted among the physicians, nurses, and pharmacists who worked with both systems. Results: The mean percentage of identified data points successfully found in the EHR/CPOE charts was 93% versus 67% in the paper charts (P < .001). Regimen complexity did not alter the number of data points found. The survey response rate was 64%, and the results showed that satisfaction was statistically significant in favor of the EHR/CPOE system. Conclusion: Using EHR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. EHR/CPOE requires constant vigilance and maintenance to optimize patient safety. PMID:22043187

  11. Statistical transformation and the interpretation of inpatient glucose control data from the intensive care unit.

    PubMed

    Saulnier, George E; Castro, Janna C; Cook, Curtiss B

    2014-05-01

    Glucose control can be problematic in critically ill patients. We evaluated the impact of statistical transformation on interpretation of intensive care unit inpatient glucose control data. Point-of-care blood glucose (POC-BG) data derived from patients in the intensive care unit for 2011 was obtained. Box-Cox transformation of POC-BG measurements was performed, and distribution of data was determined before and after transformation. Different data subsets were used to establish statistical upper and lower control limits. Exponentially weighted moving average (EWMA) control charts constructed from April, October, and November data determined whether out-of-control events could be identified differently in transformed versus nontransformed data. A total of 8679 POC-BG values were analyzed. POC-BG distributions in nontransformed data were skewed but approached normality after transformation. EWMA control charts revealed differences in projected detection of out-of-control events. In April, an out-of-control process resulting in the lower control limit being exceeded was identified at sample 116 in nontransformed data but not in transformed data. October transformed data detected an out-of-control process exceeding the upper control limit at sample 27 that was not detected in nontransformed data. Nontransformed November results remained in control, but transformation identified an out-of-control event less than 10 samples into the observation period. Using statistical methods to assess population-based glucose control in the intensive care unit could alter conclusions about the effectiveness of care processes for managing hyperglycemia. Further study is required to determine whether transformed versus nontransformed data change clinical decisions about the interpretation of care or intervention results. © 2014 Diabetes Technology Society.

  12. Statistical Transformation and the Interpretation of Inpatient Glucose Control Data From the Intensive Care Unit

    PubMed Central

    Saulnier, George E.; Castro, Janna C.

    2014-01-01

    Glucose control can be problematic in critically ill patients. We evaluated the impact of statistical transformation on interpretation of intensive care unit inpatient glucose control data. Point-of-care blood glucose (POC-BG) data derived from patients in the intensive care unit for 2011 was obtained. Box–Cox transformation of POC-BG measurements was performed, and distribution of data was determined before and after transformation. Different data subsets were used to establish statistical upper and lower control limits. Exponentially weighted moving average (EWMA) control charts constructed from April, October, and November data determined whether out-of-control events could be identified differently in transformed versus nontransformed data. A total of 8679 POC-BG values were analyzed. POC-BG distributions in nontransformed data were skewed but approached normality after transformation. EWMA control charts revealed differences in projected detection of out-of-control events. In April, an out-of-control process resulting in the lower control limit being exceeded was identified at sample 116 in nontransformed data but not in transformed data. October transformed data detected an out-of-control process exceeding the upper control limit at sample 27 that was not detected in nontransformed data. Nontransformed November results remained in control, but transformation identified an out-of-control event less than 10 samples into the observation period. Using statistical methods to assess population-based glucose control in the intensive care unit could alter conclusions about the effectiveness of care processes for managing hyperglycemia. Further study is required to determine whether transformed versus nontransformed data change clinical decisions about the interpretation of care or intervention results. PMID:24876620

  13. Assessment of contrast sensitivity by Spaeth Richman Contrast Sensitivity Test and Pelli Robson Chart Test in patients with varying severity of glaucoma.

    PubMed

    Thakur, Sahil; Ichhpujani, Parul; Kumar, Suresh; Kaur, Ravneet; Sood, Sunandan

    2018-05-14

    This study was designed to assess the efficacy, reliability and repeatability of SPARCS (Spaeth Richman Contrast Sensitivity Test) as compared to the conventional Pelli Robson Chart Test for the assessment of contrast sensitivity in patients with glaucoma. We evaluated 135 eyes of 135 patients who were age and sex matched into three groups (controls, disc suspects and glaucoma) of 45 patients each. The glaucoma subgroup was further divided into subgroups of mild, moderate and severe based on the visual field damage. There was a strong positive correlation between Pelli Robson scores and SPARCS scores (S = 0.807, P < 0.001). Intraclass correlation coefficient (ICC) for Pelli Robson Test was 0.952 and 0.988 for SPARCS. The coefficient of repeatability (COR) for mean SPARCS was 5.65%, while COR of Pelli Robson Test was 12.44%. SPARCS was found to have better repeatability than Pelli Robson Test based on COR values. Pelli Robson score had a sensitivity of 80% and a specificity of 65.6% for detecting glaucoma patients as compared to 84.4% and 70%, respectively, for SPARCS scores. SPARCS is a better alternative to conventional Pelli Robson Chart Test for assessment of contrast sensitivity in patients with glaucoma. Being independent of the effects of literacy and educational status, it offers a universal way to measure contrast sensitivity. It can also be reliably used in patients with varying severity of glaucoma.

  14. [Comparative quality measurements part 3: funnel plots].

    PubMed

    Kottner, Jan; Lahmann, Nils

    2014-02-01

    Comparative quality measurements between organisations or institutions are common. Quality measures need to be standardised and risk adjusted. Random error must also be taken adequately into account. Rankings without consideration of the precision lead to flawed interpretations and enhances "gaming". Application of confidence intervals is one possibility to take chance variation into account. Funnel plots are modified control charts based on Statistical Process Control (SPC) theory. The quality measures are plotted against their sample size. Warning and control limits that are 2 or 3 standard deviations from the center line are added. With increasing group size the precision increases and so the control limits are forming a funnel. Data points within the control limits are considered to show common cause variation; data points outside special cause variation without the focus of spurious rankings. Funnel plots offer data based information about how to evaluate institutional performance within quality management contexts.

  15. prepare_taxa_charts.py: A Python program to automate generation of publication ready taxonomic pie chart images from QIIME.

    PubMed

    Lakhujani, Vijay; Badapanda, Chandan

    2017-06-01

    QIIME (Quantitative Insights Into Microbial Ecology) is one of the most popular open-source bioinformatics suite for performing metagenome, 16S rRNA amplicon and Internal Transcribed Spacer (ITS) data analysis. Although, it is very comprehensive and powerful tool, it lacks a method to provide publication ready taxonomic pie charts. The script plot_taxa_summary . py bundled with QIIME generate a html file and a folder containing taxonomic pie chart and legend as separate images. The images have randomly generated alphanumeric names. Therefore, it is difficult to associate the pie chart with the legend and the corresponding sample identifier. Even if the option to have the legend within the html file is selected while executing plot_taxa_summary . py , it is very tedious to crop a complete image (having both the pie chart and the legend) due to unequal image sizes. It requires a lot of time to manually prepare the pie charts for multiple samples for publication purpose. Moreover, there are chances of error while identifying the pie chart and legend pair due to random alphanumeric names of the images. To bypass all these bottlenecks and make this process efficient, we have developed a python based program, prepare_taxa_charts . py , to automate the renaming, cropping and merging of taxonomic pie chart and corresponding legend image into a single, good quality publication ready image. This program not only augments the functionality of plot_taxa_summary . py but is also very fast in terms of CPU time and user friendly.

  16. Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States.

    PubMed

    Grummer-Strawn, Laurence M; Reinold, Chris; Krebs, Nancy F

    2010-09-10

    In April 2006, the World Health Organization (WHO) released new international growth charts for children aged 0-59 months. Similar to the 2000 CDC growth charts, these charts describe weight for age, length (or stature) for age, weight for length (or stature), and body mass index for age. Whereas the WHO charts are growth standards, describing the growth of healthy children in optimal conditions, the CDC charts are a growth reference, describing how certain children grew in a particular place and time. However, in practice, clinicians use growth charts as standards rather than references. In 2006, CDC, the National Institutes of Health, and the American Academy of Pediatrics convened an expert panel to review scientific evidence and discuss the potential use of the new WHO growth charts in clinical settings in the United States. On the basis of input from this expert panel, CDC recommends that clinicians in the United States use the 2006 WHO international growth charts, rather than the CDC growth charts, for children aged <24 months (available at https://www.cdc.gov/growthcharts). The CDC growth charts should continue to be used for the assessment of growth in persons aged 2--19 years. The recommendation to use the 2006 WHO international growth charts for children aged <24 months is based on several considerations, including the recognition that breastfeeding is the recommended standard for infant feeding. In the WHO charts, the healthy breastfed infant is intended to be the standard against which all other infants are compared; 100% of the reference population of infants were breastfed for 12 months and were predominantly breastfed for at least 4 months. When using the WHO growth charts to screen for possible abnormal or unhealthy growth, use of the 2.3rd and 97.7th percentiles (or ±2 standard deviations) are recommended, rather than the 5th and 95th percentiles. Clinicians should be aware that fewer U.S. children will be identified as underweight using the WHO charts, slower growth among breastfed infants during ages 3-18 months is normal, and gaining weight more rapidly than is indicated on the WHO charts might signal early signs of overweight.

  17. Customized vs population-based growth charts to identify neonates at risk of adverse outcome: systematic review and Bayesian meta-analysis of observational studies.

    PubMed

    Chiossi, G; Pedroza, C; Costantine, M M; Truong, V T T; Gargano, G; Saade, G R

    2017-08-01

    To compare the effectiveness of customized vs population-based growth charts for the prediction of adverse pregnancy outcomes. MEDLINE, ClinicalTrials.gov and The Cochrane Library were searched up to 31 May 2016 to identify interventional and observational studies comparing adverse outcomes among large- (LGA) and small- (SGA) for-gestational-age neonates, when classified according to customized vs population-based growth charts. Perinatal mortality and admission to the neonatal intensive care unit (NICU) of both SGA and LGA neonates, intrauterine fetal demise (IUFD) and neonatal mortality of SGA neonates, and neonatal shoulder dystocia and hypoglycemia as well as maternal third- and fourth-degree perineal lacerations in LGA pregnancies were evaluated. The electronic search identified 237 records that were examined based on title and abstract, of which 27 full-text articles were examined for eligibility. After excluding seven articles, 20 observational studies were included in a Bayesian meta-analysis. Neonates classified as SGA according to customized growth charts had higher risks of IUFD (odds ratio (OR), 7.8 (95% CI, 4.2-12.3)), neonatal death (OR, 3.5 (95% CI, 1.1-8.0)), perinatal death (OR, 5.8 (95% CI, 3.8-7.8)) and NICU admission (OR, 3.6 (95% CI, 2.0-5.5)) than did non-SGA cases. Neonates classified as SGA according to population-based growth charts also had increased risk for adverse outcomes, albeit the point estimates of the pooled ORs were smaller: IUFD (OR, 3.3 (95% CI, 1.9-5.0)), neonatal death (OR, 2.9 (95% CI, 1.2-4.5)), perinatal death (OR, 4.0 (95% CI, 2.8-5.1)) and NICU admission (OR, 2.4 (95% CI, 1.7-3.2)). For LGA vs non-LGA, there were no differences in pooled ORs for perinatal death, NICU admission, hypoglycemia and maternal third- and fourth-degree perineal lacerations when classified according to either the customized or the population-based approach. In contrast, both approaches indicated that LGA neonates are at increased risk for shoulder dystocia than are non-LGA ones (OR, 7.4 (95% CI, 4.9-9.8) using customized charts; OR, 8.0 (95% CI, 5.3-10.1) using population-based charts). Both customized and population-based growth charts can identify SGA neonates at risk for adverse outcomes. Although the point estimates of the pooled ORs may differ for some outcomes, the overlapping CIs and lack of direct comparisons prevent conclusions from being drawn on the superiority of one method. Future clinical trials should compare directly the two approaches in the management of fetuses of abnormal size. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  18. SOCR Motion Charts: An Efficient, Open-Source, Interactive and Dynamic Applet for Visualizing Longitudinal Multivariate Data

    PubMed Central

    Al-Aziz, Jameel; Christou, Nicolas; Dinov, Ivo D.

    2011-01-01

    The amount, complexity and provenance of data have dramatically increased in the past five years. Visualization of observed and simulated data is a critical component of any social, environmental, biomedical or scientific quest. Dynamic, exploratory and interactive visualization of multivariate data, without preprocessing by dimensionality reduction, remains a nearly insurmountable challenge. The Statistics Online Computational Resource (www.SOCR.ucla.edu) provides portable online aids for probability and statistics education, technology-based instruction and statistical computing. We have developed a new Java-based infrastructure, SOCR Motion Charts, for discovery-based exploratory analysis of multivariate data. This interactive data visualization tool enables the visualization of high-dimensional longitudinal data. SOCR Motion Charts allows mapping of ordinal, nominal and quantitative variables onto time, 2D axes, size, colors, glyphs and appearance characteristics, which facilitates the interactive display of multidimensional data. We validated this new visualization paradigm using several publicly available multivariate datasets including Ice-Thickness, Housing Prices, Consumer Price Index, and California Ozone Data. SOCR Motion Charts is designed using object-oriented programming, implemented as a Java Web-applet and is available to the entire community on the web at www.socr.ucla.edu/SOCR_MotionCharts. It can be used as an instructional tool for rendering and interrogating high-dimensional data in the classroom, as well as a research tool for exploratory data analysis. PMID:21479108

  19. Seasonal Ice Zone Reconnaissance Surveys Coordination

    DTIC Science & Technology

    2013-09-30

    of SIZRS are covered in separate reports. Our long-term goal is to track and understand the interplay among the ice, atmosphere, and ocean...OMB control number. 1. REPORT DATE 30 SEP 2013 2. REPORT TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Seasonal Ice Zone...sensing resources include MODIS visible and IR imagery, NSIDC ice extent charts based on a composite of passive microwave products (http://nsidc.org

  20. [Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives

    PubMed

    Troise Rioda, W.; Nervetti, A.

    2001-01-01

    The well known complexity to collect the clinical data of patients and in particular in the area of rheumatology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumatological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumatological clinical chart an indispensable tool for rheumatologists with a real friendly use.

  1. Value-cell bar charts for visualizing large transaction data sets.

    PubMed

    Keim, Daniel A; Hao, Ming C; Dayal, Umeshwar; Lyons, Martha

    2007-01-01

    One of the common problems businesses need to solve is how to use large volumes of sales histories, Web transactions, and other data to understand the behavior of their customers and increase their revenues. Bar charts are widely used for daily analysis, but only show highly aggregated data. Users often need to visualize detailed multidimensional information reflecting the health of their businesses. In this paper, we propose an innovative visualization solution based on the use of value cells within bar charts to represent business metrics. The value of a transaction can be discretized into one or multiple cells: high-value transactions are mapped to multiple value cells, whereas many small-value transactions are combined into one cell. With value-cell bar charts, users can 1) visualize transaction value distributions and correlations, 2) identify high-value transactions and outliers at a glance, and 3) instantly display values at the transaction record level. Value-Cell Bar Charts have been applied with success to different sales and IT service usage applications, demonstrating the benefits of the technique over traditional charting techniques. A comparison with two variants of the well-known Treemap technique and our earlier work on Pixel Bar Charts is also included.

  2. Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

    PubMed

    Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

    2017-08-01

    Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all P<0.001). Mean days between laboratory test date and evidence of completed action/treatment plan decreased by 19.4 days (P<0.001). Staff surveys showed modest but nonsignificant improvement for intervention practices relative to controls overall and for the 3 high-risk domains that were the focus of PROMISES. A consortium of stakeholders, quality improvement tools, coaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

  3. Application of the statistical process control method for prospective patient safety monitoring during the learning phase: robotic kidney transplantation with regional hypothermia (IDEAL phase 2a-b).

    PubMed

    Sood, Akshay; Ghani, Khurshid R; Ahlawat, Rajesh; Modi, Pranjal; Abaza, Ronney; Jeong, Wooju; Sammon, Jesse D; Diaz, Mireya; Kher, Vijay; Menon, Mani; Bhandari, Mahendra

    2014-08-01

    Traditional evaluation of the learning curve (LC) of an operation has been retrospective. Furthermore, LC analysis does not permit patient safety monitoring. To prospectively monitor patient safety during the learning phase of robotic kidney transplantation (RKT) and determine when it could be considered learned using the techniques of statistical process control (SPC). From January through May 2013, 41 patients with end-stage renal disease underwent RKT with regional hypothermia at one of two tertiary referral centers adopting RKT. Transplant recipients were classified into three groups based on the robotic training and kidney transplant experience of the surgeons: group 1, robot trained with limited kidney transplant experience (n=7); group 2, robot trained and kidney transplant experienced (n=20); and group 3, kidney transplant experienced with limited robot training (n=14). We employed prospective monitoring using SPC techniques, including cumulative summation (CUSUM) and Shewhart control charts, to perform LC analysis and patient safety monitoring, respectively. Outcomes assessed included post-transplant graft function and measures of surgical process (anastomotic and ischemic times). CUSUM and Shewhart control charts are time trend analytic techniques that allow comparative assessment of outcomes following a new intervention (RKT) relative to those achieved with established techniques (open kidney transplant; target value) in a prospective fashion. CUSUM analysis revealed an initial learning phase for group 3, whereas groups 1 and 2 had no to minimal learning time. The learning phase for group 3 varied depending on the parameter assessed. Shewhart control charts demonstrated no compromise in functional outcomes for groups 1 and 2. Graft function was compromised in one patient in group 3 (p<0.05) secondary to reasons unrelated to RKT. In multivariable analysis, robot training was significantly associated with improved task-completion times (p<0.01). Graft function was not adversely affected by either the lack of robotic training (p=0.22) or kidney transplant experience (p=0.72). The LC and patient safety of a new surgical technique can be assessed prospectively using CUSUM and Shewhart control chart analytic techniques. These methods allow determination of the duration of mentorship and identification of adverse events in a timely manner. A new operation can be considered learned when outcomes achieved with the new intervention are at par with outcomes following established techniques. Statistical process control techniques allowed for robust, objective, and prospective monitoring of robotic kidney transplantation and can similarly be applied to other new interventions during the introduction and adoption phase. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. A case study: application of statistical process control tool for determining process capability and sigma level.

    PubMed

    Chopra, Vikram; Bairagi, Mukesh; Trivedi, P; Nagar, Mona

    2012-01-01

    Statistical process control is the application of statistical methods to the measurement and analysis of variation process. Various regulatory authorities such as Validation Guidance for Industry (2011), International Conference on Harmonisation ICH Q10 (2009), the Health Canada guidelines (2009), Health Science Authority, Singapore: Guidance for Product Quality Review (2008), and International Organization for Standardization ISO-9000:2005 provide regulatory support for the application of statistical process control for better process control and understanding. In this study risk assessments, normal probability distributions, control charts, and capability charts are employed for selection of critical quality attributes, determination of normal probability distribution, statistical stability, and capability of production processes, respectively. The objective of this study is to determine tablet production process quality in the form of sigma process capability. By interpreting data and graph trends, forecasting of critical quality attributes, sigma process capability, and stability of process were studied. The overall study contributes to an assessment of process at the sigma level with respect to out-of-specification attributes produced. Finally, the study will point to an area where the application of quality improvement and quality risk assessment principles for achievement of six sigma-capable processes is possible. Statistical process control is the most advantageous tool for determination of the quality of any production process. This tool is new for the pharmaceutical tablet production process. In the case of pharmaceutical tablet production processes, the quality control parameters act as quality assessment parameters. Application of risk assessment provides selection of critical quality attributes among quality control parameters. Sequential application of normality distributions, control charts, and capability analyses provides a valid statistical process control study on process. Interpretation of such a study provides information about stability, process variability, changing of trends, and quantification of process ability against defective production. Comparative evaluation of critical quality attributes by Pareto charts provides the least capable and most variable process that is liable for improvement. Statistical process control thus proves to be an important tool for six sigma-capable process development and continuous quality improvement.

  5. Characteristics associated with glycemic control among family medicine patients with type 2 diabetes.

    PubMed

    Kirk, Julienne K; Davis, Stephen W; Hildebrandt, Carol A; Strachan, Elizabeth N; Peechara, Madhavi L; Lord, Richard

    2011-01-01

    As new payment models are developed for chronic diseases such as diabetes, there is a need to understand which patient characteristics impact glycemic control. This study examines the relationship between patient variables and glycemic control, defined as a hemoglobin A1c (A1c) level of <7%, in a cohort of family medicine patients with type 2 diabetes. A total of 1,398 medical charts were selected using International Classification of Diseases, Ninth Revision, Clinical Modification codes for diabetes. To gather information not available through chart review, a survey was used to collect data on individual-level characteristics. Information included marital status, education level, income level, insurance status, activity level, receipt of diabetes education, living arrangement, employment status, and annual income. A cross-sectional design was used to obtain, via chart review, data about diabetes outcomes (ie, A1c level, blood pressure, and low-density lipoprotein cholesterol [LDL-C] level). A mailed survey was completed by 669 patients (response rate, 47.9%). Almost half of patients in this sample achieved the goal A1c level, LDL-C level (ie, <100 mg/dL), and/or blood pressure (ie, <130/<80 mm Hg). Medicare insurance (odds ratio [OR], 2.16 [95% confidence interval {CI}, 1.18-3.96]) and female sex (OR, 1.61 [95% CI, 1.01-2.56]) were associated with glycemic control. Other variables, such as annual income, education level, and receipt of diabetes education, that were expected to impact glycemic control were not significantly associated with an A1c level of <7%. The survey response rate was <50%, the study was conducted at a single site, and the chart data were retrospective. Our findings indicate that Medicare insurance and female sex were associated with glycemic control. Further evaluation is needed to identify determinants that lead to achievement of optimal glycemic control among individuals with type 2 diabetes.

  6. Charts for Determining Preliminary Values of Span-load, Shear, Bending-moment, and Accumulated-torque Distributions of Swept Wings of Various Taper Ratios

    NASA Technical Reports Server (NTRS)

    Wollner, Bertram C

    1948-01-01

    Contains charts for use in determining preliminary values of the spanwise-load, shear, bending-moment, and accumulated-torque distributions of swept wings. The charts are based on strip theory and include four aerodynamic-load distributions, two section-moment distributions, and two inertia-load distributions. The taper ratios considered cover the range from 1.0 to 0 and the results are applicable to any angle of sweep.

  7. Patterns of Electronic Portal Use among Vulnerable Patients in a Nationwide Practice-based Research Network: From the OCHIN Practice-based Research Network (PBRN)

    PubMed Central

    Wallace, Lorraine S.; Angier, Heather; Huguet, Nathalie; Gaudino, James A.; Krist, Alex; Dearing, Marla; Killerby, Marie; Marino, Miguel; DeVoe, Jennifer E.

    2017-01-01

    Background Underserved patient populations experience barriers to accessing and engaging within the complex health care system. Electronic patient portals have been proposed as a potential new way to improve access and engagement. We studied patient portal use for 12 consecutive months (365 days) among a large, nationally distributed, underserved patient population within the OCHIN (originally created as the Oregon Community Health Information Network and renamed OCHIN as other states joined) practice-based research network (PBRN). Methods We retrospectively assessed adoption and use of Epic’s MyChart patient portal in the first 12 months after MyChart was made available to the OCHIN PBRN. We examined electronic health record data from 36,549 patients aged ≥18 years who were offered a MyChart access code between May 1, 2012, and April 30, 2013, across the OCHIN PBRN in 13 states. Results Overall, 29% of patients offered an access code logged into their MyChart account. Superusers (minimum of 2 logins per month over a 12-month period) accounted for 6% of users overall. Men, nonwhite patients, Hispanic patients, Spanish-speaking patients, and those with the lowest incomes were significantly less likely to activate. Publicly insured and uninsured patients were also less likely to log in to their MyChart account, but once activated they were more likely than privately insured patients to use MyChart functions. Conclusions Our findings suggest that, compared with others, certain patient groups may be less interested in using patient portals or may have experienced significant barriers that prevented use. Making portal access available is a first step. Additional studies need to specifically identify health system–, clinic-, and patient-level barriers and facilitators to portal adoption and use. PMID:27613792

  8. Using Discrete Trial Training to Identify Specific Learning Impairments in Boys with Fragile X Syndrome

    ERIC Educational Resources Information Center

    Hall, Scott S.; Hustyi, Kristin M.; Hammond, Jennifer L.; Hirt, Melissa; Reiss, Allan L.

    2014-01-01

    We examined whether "discrete trial training" (DTT) could be used to identify learning impairments in mathematical reasoning in boys with fragile X syndrome (FXS). Boys with FXS, aged 10-23 years, and age and IQ-matched controls, were trained to match fractions to pie-charts and pie-charts to decimals either on a computer or with a…

  9. The Importance of Practice in the Development of Statistics.

    DTIC Science & Technology

    1983-01-01

    RESOLUTION TEST CHART NATIONAL BUREAU OIF STANDARDS 1963 -A NRC Technical Summary Report #2471 C THE IMORTANCE OF PRACTICE IN to THE DEVELOPMENT OF STATISTICS...component analysis, bioassay, limits for a ratio, quality control, sampling inspection, non-parametric tests , transformation theory, ARIMA time series...models, sequential tests , cumulative sum charts, data analysis plotting techniques, and a resolution of the Bayes - frequentist controversy. It appears

  10. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Miall, A.D.

    The basic premise of the recent Exxon cycle chart, that there exists a globally correlatable suite of third-order eustatic cycles, remains unproven. Many of the tests of this premise are based on circular reasoning. The implied precision of the Exxon global cycle chart is not supportable, because it is greater than that of the best available chronostratigraphic techniques, such as those used to construct the global standard time scale. Correlations of new stratigraphic sections with the Exxon chart will almost always succeed, because there are so many Exxon sequence-boundary events from which to choose. This is demonstrated by the usemore » of four synthetic sections constructed from tables of random numbers. A minimum of 77% successful correlations of random events with the Exxon chart was achieved. The existing cycle chart represents an amalgam of regional and local tectonic events and probably also includes unrecognized miscorrelations. It is of questionable value as an independent standard of geologic time.« less

  11. Measuring the success of electronic medical record implementation using electronic and survey data.

    PubMed Central

    Keshavjee, K.; Troyan, S.; Holbrook, A. M.; VanderMolen, D.

    2001-01-01

    Computerization of physician practices is increasing. Stakeholders are demanding demonstrated value for their Electronic Medical Record (EMR) implementations. We developed survey tools to measure medical office processes, including administrative and physician tasks pre- and post-EMR implementation. We included variables that were expected to improve with EMR implementation and those that were not expected to improve, as controls. We measured the same processes pre-EMR, at six months and 18 months post-EMR. Time required for most administrative tasks decreased within six months of EMR implementation. Staff time spent on charting increased with time, in keeping with our anecdotal observations that nurses were given more responsibility for charting in many offices. Physician time to chart increased initially by 50%, but went down to original levels by 18 months. However, this may be due to the drop-out of those physicians who had a difficult time charting electronically. PMID:11825201

  12. [Child abuse in Tlaxcala: a case-control study].

    PubMed

    Herrada-Huidobro, A; Nazar-Beutelspacher, A; Cassaball-Núñez, M; Vega-Ramos, R; Nava-Cruz, C B

    1992-01-01

    A longitudinal, retrospective and descriptive study about child abuse was carried out in the Hospitals of the Tlaxcala Secretariat of Health, Mexico. The information was obtained from hospitalized children's charts between January first and November 30, 1991. The charts included were those belonging to zero to 14 year old children with injuries, poisoning, and II-III degrees of malnutrition. Four child-abuse criteria were established: physical, sexual, non organic malnutrition and mixed (physical and non organic malnutrition). Two control groups were defined. Different patterns were observed between accidental and non accidental injuries, malnutrition and poisoning among the case and the control groups. The study provides useful information for the integral diagnosis of child abuse in hospitalized children.

  13. Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?

    PubMed

    Wen, Frances K; Millar, James; Oberst-Walsh, Linda; Nashelsky, Joan

    2018-02-01

    No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).

  14. Analysis of patients with bodyboarding injuries transported by physician-staffed emergency helicopter.

    PubMed

    Omori, Kazuhiko; Kondo, Akihiko; Oode, Yasumasa; Itoi, Akira; Sakuraba, Keishoku; Yanagawa, Youichi

    2015-01-01

    There have been no reports that have studied the characteristics specific to bodyboard injuries. To clarify characteristics to bodyboard injuries. A retrospective medical chart review. A medical chart review was retrospectively performed for all patients with spinal cord injuries transported via physician-staffed emergency helicopters between January 2009 and October 2013. The subjects were divided into two groups based on whether they had a spinal cord injury induced by bodyboarding (Bodyboard group, n = 14) or not (Control group, n = 14). Using a χ(2)-test, Mann-Whitney U-test and non-paired Student's t-test. All but one of the subjects had spinal canal stenosis. The age of the patients in the Bodyboard group was younger than that of the Control group. The ratio of males and Glasgow Coma Scale of the Bodyboard group were higher than those on the Control group. The spinal cord injury induced by bodyboarding typically occurred after impacts of the head or face with the sea bottom while the subject was being buffeted by the waves. The severity of the spinal cord injury in the Bodyboard group was lower than that in the Control group. Bodyboarding tended to induce spinal cord injuries after the head or face collided with the sea bottom, and was more common in middle-aged males during the summer season, and was associated with a favorable outcome.

  15. "The horizon opened up very greatly": Leland O. Howard and the transition to chemical insecticides in the United States, 1894-1927.

    PubMed

    McWilliams, James E

    2008-01-01

    The transition to synthetic chemicals as a popular method of insect control in the United States was one of the most critical developments in the history of American agriculture. Historians of agriculture have effectively identified the rise and charted the dominance of early chemical insecticides as they came to define commercial agriculture between the emergence of Paris green in the 1870s and the popularity of DDT in the 1940s and beyond. Less understood, however, are the underlying mechanics of this transition. this article thus takes up the basic question of how farmers and entomologists who were once dedicated to an impressively wide range of insect control options ultimately settled on the promise of a chemically driven approach to managing destructive insects. Central to this investigation is an emphasis on the bureaucratic maneuverings of Leland O. Howard, who headed the Bureau of Entomology from 1894 to 1927. Like most entomologists of his era, Howard was theoretically interested in pursuing a wide variety of control methods--biological, chemical, and cultural included. In the end, however, he employed several tactics to streamline the government's efforts to almost exclusively support arsenic and lead-based chemical insecticides as the most commercially viable form of insect control. While Howard in no way "caused" the national turn to chemicals, this article charts the pivotal role he played in fostering that outcome.

  16. 19. DETAIL OF AIR FORCE WEATHER INFORMATION TERMINAL AND CHART ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. DETAIL OF AIR FORCE WEATHER INFORMATION TERMINAL AND CHART RECORDER LOCATED IMMEDIATELY NORTH OF CONSOLE IN PHOTOS A-15 THROUGH A-18. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. Wisconsin Recertification Manual for Public Librarians.

    ERIC Educational Resources Information Center

    Fox, Robert; And Others

    Designed to assist public librarians certified after May 1, 1979, this manual explains Wisconsin recertification requirements based on continuing education. It provides continuing education guidelines, a flow chart of the recertification process, an individual learning activity form, an annual report form, a conversion chart for assignment of…

  18. Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis.

    PubMed

    Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L; Ruderman, Eric M; Carter, Jeffrey D; Patel, Barry; Moreo, Kathleen

    2015-12-01

    In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve performance on national quality measures for RA.

  19. 40 CFR 51.359 - Quality control.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Quality control. 51.359 Section 51.359....359 Quality control. Quality control measures shall insure that emission testing equipment is calibrated and maintained properly, and that inspection, calibration records, and control charts are...

  20. 40 CFR 51.359 - Quality control.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Quality control. 51.359 Section 51.359....359 Quality control. Quality control measures shall insure that emission testing equipment is calibrated and maintained properly, and that inspection, calibration records, and control charts are...

  1. 40 CFR 51.359 - Quality control.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Quality control. 51.359 Section 51.359....359 Quality control. Quality control measures shall insure that emission testing equipment is calibrated and maintained properly, and that inspection, calibration records, and control charts are...

  2. 40 CFR 51.359 - Quality control.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Quality control. 51.359 Section 51.359....359 Quality control. Quality control measures shall insure that emission testing equipment is calibrated and maintained properly, and that inspection, calibration records, and control charts are...

  3. Web-based tools for modelling and analysis of multivariate data: California ozone pollution activity

    PubMed Central

    Dinov, Ivo D.; Christou, Nicolas

    2014-01-01

    This article presents a hands-on web-based activity motivated by the relation between human health and ozone pollution in California. This case study is based on multivariate data collected monthly at 20 locations in California between 1980 and 2006. Several strategies and tools for data interrogation and exploratory data analysis, model fitting and statistical inference on these data are presented. All components of this case study (data, tools, activity) are freely available online at: http://wiki.stat.ucla.edu/socr/index.php/SOCR_MotionCharts_CAOzoneData. Several types of exploratory (motion charts, box-and-whisker plots, spider charts) and quantitative (inference, regression, analysis of variance (ANOVA)) data analyses tools are demonstrated. Two specific human health related questions (temporal and geographic effects of ozone pollution) are discussed as motivational challenges. PMID:24465054

  4. Web-based tools for modelling and analysis of multivariate data: California ozone pollution activity.

    PubMed

    Dinov, Ivo D; Christou, Nicolas

    2011-09-01

    This article presents a hands-on web-based activity motivated by the relation between human health and ozone pollution in California. This case study is based on multivariate data collected monthly at 20 locations in California between 1980 and 2006. Several strategies and tools for data interrogation and exploratory data analysis, model fitting and statistical inference on these data are presented. All components of this case study (data, tools, activity) are freely available online at: http://wiki.stat.ucla.edu/socr/index.php/SOCR_MotionCharts_CAOzoneData. Several types of exploratory (motion charts, box-and-whisker plots, spider charts) and quantitative (inference, regression, analysis of variance (ANOVA)) data analyses tools are demonstrated. Two specific human health related questions (temporal and geographic effects of ozone pollution) are discussed as motivational challenges.

  5. Endpoint in plasma etch process using new modified w-multivariate charts and windowed regression

    NASA Astrophysics Data System (ADS)

    Zakour, Sihem Ben; Taleb, Hassen

    2017-09-01

    Endpoint detection is very important undertaking on the side of getting a good understanding and figuring out if a plasma etching process is done in the right way, especially if the etched area is very small (0.1%). It truly is a crucial part of supplying repeatable effects in every single wafer. When the film being etched has been completely cleared, the endpoint is reached. To ensure the desired device performance on the produced integrated circuit, the high optical emission spectroscopy (OES) sensor is employed. The huge number of gathered wavelengths (profiles) is then analyzed and pre-processed using a new proposed simple algorithm named Spectra peak selection (SPS) to select the important wavelengths, then we employ wavelet analysis (WA) to enhance the performance of detection by suppressing noise and redundant information. The selected and treated OES wavelengths are then used in modified multivariate control charts (MEWMA and Hotelling) for three statistics (mean, SD and CV) and windowed polynomial regression for mean. The employ of three aforementioned statistics is motivated by controlling mean shift, variance shift and their ratio (CV) if both mean and SD are not stable. The control charts show their performance in detecting endpoint especially W-mean Hotelling chart and the worst result is given by CV statistic. As the best detection of endpoint is given by the W-Hotelling mean statistic, this statistic will be used to construct a windowed wavelet Hotelling polynomial regression. This latter can only identify the window containing endpoint phenomenon.

  6. Formal Transformations from Graphically-Based Object-Oriented Representations to Theory-Based Specifications

    DTIC Science & Technology

    1996-06-01

    for Software Synthesis." KBSE 󈨡. IEEE, 1993. 51. Kang, Kyo C., et al. Feature-Oriented Domain Analysis ( FODA ) Feasibility Study. Technical Report...and usefulness in domain analysis and modeling. Rumbaugh uses three distinct views to describe a domain: (1) the object model describes structural...Gibbons describe a methodology where Structured Analysis is used to build a hierarchical system structure chart. This structure chart is then translated

  7. Army Physical Therapy Productivity According to the Performance Based Adjustment Model

    DTIC Science & Technology

    2008-05-02

    variation in processes often fell along a bell shaped curve or normal distribution. Shewart later developed a control chart to track and analyze variation in...References Abdi, H. (2003). Partial regression coefficients. In M. Lewis-Beck, A . Bryman & T. Futing (Eds.), Encyclopedia of Social Sciences Research...other provision of law. no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a

  8. Construction of a General Purpose Command Language for Use in Computer Dialog.

    DTIC Science & Technology

    1980-09-01

    Page 1 Skeletal Command Action File...............35 2 Sample from Cyber Action File.................36 3 Program MONITOR Structure Chart...return indicates subroutine call and no return Fig 3. Program MONITOR Structure Chart 48 IV. Validation The general purpose command language was...executive control of these functions, in C addition to its role as interpreter. C C The structure , concept, design, and implementation of program C

  9. Benefits of object-oriented models and ModeliChart: modern tools and methods for the interdisciplinary research on smart biomedical technology.

    PubMed

    Gesenhues, Jonas; Hein, Marc; Ketelhut, Maike; Habigt, Moriz; Rüschen, Daniel; Mechelinck, Mare; Albin, Thivaharan; Leonhardt, Steffen; Schmitz-Rode, Thomas; Rossaint, Rolf; Autschbach, Rüdiger; Abel, Dirk

    2017-04-01

    Computational models of biophysical systems generally constitute an essential component in the realization of smart biomedical technological applications. Typically, the development process of such models is characterized by a great extent of collaboration between different interdisciplinary parties. Furthermore, due to the fact that many underlying mechanisms and the necessary degree of abstraction of biophysical system models are unknown beforehand, the steps of the development process of the application are iteratively repeated when the model is refined. This paper presents some methods and tools to facilitate the development process. First, the principle of object-oriented (OO) modeling is presented and the advantages over classical signal-oriented modeling are emphasized. Second, our self-developed simulation tool ModeliChart is presented. ModeliChart was designed specifically for clinical users and allows independently performing in silico studies in real time including intuitive interaction with the model. Furthermore, ModeliChart is capable of interacting with hardware such as sensors and actuators. Finally, it is presented how optimal control methods in combination with OO models can be used to realize clinically motivated control applications. All methods presented are illustrated on an exemplary clinically oriented use case of the artificial perfusion of the systemic circulation.

  10. Ultrasonographic fetal growth charts: an informatic approach by quantitative analysis of the impact of ethnicity on diagnoses based on a preliminary report on Salentinian population.

    PubMed

    Tinelli, Andrea; Bochicchio, Mario Alessandro; Vaira, Lucia; Malvasi, Antonio

    2014-01-01

    Clear guidance on fetal growth assessment is important because of the strong links between growth restriction or macrosomia and adverse perinatal outcome in order to reduce associated morbidity and mortality. Fetal growth curves are extensively adopted to track fetal sizes from the early phases of pregnancy up to delivery. In the literature, a large variety of reference charts are reported but they are mostly up to five decades old. Furthermore, they do not address several variables and factors (e.g., ethnicity, foods, lifestyle, smoke, and physiological and pathological variables), which are very important for a correct evaluation of the fetal well-being. Therefore, currently adopted fetal growth charts are inadequate to support the melting pot of ethnic groups and lifestyles of our society. Customized fetal growth charts are needed to provide an accurate fetal assessment and to avoid unnecessary obstetric interventions at the time of delivery. Starting from the development of a growth chart purposely built for a specific population, in the paper, authors quantify and analyse the impact of the adoption of wrong growth charts on fetal diagnoses. These results come from a preliminary evaluation of a new open service developed to produce personalized growth charts for specific ethnicity, lifestyle, and other parameters.

  11. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    PubMed

    Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

    2016-01-01

    The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.

  12. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

    PubMed Central

    Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

    2016-01-01

    Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Conclusions Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers. PMID:27398803

  13. Clinical user experiences of observation and response charts: focus group findings of using a new format chart incorporating a track and trigger system.

    PubMed

    Elliott, Doug; Allen, Emily; Perry, Lin; Fry, Margaret; Duffield, Christine; Gallagher, Robyn; Iedema, Rick; McKinley, Sharon; Roche, Michael

    2015-01-01

    Optimising clinical responses to deteriorating patients is an international indicator of acute healthcare quality. Observation charts incorporating track and trigger systems are an initiative to improve early identification and response to clinical deterioration. A suite of track and trigger 'Observation and Response Charts' were designed in Australia and initially tested in simulated environments. This paper reports initial clinical user experiences and views following implementation of these charts in adult general medical-surgical wards. Across eight trial sites, 44 focus groups were conducted with 218 clinical ward staff, mostly nurses, who received training and had used the charts in routine clinical practice for the preceding 2-6 weeks. Transcripts of audio recordings were analysed for emergent themes using an inductive approach. In this exploration of initial user experiences, key emergent themes were: tensions between vital sign 'ranges versus precision' to support decision making; using a standardised 'generalist chart in a range of specialist practice' areas; issues of 'clinical credibility', 'professional autonomy' and 'influences of doctors' when communicating abnormal signs; and 'permission and autonomy' when escalating care according to the protocol. Across themes, participants presented a range of positive, negative or mixed views. Benefits were identified despite charts not always being used up to their optimal design function. Participants reported tensions between chart objectives and clinical practices, revealing mismatches between design characteristics and human staff experiences. Overall, an initial view of 'increased activity/uncertain benefit' was uncovered. Findings particularly reinforced the significant influences of organisational work-based cultures, disciplinary boundaries and interdisciplinary communication on implementation of this new practice chart. Optimal use of all chart design characteristics will be possible when these broader cultural issues are addressed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. 14 CFR 133.33 - Operating rules.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

  15. 14 CFR 133.33 - Operating rules.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

  16. 14 CFR 133.33 - Operating rules.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

  17. 14 CFR 133.33 - Operating rules.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... that directional control is adequate. (4) Accelerate into forward flight to verify that no attitude... traffic control, if necessary, and a detailed chart depicting the flight routes and altitudes. (2) Each...

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shishlo, Andrei P; Chu, Paul; Pelaia II, Tom

    A data plotting package residing in the XAL tools set is presented. This package is based on Java SWING, and therefore it has the same portability as Java itself. The data types for charts, bar-charts, and color-surface plots are described. The algorithms, performance, interactive capabilities, limitations, and the best usage practices of this plotting package are discussed.

  19. 40 CFR 51.359 - Quality control.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Quality control. 51.359 Section 51.359 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR... to assure test accuracy. Computer control of quality assurance checks and quality control charts...

  20. A brief review of vaccination coverage in immunization registries.

    PubMed

    Goldstein, Neal D; Maiese, Brett A

    2011-01-01

    Immunization registries are effective electronic tools for assessing vaccination coverage, but are only as good as the information reported to them. This review summarizes studies through August 2010 on vaccination coverage in registries and identifies key characteristics of successful registries. Based on the current state of registries, paper-based charts combined with electronic registry reporting provide the most cohesive picture of coverage. To ultimately supplant paper charts, registries must exhibit increased coverage and participation.

  1. How Nature Keeps its Balance

    ERIC Educational Resources Information Center

    Chalfant, Arnold R.

    1972-01-01

    The importance of feedback - self-controlling regulatory mechanisms - in the natural world are explained for a better understanding of the science of ecology. Various population controls are discussed accompanied by basic charts. (BL)

  2. CONTROL CHART DASHBOARDS MANAGING YOUR NUMBERS INSTEAD OF YOU NUMBER MANAGING YOU

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    PREVETTE, S.S.

    2006-11-15

    This paper, which documents Fluor Hanford's application of Statistical Process Control (SPC) and Dashboards to support planning and decision making, is a sequel to ''Leading with Leading Indicators'' that was presented at WM 05. This year's paper provides more detail on management's use of SPC and control charts and discusses their integration into an executive summary using the popular color-cod3ed dashboard methodology. Fluor Hanford has applied SPC in a non-traditional (that is non-manufacturing) manner. Dr. Shewhart's 75-year-old control-chart methodologies have been updated to modern data processing, but are still founded on his sound, tried and true principles. These methods aremore » playing a key role in safety and quality at what has been called the world's largest environmental cleanup project. The US Department of Energy's (DOE's) Hanford Site played a pivotal role in the nation's defense, beginning in the 1940s when it was established as part of the Manhattan Project. After more than 50 years of producing nuclear weapons, Hanford--which covers 586 square miles in southeastern Washington state--is now focused on three outcomes: (1) restoring the Columbia River corridor for multiple uses; (2) transitioning the central plateau to support long-term waste management; and (3) putting DOE assets to work for the future.« less

  3. Environmental monitoring: data trending using a frequency model.

    PubMed

    Caputo, Ross A; Huffman, Anne

    2004-01-01

    Environmental monitoring programs for the oversight of classified environments have used traditional statistical control charts to monitor trends in microbial recovery for classified environments. These methodologies work well for environments that yield measurable microbial recoveries. However, today successful increased control of microbial content yields numerous instances where microbial recovery in a sample is generally zero. As a result, traditional control chart methods cannot be used appropriately. Two methods to monitor the performance of a classified environment where microbial recovery is zero are presented. Both methods use the frequency between non-zero microbial recovery as an event. Therefore, the frequency of events is monitored rather than the microbial recovery count. Both methods are shown to be appropriate for use in the described instances.

  4. Women's views of two interventions designed to assist in the prophylactic oophorectomy decision: a qualitative pilot evaluation

    PubMed Central

    Bhavnani, Vanita; Clarke, Aileen; Dowie, Jack; Kennedy, Andrew; Pell, Ian

    2002-01-01

    Abstract Introduction  A qualitative pilot evaluation of two different decision interventions for the prophylactic oophorectomy (PO) decision: a Decision Chart and a computerized clinical guidance programme (CGP) was undertaken. The Decision Chart, representing current practice in decision interventions, presents population‐based information. The CGP elicits individual values to allow for quality‐adjusted life years to be calculated and an explicit guidance statement is given. Prophylactic oophorectomy involves removal of the ovaries as an adjunct to hysterectomy to prevent ovarian cancer. The decision is complex because the operation can affect a number of long‐term outcomes including breast cancer, coronary heart disease and osteoporosis. Methods  Both interventions were based on the evidence and were administered by a facilitator. The Decision Chart is a file, which progressively reveals information in the form of bar charts. The CGP is a decision‐analysis based program integrating the results from a cluster of Markov cycle trees. The research evidence is incorporated with woman's individual risk factors, values and preferences. A purposive sample of 19 women awaiting hysterectomy used the decision interventions (10 CGP, nine Decision Chart). In‐depth semi‐structured interviews were undertaken. Interviews were transcribed and analysed to derive themes. Results  Reactions to the different decision interventions were mixed. Both were seen as clarifying the decision. Some women found some of the tasks difficult (e.g. rating health status). Some were surprised by the ‘individualized’ guidance, which the CGP offered. The Decision Chart provided some with a sense of empowerment, although some found that it provided too much information. Conclusions  Women were able to use both decision interventions. Both provided decision clarification. Problems were evident with both interventions, which give useful pointers for future development. These included the possibility for women to see how their individual risks of different outcomes are affected in the Decision Chart and enhanced explanation of the CGP tasks. Future design and evaluation of decision aids, will need to accommodate differences between patients in the desire for amount and type of information and level of involvement in the decision‐making process. PMID:12031056

  5. A monitoring tool for performance improvement in plastic surgery at the individual level.

    PubMed

    Maruthappu, Mahiben; Duclos, Antoine; Orgill, Dennis; Carty, Matthew J

    2013-05-01

    The assessment of performance in surgery is expanding significantly. Application of relevant frameworks to plastic surgery, however, has been limited. In this article, the authors present two robust graphic tools commonly used in other industries that may serve to monitor individual surgeon operative time while factoring in patient- and surgeon-specific elements. The authors reviewed performance data from all bilateral reduction mammaplasties performed at their institution by eight surgeons between 1995 and 2010. Operative time was used as a proxy for performance. Cumulative sum charts and exponentially weighted moving average charts were generated using a train-test analytic approach, and used to monitor surgical performance. Charts mapped crude, patient case-mix-adjusted, and case-mix and surgical-experience-adjusted performance. Operative time was found to decline from 182 minutes to 118 minutes with surgical experience (p < 0.001). Cumulative sum and exponentially weighted moving average charts were generated using 1995 to 2007 data (1053 procedures) and tested on 2008 to 2010 data (246 procedures). The sensitivity and accuracy of these charts were significantly improved by adjustment for case mix and surgeon experience. The consideration of patient- and surgeon-specific factors is essential for correct interpretation of performance in plastic surgery at the individual surgeon level. Cumulative sum and exponentially weighted moving average charts represent accurate methods of monitoring operative time to control and potentially improve surgeon performance over the course of a career.

  6. Quality Assurance of Chemical Measurements.

    ERIC Educational Resources Information Center

    Taylor, John K.

    1981-01-01

    Reviews aspects of quality control (methods to control errors) and quality assessment (verification that systems are operating within acceptable limits) including an analytical measurement system, quality control by inspection, control charts, systematic errors, and use of SRMs, materials for which properties are certified by the National Bureau…

  7. 14 CFR 21.143 - Quality control data requirements; prime manufacturer.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Quality control data requirements; prime... describing assigned responsibilities and delegated authority of the quality control organization, together with a chart indicating the functional relationship of the quality control organization to management...

  8. Image-guided radiotherapy quality control: Statistical process control using image similarity metrics.

    PubMed

    Shiraishi, Satomi; Grams, Michael P; Fong de Los Santos, Luis E

    2018-05-01

    The purpose of this study was to demonstrate an objective quality control framework for the image review process. A total of 927 cone-beam computed tomography (CBCT) registrations were retrospectively analyzed for 33 bilateral head and neck cancer patients who received definitive radiotherapy. Two registration tracking volumes (RTVs) - cervical spine (C-spine) and mandible - were defined, within which a similarity metric was calculated and used as a registration quality tracking metric over the course of treatment. First, sensitivity to large misregistrations was analyzed for normalized cross-correlation (NCC) and mutual information (MI) in the context of statistical analysis. The distribution of metrics was obtained for displacements that varied according to a normal distribution with standard deviation of σ = 2 mm, and the detectability of displacements greater than 5 mm was investigated. Then, similarity metric control charts were created using a statistical process control (SPC) framework to objectively monitor the image registration and review process. Patient-specific control charts were created using NCC values from the first five fractions to set a patient-specific process capability limit. Population control charts were created using the average of the first five NCC values for all patients in the study. For each patient, the similarity metrics were calculated as a function of unidirectional translation, referred to as the effective displacement. Patient-specific action limits corresponding to 5 mm effective displacements were defined. Furthermore, effective displacements of the ten registrations with the lowest similarity metrics were compared with a three dimensional (3DoF) couch displacement required to align the anatomical landmarks. Normalized cross-correlation identified suboptimal registrations more effectively than MI within the framework of SPC. Deviations greater than 5 mm were detected at 2.8σ and 2.1σ from the mean for NCC and MI, respectively. Patient-specific control charts using NCC evaluated daily variation and identified statistically significant deviations. This study also showed that subjective evaluations of the images were not always consistent. Population control charts identified a patient whose tracking metrics were significantly lower than those of other patients. The patient-specific action limits identified registrations that warranted immediate evaluation by an expert. When effective displacements in the anterior-posterior direction were compared to 3DoF couch displacements, the agreement was ±1 mm for seven of 10 patients for both C-spine and mandible RTVs. Qualitative review alone of IGRT images can result in inconsistent feedback to the IGRT process. Registration tracking using NCC objectively identifies statistically significant deviations. When used in conjunction with the current image review process, this tool can assist in improving the safety and consistency of the IGRT process. © 2018 American Association of Physicists in Medicine.

  9. An experimental study of an educational intervention to promote maternal self-efficacy in breastfeeding.

    PubMed

    Dodt, Regina Cláudia Melo; Joventino, Emanuella Silva; Aquino, Priscilla Souza; Almeida, Paulo César; Ximenes, Lorena Barbosa

    2015-01-01

    to build, validate and assess an educational intervention using the flip chart titled "I Can Breastfeed My Child." an experimental study using a pretest, intervention and posttest, as well as a control group. A total of 201 women, who had been hospitalized immediately, for at least 6 hours, postpartum. The mothers were allocated to the intervention (100 women) or control groups (101 women) according to the length of their hospital stay. The effectiveness of the flip chart was assessed by applying the Breastfeeding Self-Efficacy Scale - Short-Form at admission, discharge and by telephone in the second month postpartum. The intervention and control groups were similar in their socio-demographic, obstetric and gynecological variables. the intervention was beneficial because mothers in the intervention group had higher self-efficacy scores, more mothers continued breastfeeding and mothers had a longer duration of exclusive breastfeeding, both at the time of hospital discharge and at the second month postpartum, with statistically significant associations. this experimental study assessed the educational strategy mediated via the flip chart titled "I Can Breastfeed My Child" as being effective both in increasing self-efficacy and increasing the duration of breastfeeding.

  10. [Chart for estimation of fetal weight 2014 by the French College of Fetal Sonography (CFEF)].

    PubMed

    Massoud, M; Duyme, M; Fontanges, M; Combourieu, D

    2016-01-01

    To establish a reference chart for estimated fetal weight (EFW) using the Hadlock formula based on recent biometric data (2012-2013). A prospective multicentric longitudinal study was carried out. Biometric parameters as the head circumference (HC), abdominal circumference (AC) and the femur length were measured in multiple areas of France from January 2012 until December 2013. EFW was calculated using the predictive formula of Hadlock using three parameters. The accurate gestational age was the main inclusion criteria calculated in weeks of gestation (WG). A polynomial regression approach was used to calculate the mean and standard deviation for every WG adjusted to raw data. Centiles of EFW were calculated from the z score that corresponds to the -1.88, -1.28, 0, +1.28, +1.88 respectively for the 3rd, 10th, 50th, 90th, et 97th percentile in order to establish a new chart of EFW. Measurements were obtained for 33,143 fetus between 17 et 38 WG. Reference charts with the 3rd, 10th, 50th, 90th et 97th percentiles were presented. The reference Chart 2014 is an in utero chart for EFW based on ultrasound measurements data reliable and homogenous from a sample of 33,143 fetus of a general population. It offers a tool to use in routine ultrasound examination for the survey of the fetal growth and to diagnose fetus that are small for gestational age or presenting a restriction in growth. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Trainee competence in thoracoscopic esophagectomy in the prone position: evaluation using cumulative sum techniques.

    PubMed

    Oshikiri, Taro; Yasuda, Takashi; Yamamoto, Masashi; Kanaji, Shingo; Yamashita, Kimihiro; Matsuda, Takeru; Sumi, Yasuo; Nakamura, Tetsu; Fujino, Yasuhiro; Tominaga, Masahiro; Suzuki, Satoshi; Kakeji, Yoshihiro

    2016-09-01

    Minimally invasive esophagectomy (MIE) has less morbidity than the open approach. In particular, thoracoscopic esophagectomy in the prone position (TEP) has been performed worldwide. Using the cumulative sum control chart (CUSUM) method, this study aimed to confirm whether a trainee surgeon who learned established standards would become skilled in TEP with a shorter learning curve than that of the mentoring surgeon. Surgeon A performed TEP in 100 patients; the first 22 patients comprised period 1. His learning curve, defined based on the operation time (OT) of the thoracic procedure, was evaluated using the CUSUM method, and short-term outcomes were assessed. Another 22 patients underwent TEP performed by surgeon B, with outcomes compared to those of surgeon A's period 1. Using the CUSUM chart, the peak point of the thoracic procedure OT occurred at the 44th case in surgeon A's experience of 100 cases. With surgeon A's first 22 cases (period 1), the peak point of the thoracic procedure OT could not be confirmed and graph is expanding soaring at CUSUM chart. The CUSUM chart of surgeon B's experience of 22 cases clearly indicated that the peak point of the thoracic procedure OT occurred at the 17th case. The rate of recurrent laryngeal nerve palsy for surgeon B (9 %) was significantly lower than for surgeon A in period 1 (36 %) (p = 0.0266). There is some possibility for a trainee surgeon to attain the required basic skills to perform TEP in a relatively short period of time using a standardized procedure developed by a mentoring surgeon. The CUSUM method should be useful in evaluating trainee competence during an initial series of procedures, by assessing the learning curve defined by OT.

  12. Asynchronous Transfer Mode (ATM) Switch Technology and Vendor Survey

    NASA Technical Reports Server (NTRS)

    Berry, Noemi

    1995-01-01

    Asynchronous Transfer Mode (ATM) switch and software features are described and compared in order to make switch comparisons meaningful. An ATM switch's performance cannot be measured solely based on its claimed switching capacity; traffic management and congestion control are emerging as the determining factors in an ATM network's ultimate throughput. Non-switch ATM products and experiences with actual installations of ATM networks are described. A compilation of select vendor offerings as of October 1994 is provided in chart form.

  13. PubMed Central

    Aubin, M.; Vézina, L.; Maziade, J.; Robitaille, N. M.

    1994-01-01

    OBJECTIVE: To evaluate the effectiveness of a program to improve hypertension control practices in primary care. DESIGN: Retrospective quasi-experimental study. SETTING: Three hospital-based family medicine centres (FMCs) PARTICIPANTS: Two study groups of 100 randomly-selected adult patients each, who visited the study FMC before implementation of the hypertension program (from April 1, 1983 to March 31, 1984) or afterward (from April 1, 1986 to March 31, 1987). These patients were compared to patients from control FMCs A and B seen during the same time frames (100 patients before and after at FMC A and 60 at FMC B). INTERVENTIONS: 1) Educational sessions for physicians to standardize knowledge of the recommendations of the Canadian Hypertension Society on hypertension treatment and 2) specific operational incentives to improve hypertension control, including a reference guide placed in each physician's office, a specific hypertension follow-up form placed with each patient's chart, a recall card file, and hypertension information handouts. MAIN OUTCOME MEASURE: Blood pressure measurements recorded in patient charts. Hypertension control is determined from the Canadian Hypertension Society recommendations. RESULTS: The hypertension control rate was 52% in the study group before program implementation and 34.3% afterward (p = 0.01); the corresponding rates in the two control groups moved from 47.4% to 59.8% (p > 0.05) in Group A and from 40.7% to 39.3% (p > 0.05) in Group B. Patients listed in the recall card file were not controlled more frequently (33.3%) than those not listed (35.3%). CONCLUSION: This intervention did not improve physician practice regarding hypertension control. Clinicians did not follow the protocol as recommended. Physicians must be convinced that a change in their practice is needed before any specific strategies are introduced to support the change. Different suggestions and alternatives related to hypertension management are discussed. PMID:7950469

  14. Statistical process control: separating signal from noise in emergency department operations.

    PubMed

    Pimentel, Laura; Barrueto, Fermin

    2015-05-01

    Statistical process control (SPC) is a visually appealing and statistically rigorous methodology very suitable to the analysis of emergency department (ED) operations. We demonstrate that the control chart is the primary tool of SPC; it is constructed by plotting data measuring the key quality indicators of operational processes in rationally ordered subgroups such as units of time. Control limits are calculated using formulas reflecting the variation in the data points from one another and from the mean. SPC allows managers to determine whether operational processes are controlled and predictable. We review why the moving range chart is most appropriate for use in the complex ED milieu, how to apply SPC to ED operations, and how to determine when performance improvement is needed. SPC is an excellent tool for operational analysis and quality improvement for these reasons: 1) control charts make large data sets intuitively coherent by integrating statistical and visual descriptions; 2) SPC provides analysis of process stability and capability rather than simple comparison with a benchmark; 3) SPC allows distinction between special cause variation (signal), indicating an unstable process requiring action, and common cause variation (noise), reflecting a stable process; and 4) SPC keeps the focus of quality improvement on process rather than individual performance. Because data have no meaning apart from their context, and every process generates information that can be used to improve it, we contend that SPC should be seriously considered for driving quality improvement in emergency medicine. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Binding Blocks: Building the Universe One Nucleus at a Time

    ERIC Educational Resources Information Center

    Diget, C. Aa.; Pastore, A.; Leech, K.; Haylett, T.; Lock, S.; Sanders, T.; Shelley, M.; Willett, H. V.; Keegans, J.; Sinclair, L.; Simpson, E. C.

    2017-01-01

    We present a new teaching and outreach activity based around the construction of a three-dimensional chart of isotopes using LEGO® bricks. The activity, "binding blocks", demonstrates nuclear and astrophysical processes through a seven-meter chart of all nuclear isotopes, built from over 26000 LEGO® bricks. It integrates A-Level and GCSE…

  16. Statistical Handbook on Aging Americans. 1994 Edition. Statistical Handbook Series Number 5.

    ERIC Educational Resources Information Center

    Schick, Frank L., Ed.; Schick, Renee, Ed.

    This statistical handbook contains 378 tables and charts illustrating the changes in the United States' aging population based on data collected during the 1990 census and several other surveys. The tables and charts are organized by topic as follows: demographics (age and sex distribution, life expectancy, race and ethnicity, geographic…

  17. 78 FR 59339 - Intracoastal Waterway Route “Magenta Line” on NOAA Nautical Charts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... waterways have been based principally on surveys made from 60 to 80 years ago and, necessarily, are obsolete... found where the charted Intracoastal Waterway Route (``magenta line'') passes on the wrong side of aids... specifically seeks comments regarding: 1. How do you currently access the magenta line? On paper nautical...

  18. A Robust Interpretation of Teaching Evaluation Ratings

    ERIC Educational Resources Information Center

    Bi, Henry H.

    2018-01-01

    There are no absolute standards regarding what teaching evaluation ratings are satisfactory. It is also problematic to compare teaching evaluation ratings with the average or with a cutoff number to determine whether they are adequate. In this paper, we use average and standard deviation charts (X[overbar]-S charts), which are based on the theory…

  19. Usability Testing and Workflow Analysis of the TRADOC Data Visualization Tool

    DTIC Science & Technology

    2012-09-01

    software such as blink data, saccades, and cognitive load based on pupil contraction. Eye-tracking was only a component of the data evaluated and as...line charts were a pain to read) Yes Yes Projecting the charts directly onto the regions increased clutter on the screen and is a bad stylistic

  20. Visualizations of Travel Time Performance Based on Vehicle Reidentification Data

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Young, Stanley Ernest; Sharifi, Elham; Day, Christopher M.

    This paper provides a visual reference of the breadth of arterial performance phenomena based on travel time measures obtained from reidentification technology that has proliferated in the past 5 years. These graphical performance measures are revealed through overlay charts and statistical distribution as revealed through cumulative frequency diagrams (CFDs). With overlays of vehicle travel times from multiple days, dominant traffic patterns over a 24-h period are reinforced and reveal the traffic behavior induced primarily by the operation of traffic control at signalized intersections. A cumulative distribution function in the statistical literature provides a method for comparing traffic patterns from variousmore » time frames or locations in a compact visual format that provides intuitive feedback on arterial performance. The CFD may be accumulated hourly, by peak periods, or by time periods specific to signal timing plans that are in effect. Combined, overlay charts and CFDs provide visual tools with which to assess the quality and consistency of traffic movement for various periods throughout the day efficiently, without sacrificing detail, which is a typical byproduct of numeric-based performance measures. These methods are particularly effective for comparing before-and-after median travel times, as well as changes in interquartile range, to assess travel time reliability.« less

  1. Programming for energy monitoring/display system in multicolor lidar system research

    NASA Technical Reports Server (NTRS)

    Alvarado, R. C., Jr.; Allen, R. J.

    1982-01-01

    The Z80 microprocessor based computer program that directs and controls the operation of the six channel energy monitoring/display system that is a part of the NASA Multipurpose Airborne Differential Absorption Lidar (DIAL) system is described. The program is written in the Z80 assembly language and is located on EPROM memories. All source and assembled listings of the main program, five subroutines, and two service routines along with flow charts and memory maps are included. A combinational block diagram shows the interfacing (including port addresses) between the six power sensors, displays, front panel controls, the main general purpose minicomputer, and this dedicated microcomputer system.

  2. Modeling human decision making behavior in supervisory control

    NASA Technical Reports Server (NTRS)

    Tulga, M. K.; Sheridan, T. B.

    1977-01-01

    An optimal decision control model was developed, which is based primarily on a dynamic programming algorithm which looks at all the available task possibilities, charts an optimal trajectory, and commits itself to do the first step (i.e., follow the optimal trajectory during the next time period), and then iterates the calculation. A Bayesian estimator was included which estimates the tasks which might occur in the immediate future and provides this information to the dynamic programming routine. Preliminary trials comparing the human subject's performance to that of the optimal model show a great similarity, but indicate that the human skips certain movements which require quick change in strategy.

  3. Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices.

    PubMed

    Livingstone, I A T; Tarbert, C M; Giardini, M E; Bastawrous, A; Middleton, D; Hamilton, R

    2016-01-01

    Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer's recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out-performed ETDRS charts in terms of photometric compliance with high contrast acuity standards.

  4. Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts As Visual Acuity Measurement Devices

    PubMed Central

    Livingstone, I. A. T.; Tarbert, C. M.; Giardini, M. E.; Bastawrous, A.; Middleton, D.; Hamilton, R.

    2016-01-01

    Mobile technology is increasingly used to measure visual acuity. Standards for chart-based acuity tests specify photometric requirements for luminance, optotype contrast and luminance uniformity. Manufacturers provide some photometric data but little is known about tablet performance for visual acuity testing. This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards. Tablet screen luminance and contrast were measured using nine points across a black and white checkerboard test screen at five arbitrary brightness levels. ETDRS optotypes and adjacent white background luminance and contrast were measured. All seven tablets (room lights off) exceeded the most stringent requirement for mean luminance (≥ 120 cd/m2) providing the nominal brightness setting was above 50%. All exceeded contrast requirement (Weber ≥ 90%) regardless of brightness setting, and five were marginally below the required luminance uniformity threshold (Lmin/Lmax ≥ 80%). Re-assessing three tablets with room lights on made little difference to mean luminance or contrast, and improved luminance uniformity to exceed the threshold. The three EDTRS charts (room lights off) had adequate mean luminance (≥ 120 cd/m2) and Weber contrast (≥ 90%), but all three charts failed to meet the luminance uniformity standard (Lmin/Lmax ≥ 80%). Two charts were operating beyond manufacturer’s recommended lamp replacement schedule. With room lights on, chart mean luminance and Weber contrast increased, but two charts still had inadequate luminance uniformity. Tablet computers showed less inter-device variability, higher contrast, and better luminance uniformity than charts in both lights-on and lights-off environments, providing brightness setting was >50%. Overall, iPad tablets matched or marginally out-performed ETDRS charts in terms of photometric compliance with high contrast acuity standards. PMID:27002333

  5. Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims.

    PubMed

    Chastek, Benjamin J; Oleen-Burkey, Merrikay; Lopez-Bresnahan, Maria V

    2010-01-01

    Relapse is a common measure of disease activity in relapsing-remitting multiple sclerosis (MS). The objective of this study was to test the content validity of an operational algorithm for detecting relapse in claims data. A claims-based relapse detection algorithm was tested by comparing its detection rate over a 1-year period with relapses identified based on medical chart review. According to the algorithm, MS patients in a US healthcare claims database who had either (1) a primary claim for MS during hospitalization or (2) a corticosteroid claim following a MS-related outpatient visit were designated as having a relapse. Patient charts were examined for explicit indication of relapse or care suggestive of relapse. Positive and negative predictive values were calculated. Medical charts were reviewed for 300 MS patients, half of whom had a relapse according to the algorithm. The claims-based criteria correctly classified 67.3% of patients with relapses (positive predictive value) and 70.0% of patients without relapses (negative predictive value; kappa 0.373: p < 0.001). Alternative algorithms did not improve on the predictive value of the operational algorithm. Limitations of the algorithm include lack of differentiation between relapsing-remitting MS and other types, and that it does not incorporate measures of function and disability. The claims-based algorithm appeared to successfully detect moderate-to-severe MS relapse. This validated definition can be applied to future claims-based MS studies.

  6. Comparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial.

    PubMed

    Stengel, Dirk; Bauwens, Kai; Walter, Martin; Köpfer, Thilo; Ekkernkamp, Axel

    2004-03-01

    Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. A series of consecutive patients who were admitted for the first time to a thirty-six-bed orthopaedic ward of an academic teaching hospital for a planned operation or any other treatment of an acute injury or chronic condition were randomized to daily documentation of their clinical charts on a handheld computer or on conventional paper forms. The electronic documentation consisted of a specially designed software package on a handheld computer for bedside use with structured decision trees for examination, obtaining a history, and coding. In the control arm, chart notes were compiled on standard paper forms and were subsequently entered into the hospital's information system. The number of documented ICD (International Classification of Diseases) diagnoses was the primary end point for sample size calculations. All patient charts were reread by an expert panel consisting of two surgeons and the surgical quality assurance manager. These experts assigned quality ratings to the different documentation systems by scrutinizing the extent and accuracy of the patient histories and the physical findings as assessed by daily chart notes. Eighty patients were randomized to one of the two documentation arms, and seventy-eight (forty-seven men and thirty-one women) of them were eligible for final analysis. Documentation with the handheld computer increased the median number of diagnoses per patients from four to nine (p < 0.0001), but it produced some overcoding for false or redundant items. Documentation quality ratings improved significantly with the introduction of the handheld device (p < 0.01) with respect to the correct assessment of a patient's progress and translation into ICD diagnoses. Various learning curve effects were observed with different operators. Study physicians assigned slightly better practicability ratings to the handheld device. The preliminary data from this study suggest that handheld computers may improve the quality of hospital charts in orthopaedic surgery. Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.

  7. Environmental corrections of a dual-induction logging while drilling tool in vertical wells

    NASA Astrophysics Data System (ADS)

    Kang, Zhengming; Ke, Shizhen; Jiang, Ming; Yin, Chengfang; Li, Anzong; Li, Junjian

    2018-04-01

    With the development of Logging While Drilling (LWD) technology, dual-induction LWD logging is not only widely applied in deviated wells and horizontal wells, but it is used commonly in vertical wells. Accordingly, it is necessary to simulate the response of LWD tools in vertical wells for logging interpretation. In this paper, the investigation characteristics, the effects of the tool structure, skin effect and drilling environment of a dual-induction LWD tool are simulated by the three-dimensional (3D) finite element method (FEM). In order to closely simulate the actual situation, real structure of the tool is taking into account. The results demonstrate that the influence of the background value of the tool structure can be eliminated. The values of deducting the background of a tool structure and analytical solution have a quantitative agreement in homogeneous formations. The effect of measurement frequency could be effectively eliminated by chart of skin effect correction. In addition, the measurement environment, borehole size, mud resistivity, shoulder bed, layer thickness and invasion, have an effect on the true resistivity. To eliminate these effects, borehole correction charts, shoulder bed correction charts and tornado charts are computed based on real tool structure. Based on correction charts, well logging data can be corrected automatically by a suitable interpolation method, which is convenient and fast. Verified with actual logging data in vertical wells, this method could obtain the true resistivity of formation.

  8. The spectra program library: A PC based system for gamma-ray spectra analysis and INAA data reduction

    USGS Publications Warehouse

    Baedecker, P.A.; Grossman, J.N.

    1995-01-01

    A PC based system has been developed for the analysis of gamma-ray spectra and for the complete reduction of data from INAA experiments, including software to average the results from mulitple lines and multiple countings and to produce a final report of analysis. Graphics algorithms may be called for the analysis of complex spectral features, to compare the data from alternate photopeaks and to evaluate detector performance during a given counting cycle. A database of results for control samples can be used to prepare quality control charts to evaluate long term precision and to search for systemic variations in data on reference samples as a function of time. The entire software library can be accessed through a user-friendly menu interface with internal help.

  9. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walz-Flannigan, A; Lucas, J; Buchanan, K

    Purpose: Manual technique selection in radiography is needed for imaging situations where there is difficulty in proper positioning for AEC, prosthesis, for non-bucky imaging, or for guiding image repeats. Basic information about how to provide consistent image signal and contrast for various kV and tissue thickness is needed to create manual technique charts, and relevant for physicists involved in technique chart optimization. Guidance on technique combinations and rules-of-thumb to provide consistent image signal still in use today are based on measurements with optical density of screen-film combinations and older generation x-ray systems. Tools such as a kV-scale chart can bemore » useful to know how to modify mAs when kV is changed in order to maintain consistent image receptor signal level. We evaluate these tools for modern equipment for use in optimizing proper size scaled techniques. Methods: We used a water phantom to measure calibrated signal change for CR and DR (with grid) for various beam energies. Tube current values were calculated that would yield a consistent image signal response. Data was fit to provide sufficient granularity of detail to compose technique-scale chart. Tissue thickness approximated equivalence to 80% of water depth. Results: We created updated technique-scale charts, providing mAs and kV combinations to achieve consistent signal for CR and DR for various tissue equivalent thicknesses. We show how this information can be used to create properly scaled size-based manual technique charts. Conclusion: Relative scaling of mAs and kV for constant signal (i.e. the shape of the curve) appears substantially similar between film-screen and CR/DR. This supports the notion that image receptor related differences are minor factors for relative (not absolute) changes in mAs with varying kV. However, as demonstrated creation of these difficult to find detailed technique-scales are useful tools for manual chart optimization.« less

  10. Reiki as a pain management adjunct in screening colonoscopy.

    PubMed

    Bourque, Alda L; Sullivan, Mary E; Winter, Michael R

    2012-09-01

    The purpose of this study was to determine whether the use of Reiki decreases the amount of meperidine administered to patients undergoing screening colonoscopy. The literature review reveals limited studies to show whether Reiki has been able to decrease the amount of opioid the patient receives during screening colonoscopy. A chart review of 300 patients was conducted to obtain baseline average doses of meperidine patients received as the control. Following the chart review, 30 patients were recruited to the Reiki study. Twenty-five of the study arm patients received Reiki in conjunction with meperidine. Five randomly chosen study arm patients received placebo Reiki in conjunction with meperidine in an attempt to blind the clinicians to the treatment received by the patients. Results showed that there were no significant differences in meperidine administration between the patients in the chart review group (control) and the Reiki group. The study revealed that 16% who received Reiki, together with intravenous administration of conscious sedation, received less than 50 mg of meperidine. All the patients in the chart review group received more than 50 mg of meperidine. Results from this pilot study suggest that there may be a decrease in meperidine needed during screening colonoscopy when patients receive Reiki treatments before the procedure. A larger study powered to detect smaller medication differences is the next step in more accurately determining the effect of Reiki on pain management.

  11. Cumulative sum control charts for monitoring geometrically inflated Poisson processes: An application to infectious disease counts data.

    PubMed

    Rakitzis, Athanasios C; Castagliola, Philippe; Maravelakis, Petros E

    2018-02-01

    In this work, we study upper-sided cumulative sum control charts that are suitable for monitoring geometrically inflated Poisson processes. We assume that a process is properly described by a two-parameter extension of the zero-inflated Poisson distribution, which can be used for modeling count data with an excessive number of zero and non-zero values. Two different upper-sided cumulative sum-type schemes are considered, both suitable for the detection of increasing shifts in the average of the process. Aspects of their statistical design are discussed and their performance is compared under various out-of-control situations. Changes in both parameters of the process are considered. Finally, the monitoring of the monthly cases of poliomyelitis in the USA is given as an illustrative example.

  12. 40 CFR 49.4165 - Control equipment requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., except for § 60.18(c)(2) and (f)(2) for those utility flares operated with an electronically controlled...) Equipped with one of the following: (A) A continuous burning pilot flame. (B) An electronically controlled... electronically controlled automatic igniter, such as a chart recorder, data logger or similar devices; (vi...

  13. 40 CFR 49.4165 - Control equipment requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., except for § 60.18(c)(2) and (f)(2) for those utility flares operated with an electronically controlled...) Equipped with one of the following: (A) A continuous burning pilot flame. (B) An electronically controlled... electronically controlled automatic igniter, such as a chart recorder, data logger or similar devices; (vi...

  14. Flow Charts: Visualization of Vector Fields on Arbitrary Surfaces

    PubMed Central

    Li, Guo-Shi; Tricoche, Xavier; Weiskopf, Daniel; Hansen, Charles

    2009-01-01

    We introduce a novel flow visualization method called Flow Charts, which uses a texture atlas approach for the visualization of flows defined over curved surfaces. In this scheme, the surface and its associated flow are segmented into overlapping patches, which are then parameterized and packed in the texture domain. This scheme allows accurate particle advection across multiple charts in the texture domain, providing a flexible framework that supports various flow visualization techniques. The use of surface parameterization enables flow visualization techniques requiring the global view of the surface over long time spans, such as Unsteady Flow LIC (UFLIC), particle-based Unsteady Flow Advection Convolution (UFAC), or dye advection. It also prevents visual artifacts normally associated with view-dependent methods. Represented as textures, Flow Charts can be naturally integrated into hardware accelerated flow visualization techniques for interactive performance. PMID:18599918

  15. Simple circular odor chart for characterization of trace amounts of odorants discharged from thirteen odor sources

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hoshika, Y.; Nihei, Y.; Muto, G.

    1981-04-01

    A simple circular odor chart is proposed for the explanation of the relationship between sensory responses (to odor quality and intensity) to odors and chemical analysis data of the odorants responsible for each odor discharged from thirteen odor sources. The odorants were classified into eight odorant groups and were analyzed by a systematic gas chromatographic (GC) technique. The characterization of the trace amounts of the odorants was carried out by using the values of a new proposed unit (pOU) based on the ratio of detected concentration to recognition threshold value. The calculated pOU values of the eight groups were plottedmore » in circular charts. It was found that the shape and size of each circular odor chart represent the quality and the intensity of each odor.« less

  16. Does a Claims Diagnosis of Autism Mean a True Case?

    ERIC Educational Resources Information Center

    Burke, James P.; Jain, Anjali; Yang, Wenya; Kelly, Jonathan P.; Kaiser, Marygrace; Becker, Laura; Lawer, Lindsay; Newschaffer, Craig J.

    2014-01-01

    The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis…

  17. Comparison of WHO and CDC growth charts in predicting pulmonary outcomes in cystic fibrosis.

    PubMed

    Machogu, Evans; Cao, Yumei; Miller, Tami; Simpson, Pippa; Levy, Hara; Quintero, Diana; Goday, Praveen S

    2015-03-01

    The relation of weight-for-length (WFL) and weight-for-age (WFA) measurements with pulmonary function in patients with cystic fibrosis (CF) using the World Health Organization (WHO) growth standards has not been evaluated. The objective of the present study was to show that the relation of WFL and WFA measurements at 2 years with forced expiratory volume in 1 second (FEV1) at 6 to 8 years differs when using the WHO versus the Centers for Disease Control and Prevention (CDC) growth charts. We assessed 1155 patients in the CF Foundation Patient Registry born between 2001 and 2004. Comparisons were made between the CDC and WHO growth charts. The WFL percentiles are significantly higher for the WHO growth standards compared with those for the CDC growth charts (median and interquartile range [IQR] WHO--64.8 [41.7-84.9], CDC--48.1 [23.7-75.7], P < 0.0001). WFL and WFA percentiles at 2 years on both charts are strongly associated with FEV1 at 6 to 8 years of age. The FEV1 at 6 to 8 years was statistically significantly lower for children who were classified as reaching a WFL ≥ 50 th percentile at 2 years by WHO standards alone versus those who qualified by both growth charts (median and IQR 103 [94-115] vs 107 [96-117], P < 0.05). Continued weight gain between 2 and 6 years was associated with a higher lung function at age 6 to 8 years. Although children attaining the 50th WFL percentile on the WHO growth chart by age 2 years have a lower FEV1 at 6 years than children attaining the same percentile on the CDC chart, both groups of children attain clinically normal FEV1. Further studies are needed to determine whether this difference is clinically meaningful.

  18. Synthesizing 3D Surfaces from Parameterized Strip Charts

    NASA Technical Reports Server (NTRS)

    Robinson, Peter I.; Gomez, Julian; Morehouse, Michael; Gawdiak, Yuri

    2004-01-01

    We believe 3D information visualization has the power to unlock new levels of productivity in the monitoring and control of complex processes. Our goal is to provide visual methods to allow for rapid human insight into systems consisting of thousands to millions of parameters. We explore this hypothesis in two complex domains: NASA program management and NASA International Space Station (ISS) spacecraft computer operations. We seek to extend a common form of visualization called the strip chart from 2D to 3D. A strip chart can display the time series progression of a parameter and allows for trends and events to be identified. Strip charts can be overlayed when multiple parameters need to visualized in order to correlate their events. When many parameters are involved, the direct overlaying of strip charts can become confusing and may not fully utilize the graphing area to convey the relationships between the parameters. We provide a solution to this problem by generating 3D surfaces from parameterized strip charts. The 3D surface utilizes significantly more screen area to illustrate the differences in the parameters and the overlayed strip charts, and it can rapidly be scanned by humans to gain insight. The selection of the third dimension must be a parallel or parameterized homogenous resource in the target domain, defined using a finite, ordered, enumerated type, and not a heterogeneous type. We demonstrate our concepts with examples from the NASA program management domain (assessing the state of many plans) and the computers of the ISS (assessing the state of many computers). We identify 2D strip charts in each domain and show how to construct the corresponding 3D surfaces. The user can navigate the surface, zooming in on regions of interest, setting a mark and drilling down to source documents from which the data points have been derived. We close by discussing design issues, related work, and implementation challenges.

  19. A programmable controller based on CAN field bus embedded microprocessor and FPGA

    NASA Astrophysics Data System (ADS)

    Cai, Qizhong; Guo, Yifeng; Chen, Wenhei; Wang, Mingtao

    2008-10-01

    One kind of new programmable controller(PLC) is introduced in this paper. The advanced embedded microprocessor and Field-Programmable Gate Array (FPGA) device are applied in the PLC system. The PLC system structure was presented in this paper. It includes 32 bits Advanced RISC Machines (ARM) embedded microprocessor as control core, FPGA as control arithmetic coprocessor and CAN bus as data communication criteria protocol connected the host controller and its various extension modules. It is detailed given that the circuits and working principle, IiO interface circuit between ARM and FPGA and interface circuit between ARM and FPGA coprocessor. Furthermore the interface circuit diagrams between various modules are written. In addition, it is introduced that ladder chart program how to control the transfer info of control arithmetic part in FPGA coprocessor. The PLC, through nearly two months of operation to meet the design of the basic requirements.

  20. Desktop publishing and validation of custom near visual acuity charts.

    PubMed

    Marran, Lynn; Liu, Lei; Lau, George

    2008-11-01

    Customized visual acuity (VA) assessment is an important part of basic and clinical vision research. Desktop computer based distance VA measurements have been utilized, and shown to be accurate and reliable, but computer based near VA measurements have not been attempted, mainly due to the limited spatial resolution of computer monitors. In this paper, we demonstrate how to use desktop publishing to create printed custom near VA charts. We created a set of six near VA charts in a logarithmic progression, 20/20 through 20/63, with multiple lines of the same acuity level, different letter arrangements in each line and a random noise background. This design allowed repeated measures of subjective accommodative amplitude without the potential artifact of familiarity of the optotypes. The background maintained a constant and spatial frequency rich peripheral stimulus for accommodation across the six different acuity levels. The paper describes in detail how pixel-wise accurate black and white bitmaps of Sloan optotypes were used to create the printed custom VA charts. At all acuity levels, the physical sizes of the printed custom optotypes deviated no more than 0.034 log units from that of the standard, satisfying the 0.05 log unit ISO criterion we used to demonstrate physical equivalence. Also, at all acuity levels, log unit differences in the mean target distance for which reliable recognition of letters first occurred for the printed custom optotypes compared to the standard were found to be below 0.05, satisfying the 0.05 log unit ISO criterion we used to demonstrate functional equivalence. It is possible to use desktop publishing to create custom near VA charts that are physically and functionally equivalent to standard VA charts produced by a commercial printing process.

  1. Multilevel lumbar fusion and postoperative physiotherapy rehabilitation in a patient with persistent pain.

    PubMed

    Pons, Tracey; Shipton, Edward A

    2011-04-01

    There are no comparative randomised controlled trials of physiotherapy modalities for chronic low back and radicular pain associated with multilevel fusion. Physiotherapy-based rehabilitation to control pain and improve activation levels for persistent pain following multilevel fusion can be challenging. This is a case report of a 68-year-old man who was referred for physiotherapy intervention 10 months after a multilevel spinal fusion for spinal stenosis. He reported high levels of persistent postoperative pain with minimal activity as a consequence of his pain following the surgery. The physiotherapy interventions consisted of three phases of rehabilitation starting with pool exercise that progressed to land-based walking. These were all combined with transcutaneous electrical nerve stimulation (TENS) that was used consistently for up to 8 hours per day. As outcome measures, daily pain levels and walking distances were charted once the pool programme was completed (in the third phase). Phase progression was determined by shuttle test results. The pain level was correlated with the distance walked using linear regression over a 5-day average. Over a 5-day moving average, the pain level reduced and walking distance increased. The chart of recorded pain level and walking distance showed a trend toward decreased pain with the increased distance walked. In a patient undergoing multilevel lumbar fusion, the combined use of TENS and a progressive walking programme (from pool to land) reduced pain and increased walking distance. This improvement was despite poor medication compliance and a reported high level of postsurgical pain.

  2. Quality of Life in Patients with Neurocysticercosis in Mexico

    PubMed Central

    Bhattarai, Rachana; Budke, Christine M.; Carabin, Hélène; Proaño, Jefferson V.; Flores-Rivera, Jose; Corona, Teresa; Cowan, Linda D.; Ivanek, Renata; Snowden, Karen F.; Flisser, Ana

    2011-01-01

    The objective of this study was to compare quality of life measures in patients with neurocysticercosis (NCC) to those of a matched control group. The NCC outpatients and their controls were recruited from two neurology referral hospitals in Mexico City, Mexico during 2007–2008. The quality of life of 224 NCC patients was compared with 224 age-sex-hospital-day matched controls using the short form 12 v2 (SF-12 v2) quality of life survey. Medical chart reviews were also conducted for the NCC outpatients to evaluate presenting clinical manifestations. Compared with the controls, NCC patients had a significantly lower score for each of the eight domains of health evaluated and significantly lower Physical and Mental Component Summary scores. Chart reviews indicated that hydrocephalus (48%), severe headaches (47%), and epilepsy (31%) were the most common clinical manifestations in these NCC outpatients. PMID:21540389

  3. A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gerard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent

    The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center ({+-}4% of deviation between the calculated and measured doses) by calculatingmore » a control process capability (C{sub pc}) index. The C{sub pc} index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should improve the security of treatments. They also showed that the dose delivery processes in the cancer center were in control for prostate and head-and-neck treatments. In parallel, long term process performance indices (P{sub p}, P{sub pk}, and P{sub pm}) have been analyzed. Their analysis helped defining which actions should be undertaken in order to improve the performance of the process. The prostate dose delivery process has been shown statistically capable (0.08% of the results is expected to be outside the clinical tolerances) contrary to the head-and-neck dose delivery process (5.76% of the results are expected to be outside the clinical tolerances).« less

  4. A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC).

    PubMed

    Gérard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent; Kafrouni, Hanna; Husson, François; Aletti, Pierre

    2009-04-01

    The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short-term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center (+/- 4% of deviation between the calculated and measured doses) by calculating a control process capability (C(pc)) index. The C(pc) index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short-term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should improve the security of treatments. They also showed that the dose delivery processes in the cancer center were in control for prostate and head-and-neck treatments. In parallel, long-term process performance indices (P(p), P(pk), and P(pm)) have been analyzed. Their analysis helped defining which actions should be undertaken in order to improve the performance of the process. The prostate dose delivery process has been shown statistically capable (0.08% of the results is expected to be outside the clinical tolerances) contrary to the head-and-neck dose delivery process (5.76% of the results are expected to be outside the clinical tolerances).

  5. Validity of Administrative Data in Identifying Cancer-related Events in Adolescents and Young Adults: A Population-based Study Using the IMPACT Cohort.

    PubMed

    Gupta, Sumit; Nathan, Paul C; Baxter, Nancy N; Lau, Cindy; Daly, Corinne; Pole, Jason D

    2018-06-01

    Despite the importance of estimating population level cancer outcomes, most registries do not collect critical events such as relapse. Attempts to use health administrative data to identify these events have focused on older adults and have been mostly unsuccessful. We developed and tested administrative data-based algorithms in a population-based cohort of adolescents and young adults with cancer. We identified all Ontario adolescents and young adults 15-21 years old diagnosed with leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012. Chart abstraction determined the end of initial treatment (EOIT) date and subsequent cancer-related events (progression, relapse, second cancer). Linkage to population-based administrative databases identified fee and procedure codes indicating cancer treatment or palliative care. Algorithms determining EOIT based on a time interval free of treatment-associated codes, and new cancer-related events based on billing codes, were compared with chart-abstracted data. The cohort comprised 1404 patients. Time periods free of treatment-associated codes did not validly identify EOIT dates; using subsequent codes to identify new cancer events was thus associated with low sensitivity (56.2%). However, using administrative data codes that occurred after the EOIT date based on chart abstraction, the first cancer-related event was identified with excellent validity (sensitivity, 87.0%; specificity, 93.3%; positive predictive value, 81.5%; negative predictive value, 95.5%). Although administrative data alone did not validly identify cancer-related events, administrative data in combination with chart collected EOIT dates was associated with excellent validity. The collection of EOIT dates by cancer registries would significantly expand the potential of administrative data linkage to assess cancer outcomes.

  6. Comparing Subscription-Based Anatomy E-Resources for Collections Development.

    PubMed

    McClurg, Caitlin; Stieda, Vivian; Talsma, Nicole

    2015-01-01

    This article describes a chart-based approach for health sciences libraries to compare anatomy e-resources. The features, functionalities, and user experiences of seven leading subscription-based e-resources were assessed using a chart that was iteratively developed by the investigators. Acland's Video Atlas of Human Anatomy, Thieme Winking Skull, and Visible Body were the preferred products as they respectively excel in cadaver-based videos, self-assessment, and 3D graphical manipulation. Moreover, each product affords a pleasant user experience. The investigative team found that resources specializing in one aspect of anatomy teaching are superior to those that contain a wealth of content for diverse audiences.

  7. Computer graphics for management: An abstract of capabilities and applications of the EIS system

    NASA Technical Reports Server (NTRS)

    Solem, B. J.

    1975-01-01

    The Executive Information Services (EIS) system, developed as a computer-based, time-sharing tool for making and implementing management decisions, and including computer graphics capabilities, was described. The following resources are available through the EIS languages: centralized corporate/gov't data base, customized and working data bases, report writing, general computational capability, specialized routines, modeling/programming capability, and graphics. Nearly all EIS graphs can be created by a single, on-line instruction. A large number of options are available, such as selection of graphic form, line control, shading, placement on the page, multiple images on a page, control of scaling and labeling, plotting of cum data sets, optical grid lines, and stack charts. The following are examples of areas in which the EIS system may be used: research, estimating services, planning, budgeting, and performance measurement, national computer hook-up negotiations.

  8. Charts for weight loss to detect hypernatremic dehydration and prevent formula supplementing.

    PubMed

    van Dommelen, Paula; Boer, Suzanne; Unal, Sevim; van Wouwe, Jacobus P

    2014-06-01

    Most breast-fed newborns get the milk they need. However, very rarely milk intake is insufficient mostly as a result of poor breastfeeding techniques. Dramatic weight loss and hypernatremic dehydration may occur. Our aim was to construct charts for weight loss. A case-control study was performed. Charts with standard deviation score (SDS) lines for weight loss in the first month were constructed for 2,359 healthy breast-fed term newborns and 271 cases with breastfeeding-associated hypernatremic dehydration with serum sodium level > 149 mEq/L. Day 0 was defined as the day of birth. Many cases with (or who will develop) hypernatremic dehydration (84%; +1 SDS line) fell below the -1 SDS line at day 3, the -2 SDS line at day 4, and the -2.5 SDS line at day 5 in the chart of the healthy breast-fed newborns. Weight loss of cases with permanent residual symptoms was far below the -2.5 SDS. Already at an early age, weight loss differs between healthy breast-fed newborns and those with hypernatremic dehydration. Charts for weight loss are, therefore, useful tools to detect early, or prevent newborns from developing, breastfeeding-associated hypernatremic dehydration, and also to prevent unnecessary formula supplementing. © 2014 Wiley Periodicals, Inc.

  9. Time-saving impact of an algorithm to identify potential surgical site infections.

    PubMed

    Knepper, B C; Young, H; Jenkins, T C; Price, C S

    2013-10-01

    To develop and validate a partially automated algorithm to identify surgical site infections (SSIs) using commonly available electronic data to reduce manual chart review. Retrospective cohort study of patients undergoing specific surgical procedures over a 4-year period from 2007 through 2010 (algorithm development cohort) or over a 3-month period from January 2011 through March 2011 (algorithm validation cohort). A single academic safety-net hospital in a major metropolitan area. Patients undergoing at least 1 included surgical procedure during the study period. Procedures were identified in the National Healthcare Safety Network; SSIs were identified by manual chart review. Commonly available electronic data, including microbiologic, laboratory, and administrative data, were identified via a clinical data warehouse. Algorithms using combinations of these electronic variables were constructed and assessed for their ability to identify SSIs and reduce chart review. The most efficient algorithm identified in the development cohort combined microbiologic data with postoperative procedure and diagnosis codes. This algorithm resulted in 100% sensitivity and 85% specificity. Time savings from the algorithm was almost 600 person-hours of chart review. The algorithm demonstrated similar sensitivity on application to the validation cohort. A partially automated algorithm to identify potential SSIs was highly sensitive and dramatically reduced the amount of manual chart review required of infection control personnel during SSI surveillance.

  10. Initial review of Electronic Residency Application Service charts by orthopaedic residency faculty members. Does applicant gender matter?

    PubMed

    Scherl, S A; Lively, N; Simon, M A

    2001-01-01

    Orthopaedic surgery is a male-dominated field. As of 1998, women accounted for 42% of medical school graduates, yet only 6.9% of the total number of orthopaedic residents were female. The purpose of our study was to determine whether the Electronic Residency Application Service charts of female candidates for orthopaedic residencies are ranked lower by faculty reviewers than are those of male candidates with similar qualifications. After we obtained permission from the applicants, the Electronic Residency Application Service applications submitted by ninety male and ten female candidates for admission to a university orthopaedic residency program for the 1998 National Residency Matching Program were randomly divided into ten groups, consisting of the charts of nine male candidates and one female candidate. Each chart from a female candidate was altered into a "male" version, in which all names and personal pronouns were changed but which was otherwise identical to the original female version. Therefore, each group of ten charts existed as a paired set: one containing the true female chart and one, the altered "male" chart. The paired sets acted as their own control. One hundred and twenty-one faculty reviewers from fourteen orthopaedic residency programs around the United States each reviewed either the "male" or the female version of one set, without knowledge of the goals of the study, and ranked the ten charts in the order in which they would like to have the candidates as residents in their own programs. Each version of the sets was reviewed by at least five separate reviewers. Reviewers at a given institution were randomized to review different sets, so that there was no overlap among them. The rankings of the female-"male" pairs were compared with use of a standard paired t test. No significant difference was detected in the rankings of the female and "male" charts (p = 0.5). The mean difference in rankings was -0.33, with a 95% confidence interval ranging from -1.41 (favoring females) to 0.74 (favoring "males"). The low percentage of female residents is not due to bias against female applicants in the initial chart-review phase of the orthopaedic residency selection process. It is possible that bias is introduced in other stages of the selection process, such as the interview.

  11. Ten tools of continuous quality improvement: a review and case example of hospital discharge.

    PubMed

    Ziegenfuss, J T; McKenna, C K

    1995-01-01

    Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

  12. The International Bathymetric Chart of the Southern Ocean (IBCSO) Version 1.0 - A new bathymetric compilation covering circum-Antarctic waters

    NASA Astrophysics Data System (ADS)

    Arndt, Jan Erik; Schenke, Hans Werner; Jakobsson, Martin; Nitsche, Frank O.; Buys, Gwen; Goleby, Bruce; Rebesco, Michele; Bohoyo, Fernando; Hong, Jongkuk; Black, Jenny; Greku, Rudolf; Udintsev, Gleb; Barrios, Felipe; Reynoso-Peralta, Walter; Taisei, Morishita; Wigley, Rochelle

    2013-06-01

    International Bathymetric Chart of the Southern Ocean (IBCSO) Version 1.0 is a new digital bathymetric model (DBM) portraying the seafloor of the circum-Antarctic waters south of 60°S. IBCSO is a regional mapping project of the General Bathymetric Chart of the Oceans (GEBCO). The IBCSO Version 1.0 DBM has been compiled from all available bathymetric data collectively gathered by more than 30 institutions from 15 countries. These data include multibeam and single-beam echo soundings, digitized depths from nautical charts, regional bathymetric gridded compilations, and predicted bathymetry. Specific gridding techniques were applied to compile the DBM from the bathymetric data of different origin, spatial distribution, resolution, and quality. The IBCSO Version 1.0 DBM has a resolution of 500 × 500 m, based on a polar stereographic projection, and is publicly available together with a digital chart for printing from the project website (www.ibcso.org) and at http://dx.doi.org/10.1594/PANGAEA.805736.

  13. Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

    PubMed

    Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care facilities. The accuracy and safety of these systems has not been studied. What does this paper add? The present study identified discrepancies between general practitioners' orders and pharmacy-prepared electronic medication administration charts, back-up paper medication charts and dose-administration aids, as well as delays between ordering, charting and administering medicines. Discrepancies and delays sometimes led to medication administration errors. What are the implications for practitioners? Facilities that use hybrid systems need to implement robust systems for communicating medication changes to their pharmacy and reconciling prescribers' orders against pharmacy-generated medication charts and dose-administration aids. Fully integrated, paperless medication management systems, in which prescribers' electronic medication orders directly populate an electronic medication administration chart and are automatically communicated to the facility's pharmacy, could improve patient safety.

  14. A Multicenter Collaborative to Improve Care of Community Acquired Pneumonia in Hospitalized Children.

    PubMed

    Parikh, Kavita; Biondi, Eric; Nazif, Joanne; Wasif, Faiza; Williams, Derek J; Nichols, Elizabeth; Ralston, Shawn

    2017-03-01

    The Value in Inpatient Pediatrics Network sponsored the Improving Care in Community Acquired Pneumonia collaborative with the goal of increasing evidence-based management of children hospitalized with community acquired pneumonia (CAP). Project aims included: increasing use of narrow-spectrum antibiotics, decreasing use of macrolides, and decreasing concurrent treatment of pneumonia and asthma. Data were collected through chart review across emergency department (ED), inpatient, and discharge settings. Sites reviewed up to 20 charts in each of 6 3-month cycles. Analysis of means with 3-σ control limits was the primary method of assessment for change. The expert panel developed project measures, goals, and interventions. A change package of evidence-based tools to promote judicious use of antibiotics and raise awareness of asthma and pneumonia codiagnosis was disseminated through webinars. Peer coaching and periodic benchmarking were used to motivate change. Fifty-three hospitals enrolled and 48 (91%) completed the 1-year project (July 2014-June 2015). A total of 3802 charts were reviewed for the project; 1842 during baseline cycles and 1960 during postintervention cycles. The median before and after use of narrow-spectrum antibiotics in the collaborative increased by 67% in the ED, 43% in the inpatient setting, and 25% at discharge. Median before and after use of macrolides decreased by 22% in the ED and 27% in the inpatient setting. A decrease in asthma and CAP codiagnosis was noted, but the change was not sustained. Low-cost strategies, including collaborative sharing, peer benchmarking, and coaching, increased judicious use of antibiotics in a diverse range of hospitals for pediatric CAP. Copyright © 2017 by the American Academy of Pediatrics.

  15. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Quality and Reliability Date

    NASA Technical Reports Server (NTRS)

    Orr, James K.; Peltier, Daryl

    2010-01-01

    Thsi slide presentation reviews the avionics software system on board the space shuttle, with particular emphasis on the quality and reliability. The Primary Avionics Software System (PASS) provides automatic and fly-by-wire control of critical shuttle systems which executes in redundant computers. Charts given show the number of space shuttle flights vs time, PASS's development history, and other charts that point to the reliability of the system's development. The reliability of the system is also compared to predicted reliability.

  16. A model for preemptive maintenance of medical linear accelerators-predictive maintenance.

    PubMed

    Able, Charles M; Baydush, Alan H; Nguyen, Callistus; Gersh, Jacob; Ndlovu, Alois; Rebo, Igor; Booth, Jeremy; Perez, Mario; Sintay, Benjamin; Munley, Michael T

    2016-03-10

    Unscheduled accelerator downtime can negatively impact the quality of life of patients during their struggle against cancer. Currently digital data accumulated in the accelerator system is not being exploited in a systematic manner to assist in more efficient deployment of service engineering resources. The purpose of this study is to develop an effective process for detecting unexpected deviations in accelerator system operating parameters and/or performance that predicts component failure or system dysfunction and allows maintenance to be performed prior to the actuation of interlocks. The proposed predictive maintenance (PdM) model is as follows: 1) deliver a daily quality assurance (QA) treatment; 2) automatically transfer and interrogate the resulting log files; 3) once baselines are established, subject daily operating and performance values to statistical process control (SPC) analysis; 4) determine if any alarms have been triggered; and 5) alert facility and system service engineers. A robust volumetric modulated arc QA treatment is delivered to establish mean operating values and perform continuous sampling and monitoring using SPC methodology. Chart limits are calculated using a hybrid technique that includes the use of the standard SPC 3σ limits and an empirical factor based on the parameter/system specification. There are 7 accelerators currently under active surveillance. Currently 45 parameters plus each MLC leaf (120) are analyzed using Individual and Moving Range (I/MR) charts. The initial warning and alarm rule is as follows: warning (2 out of 3 consecutive values ≥ 2σ hybrid) and alarm (2 out of 3 consecutive values or 3 out of 5 consecutive values ≥ 3σ hybrid). A customized graphical user interface provides a means to review the SPC charts for each parameter and a visual color code to alert the reviewer of parameter status. Forty-five synthetic errors/changes were introduced to test the effectiveness of our initial chart limits. Forty-three of the forty-five errors (95.6 %) were detected in either the I or MR chart for each of the subsystems monitored. Our PdM model shows promise in providing a means for reducing unscheduled downtime. Long term monitoring will be required to establish the effectiveness of the model.

  17. Development and testing of an automated computer tablet-based method for self-testing of high and low contrast near visual acuity in ophthalmic patients.

    PubMed

    Aslam, Tariq M; Parry, Neil R A; Murray, Ian J; Salleh, Mahani; Col, Caterina Dal; Mirza, Naznin; Czanner, Gabriela; Tahir, Humza J

    2016-05-01

    Many eye diseases require on-going assessment for optimal management, creating an ever-increasing burden on patients and hospitals that could potentially be reduced through home vision monitoring. However, there is limited evidence for the utility of current applications and devices for this. To address this, we present a new automated, computer tablet-based method for self-testing near visual acuity (VA) for both high and low contrast targets. We report on its reliability and agreement with gold standard measures. The Mobile Assessment of Vision by intERactIve Computer (MAVERIC) system consists of a calibrated computer tablet housed in a bespoke viewing chamber. Purpose-built software automatically elicits touch-screen responses from subjects to measure their near VA for either low or high contrast acuity. Near high contrast acuity was measured using both the MAVERIC system and a near Landolt C chart in one eye for 81 patients and low contrast acuity using the MAVERIC system and a 25 % contrast near EDTRS chart in one eye of a separate 95 patients. The MAVERIC near acuity was also retested after 20 min to evaluate repeatability. Repeatability of both high and low contrast MAVERIC acuity measures, and their agreement with the chart tests, was assessed using the Bland-Altman comparison method. One hundred and seventy-three patients (96 %) completed the self- testing MAVERIC system without formal assistance. The resulting MAVERIC vision demonstrated good repeatability and good agreement with the gold-standard near chart measures. This study demonstrates the potential utility of the MAVERIC system for patients with ophthalmic disease to self-test their high and low contrast VA. The technique has a high degree of reliability and agreement with gold standard chart based measurements.

  18. Prescribe for health. Improving cancer screening in physician practices serving low-income and minority populations.

    PubMed

    Manfredi, C; Czaja, R; Freels, S; Trubitt, M; Warnecke, R; Lacey, L

    1998-01-01

    To evaluate a health maintenance organization (HMO)-sponsored intervention to improve cancer screening in private physician practices serving low-income, minority populations. A randomized controlled trial with preintervention and postintervention measurements. Measurements were obtained by abstracting information from independent random samples of medical charts (N = 2316 at preintervention and 2238 at postintervention). Forty-seven primary care physician practices located in low-income and minority urban neighborhoods in Chicago, Ill. Practices were encouraged to adopt an office chart reminder system and to use a patient health maintenance card. Activities to facilitate the adoption of these items and for compliance with cancer screening guidelines included on-site training and start-up assistance visits, a physician continuing medical education seminar, and quality assurance visits with feedback to physicians. The proportions of patients with a chart-documented mammogram, clinical breast examination, Papanicolaou smear, or fecal occult blood slide test in the 2 years before preintervention and postintervention chart abstractions. Between baseline and postintervention, there was a net increase in the proportion of HMO members in the intervention, compared with the control practices, who received in the preceding 2 years a Papanicolaou smear (11.9%) and a fecal occult blood slide test (14.1%). There was a net increase in the proportion of non-HMO patients in the intervention compared with the control practices who received a clinical breast examination (15.3%) and a fecal occult blood slide test (20.2%). Implementation of an HMO-mediated, multicomponent intervention to improve cancer screening was feasible and effective for the Papanicolaou smear, fecal occult blood slide test, and the clinical breast examination, but not for mammography.

  19. Operational Control Procedures for the Activated Sludge Process: Appendix.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This document is the appendix for a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. Categories discussed include: control test data, trend charts, moving averages, semi-logarithmic plots, probability…

  20. [Monitoring method of extraction process for Schisandrae Chinensis Fructus based on near infrared spectroscopy and multivariate statistical process control].

    PubMed

    Xu, Min; Zhang, Lei; Yue, Hong-Shui; Pang, Hong-Wei; Ye, Zheng-Liang; Ding, Li

    2017-10-01

    To establish an on-line monitoring method for extraction process of Schisandrae Chinensis Fructus, the formula medicinal material of Yiqi Fumai lyophilized injection by combining near infrared spectroscopy with multi-variable data analysis technology. The multivariate statistical process control (MSPC) model was established based on 5 normal batches in production and 2 test batches were monitored by PC scores, DModX and Hotelling T2 control charts. The results showed that MSPC model had a good monitoring ability for the extraction process. The application of the MSPC model to actual production process could effectively achieve on-line monitoring for extraction process of Schisandrae Chinensis Fructus, and can reflect the change of material properties in the production process in real time. This established process monitoring method could provide reference for the application of process analysis technology in the process quality control of traditional Chinese medicine injections. Copyright© by the Chinese Pharmaceutical Association.

  1. Statistical monitoring of the hand, foot and mouth disease in China.

    PubMed

    Zhang, Jingnan; Kang, Yicheng; Yang, Yang; Qiu, Peihua

    2015-09-01

    In a period starting around 2007, the Hand, Foot, and Mouth Disease (HFMD) became wide-spreading in China, and the Chinese public health was seriously threatened. To prevent the outbreak of infectious diseases like HFMD, effective disease surveillance systems would be especially helpful to give signals of disease outbreaks as early as possible. Statistical process control (SPC) charts provide a major statistical tool in industrial quality control for detecting product defectives in a timely manner. In recent years, SPC charts have been used for disease surveillance. However, disease surveillance data often have much more complicated structures, compared to the data collected from industrial production lines. Major challenges, including lack of in-control data, complex seasonal effects, and spatio-temporal correlations, make the surveillance data difficult to handle. In this article, we propose a three-step procedure for analyzing disease surveillance data, and our procedure is demonstrated using the HFMD data collected during 2008-2009 in China. Our method uses nonparametric longitudinal data and time series analysis methods to eliminate the possible impact of seasonality and temporal correlation before the disease incidence data are sequentially monitored by a SPC chart. At both national and provincial levels, our proposed method can effectively detect the increasing trend of disease incidence rate before the disease becomes wide-spreading. © 2015, The International Biometric Society.

  2. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol

    PubMed Central

    2011-01-01

    Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. Methods/design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. Discussion We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. Trial Registration http://www.clinicaltrials.gov NCT00302718 PMID:21967830

  3. Verification of out-of-control situations detected by "average of normal" approach.

    PubMed

    Liu, Jiakai; Tan, Chin Hon; Loh, Tze Ping; Badrick, Tony

    2016-11-01

    "Average of normal" (AoN) or "moving average" is increasingly used as an adjunct quality control tool in laboratory practice. Little guidance exists on how to verify if an out-of-control situation in the AoN chart is due to a shift in analytical performance, or underlying patient characteristics. Through simulation based on clinical data, we examined 1) the location of the last apparently stable period in the AoN control chart after an analytical shift, and 2) an approach to verify if the observed shift is related to an analytical shift by repeat testing of archived patient samples from the stable period for 21 common analytes. The number of blocks of results to look back for the stable period increased with the duration of the analytical shift, and was larger when smaller AoN block sizes were used. To verify an analytical shift, 3 archived samples from the analytically stable period should be retested. In particular, the process is deemed to have shifted if a difference of >2 analytical standard deviations (i.e. 1:2s rejection rule) between the original and retested results are observed in any of the 3 samples produced. The probability of Type-1 error (i.e., false rejection) and power (i.e., detecting true analytical shift) of this rule are <0.1 and >0.9, respectively. The use of appropriately archived patient samples to verify an apparent analytical shift is preferred to quality control materials. Nonetheless, the above findings may also apply to quality control materials, barring matrix effects. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  4. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol.

    PubMed

    Petersen, Laura A; Urech, Tracy; Simpson, Kate; Pietz, Kenneth; Hysong, Sylvia J; Profit, Jochen; Conrad, Douglas; Dudley, R Adams; Lutschg, Meghan Z; Petzel, Robert; Woodard, Lechauncy D

    2011-10-03

    Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP) control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control). All participants at the hospital (cluster) were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful quality improvements. http://www.clinicaltrials.govNCT00302718.

  5. The Relationship between Health Survey and Medical Chart Review Results in a Rural Population

    ERIC Educational Resources Information Center

    Voaklander, Donald C.; Thommasen, Harvey V.; Michalos, Alex C.

    2006-01-01

    The objective of this study was to understand the relationship between health survey and medical chart based information. The study population consisted of adult patients (17 years of age and older) attending the Bella Coola Medical Clinic who also completed a detailed Health and Quality of Life Survey. A total of 674 adults completed the Health…

  6. Tularosa Basin Play Fairway Analysis: Methodology Flow Charts

    DOE Data Explorer

    Adam Brandt

    2015-11-15

    These images show the comprehensive methodology used for creation of a Play Fairway Analysis to explore the geothermal resource potential of the Tularosa Basin, New Mexico. The deterministic methodology was originated by the petroleum industry, but was custom-modified to function as a knowledge-based geothermal exploration tool. The stochastic PFA flow chart uses weights of evidence, and is data-driven.

  7. The Use of Graphics to Communicate Findings of Longitudinal Data in Design-Based Research

    ERIC Educational Resources Information Center

    Francis, Krista; Jacobsen, Michele; Friesen, Sharon

    2014-01-01

    Visuals and graphics have been used for communicating complex ideas since 1786 when William Playfair first invented the line graph and bar chart. Graphs and charts are useful for interpretation and making sense of data. For instance, John Snow's scatter plot helped pinpoint the source of a cholera outbreak in London in 1854 and also changed…

  8. Developing and Applying Control Charts to Detect Change Water Chemistry Parameters Measured in the Athabasca River Near the Oil Sands: A Tool for Surveillance Monitoring.

    PubMed

    Arciszewski, Tim J; Hazewinkel, Rod R; Munkittrick, Kelly R; Kilgour, Bruce W

    2018-05-10

    Control charting is a simple technique to identify change and is well-suited for use in water quality programs. Control charts accounting for co-variation associated with discharge and time were used to explore example and representative variables routinely measured in the Athabasca River near the oil sands area for indications of change, including 5 major ions (chloride, sodium, sulphate, calcium, magnesium), 5 total metals (aluminum, iron, thallium, molybdenum, vanadium) and total suspended solids (TSS). Regression equations developed from reference data (1988-2009) were used to predict observations and calculate residuals from later test observations (2010-2016). Evidence of change was sought in the deviation of residual errors from the test period compared to the patterns expected and defined from probability distributions of the reference residuals using the Odds Ratio. In most cases, the patterns in test residuals were not statistically different from those expected from the reference period, especially when data was examined annually. However, some differences were apparent and more differences were apparent as data accumulated and was analysed over time. In sum, the analyses suggest higher concentrations than predicted in most major ions, but the source of the changes is uncertain. In contrast, most metals were lower than expected and may be related to changing deposition patterns of materials or weathering of minerals during construction activities of the 2000's which influence the reference data used. The analyses also suggest alternative approaches may be necessary to understand change in some variables. Despite this, the results support the use of control charts to detect changes in water chemistry parameters and the value of the tool in surveillance phases of long-term and adaptive monitoring programs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy.

    PubMed

    Olesen, Tine Kold; Denys, Marie-Astrid; Vande Walle, Johan; Everaert, Karel

    2018-02-06

    Background Evidence of diagnostic accuracy for proposed definitions of nocturnal polyuria is currently unclear. Purpose Systematic review to determine population-based evidence of the diagnostic accuracy of proposed definitions of nocturnal polyuria based on data from frequency-volume charts. Methods Seventeen pre-specified search terms identified 351 unique investigations published from 1990 to 2016 in BIOSIS, Embase, Embase Alerts, International Pharmaceutical Abstract, Medline, and Cochrane. Thirteen original communications were included in this review based on pre-specified exclusion criteria. Data were extracted from each paper regarding subject age, sex, ethnicity, health status, sample size, data collection methods, and diagnostic discrimination of proposed definitions including sensitivity, specificity, positive and negative predictive value. Results The sample size of study cohorts, participant age, sex, ethnicity, and health status varied considerably in 13 studies reporting on the diagnostic performance of seven different definitions of nocturnal polyuria using frequency-volume chart data from 4968 participants. Most study cohorts were small, mono-ethnic, including only Caucasian males aged 50 or higher with primary or secondary polyuria that were compared to a control group of healthy men without nocturia in prospective or retrospective settings. Proposed definitions had poor discriminatory accuracy in evaluations based on data from subjects independent from the original study cohorts with findings being similar regarding the most widely evaluated definition endorsed by ICS. Conclusions Diagnostic performance characteristics for proposed definitions of nocturnal polyuria show poor to modest discrimination and are not based on sufficient level of evidence from representative, multi-ethnic population-based data from both females and males of all adult ages.

  10. 15 CFR 732.3 - Steps regarding the ten general prohibitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... The CCL and the Country Chart are taken together to define these license requirements. The applicable... 'bundled' with controlled U.S.-origin software, foreign-made software that is commingled with controlled U.S.-origin software, or foreign-made technology that is commingled with controlled U.S.-origin...

  11. On the use of multi-agent systems for the monitoring of industrial systems

    NASA Astrophysics Data System (ADS)

    Rezki, Nafissa; Kazar, Okba; Mouss, Leila Hayet; Kahloul, Laid; Rezki, Djamil

    2016-03-01

    The objective of the current paper is to present an intelligent system for complex process monitoring, based on artificial intelligence technologies. This system aims to realize with success all the complex process monitoring tasks that are: detection, diagnosis, identification and reconfiguration. For this purpose, the development of a multi-agent system that combines multiple intelligences such as: multivariate control charts, neural networks, Bayesian networks and expert systems has became a necessity. The proposed system is evaluated in the monitoring of the complex process Tennessee Eastman process.

  12. Association between hospital size and quality improvement for pharmaceutical services.

    PubMed

    Nau, David P; Garber, Mathew C; Lipowski, Earlene E; Stevenson, James G

    2004-01-15

    The relationship between hospital size and quality improvement (QI) for pharmaceutical services was studied. A questionnaire on QI was sent to hospital pharmacy directors in Michigan and Florida in 2002. The questionnaire included items on QI lead-team composition, QI tools, QI training, and QI culture. Usable responses were received from 162 (57%) of 282 pharmacy directors. Pharmacy QI lead teams were present in 57% of institutions, with larger teams in large hospitals (> or = 300 patients). Only two QI tools were used by a majority of hospitals: root-cause analysis (62%) and flow charts (66%). Small hospitals (< 50 patients) were less likely than medium-sized hospitals (50-299 patients) and large hospitals to use several QI tools, including control charts, cause-and-effect diagrams, root-cause analysis, flow charts, and histograms. Large hospitals were more likely than small and medium-sized hospitals to use root-cause analysis and control charts. There was no relationship between hospital size and the frequency with which physician or patient satisfaction with pharmaceutical services was measured. There were no differences in QI training or QI culture across hospital size categories. A survey suggested that a majority of hospital pharmacies in Michigan and Florida have begun to adopt QI techniques but that most are not using rigorous QI tools. Pharmacies in large hospitals had more QI lead-team members and were more likely to use certain QI tools, but there was no relationship between hospital size and satisfaction measurements, QI training, or QI culture.

  13. The design and application of virtual ion meter based on LABVIEW 8.0.

    PubMed

    Meng, Hu; Li, Jiangyuan; Tang, Yonghuai

    2009-08-01

    The virtual ion meter is developed based on LABVIEW 8.0 by homemade adjusting circuit, data acquisition (DAQ) board, and computer. This note provides details of the structure of testing system and flow chart of DAQ program. This virtual instrument system is applied to multitask testing such as determining rate constant of second-order reaction by pX, pX potentiometric titration, determining oscillating reaction by potential, etc. The result of application indicates that this test system not only has function of real-time data acquiring, displaying, storage, but also realizes remote monitoring and controlling test-control spots through internet, automatic analyzing and processing of data, reporting of result according to the different testing task; moreover, the veracity and repeatability of data processing result are higher than the results of manual data processing.

  14. Instrumentation and Controls Division progress report, July 1, 1990--June 30, 1992. Volume 2

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1993-01-01

    This report contains the following information from the Instrumentation and Controls Division of Oak Ridge National Laboratory: supplementary activities; seminars; publications and presentations; scientific and professional activities, achievements, and awards; and division organization charts.

  15. Statistical methods for the quality control of steam cured concrete : final report.

    DOT National Transportation Integrated Search

    1971-01-01

    Concrete strength test results from three prestressing plants utilizing steam curing were evaluated statistically in terms of the concrete as received and the effectiveness of the plants' steaming procedures. Control charts were prepared to show tren...

  16. Readability of New Aviation Chart Symbology in Day and NVG Reading Conditions.

    PubMed

    Wagstaff, Anthony S; Larsen, Terje

    2017-11-01

    The Swedish Air Force (SwAF) conducted a study in 2010 to harmonize portrayal of aeronautical info (AI) on SwAF charts with NATO standards. A mismatch was found concerning vertical obstructions (VO). Norway regarded Sweden's existing symbology as a way to solve the problem of overcrowded air charts and the two countries started to cooperate. The result of this development was a new set of symbology for obstacles. The aim of this study was to test the readability of the new obstacle and power line symbols compared to the old symbols. We also wished to assess the readability in NVG illumination conditions, particularly regarding the new symbols compared to the old. In a randomized controlled study design, 21 volunteer military pilots from the Norwegian and Swedish Air Force were asked to perform tracking and chart-reading tests. The chart-reading test scored both errors and readability using a predefined score index. Subjective scoring was also done at the end of the test day. Overall response time improved by approximately 20% using the new symbology and error rate decreased by approximately 30-90% where statistically significant differences were found. The tracking test turned out to be too difficult due to several factors in the experimental design. Even though some caution should be shown in drawing conclusions from this study, the general trends seem well supported with the number of aircrew subjects we were able to recruit.Wagstaff AS, Larsen T. Readability of new aviation chart symbology in day and NVG reading conditions. Aerosp Med Hum Perform. 2017; 88(11):978-984.

  17. Comparison of reading speed with 3 different log-scaled reading charts.

    PubMed

    Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini

    2014-01-01

    A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age=22.98±1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200±30wpm, 196±28wpm and 194±31wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t=-0.73, p=0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t=-0.97, p=0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  18. Comparison of reading speed with 3 different log-scaled reading charts

    PubMed Central

    Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini

    2014-01-01

    Background A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Materials and methods Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age = 22.98 ± 1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). Results The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200 ± 30 wpm, 196 ± 28 wpm and 194 ± 31 wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t = −0.73, p = 0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t = −0.97, p = 0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. Conclusion UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. PMID:25323642

  19. Impaired work performance among women with symptomatic uterine fibroids.

    PubMed

    Lerner, Debra; Mirza, Fadi G; Mirza, Fadi; Chang, Hong; Renzulli, Karen; Perch, Katherine; Chelmow, David

    2008-10-01

    To assess the work impact of symptomatic uterine fibroids (UFs). A cohort study compared 58 employed women with symptomatic UFs to 56 healthy controls. Data sources included a self-administered mail questionnaire and medical charts. At-work performance limitations and productivity loss were measured with the Work Limitations Questionnaire. Univariate and multivariate case-control group differences were tested. Based on adjusted mean scores, the UF group had significantly more at-work limitations and productivity loss than controls, while absence rates were similar. The UF group's performance was impaired 18% of the time on average versus 8% for controls (P-values, 0.005-0.040). At-work limitations were explained by depression symptoms, Non-White race/ethnicity, and poorer health-related quality of life. Fibroids and related symptoms impose a burden on the working lives' of women, their employers, and the economy.

  20. Preliminary alinement charts for determining growth in selectively cut stands of western yellow pine.

    Treesearch

    1931-01-01

    An investigation of the growth and yield of western yellow pine has been under way at the Pacific Northwest Forest Experiment Station for the past three years. Some of the results of the study are now available and are presented herewith. The attached alinement charts showing the growth of selectively cut forests are based upon the detailed measurements of 179 plots,...

  1. Detecting significant change in stream benthic macroinvertebrate communities in wilderness areas

    USGS Publications Warehouse

    Milner, Alexander M.; Woodward, Andrea; Freilich, Jerome E.; Black, Robert W.; Resh, Vincent H.

    2016-01-01

    Within a region, both MDS analyses typically identified similar years as exceeding reference condition variation, illustrating the utility of the approach for identifying wider spatial scale effects that influence more than one stream. MDS responded to both simulated water temperature stress and a pollutant event, and generally outlying years on MDS plots could be explained by environmental variables, particularly higher precipitation. Multivariate control charts successfully identified whether shifts in community structure identified by MDS were significant and whether the shift represented a press disturbance (long-term change) or a pulse disturbance. We consider a combination of TD and MDS with control charts to be a potentially powerful tool for determining years significantly outside of a reference condition variation.

  2. Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

    PubMed Central

    Kuperman, Ethan F.; Tobin, Kristen; Kraschnewski, Jennifer L.

    2014-01-01

    Background Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. Objective To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. Methods During the 2010–2011 academic year, second- and third-year internal medicine residents at a single, university hospital–based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Results Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P < .001). Of 16 guidelines, external audits found significantly lower rates of adherence for 5 (tetanus vaccination, osteoporosis screening, colon cancer screening, cholesterol screening, and obesity screening). Chlamydia screening was more common in audited charts than in self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P < .001), external audits for third-year residents found lower overall adherence (64% versus 72%, P  =  .040). Conclusions Residents' self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance. PMID:26140117

  3. Toward developing a standardized Arabic continuous text reading chart.

    PubMed

    Alabdulkader, Balsam; Leat, Susan Jennifer

    Near visual acuity is an essential measurement during an oculo-visual assessment. Short duration continuous text reading charts measure reading acuity and other aspects of reading performance. There is no standardized version of such chart in Arabic. The aim of this study is to create sentences of equal readability to use in the development of a standardized Arabic continuous text reading chart. Initially, 109 Arabic pairs of sentences were created for use in constructing a chart with similar layout to the Colenbrander chart. They were created to have the same grade level of difficulty and physical length. Fifty-three adults and sixteen children were recruited to validate the sentences. Reading speed in correct words per minute (CWPM) and standard length words per minute (SLWPM) was measured and errors were counted. Criteria based on reading speed and errors made in each sentence pair were used to exclude sentence pairs with more outlying characteristics, and to select the final group of sentence pairs. Forty-five sentence pairs were selected according to the elimination criteria. For adults, the average reading speed for the final sentences was 166 CWPM and 187 SLWPM and the average number of errors per sentence pair was 0.21. Childrens' average reading speed for the final group of sentences was 61 CWPM and 72 SLWPM. Their average error rate was 1.71. The reliability analysis showed that the final 45 sentence pairs are highly comparable. They will be used in constructing an Arabic short duration continuous text reading chart. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  4. Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

    PubMed

    Kuperman, Ethan F; Tobin, Kristen; Kraschnewski, Jennifer L

    2014-12-01

    Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. During the 2010-2011 academic year, second- and third-year internal medicine residents at a single, university hospital-based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P < .001). Of 16 guidelines, external audits found significantly lower rates of adherence for 5 (tetanus vaccination, osteoporosis screening, colon cancer screening, cholesterol screening, and obesity screening). Chlamydia screening was more common in audited charts than in self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P < .001), external audits for third-year residents found lower overall adherence (64% versus 72%, P  =  .040). Residents' self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance.

  5. An analysis of the stability of an airplane with free controls

    NASA Technical Reports Server (NTRS)

    Jones, Robert T; Cohen, Doris

    1941-01-01

    Report presents the results of an investigation made of the essentials to the stability of an airplane with free control surfaces. Calculations are based on typical airplane characteristics with certain factors varied to cover a range of current designs. Stability charts are included to show the limiting values of the aerodynamic hinge moments and the weight hinge moments of the control surfaces for various positions of the center of gravity of the airplane and for control systems with various moments of inertia. The effects of reducing the chord and of eliminating the floating tendency of the surface, of changing the wing loading, and of decreasing the radius of gyration of the airplane are also indicated. An investigation has also been made of the nature of the motion of the airplane with controls free and of the modes of instability that may occur.

  6. Safe, Effective Use of Pesticides, A Manual for Commercial Applicators: Ornamental and Turf Pest Control.

    ERIC Educational Resources Information Center

    Extension Service (USDA), Washington, DC.

    This manual is intended to assist pesticide applicators in the area of ornamental and turf pest control prepare for certification under the Michigan Pesticide Control Act of 1976. The three sections presented describe: (1) Ornamentals; (2) Turfgrass; and (3) Pest Control. Section one discusses the diagnostic chart for plant problems, non-pest…

  7. Use of locally weighted scatterplot smoothing (LOWESS) regression to study selection signatures in Piedmontese and Italian Brown cattle breeds.

    PubMed

    Pintus, Elia; Sorbolini, Silvia; Albera, Andrea; Gaspa, Giustino; Dimauro, Corrado; Steri, Roberto; Marras, Gabriele; Macciotta, Nicolò P P

    2014-02-01

    Selection is the major force affecting local levels of genetic variation in species. The availability of dense marker maps offers new opportunities for a detailed understanding of genetic diversity distribution across the animal genome. Over the last 50 years, cattle breeds have been subjected to intense artificial selection. Consequently, regions controlling traits of economic importance are expected to exhibit selection signatures. The fixation index (Fst ) is an estimate of population differentiation, based on genetic polymorphism data, and it is calculated using the relationship between inbreeding and heterozygosity. In the present study, locally weighted scatterplot smoothing (LOWESS) regression and a control chart approach were used to investigate selection signatures in two cattle breeds with different production aptitudes (dairy and beef). Fst was calculated for 42 514 SNP marker loci distributed across the genome in 749 Italian Brown and 364 Piedmontese bulls. The statistical significance of Fst values was assessed using a control chart. The LOWESS technique was efficient in removing noise from the raw data and was able to highlight selection signatures in chromosomes known to harbour genes affecting dairy and beef traits. Examples include the peaks detected for BTA2 in the region where the myostatin gene is located and for BTA6 in the region harbouring the ABCG2 locus. Moreover, several loci not previously reported in cattle studies were detected. © 2013 The Authors, Animal Genetics © 2013 Stichting International Foundation for Animal Genetics.

  8. The Measurement of the Field of View from Airplane Cockpits

    NASA Technical Reports Server (NTRS)

    Gough, Melvin N

    1936-01-01

    A method has been devised for the angular measurement and graphic portrayal of the view obtained from the pilot's cockpit of an airplane. The assumption upon which the method is based and a description of the instrument, designated a "visiometer", used in the measurement are given. Account is taken of the fact that the pilot has two eyes and two separate sources of vision. The view is represented on charts using an equal-area polar projection, a description and proof of which are given. The use of this chart, aside from its simplicity, may make possible the establishment of simple criterions of the field of view. Charts of five representative airplanes with various cockpit arrangements are included.

  9. Binding blocks: building the Universe one nucleus at a time

    NASA Astrophysics Data System (ADS)

    Diget, C. Aa; Pastore, A.; Leech, K.; Haylett, T.; Lock, S.; Sanders, T.; Shelley, M.; Willett, H. V.; Keegans, J.; Sinclair, L.; Simpson, E. C.; Binding Blocks Collaboration

    2017-03-01

    We present a new teaching and outreach activity based around the construction of a three-dimensional chart of isotopes using \\text{LEG}{{\\text{O}}\\circledR} bricks5. The activity, binding blocks, demonstrates nuclear and astrophysical processes through a seven-meter chart of all nuclear isotopes, built from over 26 000 \\text{LEG}{{\\text{O}}\\circledR} bricks. It integrates A-Level and GCSE curricula across areas of nuclear physics, astrophysics, and chemistry, including: nuclear decays (through the colours in the chart); nuclear binding energy (through tower heights); production of chemical elements in the cosmos; fusion processes in stars and fusion energy on Earth; as well as links to medical physics, particularly diagnostics and radiotherapy.

  10. A Global Ocean Tide Model From TOPEX/POSEIDON Altimetry: GOT99.2

    NASA Technical Reports Server (NTRS)

    Ray, Richard D.

    1999-01-01

    Goddard Ocean Tide model GOT99.2 is a new solution for the amplitudes and phases of the global oceanic tides, based on over six years of sea-surface height measurements by the TOPEX/POSEIDON satellite altimeter. Comparison with deep-ocean tide-gauge measurements show that this new tidal solution is an improvement over previous global models, with accuracies for the main semidiurnal lunar constituent M2 now below 1.5 cm (deep water only). The new solution benefits from use of prior hydrodynamic models, several in shallow and inland seas as well as the global finite-element model FES94.1. This report describes some of the data processing details involved in handling the altimetry, and it provides a comprehensive set of global cotidal charts of the resulting solutions. Various derived tidal charts are also provided, including tidal loading deformation charts, tidal gravimetric charts, and tidal current velocity (or transport) charts. Finally, low-degree spherical harmonic coefficients are computed by numerical quadrature and are tabulated for the major short-period tides; these are useful for a variety of geodetic and geophysical purposes, especially in combination with similar estimates from satellite laser ranging.

  11. A simple signaling rule for variable life-adjusted display derived from an equivalent risk-adjusted CUSUM chart.

    PubMed

    Wittenberg, Philipp; Gan, Fah Fatt; Knoth, Sven

    2018-04-17

    The variable life-adjusted display (VLAD) is the first risk-adjusted graphical procedure proposed in the literature for monitoring the performance of a surgeon. It displays the cumulative sum of expected minus observed deaths. It has since become highly popular because the statistic plotted is easy to understand. But it is also easy to misinterpret a surgeon's performance by utilizing the VLAD, potentially leading to grave consequences. The problem of misinterpretation is essentially caused by the variance of the VLAD's statistic that increases with sample size. In order for the VLAD to be truly useful, a simple signaling rule is desperately needed. Various forms of signaling rules have been developed, but they are usually quite complicated. Without signaling rules, making inferences using the VLAD alone is difficult if not misleading. In this paper, we establish an equivalence between a VLAD with V-mask and a risk-adjusted cumulative sum (RA-CUSUM) chart based on the difference between the estimated probability of death and surgical outcome. Average run length analysis based on simulation shows that this particular RA-CUSUM chart has similar performance as compared to the established RA-CUSUM chart based on the log-likelihood ratio statistic obtained by testing the odds ratio of death. We provide a simple design procedure for determining the V-mask parameters based on a resampling approach. Resampling from a real data set ensures that these parameters can be estimated appropriately. Finally, we illustrate the monitoring of a real surgeon's performance using VLAD with V-mask. Copyright © 2018 John Wiley & Sons, Ltd.

  12. Agent Architecture for Aviation Data Integration System

    NASA Technical Reports Server (NTRS)

    Kulkarni, Deepak; Wang, Yao; Windrem, May; Patel, Hemil; Wei, Mei

    2004-01-01

    This paper describes the proposed agent-based architecture of the Aviation Data Integration System (ADIS). ADIS is a software system that provides integrated heterogeneous data to support aviation problem-solving activities. Examples of aviation problem-solving activities include engineering troubleshooting, incident and accident investigation, routine flight operations monitoring, safety assessment, maintenance procedure debugging, and training assessment. A wide variety of information is typically referenced when engaging in these activities. Some of this information includes flight recorder data, Automatic Terminal Information Service (ATIS) reports, Jeppesen charts, weather data, air traffic control information, safety reports, and runway visual range data. Such wide-ranging information cannot be found in any single unified information source. Therefore, this information must be actively collected, assembled, and presented in a manner that supports the users problem-solving activities. This information integration task is non-trivial and presents a variety of technical challenges. ADIS has been developed to do this task and it permits integration of weather, RVR, radar data, and Jeppesen charts with flight data. ADIS has been implemented and used by several airlines FOQA teams. The initial feedback from airlines is that such a system is very useful in FOQA analysis. Based on the feedback from the initial deployment, we are developing a new version of the system that would make further progress in achieving following goals of our project.

  13. Digital waterway construction based on inland electronic navigation chart

    NASA Astrophysics Data System (ADS)

    Wang, Xue; Pan, Junfeng; Zhu, Weiwei

    2015-12-01

    With advantages of large capacity, long distance, low energy consumption, low cost, less land occupation and light pollution, inland waterway transportation becomes one of the most important constituents of the comprehensive transportation system and comprehensive water resources utilization in China. As one of "three elements" of navigation, waterway is the important basis for the development of water transportation and plays a key supporting role in shipping economic. The paper discuss how to realize the informatization and digitization of waterway management based on constructing an integrated system of standard inland electronic navigation chart production, waterway maintenance, navigation mark remote sensing and control, ship dynamic management, and water level remote sensing and report, which can also be the foundation of the intelligent waterway construction. Digital waterway construction is an information project and also has a practical meaning for waterway. It can not only meet the growing high assurance and security requirements for waterway, but also play a significant advantage in improving transport efficiency, reducing costs, promoting energy conservation and so on. This study lays a solid foundation on realizing intelligent waterway and building a smooth, efficient, safe, green modern inland waterway system, and must be considered as an unavoidable problem for the coordinated development between "low carbon" transportation and social economic.

  14. Using Paper Helicopters to Teach Statistical Process Control

    ERIC Educational Resources Information Center

    Johnson, Danny J.

    2011-01-01

    This hands-on project uses a paper helicopter to teach students how to distinguish between common and special causes of variability when developing and using statistical process control charts. It allows the student to experience a process that is out-of-control due to imprecise or incomplete product design specifications and to discover how the…

  15. 15 CFR 732.3 - Steps regarding the ten general prohibitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... The CCL and the Country Chart are taken together to define these license requirements. The applicable... commodity that is ‘bundled’ with controlled U.S.-origin software, foreign-made software that is commingled with controlled U.S.-origin software, or foreign-made technology that is commingled with controlled U.S...

  16. Introducing Quality Control in the Chemistry Teaching Laboratory Using Control Charts

    ERIC Educational Resources Information Center

    Schazmann, Benjamin; Regan, Fiona; Ross, Mary; Diamond, Dermot; Paull, Brett

    2009-01-01

    Quality control (QC) measures are less prevalent in teaching laboratories than commercial settings possibly owing to a lack of commercial incentives or teaching resources. This article focuses on the use of QC assessment in the analytical techniques of high performance liquid chromatography (HPLC) and ultraviolet-visible spectroscopy (UV-vis) at…

  17. GIS and RDBMS Used with Offline FAA Airspace Databases

    NASA Technical Reports Server (NTRS)

    Clark, J.; Simmons, J.; Scofield, E.; Talbott, B.

    1994-01-01

    A geographic information system (GIS) and relational database management system (RDBMS) were used in a Macintosh environment to access, manipulate, and display off-line FAA databases of airport and navigational aid locations, airways, and airspace boundaries. This proof-of-concept effort used data available from the Adaptation Controlled Environment System (ACES) and Digital Aeronautical Chart Supplement (DACS) databases to allow FAA cartographers and others to create computer-assisted charts and overlays as reference material for air traffic controllers. These products were created on an engineering model of the future GRASP (GRaphics Adaptation Support Position) workstation that will be used to make graphics and text products for the Advanced Automation System (AAS), which will upgrade and replace the current air traffic control system. Techniques developed during the prototyping effort have shown the viability of using databases to create graphical products without the need for an intervening data entry step.

  18. Cooperative organic mine avoidance path planning

    NASA Astrophysics Data System (ADS)

    McCubbin, Christopher B.; Piatko, Christine D.; Peterson, Adam V.; Donnald, Creighton R.; Cohen, David

    2005-06-01

    The JHU/APL Path Planning team has developed path planning techniques to look for paths that balance the utility and risk associated with different routes through a minefield. Extending on previous years' efforts, we investigated real-world Naval mine avoidance requirements and developed a tactical decision aid (TDA) that satisfies those requirements. APL has developed new mine path planning techniques using graph based and genetic algorithms which quickly produce near-minimum risk paths for complicated fitness functions incorporating risk, path length, ship kinematics, and naval doctrine. The TDA user interface, a Java Swing application that obtains data via Corba interfaces to path planning databases, allows the operator to explore a fusion of historic and in situ mine field data, control the path planner, and display the planning results. To provide a context for the minefield data, the user interface also renders data from the Digital Nautical Chart database, a database created by the National Geospatial-Intelligence Agency containing charts of the world's ports and coastal regions. This TDA has been developed in conjunction with the COMID (Cooperative Organic Mine Defense) system. This paper presents a description of the algorithms, architecture, and application produced.

  19. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    This report contains the following information from the Instrumentation and Controls Division of Oak Ridge National Laboratory: supplementary activities; seminars; publications and presentations; scientific and professional activities, achievements, and awards; and division organization charts.

  20. Twenty-Four-Hour Voiding Diaries Versus 3-Day Voiding Diaries: A Clinical Comparison.

    PubMed

    Elmer, Caroline; Murphy, Amber; Elliott, John O; Book, Nicole M

    This study aimed to determine if 24-hour versus 3-day voiding diary affects medical decision making for women with urinary incontinence. A retrospective chart review was conducted of patients presenting to the OhioHealth Urogynecology Physician group for urinary incontinence from 2009 to 2011. Practice protocol includes patient completion of a 3-day voiding diary before their appointment. Diagnostic and treatment plans were extracted based on the initial patient encounter and 3-day voiding diary. A chart review was then completed with the first 24 hours of the same diaries, principal history, and physical examination data compiled into a separate chart. These charts were then reevaluated by the same physician who initially provided care to the patient but were blinded to their previous orders, impressions, and plans. New plans were then created based on the 24-hour diaries and compared with the original plans. One hundred eighty-six charts were reviewed. There was good agreement between 24-hour and 3-day diaries in recommendations for first-line behavioral modifications (Κ > 0.6) and moderate agreement between diaries in initiation of medical therapy or trial of incontinence pessary (Κ > 0.4). However, 24-hour diaries resulted in a statistically significant increase in invasive diagnostic tests (P < 0.019) and other treatment recommendations when compared with 3-day diaries. Use of 24-hour diaries may result in increased testing when compared with 3-day diaries. It may be prudent to postpone invasive testing in those patients who initially are noncompliant with a longer diary until a more complete history can be obtained.

  1. Using statistical process control for monitoring the prevalence of hospital-acquired pressure ulcers.

    PubMed

    Kottner, Jan; Halfens, Ruud

    2010-05-01

    Institutionally acquired pressure ulcers are used as outcome indicators to assess the quality of pressure ulcer prevention programs. Determining whether quality improvement projects that aim to decrease the proportions of institutionally acquired pressure ulcers lead to real changes in clinical practice depends on the measurement method and statistical analysis used. To examine whether nosocomial pressure ulcer prevalence rates in hospitals in the Netherlands changed, a secondary data analysis using different statistical approaches was conducted of annual (1998-2008) nationwide nursing-sensitive health problem prevalence studies in the Netherlands. Institutions that participated regularly in all survey years were identified. Risk-adjusted nosocomial pressure ulcers prevalence rates, grade 2 to 4 (European Pressure Ulcer Advisory Panel system) were calculated per year and hospital. Descriptive statistics, chi-square trend tests, and P charts based on statistical process control (SPC) were applied and compared. Six of the 905 healthcare institutions participated in every survey year and 11,444 patients in these six hospitals were identified as being at risk for pressure ulcers. Prevalence rates per year ranged from 0.05 to 0.22. Chi-square trend tests revealed statistically significant downward trends in four hospitals but based on SPC methods, prevalence rates of five hospitals varied by chance only. Results of chi-square trend tests and SPC methods were not comparable, making it impossible to decide which approach is more appropriate. P charts provide more valuable information than single P values and are more helpful for monitoring institutional performance. Empirical evidence about the decrease of nosocomial pressure ulcer prevalence rates in the Netherlands is contradictory and limited.

  2. Paucity of family planning.

    PubMed

    Hawkins, C

    1988-04-01

    A wall chart compiled by the Population Crisis Committee of Washington D.C. called "World Access to Birth Control" is described. The chart compares developing countries and developed countries with respect to need of effective contraception, using data from the World Fertility Surveys. Up to 250 million women need contraception; a substantial percentage want no more children, over half in several large countries. The chart ranks the United Kingdom as 1st in providing family planning services, information, education and advertising. All of the developed countries were considered good except Russia and Romania, although some had deficiencies, such as Japan for lacking sterilization services. The U.S. ranked 7th, failing to provide women the full range of contraceptive methods, to provide adequate sex education and services to adolescents, and to publish information and adequate advertising about birth control. The USSR was placed 14th on the list of 15 because of poor quality and erratic supplies. Among the developing countries, Libya, Kampuchea and Laos were cited as having no services whatsoever. In contrast, several Asian national family planning programs, notably China, Taiwan, Singapore, South Korea and Hong Kong, had such excellent programs that fertility had declined over 30% in 15 years. In China, fertility has fallen 50% in that time.

  3. Investing in Change: The Walton Family Foundation Charts a New Course. Principles for Effective Education Grantmaking. Case Study No. 12

    ERIC Educational Resources Information Center

    Wisdom, Michelle

    2015-01-01

    The Walton Family Foundation was at a pivotal point in early 2015. After investing $1.3 billion in K-12 education over the previous two decades, executive and board leadership were reflecting on past work, and charting a course for the Foundation's strategic direction based on key learnings from their investments in education. The Walton Family…

  4. IMS/Satellite Situation Center report: Orbit plots and bar charts for Prognoz 4, days 1-91 1976

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Orbit plots for the Prognoz 4 satellite for the time period January to March 1976 are given. This satellite was identified as a possible important contributor to the International Magnetospheric Study project. The orbits were based on an element epoch of December 26, 1975, 3h 8min and 17s. In view of the low perigee of this satellite, the Satellite Situation Center (SSC) considered that the effect of atmospheric drag precludes orbit predictions for the length of time normally used by the SSC for high-altitude satellites. Consequently, orbit data are shown for the first 3 months of 1976 only. The orbit generated for this report was based on the earlier epoch, and it positions the satellite within 30s of the ascending node at the later epoch. Therefore, within the accuracy of the plots shown in this report, the orbit used was regarded as an achieved orbit. The orbit information is displayed graphically in four ways: bar charts, geocentric solar ecliptic plots, boundary plots, and solar magnetic latitude versus local time plots. The most concise presentation is the bar charts. The bar charts give the crude three-dimensional position of the satellite for each magnetospheric region.

  5. Design of Customizable Automated Low Cost Eye Testing System

    PubMed Central

    K, Ganesan; D, Shalini

    2014-01-01

    Background and Objectives: In many underdeveloped and third world countries, eye care is often neglected due to illiteracy. Particularly people in rural areas suffer with eye problems due to mal nutrition. The government is spending lot of money and efforts in screening the people at periodic intervals. One of the challenges faced by the doctors is screening the school children. Materials and Methods: The standard Snellen letter chart based diagnostic system does not work always. There are instances where the first few students who undergo this diagnostic system, memorize the letter sequence of the Snellen letter chart and convey the same to other fellow students. Hence other students simply read out the Snellen letter sequence from their memory, not by looking at the Snellen letter chart. Thus there is a need of randomizing the sequence of letters being displayed on the Snellen letter chart for every student to be diagnosed for eye testing. Conclusion: In the present paper we are proposing a customizable, software based, cost effective solution which involves a standard personal computer (PC) fitted with a camera, headphone and speaker system. The envisaged system can be administered even by the trained persons. The proposed system is also suitable for remote diagnosis of patients, particularly in the field of telemedicine. PMID:24783089

  6. [Experiences with an anesthesia protocol written by computer].

    PubMed

    Karliczek, G F; Brenken, U; van den Broeke, J J; Mooi, B; de Geus, A F; Wiersma, G; Oosterhaven, S

    1988-04-01

    Since December 1983, we have used a computer system for charting and data logging in cardiac and thoracic anesthesia. These computers, designed as stand-alone units, were developed at our hospital based on Motorola 6809 microprocessor systems. All measurements derived from anesthetic monitoring, ventilator, and heart-lung machine are automatically sampled at regular intervals and stored for later data management. Laboratory results are automatically received from the hospital computer system. The user communicates with the system via a terminal and a keyboard; this also facilitates the entering of all comments, medications, infusions, and fluid losses. All data are continuously displayed on an A3 format anesthetic chart using a multi-pen, flat-bed plotter. The operation of the system has proved to be simple and needs less time than charting by hand, while the result, the display on the chart, is far clearer and more complete than any handwritten document. Up to now 3,200 operations (corresponding to 12,500 anesthetic h) have been documented. The failure rate of the system, defined as an interruption of the documentation for more than 30 min is 2.1%. Further development of the system is discussed. A data base for processing the stored data has been developed and is being tested at present.

  7. Water Pollution Control Across the Nation

    ERIC Educational Resources Information Center

    Environmental Science and Technology, 1973

    1973-01-01

    Reviewed are accomplishments, problems, and frustrations faced by individual states in meeting requirements of P.L. 92-500, Federal Water Pollution Control Act Amendments of 1972. State Environmental officials complain the new law may be a hindrance to established cleanup programs. Statistics and charts are given. (BL)

  8. TU-FG-201-05: Varian MPC as a Statistical Process Control Tool

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carver, A; Rowbottom, C

    Purpose: Quality assurance in radiotherapy requires the measurement of various machine parameters to ensure they remain within permitted values over time. In Truebeam release 2.0 the Machine Performance Check (MPC) was released allowing beam output and machine axis movements to be assessed in a single test. We aim to evaluate the Varian Machine Performance Check (MPC) as a tool for Statistical Process Control (SPC). Methods: Varian’s MPC tool was used on three Truebeam and one EDGE linac for a period of approximately one year. MPC was commissioned against independent systems. After this period the data were reviewed to determine whethermore » or not the MPC was useful as a process control tool. Analyses on individual tests were analysed using Shewhart control plots, using Matlab for analysis. Principal component analysis was used to determine if a multivariate model was of any benefit in analysing the data. Results: Control charts were found to be useful to detect beam output changes, worn T-nuts and jaw calibration issues. Upper and lower control limits were defined at the 95% level. Multivariate SPC was performed using Principal Component Analysis. We found little evidence of clustering beyond that which might be naively expected such as beam uniformity and beam output. Whilst this makes multivariate analysis of little use it suggests that each test is giving independent information. Conclusion: The variety of independent parameters tested in MPC makes it a sensitive tool for routine machine QA. We have determined that using control charts in our QA programme would rapidly detect changes in machine performance. The use of control charts allows large quantities of tests to be performed on all linacs without visual inspection of all results. The use of control limits alerts users when data are inconsistent with previous measurements before they become out of specification. A. Carver has received a speaker’s honorarium from Varian.« less

  9. Hattori chart based evaluation of body composition and its relation to body mass index in a group of Sri Lankan children.

    PubMed

    Wickramasinghe, V P

    2012-05-01

    To assess the relationship between fat free mass (FFM), fat mass (FM), body mass index (BMI) and percentage fat mass (%FM) using Hattori chart in a group of Sri Lankan children. In this cross sectional descriptive study involving 5-15 y old children, data from 4 different school surveys were pooled together. Height and weight were measured and BMI calculated. Total body water (TBW) was assessed using a height and weight based equation. Thus FFM and FM were assessed based on 2 C body composition model. Fat mass index (FMI) and Fat free mass index (FFMI) were calculated and plotted on Hattori chart. 4278 individuals (1297 boys and 2981 girls) were studied. Individual values clearly showed that Sri Lankan children had a low FFMI and a high FMI. Individuals with similar BMI had their %FM distributed in a wide range. Even children categorized as wasted had high levels of %FM in their body. Mean FMI and FFMI for each age was plotted, and it showed that most of the weight gain is due to accumulation of fat in the body. This study shows that Sri Lankan children have a higher %FM from a younger age even when they are classified as wasted. As they grow older, the changes that occur in FM are more than FFM. This chart analysis clearly shows that BMI is not a good index to measure %FM in individuals of this population.

  10. Presenting risk information to people with diabetes: evaluating effects and preferences for different formats by a web-based randomised controlled trial.

    PubMed

    Edwards, Adrian; Thomas, Richard; Williams, Rhys; Ellner, Andrew L; Brown, Polly; Elwyn, Glyn

    2006-11-01

    Web-based patient information is widespread and information on the benefits and risks of treatments is often difficult to understand. We therefore evaluated different risk presentation formats - numerical, graphical and others - addressing the pros and cons of tight control versus usual treatment approaches for diabetes. Randomised controlled trial. Online. Publicity disseminated via Diabetes UK. People with diabetes or their carers. Control group information based on British Medical Journal 'Best Treatments'. Four intervention groups received enhanced information resources: (1) detailed numerical information (absolute/relative risk, numbers-needed-to-treat); (2) 'anchoring' to familiar risks or descriptions; (3) graphical (bar charts, thermometer scales, crowd figure formats); (4) combination of 1-3. Decision conflict scale (DCS, a measure of uncertainty); satisfaction with information; further free text responses for qualitative content analysis. Seven hundred and ten people visited the website and were randomised. Five hundred and eight completed the questionnaire for quantitative data. Mean DCS scores ranged from 2.12 to 2.24 for the five randomisation groups, indicating neither clear delay or vacillation about decisions (usually DCS>2.5) nor tending to make decisions (usually DCS<2.0). There were no statistically significant effects of the interventions on DCS, or satisfaction with information. Two hundred and fifty-six participants provided responses for qualitative analysis: most found graphical representations helpful, specifically bar chart formats; many found other graphic formats (thermometer style, crowd figures/smiley faces) and 'anchoring' information unhelpful, and indicated information overload. Many negative experiences with healthcare indicate a challenging context for effective information provision and decision support. Online evaluation of different risk representation formats was feasible. There was a lack of intervention effects on quantitative outcomes, perhaps reflecting already well-informed participants from the Diabetes UK patient organisation. The large qualitative dataset included many comments about what participants found helpful as formats for communicating risk information. These findings assist the design of online decision aids and the representation of risk information. The challenge is to provide more information, in appropriate and clear formats, but without risking information overload. Interactive web designs hold much promise to achieve this.

  11. NIRP Core Software Suite v. 1.0

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Whitener, Dustin Heath; Folz, Wesley; Vo, Duong

    The NIRP Core Software Suite is a core set of code that supports multiple applications. It includes miscellaneous base code for data objects, mathematic equations, and user interface components; and the framework includes several fully-developed software applications that exist as stand-alone tools to compliment other applications. The stand-alone tools are described below. Analyst Manager: An application to manage contact information for people (analysts) that use the software products. This information is often included in generated reports and may be used to identify the owners of calculations. Radionuclide Viewer: An application for viewing the DCFPAK radiological data. Compliments the Mixture Managermore » tool. Mixture Manager: An application to create and manage radionuclides mixtures that are commonly used in other applications. High Explosive Manager: An application to manage explosives and their properties. Chart Viewer: An application to view charts of data (e.g. meteorology charts). Other applications may use this framework to create charts specific to their data needs.« less

  12. An Investigation of Applications for Thermodynamic Work Potential Methods: Working Tables and Charts for Estimation of Thermodynamic Work Potential in Equilibrium Mixtures of Jet-A and Air

    NASA Technical Reports Server (NTRS)

    Mavris, Dimitri; Roth, Bryce; McDonald, Rob

    2002-01-01

    The objective of this report is to provide a tool to facilitate the application of thermodynamic work potential methods to aircraft and engine analysis. This starts with a discussion of the theoretical background underlying these methods, which is then used to derive various equations useful for thermodynamic analysis of aircraft engines. The work potential analysis method is implemented in the form of a set of working charts and tables that can be used to graphically evaluate work potential stored in high-enthalpy gas. The range of validity for these tables is 300 to 36,000 R, pressures between between 0.01 atm and 100 atm, and fuel-air ratios from zero to stoichiometric. The derivations and charts assume mixtures of Jet-A and air as the working fluid. The thermodynamic properties presented in these charts were calculated based upon standard thermodynamic curve fits.

  13. Testing an alternate informed consent process.

    PubMed

    Yates, Bernice C; Dodendorf, Diane; Lane, Judy; LaFramboise, Louise; Pozehl, Bunny; Duncan, Kathleen; Knodel, Kendra

    2009-01-01

    One of the main problems in conducting clinical trials is low participation rate due to potential participants' misunderstanding of the rationale for the clinical trial or perceptions of loss of control over treatment decisions. The objective of this study was to test an alternate informed consent process in cardiac rehabilitation participants that involved the use of a multimedia flip chart to describe a future randomized clinical trial and then asked, hypothetically, if they would participate in the future trial. An attractive and inviting visual presentation of the study was created in the form of a 23-page flip chart that included 24 color photographs displaying information about the purpose of the study, similarities and differences between the two treatment groups, and the data collection process. We tested the flip chart in 35 cardiac rehabilitation participants. Participants were asked if they would participate in this future study on two occasions: immediately after the description of the flip chart and 24 hours later, after reading through the informed consent document. Participants were also asked their perceptions of the flip chart and consent process. Of the 35 participants surveyed, 19 (54%) indicated that they would participate in the future study. No participant changed his or her decision 24 hours later after reading the full consent form. The participation rate improved 145% over that of an earlier feasibility study where the recruitment rate was 22%. Most participants stated that the flip chart was helpful and informative and that the photographs were effective in communicating the purpose of the study. Participation rates could be enhanced in future clinical trials by using a visual presentation to explain and describe the study as part of the informed consent process. More research is needed to test alternate methods of obtaining informed consent.

  14. Making large amounts of meteorological plots easily accessible to users

    NASA Astrophysics Data System (ADS)

    Lamy-Thepaut, Sylvie; Siemen, Stephan; Sahin, Cihan; Raoult, Baudouin

    2015-04-01

    The European Centre for Medium-Range Weather Forecasts (ECMWF) is an international organisation providing its member organisations with forecasts in the medium time range of 3 to 15 days, and some longer-range forecasts for up to a year ahead, with varying degrees of detail. As part of its mission, ECMWF generates an increasing number of forecast data products for its users. To support the work of forecasters and researchers and to let them make best use of ECMWF forecasts, the Centre also provides tools and interfaces to visualise their products. This allows users to make use of and explore forecasts without having to transfer large amounts of raw data. This is especially true for products based on ECMWF's 50 member ensemble forecast, where some specific processing and visualisation are applied to extract information. Every day, thousands of raw data are being pushed to the ECMWF's interactive web charts application called ecCharts, and thousands of products are processed and pushed to ECMWF's institutional web site ecCharts provides a highly interactive application to display and manipulate recent numerical forecasts to forecasters in national weather services and ECMWF's commercial customers. With ecCharts forecasters are able to explore ECMWF's medium-range forecasts in far greater detail than has previously been possible on the web, and this as soon as the forecast becomes available. All ecCharts's products are also available through a machine-to-machine web map service based on the OGC Web Map Service (WMS) standard. ECMWF institutional web site provides access to a large number of graphical products. It was entirely redesigned last year. It now shares the same infrastructure as ECMWF's ecCharts, and can benefit of some ecCharts functionalities, for example the dashboard. The dashboard initially developed for ecCharts allows users to organise their own collection of products depending on their work flow, and is being further developed. In its first implementation, It presents the user's products in a single interface with fast access to the original product, and possibilities of synchronous animations between them. But its functionalities are being extended to give users the freedom to collect not only ecCharts's 2D maps and graphs, but also other ECMWF Web products such as monthly and seasonal products, scores, and observation monitoring. The dashboard will play a key role to help the user to interpret the large amount of information that ECMWF is providing. This talk will present examples of how the new user interface can organise complex meteorological maps and graphs and show the new possibilities users have gained by using the web as a medium.

  15. Growth Charts for Prader-Willi Syndrome During Growth Hormone Treatment

    PubMed Central

    Butler, Merlin G.; Lee, Jaehoon; Cox, Devin M.; Manzardo, Ann M.; Gold, June-Anne; Miller, Jennifer L.; Roof, Elizabeth; Dykens, Elisabeth; Kimonis, Virginia; Driscoll, Daniel J.

    2018-01-01

    The purpose of the current study was to develop syndrome-specific standardized growth curves for growth hormone–treated Prader-Willi syndrome (PWS) individuals aged 0 to 18 years. Anthropometric growth-related measures were obtained on 171 subjects with PWS who were treated with growth hormone for at least 40% of their lifespan. They had no history of scoliosis. PWS standardized growth curves were developed for 7 percentile ranges using the LMS method for weight, height, head circumference, weight/length, and BMI along with normative 3rd, 50th, and 97th percentiles plotted using control data from the literature and growth databases. Percentiles were plotted on growth charts for comparison purposes. Growth hormone treatment appears to normalize stature and markedly improves weight in PWS compared with standardized curves for non–growth hormone–treated PWS individuals. Growth chart implications and recommended usage are discussed. PMID:26842920

  16. Impact of live medication therapy management on cholesterol values in patients with cardiovascular disease.

    PubMed

    Thumar, Ricky; Zaiken, Kathy

    2014-01-01

    To compare the impact of clinical pharmacist (CP) recommendations through a live, primary care-based, medication therapy management (MTM) protocol on low-density-lipoprotein (LDL) cholesterol in patients who have cardiovascular disease (CVD) with standard, chart-review MTM. Patients with established CVD who were not at their LDL goal were identified and analyzed by either a chart-review MTM service or a live, one-on-one pharmacist-physician MTM service over a 6-month timeframe. For the chart-review MTM service, recommendations were communicated through an electronic medical record (EMR) that the physician and pharmacist had access to. Primary outcomes included mean LDL reduction from baseline, number of patients achieving their LDL goal, and percent of implemented CP recommendations. Mean LDL reduction from baseline in the chart-review MTM group and the live MTM group was 36 mg/dL ± 23.2 mg/dL (P = 0.001) and 62 mg/dL ± 28.3 mg/dL (P = 0.001), respectively. The difference between these two groups was statistically significant (P = 0.001). The chart-review MTM group had 30% of patients reach their LDL goal with 66.3% of CP recommendations implemented compared to 51.3% and 86.3% for the same parameters in the live MTM group (P = 0.006 and P = 0.003, respectively). Although both MTM services provide a significant LDL reduction from baseline in patients with CVD, live MTM provides significantly greater LDL reductions, implemented CP recommendations, and goal attainment than chart-review MTM. Thus, live MTM services are more effective than chart-review MTM services, at least within the clinics that these protocols were assessed for the purposes of this study.

  17. Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart.

    PubMed

    Birch, Eileen E; Morale, Sarah E; Jost, Reed M; De La Cruz, Angie; Kelly, Krista R; Wang, Yi-Zhong; Bex, Peter J

    2016-10-01

    Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children. We enrolled 100 children (7-12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3-6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported. Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P < 0.0001). Amblyopic eye visual acuity was correlated with contrast balance ratio (r ranged from 0.49-0.57 for the 3 letter sizes). Change in visual acuity with amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43-0.62 for the 3 letter sizes). Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children.

  18. Assessing Suppression in Amblyopic Children With a Dichoptic Eye Chart

    PubMed Central

    Birch, Eileen E.; Morale, Sarah E.; Jost, Reed M.; De La Cruz, Angie; Kelly, Krista R.; Wang, Yi-Zhong; Bex, Peter J.

    2016-01-01

    Purpose Suppression has a key role in the etiology of amblyopia, and contrast-balanced binocular treatment can overcome suppression and improve visual acuity. Quantitative assessment of suppression could have a role in managing amblyopia. We describe a novel eye chart to assess suppression in children. Methods We enrolled 100 children (7–12 years; 63 amblyopic, 25 nonamblyopic with strabismus or anisometropia, 12 controls) in the primary cohort and 22 children (3–6 years; 13 amblyopic, 9 nonamblyopic) in a secondary cohort. Letters were presented on a dichoptic display (5 letters per line). Children wore polarized glasses so that each eye saw a different letter chart. At each position, the identity of the letter and its contrast on each eye's chart differed. Children read 8 lines of letters for each of 3 letter sizes. The contrast balance ratio was the ratio at which 50% of letters seen by the amblyopic eye were reported. Results Amblyopic children had significantly higher contrast balance ratios for all letter sizes compared to nonamblyopic children and controls, requiring 4.6 to 5.6 times more contrast in the amblyopic eye compared to the fellow eye (P < 0.0001). Amblyopic eye visual acuity was correlated with contrast balance ratio (r ranged from 0.49–0.57 for the 3 letter sizes). Change in visual acuity with amblyopia treatment was correlated with change in contrast balance ratio (r ranged from 0.43–0.62 for the 3 letter sizes). Conclusions Severity of suppression can be monitored as part of a routine clinical exam in the management of amblyopia in children. PMID:27784068

  19. [Systematic development of a scale for determination of health-related quality of life in multiple trauma patients. The Polytrauma Outcome (POLO) Chart].

    PubMed

    Pirente, N; Bouillon, B; Schäfer, B; Raum, M; Helling, H J; Berger, E; Neugebauer, E

    2002-05-01

    Even years after having sustained multiple injuries patients often suffer from its sequelae. These comprise restrictions in physical function, but also pain, social and psychological impairments. Although the Meran Consensus Conference in 1990 defined the contents of "quality of life" (QoL) measures in surgery, still no instrument is available for the valid assessment of all relevant QoL domains in multiple injured patients. This paper describes the systematic development of a modular instrument for the assessment of health related QoL. Within three phases (phase I: generation of items, phase II: item reduction, phase III: pre-testing in 70 multiple injured and control patients) a questionnaire of 57 items was developed, which measures all relevant trauma-related aspects of QoL after acute hospital care. In combination with the Glascow Outcome Scale (GOS), the EUROQOL and the SF-36, the newly developed instrument builds the Polytrauma Outcome Chart (POLO-Chart) which will also be used as "Part E" for outcome assessment within the "Trauma registry" of the German Society for Trauma Surgery. In phase IV, the POLO-Chart will finally be validated in five trauma centres (Celle, Essen, Hanover, Cologne und Munich).

  20. View southeast of computer controlled energy monitoring system. System replaced ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View southeast of computer controlled energy monitoring system. System replaced strip chart recorders and other instruments under the direct observation of the load dispatcher. - Thirtieth Street Station, Load Dispatch Center, Thirtieth & Market Streets, Railroad Station, Amtrak (formerly Pennsylvania Railroad Station), Philadelphia, Philadelphia County, PA

  1. Simplified hydrodynamic analysis on the general shape of the hill charts of Francis turbines using shroud-streamline modeling

    NASA Astrophysics Data System (ADS)

    Iliev, I.; Trivedi, C.; Dahlhaug, O. G.

    2018-06-01

    The paper presents a simplified one-dimensional calculation of the efficiency hill-chart for Francis turbines, based on the velocity triangles at the inlet and outlet of the runner’s blade. Calculation is done for one streamline, namely the shroud streamline in the meridional section, where an efficiency model is established and iteratively approximated in order to satisfy the Euler equation for turbomachines at a wide operating range around the best efficiency point (BEP). Using the presented method, hill charts are calculated for one splitter-bladed Francis turbine runner and one Reversible Pump-Turbine (RPT) runner operated in the turbine mode. Both turbines have similar and relatively low specific speeds of nsQ = 23.3 and nsQ = 27, equal inlet and outlet diameters and are designed to fit in the same turbine rig for laboratory measurements (i.e. spiral casing and draft tube are the same). Calculated hill charts are compared against performance data obtained experimentally from model tests according to IEC standards for both turbines. Good agreement between theoretical and experimental results is observed when comparing the shapes of the efficiency contours in the hill-charts. The simplified analysis identifies the design parameters that defines the general shape and inclination of the turbine’s hill charts and, with some additional improvements in the loss models used, it can be used for quick assessment of the performance at off-design conditions during the design process of hydraulic turbines.

  2. Pediatric reference intervals for alkaline phosphatase.

    PubMed

    Zierk, Jakob; Arzideh, Farhad; Haeckel, Rainer; Cario, Holger; Frühwald, Michael C; Groß, Hans-Jürgen; Gscheidmeier, Thomas; Hoffmann, Reinhard; Krebs, Alexander; Lichtinghagen, Ralf; Neumann, Michael; Ruf, Hans-Georg; Steigerwald, Udo; Streichert, Thomas; Rascher, Wolfgang; Metzler, Markus; Rauh, Manfred

    2017-01-01

    Interpretation of alkaline phosphatase activity in children is challenging due to extensive changes with growth and puberty leading to distinct sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics and seem reasonable for an analyte as closely linked to growth as alkaline phosphatase. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, resulting in limitations when clinical decisions are based on alkaline phosphatase activity. We applied an indirect method to generate percentile charts for alkaline phosphatase activity using clinical laboratory data collected during the clinical care of patients. A total of 361,405 samples from 124,440 patients from six German tertiary care centers and one German laboratory service provider measured between January 2004 and June 2015 were analyzed. Measurement of alkaline phosphatase activity was performed on Roche Cobas analyzers using the IFCC's photometric method. We created percentile charts for alkaline phosphatase activity in girls and boys from birth to 18 years which can be used as reference intervals. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. The percentile charts provided enable the appropriate differential diagnosis of changes in alkaline phosphatase activity due to disease and changes due to physiological development. After local validation, integration of the provided percentile charts into result reporting facilitates precise assessment of alkaline phosphatase dynamics in pediatrics.

  3. Software architecture of INO340 telescope control system

    NASA Astrophysics Data System (ADS)

    Ravanmehr, Reza; Khosroshahi, Habib

    2016-08-01

    The software architecture plays an important role in distributed control system of astronomical projects because many subsystems and components must work together in a consistent and reliable way. We have utilized a customized architecture design approach based on "4+1 view model" in order to design INOCS software architecture. In this paper, after reviewing the top level INOCS architecture, we present the software architecture model of INOCS inspired by "4+1 model", for this purpose we provide logical, process, development, physical, and scenario views of our architecture using different UML diagrams and other illustrative visual charts. Each view presents INOCS software architecture from a different perspective. We finish the paper by science data operation of INO340 and the concluding remarks.

  4. Understanding medical group financial and operational performance: the synergistic effect of linking statistical process control and profit and loss.

    PubMed

    Smolko, J R; Greisler, D S

    2001-01-01

    There is ongoing pressure for medical groups owned by not-for-profit health care systems or for-profit entrepreneurs to generate profit. The fading promise of superior strategy through health care integration has boards of directors clamoring for bottom-line performance. While prudent, sole focus on the bottom line through the lens of the profit-and-loss (P&L) statement provides incomplete information upon which to base executive decisions. The purpose of this paper is to suggest that placing statistical process control (SPC) charts in tandem with the P&L statement provides a more complete picture of medical group performance thereby optimizing decision making as executives deal with the whitewater issues surrounding physician practice ownership.

  5. An Automated Statistical Process Control Study of Inline Mixing Using Spectrophotometric Detection

    ERIC Educational Resources Information Center

    Dickey, Michael D.; Stewart, Michael D.; Willson, C. Grant

    2006-01-01

    An experiment is described, which is designed for a junior-level chemical engineering "fundamentals of measurements and data analysis" course, where students are introduced to the concept of statistical process control (SPC) through a simple inline mixing experiment. The students learn how to create and analyze control charts in an effort to…

  6. Reducing lumber thickness variation using real-time statistical process control

    Treesearch

    Thomas M. Young; Brian H. Bond; Jan Wiedenbeck

    2002-01-01

    A technology feasibility study for reducing lumber thickness variation was conducted from April 2001 until March 2002 at two sawmills located in the southern U.S. A real-time statistical process control (SPC) system was developed that featured Wonderware human machine interface technology (HMI) with distributed real-time control charts for all sawing centers and...

  7. Family Food Choices: A Guide to Weight and Diabetes Control.

    ERIC Educational Resources Information Center

    Indian Health Service (PHS/HSA), Rockville, MD.

    Written for American Indians who have diabetes, this folder explains diabetes and outlines a weight control program and diet. The folder discusses the five things diabetics can do to help control their disease: lose weight, watch the amount and kind of fat eaten, eat more food with fiber, avoid sugar, and avoid alcohol. Charts for foods containing…

  8. Automatic Extraction of High-Resolution Rainfall Series from Rainfall Strip Charts

    NASA Astrophysics Data System (ADS)

    Saa-Requejo, Antonio; Valencia, Jose Luis; Garrido, Alberto; Tarquis, Ana M.

    2015-04-01

    Soil erosion is a complex phenomenon involving the detachment and transport of soil particles, storage and runoff of rainwater, and infiltration. The relative magnitude and importance of these processes depends on a host of factors, including climate, soil, topography, cropping and land management practices among others. Most models for soil erosion or hydrological processes need an accurate storm characterization. However, this data are not always available and in some cases indirect models are generated to fill this gap. In Spain, the rain intensity data known for time periods less than 24 hours back to 1924 and many studies are limited by it. In many cases this data is stored in rainfall strip charts in the meteorological stations but haven't been transfer in a numerical form. To overcome this deficiency in the raw data a process of information extraction from large amounts of rainfall strip charts is implemented by means of computer software. The method has been developed that largely automates the intensive-labour extraction work based on van Piggelen et al. (2011). The method consists of the following five basic steps: 1) scanning the charts to high-resolution digital images, 2) manually and visually registering relevant meta information from charts and pre-processing, 3) applying automatic curve extraction software in a batch process to determine the coordinates of cumulative rainfall lines on the images (main step), 4) post processing the curves that were not correctly determined in step 3, and 5) aggregating the cumulative rainfall in pixel coordinates to the desired time resolution. A colour detection procedure is introduced that automatically separates the background of the charts and rolls from the grid and subsequently the rainfall curve. The rainfall curve is detected by minimization of a cost function. Some utilities have been added to improve the previous work and automates some auxiliary processes: readjust the bands properly, merge bands when those have been scanned in two parts, detect and cut the borders of bands not used (demanded by the software). Also some variations in which colour system is tried basing in HUE or RGB colour have been included. Thanks to apply this digitization rainfall strip charts 209 station-years of three locations in the centre of Spain have been transformed to long-term rainfall time series with 5-min resolution. References van Piggelen, H.E., T. Brandsma, H. Manders, and J. F. Lichtenauer, 2011: Automatic Curve Extraction for Digitizing Rainfall Strip Charts. J. Atmos. Oceanic Technol., 28, 891-906. Acknowledgements Financial support for this research by DURERO Project (Env.C1.3913442) is greatly appreciated.

  9. Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

    PubMed

    Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

    2015-06-01

    Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- mBC patients treated in community oncology settings, treatment with everolimus-based therapy was associated with significantly longer TOT and PFS compared to endocrine monotherapy.

  10. Root Cause Analysis of Quality Defects Using HPLC-MS Fingerprint Knowledgebase for Batch-to-batch Quality Control of Herbal Drugs.

    PubMed

    Yan, Binjun; Fang, Zhonghua; Shen, Lijuan; Qu, Haibin

    2015-01-01

    The batch-to-batch quality consistency of herbal drugs has always been an important issue. To propose a methodology for batch-to-batch quality control based on HPLC-MS fingerprints and process knowledgebase. The extraction process of Compound E-jiao Oral Liquid was taken as a case study. After establishing the HPLC-MS fingerprint analysis method, the fingerprints of the extract solutions produced under normal and abnormal operation conditions were obtained. Multivariate statistical models were built for fault detection and a discriminant analysis model was built using the probabilistic discriminant partial-least-squares method for fault diagnosis. Based on multivariate statistical analysis, process knowledge was acquired and the cause-effect relationship between process deviations and quality defects was revealed. The quality defects were detected successfully by multivariate statistical control charts and the type of process deviations were diagnosed correctly by discriminant analysis. This work has demonstrated the benefits of combining HPLC-MS fingerprints, process knowledge and multivariate analysis for the quality control of herbal drugs. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Comments on "Modified wind chill temperatures determined by a whole body thermoregulation model and human-based convective coefficients" by Ben Shabat, Shitzer and Fiala (2013) and "Facial convective heat exchange coefficients in cold and windy environments estimated from human experiments" by Ben Shabat and Shitzer (2012)

    NASA Astrophysics Data System (ADS)

    Osczevski, Randall J.

    2014-08-01

    Ben Shabat et al. (Int J Biometeorol 56(4):639-51, 2013) present revised charts for wind chill equivalent temperatures (WCET) and facial skin temperatures (FST) that differ significantly from currently accepted charts. They credit these differences to their more sophisticated calculation model and to the human-based equation that it used for finding the convective heat transfer coefficient (Ben Shabat and Shitzer, Int J Biometeorol 56:639-651, 2012). Because a version of the simple model that was used to create the current charts accurately reproduces their results when it uses the human-based equation, the differences that they found must be entirely due to this equation. In deriving it, Ben Shabat and Shitzer assumed that all of the heat transfer from the surface of their cylindrical model was due to forced convection alone. Because several modes of heat transfer were occurring in the human experiments they were attempting to simulate, notably radiation, their coefficients are actually total external heat transfer coefficients, not purely convective ones, as the calculation models assume. Data from the one human experiment that used heat flux sensors supports this conclusion and exposes the hazard of using a numerical model with several adjustable parameters that cannot be measured. Because the human-based equation is faulty, the values in the proposed charts are not correct. The equation that Ben Shabat et al. (Int J Biometeorol 56(4):639-51, 2013) propose to calculate WCET should not be used.

  12. Correlation of the Cretaceous formations of Greenland and Alaska

    USGS Publications Warehouse

    Imlay, Ralph Willard; Reeside, John B.

    1953-01-01

    This is Number 10d of a series of correlation charts prepared for the Committee on Stratigraphy of the National Research Council. It has been sponsored by the U.S. Geological Survey and has required about seven months' time of both authors gathering and compiling data and evaluating fossil evidence. As the two regions dealt with in the chart are widely separated, the lists of references are also given separately. The annotations dealing with Greenland are based entirely on published information. The annotations dealing with Alaska are based on a re-examination of nearly all the Cretaceous fossils from Alaska are based on a re-examination of nearly all the Cretaceous fossils from Alaska in the collections of the Geological Survey. This has resulted in many concepts not hitherto published and in some concepts that are completely at variance with those that have been published. Naturally for large areas undergoing active exploration, such as Alaska, a correlation chart is out of date in many particulars as soon as published. Nevertheless it is valuable to the field man whose activities are confined to small areas but who must interpret much of his data in terms of surrounding areas that he has not seen. It is valuable to the student and to the general geologist because it organizes scattered information in a manner that can be applied in their field problems, makes quite unnecessary the memorization of stratigraphic correlations are based on observation and reasoning and not on a vast memory. It is probably of greatest value to the specialist who makes the chart because he discovers what areas and problems are most in need of research and can thereby direct his efforts and those of his associates in a manner that will yield the greatest results.

  13. Experimental Design For Photoresist Characterization

    NASA Astrophysics Data System (ADS)

    Luckock, Larry

    1987-04-01

    In processing a semiconductor product (from discrete devices up to the most complex products produced) we find more photolithographic steps in wafer fabrication than any other kind of process step. Thus, the success of a semiconductor manufacturer hinges on the optimization of their photolithographic processes. Yet, we find few companies that have taken the time to properly characterize this critical operation; they are sitting in the "passenger's seat", waiting to see what will come out, hoping that the yields will improve someday. There is no "black magic" involved in setting up a process at its optimum conditions (i.e. minimum sensitivity to all variables at the same time). This paper gives an example of a real world situation for optimizing a photolithographic process by the use of a properly designed experiment, followed by adequate multidimensional analysis of the data. Basic SPC practices like plotting control charts will not, by themselves, improve yields; the control charts are, however, among the necessary tools used in the determination of the process capability and in the formulation of the problems to be addressed. The example we shall consider is the twofold objective of shifting the process average, while tightening the variance, of polysilicon line widths. This goal was identified from a Pareto analysis of yield-limiting mechanisms, plus inspection of the control charts. A key issue in a characterization of this type of process is the number of interactions between variables; this example rules out two-level full factorial and three-level fractional factorial designs (which cannot detect all of the interactions). We arrive at an experiment with five factors at five levels each. A full factorial design for five factors at three levels would require 3125 wafers. Instead, we will use a design that allows us to run this experiment with only 25 wafers, for a significant reduction in time, materials and manufacturing interruption in order to complete the experiment. An optimum solution is then determined via response surface analysis and a series of 3-D and contour plots are shown. The offset between the mask dimensions and poly CD at the optimum operating conditions is discussed with respect to yield, profits and return-on-investment. The expert system used for process optimization covers all types of process steps, producing the best custom designed experiment based on the actual equipment used. The knowledge base contains parameter lists, by machine make and model, ranked by sensitivity and controllability. One option allows 3-D spatial characterization of equipment. For the purpose of this presentation, we will assume that we want to optimize a photo-lithographic process used for polysilicon pattern definition and that we have determined minimum and maximum line widths, based on electrical yield requirements of the product. For this MOS process, the minimum critical dimension (CD) for the poly gate was determined by punchthrough voltage, threshold voltage, etc., while the maximum CD was determined from other performance factors like access time. We will start with the product engineer's analysis.

  14. A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy.

    PubMed

    Hutcheon, Jennifer A; Platt, Robert W; Abrams, Barbara; Himes, Katherine P; Simhan, Hyagriv N; Bodnar, Lisa M

    2013-05-01

    To establish the unbiased relation between maternal weight gain in pregnancy and perinatal health, a classification for maternal weight gain is needed that is uncorrelated with gestational age. The goal of this study was to create a weight-gain-for-gestational-age percentile and z score chart to describe the mean, SD, and selected percentiles of maternal weight gain throughout pregnancy in a contemporary cohort of US women. The study population was drawn from normal-weight women with uncomplicated, singleton pregnancies who delivered at the Magee-Womens Hospital in Pittsburgh, PA, 1998-2008. Analyses were based on a randomly selected subset of 648 women for whom serial prenatal weight measurements were available through medical chart record abstraction (6727 weight measurements). The pattern of maternal weight gain throughout gestation was estimated by using a random-effects regression model. The estimates were used to create a chart with the smoothed means, percentiles, and SDs of gestational weight gain for each week of pregnancy. This chart allows researchers to express total weight gain as an age-standardized z score, which can be used in epidemiologic analyses to study the association between pregnancy weight gain and adverse or physiologic pregnancy outcomes independent of gestational age.

  15. Engineering the Ideal Array (BRIEFING CHARTS)

    DTIC Science & Technology

    2007-03-05

    48 V, f = 10 GHz GaN HEMT Transistor i t Dramatically higher: • Output power • Efficiency • Bandwidth GaN HEMT Power Amplifier lifi ...functions – RF amplifiers – 4-bit phase shifters – Amplitude controllers – Summing network – Power control – Latches for phase state – Address

  16. OAP- OFFICE AUTOMATION PILOT GRAPHICS DATABASE SYSTEM

    NASA Technical Reports Server (NTRS)

    Ackerson, T.

    1994-01-01

    The Office Automation Pilot (OAP) Graphics Database system offers the IBM PC user assistance in producing a wide variety of graphs and charts. OAP uses a convenient database system, called a chartbase, for creating and maintaining data associated with the charts, and twelve different graphics packages are available to the OAP user. Each of the graphics capabilities is accessed in a similar manner. The user chooses creation, revision, or chartbase/slide show maintenance options from an initial menu. The user may then enter or modify data displayed on a graphic chart. The cursor moves through the chart in a "circular" fashion to facilitate data entries and changes. Various "help" functions and on-screen instructions are available to aid the user. The user data is used to generate the graphics portion of the chart. Completed charts may be displayed in monotone or color, printed, plotted, or stored in the chartbase on the IBM PC. Once completed, the charts may be put in a vector format and plotted for color viewgraphs. The twelve graphics capabilities are divided into three groups: Forms, Structured Charts, and Block Diagrams. There are eight Forms available: 1) Bar/Line Charts, 2) Pie Charts, 3) Milestone Charts, 4) Resources Charts, 5) Earned Value Analysis Charts, 6) Progress/Effort Charts, 7) Travel/Training Charts, and 8) Trend Analysis Charts. There are three Structured Charts available: 1) Bullet Charts, 2) Organization Charts, and 3) Work Breakdown Structure (WBS) Charts. The Block Diagram available is an N x N Chart. Each graphics capability supports a chartbase. The OAP graphics database system provides the IBM PC user with an effective means of managing data which is best interpreted as a graphic display. The OAP graphics database system is written in IBM PASCAL 2.0 and assembler for interactive execution on an IBM PC or XT with at least 384K of memory, and a color graphics adapter and monitor. Printed charts require an Epson, IBM, OKIDATA, or HP Laser printer (or equivalent). Plots require the Tektronix 4662 Penplotter. Source code is supplied to the user for modification and customizing. Executables are also supplied for all twelve graphics capabilities. This system was developed in 1983, and Version 3.1 was released in 1986.

  17. New aids for the non-invasive prenatal diagnosis of achondroplasia: dysmorphic features, charts of fetal size and molecular confirmation using cell-free fetal DNA in maternal plasma.

    PubMed

    Chitty, L S; Griffin, D R; Meaney, C; Barrett, A; Khalil, A; Pajkrt, E; Cole, T J

    2011-03-01

    To improve the prenatal diagnosis of achondroplasia by constructing charts of fetal size, defining frequency of sonographic features and exploring the role of non-invasive molecular diagnosis based on cell-free fetal deoxyribonucleic acid (DNA) in maternal plasma. Data on fetuses with a confirmed diagnosis of achondroplasia were obtained from our databases, records reviewed, sonographic features and measurements determined and charts of fetal size constructed using the LMS (lambda-mu-sigma) method and compared with charts used in normal pregnancies. Cases referred to our regional genetics laboratory for molecular diagnosis using cell-free fetal DNA were identified and results reviewed. Twenty-six cases were scanned in our unit. Fetal size charts showed that femur length was usually on or below the 3(rd) centile by 25 weeks' gestation, and always below the 3(rd) by 30 weeks. Head circumference was above the 50(th) centile, increasing to above the 95(th) when compared with normal for the majority of fetuses. The abdominal circumference was also increased but to a lesser extent. Commonly reported sonographic features were bowing of the femora, frontal bossing, short fingers, a small chest and polyhydramnios. Analysis of cell-free fetal DNA in six pregnancies confirmed the presence of the c.1138G > A mutation in the FGRF3 gene in four cases with achondroplasia, but not the two subsequently found to be growth restricted. These data should improve the accuracy of diagnosis of achondroplasia based on sonographic findings, and have implications for targeted molecular confirmation that can reliably and safely be carried out using cell-free fetal DNA. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  18. Occupational Injury and Treatment Patterns of Migrant and Seasonal Farmworkers

    PubMed Central

    Brower, Melissa A.; Earle-Richardson, Giulia B.; May, John J.; Jenkins, Paul L.

    2010-01-01

    Migrant and seasonal farmworkers are thought to be at increased risk for occupational injury and illness. Past surveillance efforts that employed medical chart review may not be representative of all farmworkers, since the proportion of farmworkers using migrant health centers (MHC) and area hospital emergency rooms (ER) was unknown. The purpose of the current study was to determine the proportion of workers using MHCs versus other sources of occupational health care, and to use this data to correct previous occupational injury and illness rate estimates. Researchers conducted a survey of migrant and seasonal farmworkers in two sites: the Finger Lakes Region of New York and the apple, broccoli and blueberry regions of Maine. Researchers also conducted MHC and ER medical chart reviews in these regions for comparison purposes. Proportions of occupational morbidity by treatment location were calculated from the survey, and a correction factor was computed to adjust chart review morbidity estimates for Maine and New York State. Among 1,103 subjects, 56 work-related injuries were reported: 30 (53.6%) were treated at a MHC, 8 (14.3%) at an ER, 9 (16.1%) at some other location (e.g., home, relative, chiropractor), and 9 (16.1%) were untreated. Mechanisms of injuries treated at MHCs versus all other sources did not differ significantly. The survey-based multiplier (1.87) was applied to previous statewide MHC chart review injury counts from Maine and New York. The corrected injury rates were 7.9 per 100 full time equivalents (FTE) per year in Maine, and 11.7 per 100 FTE in New York. A chart-review based surveillance system, combined with a correction factor, may provide an effective method of estimating occupational illness and injury rates in this population. PMID:19437274

  19. How well do commonly used data presentation formats support comparative effectiveness evaluations?

    PubMed Central

    Dolan, James G.; Qian, Feng; Veazie, Peter J.

    2012-01-01

    Background Good decisions depend on an accurate understanding of the comparative effectiveness of decision alternatives. The best way convey data needed to support these comparisons is unknown. Objective To determine how well five commonly used data presentation formats convey comparative effectiveness information. Design Internet survey using a factorial design. Subjects 279 members of an online survey panel. Intervention Study participants compared outcomes associated with three hypothetical screening test options relative to five possible outcomes with probabilities ranging from 2 per 5,000 (0.04%) to 500 per 1,000 (50%). Data presentation formats included a table, a “magnified” bar chart, a risk scale, a frequency diagram, and an icon array. Measurements Outcomes included the number of correct ordinal judgments regarding the more likely of two outcomes, the ratio of perceived versus actual relative likelihoods of the paired outcomes, the inter-subject consistency of responses, and perceived clarity. Results The mean number of correct ordinal judgments was 12 of 15 (80%), with no differences among data formats. On average, there was a 3.3-fold difference between perceived and actual likelihood ratios,95%CI: 3.0 to 3.6. Comparative judgments based on flow charts, icon arrays, and tables were all significantly more accurate and consistent than those based on risk scales and bar charts, p < 0.001. The most clearly perceived formats were the table and the flow chart. Low subjective numeracy was associated with less accurate and more variable data interpretations and lower perceived clarity for icon displays, bar charts, and flow diagrams. Conclusions None of the data presentation formats studied can reliably provide patients, especially those with low subjective numeracy, with an accurate understanding of comparative effectiveness information. PMID:22618998

  20. System for verifiable CT radiation dose optimization based on image quality. part II. process control system.

    PubMed

    Larson, David B; Malarik, Remo J; Hall, Seth M; Podberesky, Daniel J

    2013-10-01

    To evaluate the effect of an automated computed tomography (CT) radiation dose optimization and process control system on the consistency of estimated image noise and size-specific dose estimates (SSDEs) of radiation in CT examinations of the chest, abdomen, and pelvis. This quality improvement project was determined not to constitute human subject research. An automated system was developed to analyze each examination immediately after completion, and to report individual axial-image-level and study-level summary data for patient size, image noise, and SSDE. The system acquired data for 4 months beginning October 1, 2011. Protocol changes were made by using parameters recommended by the prediction application, and 3 months of additional data were acquired. Preimplementation and postimplementation mean image noise and SSDE were compared by using unpaired t tests and F tests. Common-cause variation was differentiated from special-cause variation by using a statistical process control individual chart. A total of 817 CT examinations, 490 acquired before and 327 acquired after the initial protocol changes, were included in the study. Mean patient age and water-equivalent diameter were 12.0 years and 23.0 cm, respectively. The difference between actual and target noise increased from -1.4 to 0.3 HU (P < .01) and the standard deviation decreased from 3.9 to 1.6 HU (P < .01). Mean SSDE decreased from 11.9 to 7.5 mGy, a 37% reduction (P < .01). The process control chart identified several special causes of variation. Implementation of an automated CT radiation dose optimization system led to verifiable simultaneous decrease in image noise variation and SSDE. The automated nature of the system provides the opportunity for consistent CT radiation dose optimization on a broad scale. © RSNA, 2013.

  1. Improving Practice Guideline Adherence Through Peer Feedback: Impact of an Ambulatory Cardiology Curriculum.

    PubMed

    Richardson, Karl M; Singh, Jai; Muñoz, Dan; Damp, Julie B; Mendes, Lisa A

    2018-01-01

    Graduate medical trainees must be prepared to practice in a quality-driven system that values adherence to and documentation of evidence-based care. Few validated approaches exist to teach these skills. Our objective was to develop, implement, and evaluate an ambulatory practice improvement curriculum capitalizing on peer feedback aimed at improving cardiology fellow guideline knowledge, adherence, and chart documentation. Four outpatient topics were reviewed in dedicated 1-hour sessions: stable ischemic heart disease, heart failure, atrial fibrillation, and aortic valvular disease. Each session began with peer review, critique, and guideline adherence discussion of deidentified outpatient fellow clinic charts, followed by discussion of clinical guidelines. The open discussion of real clinic notes provided a forum for peer feedback exchange. Before each session and after the final session, participants completed a multiple-choice knowledge assessment and self-assessment of comfort with the guidelines. To evaluate the potential effect on patient care, random clinic chart audits were conducted before and after the curriculum using a chart scoring system. Although the format is broadly applicable, the specific curriculum content was designed for a cardiology fellowship cohort in a large academic medical center. It was organized and implemented by 2 cardiology fellows under the direction and supervision of program directors. The curriculum was implemented during prescheduled noon conference hours. The intention was to carry forward this ambulatory curriculum in subsequent years and to use the first 4 sessions to study its potential successes and opportunities for improvement. All 22 general cardiology fellows attended at least two sessions (M = 3.1). Knowledge test scores rose from 52.6% to 73.0% (20.4% increase, p < .001), 95% confidence interval (CI) [13.6%, 27.2%]. Self-reported guidelines knowledge improved by 15.1% (p = .002), 95% CI [6.2%, 24.0%], and self-reported documentation improved by 12.5% (p = .008), 95% CI [3.8%, 21.7%]. Chart audit scores improved by 17.8% (p < .001), 95% CI [10.6%, 25.0%], driven in part by 16.4% improvement in adherence to Class I therapies (p = .001). A targeted curriculum combining peer chart review, feedback, and guideline discussion was associated with significant improvement in fellows' knowledge and adherence to evidence-based therapies. Peer assessment and group-based education and feedback can be leveraged to improve trainee education and impact patient care.

  2. Comparison of the Handy Eye Chart and the Lea Symbols Chart in a population of deaf children aged 7–18 years

    PubMed Central

    Gorham, John Paul; Bruce, Beau B.; Hutchinson, Amy K.

    2016-01-01

    Purpose To compare the results of visual acuity testing in a population of deaf children using the Handy Eye Chart versus the Lea Symbols Chart and to compare testability and preference between charts. Methods A total of 24 participants were recruited at the Atlanta Area School for the Deaf. Visual Acuity was evaluated using the Handy Eye Chart and the Lea Symbols Chart. Patient preference and duration of testing were measured. Results The mean difference between the visual acuity as measured by each chart was –0.02 logMAR (95% CI, −0.06 to 0.03). Testing with the Handy Eye Chart was an average of 13.79 seconds faster than testing with the Lea Symbols Chart (95% CI, 1.1–26.47; P = 0.03). Of the 24 participants, 17 (71%) preferred the Handy Eye Chart (95% CI: 49%–87%; P = 0.07). Conclusions The Handy Eye Chart is a fast, valid, and preferred tool for measuring visual acuity in deaf children age 7–18 years. Additional research is needed to evaluate the utility of the Handy Eye Chart in younger children and deaf adults. PMID:27164427

  3. Weight-Independent Percentile Chart of 2880 Gastric Bypass Patients: a New Look at Bariatric Weight Loss Results.

    PubMed

    van de Laar, Arnold W; de Brauw, Maurits; Bruin, Sjoerd C; Acherman, Yair I

    2016-12-01

    Percentile charts would be ideal for assessing sufficient weight loss in bariatric surgery. They allow comparing individual results to the outcome of many others, at any postoperative time. Unfortunately, percentile charts can be problematic when comparing unequally heavy peers, a circumstance not uncommon among bariatric patients. We investigate the relevance of this disadvantage and combine new insights to improve the practical use of percentile charts in bariatric surgery. Laparoscopic Roux-en-Y gastric bypass outcome expressed with body mass index (BMI), excess weight loss (%EWL), total weight loss (%TWL), and alterable weight loss (%AWL), a new metric rendering outcome independent of baseline BMI, is used to build percentile curves p97/p90/p75/p50/p25/p10/p03 with the lambda-mu-sigma method. We used the %AWL p25 curve as baseline BMI-independent reference for sufficient weight loss and compared it to p25 curves based on common metrics and to traditional criteria ≥50 % EWL, <25 % EWL, and BMI < 35 kg/m 2 . We operated 2880 patients, with baseline BMI of 43.4 kg/m 2 , follow-up 71 %, and mean of 23.3 (0-87.6) months. Independent %AWL outcome is presented in one percentile chart. Percentile curves p25/p50/p75 show 40/48/57 % AWL at nadir 15/16/19 months, 35/45/54 % AWL at 3 years, and 30/38/47 % AWL at 7 years. Traditional criteria and p25 curves based on %EWL and BMI match with most sufficient results (high sensitivities), but overlook many insufficient results (low specificities). We present the first baseline BMI-independent bariatric weight loss percentile chart. It allows comparing heavier patients to lighter peers and vice versa, at any postoperative time, up to 7 years. With these advantages, we compared it to traditional bariatric criteria like ≥50 % EWL and found that they are weak in recognizing insufficient weight loss. The visual aspect of consecutive results plotted on a chart among the percentile curves of peers conveys a strong, intuitive message on the personal progress of postoperative weight loss.

  4. The International Geomagnetic Reference Field, 2005

    USGS Publications Warehouse

    Rukstales, Kenneth S.; Love, Jeffrey J.

    2007-01-01

    This is a set of five world charts showing the declination, inclination, horizontal intensity, vertical component, and total intensity of the Earth's magnetic field at mean sea level at the beginning of 2005. The charts are based on the International Geomagnetic Reference Field (IGRF) main model for 2005 and secular change model for 2005-2010. The IGRF is referenced to the World Geodetic System 1984 ellipsoid. Additional information about the USGS geomagnetism program is available at: http://geomag.usgs.gov/

  5. Minimizing the Workup of Blood Culture Contaminants: Implementation and Evaluation of a Laboratory-Based Algorithm

    PubMed Central

    Richter, S. S.; Beekmann, S. E.; Croco, J. L.; Diekema, D. J.; Koontz, F. P.; Pfaller, M. A.; Doern, G. V.

    2002-01-01

    An algorithm was implemented in the clinical microbiology laboratory to assess the clinical significance of organisms that are often considered contaminants (coagulase-negative staphylococci, aerobic and anaerobic diphtheroids, Micrococcus spp., Bacillus spp., and viridans group streptococci) when isolated from blood cultures. From 25 August 1999 through 30 April 2000, 12,374 blood cultures were submitted to the University of Iowa Clinical Microbiology Laboratory. Potential contaminants were recovered from 495 of 1,040 positive blood cultures. If one or more additional blood cultures were obtained within ±48 h and all were negative, the isolate was considered a contaminant. Antimicrobial susceptibility testing (AST) of these probable contaminants was not performed unless requested. If no additional blood cultures were submitted or there were additional positive blood cultures (within ±48 h), a pathology resident gathered patient clinical information and made a judgment regarding the isolate's significance. To evaluate the accuracy of these algorithm-based assignments, a nurse epidemiologist in approximately 60% of the cases performed a retrospective chart review. Agreement between the findings of the retrospective chart review and the automatic classification of the isolates with additional negative blood cultures as probable contaminants occurred among 85.8% of 225 isolates. In response to physician requests, AST had been performed on 15 of the 32 isolates with additional negative cultures considered significant by retrospective chart review. Agreement of pathology resident assignment with the retrospective chart review occurred among 74.6% of 71 isolates. The laboratory-based algorithm provided an acceptably accurate means for assessing the clinical significance of potential contaminants recovered from blood cultures. PMID:12089259

  6. The Computational and Neural Basis of Cognitive Control: Charted Territory and New Frontiers

    ERIC Educational Resources Information Center

    Botvinick, Matthew M.; Cohen, Jonathan D.

    2014-01-01

    Cognitive control has long been one of the most active areas of computational modeling work in cognitive science. The focus on computational models as a medium for specifying and developing theory predates the PDP books, and cognitive control was not one of the areas on which they focused. However, the framework they provided has injected work on…

  7. 14 CFR 121.420 - Flight navigators: Initial and transition ground training.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... limitations and methods of compensation. (6) Cruise control charts and data, including fuel consumption rates... type airplane: (1) Limitations on climb, cruise, and descent speeds. (2) Each item of navigational...

  8. 14 CFR 121.420 - Flight navigators: Initial and transition ground training.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... limitations and methods of compensation. (6) Cruise control charts and data, including fuel consumption rates... type airplane: (1) Limitations on climb, cruise, and descent speeds. (2) Each item of navigational...

  9. Integration of PGD-virtual charts into an engineering design process

    NASA Astrophysics Data System (ADS)

    Courard, Amaury; Néron, David; Ladevèze, Pierre; Ballere, Ludovic

    2016-04-01

    This article deals with the efficient construction of approximations of fields and quantities of interest used in geometric optimisation of complex shapes that can be encountered in engineering structures. The strategy, which is developed herein, is based on the construction of virtual charts that allow, once computed offline, to optimise the structure for a negligible online CPU cost. These virtual charts can be used as a powerful numerical decision support tool during the design of industrial structures. They are built using the proper generalized decomposition (PGD) that offers a very convenient framework to solve parametrised problems. In this paper, particular attention has been paid to the integration of the procedure into a genuine engineering design process. In particular, a dedicated methodology is proposed to interface the PGD approach with commercial software.

  10. Metabolic effects of antipsychotics in prepubertal children: a retrospective chart review.

    PubMed

    Ebert, Tanya; Midbari, Yael; Shmilovitz, Ronen; Kosov, Ira; Kotler, Moshe; Weizman, Abraham; Ram, Anca

    2014-05-01

    Antipsychotics, especially atypical ones, are in common use in children and adolescents with psychotic or affective spectrum disorders, as well as in various other psychopathologies. The adverse effects of atypical antipsychotics in children and adolescents are similar to those seen in adults, and include weight gain, elevated blood glucose levels, and hyperlipidemia. In this retrospective chart review, we compared these adverse events in children who were treated with typical, atypical, or no antipsychotic treatment. The medical charts of 72 children, 65 boys and 7 girls, were reviewed. All children were 6-13 years old (mean age 9.5±1.7 years). In total, 48 children received antipsychotic treatment, and 24 children were in the control group. Data were extracted from the medical charts, including weight, height, body mass index (BMI), blood pressure, aspartate transaminase (AST), alanine transaminase (ALT), triglycerides, total cholesterol, and glucose blood levels. We examined the values in the beginning of the antipsychotic treatment and at release from the hospital in the study group, and at admission and in the end of the drug-free period or at release from the hospital (a duration of at least 4 weeks) in the control group. The average weight gain was 3.9±3.8 kg in the atypical antipsychotic treatment (AAT) group, 1.1±4.4 kg in the typical antipsychotic treatment (TAT) group, and 0.23±2.9 kg in the control group. The average increase in BMI was 15.1±22.0 percentiles in the AAT group, 6.4±14.2 percentiles in the TAT group, and 1.6±12.5 percentiles in the control group. No statistically significant difference was found in the increase in height percentile. There were no significant differences in the rates of elevated values of serum triglycerides, cholesterol, AST, ALT, or fasting blood glucose. We found a significant increase in both absolute weight gain and BMI percentile following atypical antipsychotic treatment. In contrast, typical antipsychotic treatment did not affect weight gain significantly, and the same was true for the control group. In addition, the rates of elevated values of biochemical parameters (AST, ALT, total cholesterol, triglycerides, and fasting blood glucose levels) were very low at the beginning of the study, and were not significantly altered by the various treatments.

  11. Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation.

    PubMed

    Mansfield, Avril; Mochizuki, George; Inness, Elizabeth L; McIlroy, William E

    2012-01-01

    Stroke-related sensorimotor impairment potentially contributes to impaired balance. Balance measures that reveal underlying limb-specific control problems, such as a measure of the synchronization of both lower limbs to maintain standing balance, may be uniquely informative about poststroke balance control. This study aimed to determine the relationships between clinical measures of sensorimotor control, functional balance, and fall risk and between-limb synchronization of balance control. The authors conducted a retrospective chart review of 100 individuals with stroke admitted to inpatient rehabilitation. Force plate-based measures were obtained while standing on 2 force plates, including postural sway (root mean square of anteroposterior and mediolateral center of pressure [COP]), stance load asymmetry (percentage of body weight borne on the less-loaded limb), and between-limb synchronization (cross-correlation of the COP recordings under each foot). Clinical measures obtained were motor impairment (Chedoke-McMaster Stroke Assessment), plantar cutaneous sensation, functional balance (Berg Balance Scale), and falls experienced in rehabilitation. Synchronization was significantly related to motor impairment and prospective falls, even when controlling for other force plate-based measures of standing balance control (ie, postural sway and stance load symmetry). Between-limb COP synchronization for standing balance appears to be a uniquely important index of balance control, independent of postural sway and load symmetry during stance.

  12. Comparison of optotypes of Amsterdam Picture Chart with those of Tumbling-E, LEA symbols, ETDRS, and Landolt-C in non-amblyopic and amblyopic patients.

    PubMed

    Engin, O; Despriet, D D G; van der Meulen-Schot, H M; Romers, A; Slot, X; Sang, M Tjon Fo; Fronius, M; Kelderman, H; Simonsz, H J

    2014-12-01

    To compare optotypes of the Amsterdam Picture Chart (APK) with those of Landolt-C (LC), Tumbling-E (TE), ETDRS and LEA symbols (LEA), to assess their reliability in measuring visual acuity (VA). We recruited healthy controls with equal VA and amblyopes with ≥2 LogMAR lines interocular difference. New logarithmic charts were developed with LC, TE, ETDRS, LEA, and APK with identical size and spacing (four optotypes) between optotypes. Charts were randomly presented at 5 m under DIN EN ISO 8596 and 8597 conditions. VA was measured with LC (LC-VA), TE, ETDRS, LEA, and APK, using six out of ten optotypes answered correctly as threshold. In 100 controls aged 17-31, LC-VA was -0.207 ± SD 0.089 LogMAR. Visual acuity measured with TE differed from LC-VA by 0.021 (positive value meaning less recognizable), with ETDRS 0.012, with Lea 0.054, and with APK 0.117. In 46 amblyopic eyes with LC-VA <0.5 LogMAR, the difference was for TE 0.017, for ETDRS 0.017, for LEA 0.089, and for APK 0.213. In 13 amblyopic eyes with LC-VA ≥0.5 LogMAR, the difference was for TE 0.122, ETDRS 0.047, LEA 0.057, and APK 0.019. APK optotypes had a lower percentage of passed subjects at each LogMAR line compared to Landolt-C. The 11 APK optotypes had different thresholds. Small APK optotypes were recognized worse than all other optotypes, probably because of their thinner lines. Large APK optotypes were recognized relatively well, possibly reflecting recognition acuity. Differences between the thresholds of the 11 APK optotypes reduced its sensitivity further.

  13. Design charts for predicting downwash angles and wake characteristics behind plain and flapped wings

    NASA Technical Reports Server (NTRS)

    Silverstein, Abe; Katzoff, S

    1939-01-01

    Equations and design charts are given for predicting the downwash angles and the wake characteristics for power-off conditions behind plain and flapped wings of the types used in modern design practice. The downwash charts cover the cases of elliptical wings and wings of taper ratios 1, 2, 3, and 5, with aspect ratios of 6, 9, and 12, having flaps covering 0, 40, 70, and 100 percent of the span. Curves of the span load distributions for all these cases are included. Data on the lift and the drag of flapped airfoil sections and curves for finding the contribution of the flap to the total wing lift for different types of flap and for the entire range of flap spans are also included. The wake width and the distribution of dynamic pressure across the wake are given in terms of the profile-drag coefficient and the distance behind the wing. A method of estimating the wake position is also given. The equations and charts are based on theory that has been shown in a previous report to be in agreement with experiment.

  14. Interactive SIGHT: textual access to simple bar charts

    NASA Astrophysics Data System (ADS)

    Demir, Seniz; Oliver, David; Schwartz, Edward; Elzer, Stephanie; Carberry, Sandra; Mccoy, Kathleen F.; Chester, Daniel

    2010-12-01

    Information graphics, such as bar charts and line graphs, are an important component of many articles from popular media. The majority of such graphics have an intention (a high-level message) to communicate to the graph viewer. Since the intended message of a graphic is often not repeated in the accompanying text, graphics together with the textual segments contribute to the overall purpose of an article and cannot be ignored. Unfortunately, these visual displays are provided in a format which is not readily accessible to everyone. For example, individuals with sight impairments who use screen readers to listen to documents have limited access to the graphics. This article presents a new accessibility tool, the Interactive SIGHT (Summarizing Information GrapHics Textually) system, that is intended to enable visually impaired users to access the knowledge that one would gain from viewing information graphics found on the web. The current system, which is implemented as a browser extension that works on simple bar charts, can be invoked by a user via a keystroke combination while navigating the web. Once launched, Interactive SIGHT first provides a brief summary that conveys the underlying intention of a bar chart along with the chart's most significant and salient features, and then produces history-aware follow-up responses to provide further information about the chart upon request from the user. We present two user studies that were conducted with sighted and visually impaired users to determine how effective the initial summary and follow-up responses are in conveying the informational content of bar charts, and to evaluate how easy it is to use the system interface. The evaluation results are promising and indicate that the system responses are well-structured and enable visually impaired users to answer key questions about bar charts in an easy-to-use manner. Post-experimental interviews revealed that visually impaired participants were very satisfied with the system offering different options to access the content of a chart to meet their specific needs and that they would use Interactive SIGHT if it was publicly available so as not to have to ignore graphics on the web. Being a language based assistive technology designed to compensate for the lack of sight, our work paves the road for a stronger acceptance of natural language interfaces to graph interpretation that we believe will be of great benefit to the visually impaired community.

  15. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Knight, Stephen P, E-mail: stephen.knight@health.qld.gov.au

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-secondsmore » (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes.« less

  16. Check Calibration of the NASA Glenn 10- by 10-Foot Supersonic Wind Tunnel (2014 Test Entry)

    NASA Technical Reports Server (NTRS)

    Johnson, Aaron; Pastor-Barsi, Christine; Arrington, E. Allen

    2016-01-01

    A check calibration of the 10- by 10-Foot Supersonic Wind Tunnel (SWT) was conducted in May/June 2014 using an array of five supersonic wedge probes to verify the 1999 Calibration. This check calibration was necessary following a control systems upgrade and an integrated systems test (IST). This check calibration was required to verify the tunnel flow quality was unchanged by the control systems upgrade prior to the next test customer beginning their test entry. The previous check calibration of the tunnel occurred in 2007, prior to the Mars Science Laboratory test program. Secondary objectives of this test entry included the validation of the new Cobra data acquisition system (DAS) against the current Escort DAS and the creation of statistical process control (SPC) charts through the collection of series of repeated test points at certain predetermined tunnel parameters. The SPC charts secondary objective was not completed due to schedule constraints. It is hoped that this effort will be readdressed and completed in the near future.

  17. Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

    PubMed

    Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

    2006-02-01

    A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of risk-adjusted mortality data with an E-O plot and a risk-adjusted p chart is feasible and allows the rapid detection of changes in risk-adjusted outcome of intensive care patients. This complements the centralised national database, which is more archival and comparative in nature.

  18. 9 CFR 381.305 - Equipment and procedures for heat processing systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... control unit. A nonreturn valve shall be provided in the air supply line to prevent water from entering... control unit. A nonreturn valve shall be provided in the air supply line to prevent water from entering... supply of clean, dry air. The recorder timing mechanism shall be accurate. (i) Chart-type devices...

  19. Math Problems for Water Quality Control Personnel, Instructor's Manual. Second Edition.

    ERIC Educational Resources Information Center

    Delvecchio, Fred; Brutsch, Gloria

    This document is the instructor's manual for a course in mathematics for water quality control personnel. It is designed so a program may be designed for a specific facility. The problem structures are arranged alphabetically by treatment process. Charts, graphs and/or drawings representing familiar data forms contain the necessary information to…

  20. Math Problems for Water Quality Control Personnel, Student Workbook. Second Edition.

    ERIC Educational Resources Information Center

    Delvecchio, Fred; Brutsch, Gloria

    This document is the student workbook for a course in mathematics for water quality control personnel. This version contains complete problems, answers and references. Problems are arranged alphabetically by treatment process. Charts, graphs, and drawings represent data forms an operator might see in a plant containing information necessary for…

  1. Developing leadership capacity for guideline use: a pilot cluster randomized control trial.

    PubMed

    Gifford, Wendy A; Davies, Barbara L; Graham, Ian D; Tourangeau, Ann; Woodend, A Kirsten; Lefebre, Nancy

    2013-02-01

    The importance of leadership to influence nurses' use of clinical guidelines has been well documented. However, little is known about how to develop and evaluate leadership interventions for guideline use. The purpose of this study was to pilot a leadership intervention designed to influence nurses' use of guideline recommendations when caring for patients with diabetic foot ulcers in home care nursing. This paper reports on the feasibility of implementing the study protocol, the trial findings related to nursing process outcomes, and leadership behaviors. A mixed methods pilot study was conducted with a post-only cluster randomized controlled trial and descriptive qualitative interviews. Four units were randomized to control or experimental groups. Clinical and management leadership teams participated in a 12-week leadership intervention (workshop, teleconferences). Participants received summarized chart audit data, identified goals for change, and created a team leadership action. Criteria to assess feasibility of the protocol included: design, intervention, measures, and data collection procedures. For the trial, chart audits compared differences in nursing process outcomes. 8-item nursing assessments score. Secondary outcome: 5-item score of nursing care based on goals for change identified by intervention participants. Qualitative interviews described leadership behaviors that influenced guideline use. Conducting this pilot showed some aspects of the study protocol were feasible, while others require further development. Trial findings observed no significant difference in the primary outcome. A significant increase was observed in the 5-item score chosen by intervention participants (p = 0.02). In the experimental group more relations-oriented leadership behaviors, audit and feedback and reminders were described as leadership strategies. Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research. © 2012 The authors. World Views on Evidence-Based Nursing © Sigma Theta Tau International.

  2. Care for Patients with Type 2 Diabetes in a Random Sample of Community Family Practices in Ontario, Canada

    PubMed Central

    Agarwal, Gina; Kaczorowski, Janusz; Hanna, Steve

    2012-01-01

    Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = −0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets. PMID:22852083

  3. Effect of a Simulation Exercise on Restorative Identification Skills of First Year Dental Hygiene Students.

    PubMed

    Lemaster, Margaret; Flores, Joyce M; Blacketer, Margaret S

    2016-02-01

    This study explored the effectiveness of simulated mouth models to improve identification and recording of dental restorations when compared to using traditional didactic instruction combined with 2-dimensional images. Simulation has been adopted into medical and dental education curriculum to improve both student learning and patient safety outcomes. A 2-sample, independent t-test analysis of data was conducted to compare graded dental recordings of dental hygiene students using simulated mouth models and dental hygiene students using 2-dimensional photographs. Evaluations from graded dental charts were analyzed and compared between groups of students using the simulated mouth models containing random placement of custom preventive and restorative materials and traditional 2-dimensional representations of didactically described conditions. Results demonstrated a statistically significant (p≤0.0001) difference: for experimental group, students using the simulated mouth models to identify and record dental conditions had a mean of 86.73 and variance of 33.84. The control group students using traditional 2-dimensional images mean graded dental chart scores were 74.43 and variance was 14.25. Using modified simulation technology for dental charting identification may increase level of dental charting skill competency in first year dental hygiene students. Copyright © 2016 The American Dental Hygienists’ Association.

  4. The Validity of Uniform Chart of Accounts as a Measure of Resource Consumption at the Patient Level.

    DTIC Science & Technology

    1984-05-20

    required to meet the projected rates of demand based on the DIE case-mix concept . However, this is futuristic and the concern of today’s military...on the DRG case-mix concept . However, ihis is futuristic and the concern of today’s military health care manager is with the Uniform Chart of Accounts...product of a healthcare institution. This concept is vastly different from the one which considers the proxy measure of the number of institutional

  5. Energy Navigation: Simulation Evaluation and Benefit Analysis

    NASA Technical Reports Server (NTRS)

    Williams, David H.; Oseguera-Lohr, Rosa M.; Lewis, Elliot T.

    2011-01-01

    This paper presents results from two simulation studies investigating the use of advanced flight-deck-based energy navigation (ENAV) and conventional transport-category vertical navigation (VNAV) for conducting a descent through a busy terminal area, using Continuous Descent Arrival (CDA) procedures. This research was part of the Low Noise Flight Procedures (LNFP) element within the Quiet Aircraft Technology (QAT) Project, and the subsequent Airspace Super Density Operations (ASDO) research focus area of the Airspace Project. A piloted simulation study addressed development of flight guidance, and supporting pilot and Air Traffic Control (ATC) procedures for high density terminal operations. The procedures and charts were designed to be easy to understand, and to make it easy for the crew to make changes via the Flight Management Computer Control-Display Unit (FMC-CDU) to accommodate changes from ATC.

  6. The Fibonacci Life-Chart Method (FLCM) as a foundation for Carl Jung's theory of synchronicity.

    PubMed

    Sacco, Robert G

    2016-04-01

    Since the scientific method requires events to be subject to controlled examination it would seem that synchronicities are not scientifically investigable. Jung speculated that because these incredible events are like the random sparks of a firefly they cannot be pinned down. However, doubting Jung's doubts, the author provides a possible method of elucidating these seemingly random and elusive events. The author draws on a new method, designated the Fibonacci Life-Chart Method (FLCM), which categorizes phase transitions and Phi fractal scaling in human development based on the occurrence of Fibonacci numbers in biological cell division and self-organizing systems. The FLCM offers an orientation towards psychological experience that may have relevance to Jung's theory of synchronicity in which connections are deemed to be intrinsically meaningful rather than demonstrable consequences of cause and effect. In such a model synchronistic events can be seen to be, as the self-organizing system enlarges, manifestations of self-organized critical moments and Phi fractal scaling. Recommendations for future studies include testing the results of the FLCM using case reports of synchronistic and spiritual experiences. © 2016, The Society of Analytical Psychology.

  7. Critical outlook and trends for environmental reference materials at the Measurements & Testing Generic Activity (European Commission).

    PubMed

    Quevauviller, P; Bennink, D; Bøwadt, S

    2001-05-01

    It is now well recognised that the quality control (QC) of all types of analyses, including environmental analyses depends on the appropriate use of reference materials. One of the ways to check the accuracy of methods is based on the use of Certified Reference Materials (CRMs), whereas other types of (not certified) Reference Materials (RMs) are used for routine quality control (establishment of control charts) and interlaboratory testing (e.g. proficiency testing). The perception of these materials, in particular with respect to their production and use, differs widely according to various perspectives (e.g. RM producers, routine laboratories, researchers). This review discusses some critical aspects of RM use and production for the QC of environmental analyses and describes the new approach followed by the Measurements & Testing Generic Activity (European Commission) to tackle new research and production needs.

  8. Vision of low astigmats through thick and thin lathe-cut soft contact lenses.

    PubMed

    Cho, P; Woo, G C

    2001-01-01

    Distance and near visual acuity of 13 low astigmats were determined in a double-masked experiment through thick and thin (centre thickness 0.12 mm and 0.06 mm, respectively) spherical lathe-cut soft lenses. For each lens type, distance and near LogMAR VA and over-refraction were assessed with different logMAR VA charts. For 70% of the subjects, the residual astigmatism was significantly lower than the refractive astigmatism with thicker lenses. No statistically significant differences in the distance and near logMAR VA was found between the two lens types using any of the charts used, though, in general, logMAR VA obtained through the thicker lens was better than logMAR VA through the thinner lens. The variabilities in distance and near logMAR VA between the two lens types increased with decreased contrast. The variabilities in distance logMAR VA were greater with Chinese charts than with English charts, and LogMAR VA with Chinese charts were significantly worse for both lens types. Based on the results of this study, we concluded that thicker spherical lathe-cut soft lenses provide better vision in low astigmats. The Snellen acuity test is inadequate for vision assessment of soft contact lens wearers. When a patient wearing thin soft contact lenses complains of poor vision in spite of 6/6 or 6/5 Snellen acuity, changing to thicker lenses may be considered.

  9. SU-E-T-144: Effective Analysis of VMAT QA Generated Trajectory Log Files for Medical Accelerator Predictive Maintenance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Able, CM; Baydush, AH; Nguyen, C

    Purpose: To determine the effectiveness of SPC analysis for a model predictive maintenance process that uses accelerator generated parameter and performance data contained in trajectory log files. Methods: Each trajectory file is decoded and a total of 131 axes positions are recorded (collimator jaw position, gantry angle, each MLC, etc.). This raw data is processed and either axis positions are extracted at critical points during the delivery or positional change over time is used to determine axis velocity. The focus of our analysis is the accuracy, reproducibility and fidelity of each axis. A reference positional trace of the gantry andmore » each MLC is used as a motion baseline for cross correlation (CC) analysis. A total of 494 parameters (482 MLC related) were analyzed using Individual and Moving Range (I/MR) charts. The chart limits were calculated using a hybrid technique that included the use of the standard 3σ limits and parameter/system specifications. Synthetic errors/changes were introduced to determine the initial effectiveness of I/MR charts in detecting relevant changes in operating parameters. The magnitude of the synthetic errors/changes was based on: TG-142 and published analysis of VMAT delivery accuracy. Results: All errors introduced were detected. Synthetic positional errors of 2mm for collimator jaw and MLC carriage exceeded the chart limits. Gantry speed and each MLC speed are analyzed at two different points in the delivery. Simulated Gantry speed error (0.2 deg/sec) and MLC speed error (0.1 cm/sec) exceeded the speed chart limits. Gantry position error of 0.2 deg was detected by the CC maximum value charts. The MLC position error of 0.1 cm was detected by the CC maximum value location charts for every MLC. Conclusion: SPC I/MR evaluation of trajectory log file parameters may be effective in providing an early warning of performance degradation or component failure for medical accelerator systems.« less

  10. Effects of lines of progress and semilogarithmic charts on ratings of charted data

    PubMed Central

    Bailey, Donald B.

    1984-01-01

    The extent to which interrater agreement and ratings of significance on both changes in level and trend are affected by lines of progress and semilogarithmic charts was investigated. Thirteen graduate students rated four sets of charts, each set containing 19 phase changes. Set I data were plotted on equal interval charts. In Set II a line of progress was drawn through each phase on each chart. In Set III data points were replotted on semilogarithmic charts. In Set IV a line of progress was drawn through each phase of each Set III chart. A significant main effect on interrater agreement was found for lines of progress as well as a significant 2-way interaction between lines of progress and change type. Three main effects (chart type, lines of progress, and type of change) and a significant 3-way interaction were found for ratings of significance. Implications of these data for visual analysis of charted data are discussed. PMID:16795676

  11. Family support for stroke: a randomised controlled trial.

    PubMed

    Mant, J; Carter, J; Wade, D T; Winner, S

    2000-09-02

    Attention is currently focused on family care of stroke survivors, but the effectiveness of support services is unclear. We did a single-blind, randomised, controlled trial to assess the impact of family support on stroke patients and their carers. Patients with acute stroke admitted to hospitals in Oxford, UK, were assigned family support or normal care within 6 weeks of stroke. After 6 months, we assessed, for carers, knowledge about stroke, Frenchay activities index, general health questionnaire-28 scores, caregiver strain index, Dartmouth co-op charts, short form 36 (SF-36), and satisfaction scores, and, for patients, knowledge about stroke and use of services, Barthel index, Rivermead mobility index, Frenchay activities index, London handicap scale, hospital anxiety and depression scales, Dartmouth co-op charts, and satisfaction. 323 patients and 267 carers were followed up. Carers in the intervention group had significantly better Frenchay activities indices (p=0.03), SF-36 scores (energy p=0.02, mental health p=0.004, pain p=0.03, physical function p=0.025, and general health perception p=0.02), quality of life on the Dartmouth co-op chart (p=0.01), and satisfaction with understanding of stroke (82 vs 71%, p=0.04) than those in the control group. Patients' knowledge about stroke, disability, handicap, quality of life, and satisfaction with services and understanding of stroke did not differ between groups. Fewer patients in the intervention group than in the control group saw a physiotherapist after discharge (44 vs 56%, p=0.04), but use of other services was similar. Family support significantly increased social activities and improved quality of life for carers, with no significant effects on patients.

  12. Characterisation of Intensity Values on Terrestrial Laser Scanning for Recording Enhancement

    NASA Astrophysics Data System (ADS)

    Balaguer-Puig, M.; Molada-Tebar, A.; Marqués-Mateu, A.; Lerma, J. L.

    2017-08-01

    Mapping surveys based on terrestrial laser scanning (TLS) are common nowadays for different purposes such as documentation of cultural heritage assets. The chance to extract relevant information from TLS surveys depends not only on the fast acquisition of XYZ coordinates, but also on the meaningful intensity values of the fired objects. TLS behaviour depends on several known factors such as distance, texture, roughness, colour and albedo. This paper seeks to find out the mathematical relationship between the TLS intensity values and the colorimetric data using a colour chart. In order to do so, objective colour specification based on well-known colour spaces is needed. The approach used here started with scanning a colour chart containing a number of colour patches with known chromatic and reflection characteristics. After several transformations, the results allowed us to characterise the intensity behaviour of a time-of-flight laser scanner. The characterisation of the intensity values are tested indoor on the colour chart and outdoor on an archaeological shelter. Promising results are obtained to enhance the behaviour of the intensity values coming from the TLS.

  13. Charting molecular free-energy landscapes with an atlas of collective variables

    NASA Astrophysics Data System (ADS)

    Hashemian, Behrooz; Millán, Daniel; Arroyo, Marino

    2016-11-01

    Collective variables (CVs) are a fundamental tool to understand molecular flexibility, to compute free energy landscapes, and to enhance sampling in molecular dynamics simulations. However, identifying suitable CVs is challenging, and is increasingly addressed with systematic data-driven manifold learning techniques. Here, we provide a flexible framework to model molecular systems in terms of a collection of locally valid and partially overlapping CVs: an atlas of CVs. The specific motivation for such a framework is to enhance the applicability and robustness of CVs based on manifold learning methods, which fail in the presence of periodicities in the underlying conformational manifold. More generally, using an atlas of CVs rather than a single chart may help us better describe different regions of conformational space. We develop the statistical mechanics foundation for our multi-chart description and propose an algorithmic implementation. The resulting atlas of data-based CVs are then used to enhance sampling and compute free energy surfaces in two model systems, alanine dipeptide and β-D-glucopyranose, whose conformational manifolds have toroidal and spherical topologies.

  14. The Relationship of Welding Fume Exposure, Smoking, and Pulmonary Function in Welders.

    PubMed

    Roach, Laura L

    2018-01-01

    The purpose of this study was to explore the relationship between occupational exposure to welding fumes and pulmonary function in an effort to add supportive evidence and clarity to the current body of research. This study utilized a retrospective chart review of pulmonary function testing and pulmonary questionnaires already available in charts from preplacement physicals to the most recent test. When comparing smokers to nonsmokers, utilizing multiple regression and controlling for age and percentage of time using a respirator, years welding was statistically significant at p = .04. Data support that smoking has a synergistic effect when combined with welding fume exposure on pulmonary decline.

  15. Growth Charts for Children With Down Syndrome in the United States.

    PubMed

    Zemel, Babette S; Pipan, Mary; Stallings, Virginia A; Hall, Waynitra; Schadt, Kim; Freedman, David S; Thorpe, Phoebe

    2015-11-01

    Children with Down syndrome (DS) have lower birth weights and grow more slowly than children without DS. Advances in and increased access to medical care have improved the health and well-being of individuals with DS; however, it is unknown whether their growth has also improved. Our objective was to develop new growth charts for children with DS and compare them to older charts from the United States and more contemporary charts from the United Kingdom. The Down Syndrome Growing Up Study (DSGS) enrolled a convenience sample of children with DS up to 20 years of age and followed them longitudinally. Growth parameters were measured by research anthropometrists. Sex-specific growth charts were generated for the age ranges birth to 36 months and 2 to 20 years using the LMS method. Weight-for-length and BMI charts were also generated. Comparisons with other curves were presented graphically. New DSGS growth charts were developed by using 1520 measurements on 637 participants. DSGS growth charts for children <36 months of age showed marked improvements in weight compared with older US charts. DSGS charts for 2- to 20-year-olds showed that contemporary males are taller than previous charts showed. Generally, the DSGS growth charts are similar to the UK charts. The DSGS growth charts can be used as screening tools to assess growth and nutritional status and to provide indications of how growth of an individual child compares with peers of the same age and sex with DS. Copyright © 2015 by the American Academy of Pediatrics.

  16. Growth Charts for Children With Down Syndrome in the United States

    PubMed Central

    Zemel, Babette S.; Pipan, Mary; Stallings, Virginia A.; Hall, Waynitra; Schadt, Kim; Freedman, David S.; Thorpe, Phoebe

    2017-01-01

    BACKGROUND AND OBJECTIVES Children with Down syndrome (DS) have lower birth weights and grow more slowly than children without DS. Advances in and increased access to medical care have improved the health and well-being of individuals with DS; however, it is unknown whether their growth has also improved. Our objective was to develop new growth charts for children with DS and compare them to older charts from the United States and more contemporary charts from the United Kingdom. METHODS The Down Syndrome Growing Up Study (DSGS) enrolled a convenience sample of children with DS up to 20 years of age and followed them longitudinally. Growth parameters were measured by research anthropometrists. Sex-specific growth charts were generated for the age ranges birth to 36 months and 2 to 20 years using the LMS method. Weight-for-length and BMI charts were also generated. Comparisons with other curves were presented graphically. RESULTS New DSGS growth charts were developed by using 1520 measurements on 637 participants. DSGS growth charts for children <36 months of age showed marked improvements in weight compared with older US charts. DSGS charts for 2- to 20-year-olds showed that contemporary males are taller than previous charts showed. Generally, the DSGS growth charts are similar to the UK charts. CONCLUSIONS The DSGS growth charts can be used as screening tools to assess growth and nutritional status and to provide indications of how growth of an individual child compares with peers of the same age and sex with DS. PMID:26504127

  17. Differences in reported sepsis incidence according to study design: a literature review.

    PubMed

    Mariansdatter, Saga Elise; Eiset, Andreas Halgreen; Søgaard, Kirstine Kobberøe; Christiansen, Christian Fynbo

    2016-10-12

    Sepsis and severe sepsis are common conditions in hospital settings, and are associated with high rates of morbidity and mortality, but reported incidences vary considerably. In this literature review, we describe the variation in reported population-based incidences of sepsis and severe sepsis. We also examine methodological and demographic differences between studies that may explain this variation. We carried out a literature review searching three major databases and reference lists of relevant articles, to identify all original studies reporting the incidence of sepsis or severe sepsis in the general population. Two authors independently assessed all articles, and the final decision to exclude an article was reached by consensus. We extracted data according to predetermined variables, including study country, sepsis definition, and data source. We then calculated descriptive statistics for the reported incidences of sepsis and severe sepsis. The studies were classified according to the method used to identify cases of sepsis or severe sepsis: chart-based (i.e. review of patient charts) or code-based (i.e. predetermined International Classification of Diseases [ICD] codes). Among 482 articles initially screened, we identified 23 primary publications reporting incidence of sepsis and/or severe sepsis in the general population. The reported incidences ranged from 74 to 1180 per 100,000 person-years and 3 to 1074 per 100,000 person-years for sepsis and severe sepsis, respectively. Most chart-based studies used the Bone criteria (or a modification hereof) and Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study criteria to identify cases of sepsis and severe sepsis. Most code-based studies used ICD-9 codes, but the number of codes used ranged from 1 to more than 1200. We found that the incidence varied according to how sepsis was identified (chart-based vs. code-based), calendar year, data source, and world region. The reported incidences of sepsis and severe sepsis in the general population varied greatly between studies. Such differences may be attributable to differences in the methods used to collect the data, the study period, or the world region where the study was undertaken. This finding highlights the importance of standardised definitions and acquisition of data regarding sepsis and severe sepsis.

  18. Human Factors Considerations for Performance-Based Navigation

    NASA Technical Reports Server (NTRS)

    Barhydt, Richard; Adams, Catherine A.

    2006-01-01

    A transition toward a performance-based navigation system is currently underway in both the United States and around the world. Performance-based navigation incorporates Area Navigation (RNAV) and Required Navigation Performance (RNP) procedures that do not rely on the location of ground-based navigation aids. These procedures offer significant benefits to both operators and air traffic managers. Under sponsorship from the Federal Aviation Administration (FAA), the National Aeronautics and Space Administration (NASA) has undertaken a project to document human factors issues that have emerged during RNAV and RNP operations and propose areas for further consideration. Issues were found to include aspects of air traffic control and airline procedures, aircraft systems, and procedure design. Major findings suggest the need for human factors-specific instrument procedure design guidelines. Ongoing industry and government activities to address air-ground communication terminology, procedure design improvements, and chart-database commonality are strongly encouraged.

  19. Updating the Nomographical Diagrams for Dimensioning the Beams

    NASA Astrophysics Data System (ADS)

    Pop, Maria T.

    2015-12-01

    In order to reduce the time period needed for structures design it is strongly recommended to use nomographical diagrams. The base for formation and updating the nomographical diagrams, stands on the charts presented by different technical publications. The updated charts use the same algorithm and calculation elements as the former diagrams in accordance to the latest prescriptions and European standards. The result consists in a chart, having the same properties, similar with the nomogragraphical diagrams already in us. As a general conclusion, even in our days, the nomographical diagrams are very easy to use. Taking into consideration the value of the moment it's easy to find out the necessary reinforcement area and vice-verse, having the reinforcement area you can find out the capable moment. It still remains a useful opportunity for pre-sizing and designs the reinforced concrete sections.

  20. Application of competency-based education in laparoscopic training.

    PubMed

    Xue, Dongbo; Bo, Hong; Zhang, Weihui; Zhao, Song; Meng, Xianzhi; Zhang, Donghua

    2015-01-01

    To induce competency-based education/developing a curriculum in the training of postgraduate students in laparoscopic surgery. This study selected postgraduate students before the implementation of competency-based education (n = 16) or after the implementation of competency-based education (n = 17). On the basis of the 5 competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, and professionalism, the research team created a developing a curriculum chart and specific improvement measures that were implemented in the competency-based education group. On the basis of the developing a curriculum chart, the assessment of the 5 comprehensive competencies using the 360° assessment method indicated that the competency-based education group's competencies were significantly improved compared with those of the traditional group (P < .05). The improvement in the comprehensive assessment was also significant compared with the traditional group (P < .05). The implementation of competency-based education/developing a curriculum teaching helps to improve the comprehensive competencies of postgraduate students and enables them to become qualified clinicians equipped to meet society's needs.

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