Do Diagnosis Delays Impact Receipt of Test Results? Evidence from the HIV Early Infant Diagnosis Program in Uganda

PubMed Central

Mugambi, Melissa Latigo; Deo, Sarang; Kekitiinwa, Adeodata; Kiyaga, Charles; Singer, Mendel E.

2013-01-01

Background There is scant evidence on the association between diagnosis delays and the receipt of test results in HIV Early Infant Diagnosis (EID) programs. We determine the association between diagnosis delays and other health care system and patient factors on result receipt. Methods We reviewed 703 infant HIV test records for tests performed between January 2008 and February 2009 at a regional referral hospital and level four health center in Uganda. The main outcome was caregiver receipt of the test result. The primary study variable was turnaround time (time between sample collection and result availability at the health facility). Additional variables included clinic entry point, infant age at sample collection, reported HIV status and receipt of antiretroviral prophylaxis for prevention of mother-to-child transmission. We conducted a pooled analysis in addition to separate analyses for each facility. We estimated the relative risk of result receipt using modified Poisson regression with robust standard errors. Results Overall, the median result turnaround time, was 38 days. 59% of caregivers received infant test results. Caregivers were less likely to receive results at turnaround times greater than 49 days compared to 28 days or fewer (ARR = 0.83; 95% CI = 0.70–0.98). Caregivers were more likely to receive results at the PMTCT clinic (ARR = 1.81; 95% CI = 1.40–2.33) and less likely at the pediatric ward (ARR = 0.54; 95% CI = 0.37–0.81) compared to the immunization clinic. At the level four health center, result receipt was half as likely among infants older than 9 months compared to 3 months and younger (ARR= 0.47; 95% CI = 0.25–0.93). Conclusion In this study setting, we find evidence that longer turnaround times, clinic entry point and age at sample collection may be associated with receipt of infant HIV test results. PMID:24282502

The Fulton County Medical Examiner's experience with the Federal Bureau of Investigation National Missing Person DNA Database Program, 2004-2007.

PubMed

Heninger, Michael; Hanzlick, Randy

2011-03-01

Medical examiners and coroners occasionally encounter unidentified human bodies, which remain unidentified for extended periods. In such cases, when traditional methods of identification have failed or cannot be used, DNA profiling may be used. The Federal Bureau of Investigation has a National Missing Person DNA database (NMPDD) laboratory to which samples may be submitted on such cases and from possible relatives or environments of unidentified decedents. This article describes the experience of the Fulton County Medical Examiner (FCME) in submitting samples to the NMPDD laboratory. A database was established at the FCME to track the submission of samples from unidentified decedents to the NMPDD laboratory for DNA testing along with the results and turnaround times. In December 2004, the FCME inventoried all cases for which samples were available and began to submit them to the NMPDD laboratory for testing. DNA testing and isolation rates, sample type, and turnaround times were tabulated in October 2006 for samples submitted between December 16, 2004 and December 16, 2005. An overall summary of data was also prepared concerning the status of all samples submitted as of April 17, 2007. During the 1-year study period, samples from 77 unidentified decedents were submitted to the laboratory. As of October 2006 (22 months after submission of the first samples and 10 months after submission of the last samples), testing had been completed on 53% of the samples submitted, and 68% of those tested resulted in a mitochondrial DNA profile. Turnaround times ranged from 66 to 557 days, improved with time, and had a mean of 107 days for specimens submitted during the latter part of the study period. As of April 17, 2007, we had submitted samples involving 84 unidentified decedents. Seventy-five percent of the samples have now been tested. Data from the NMPDD laboratory have resulted in 4 identifications by comparison with putative relatives, 4 exclusions, and no cold hits through comparison NMPDD DNA profiles from missing persons. More extensive data are presented in the body of this article. The NMPDD laboratory provides useful and free services to medical examiners, coroners, and law enforcement agencies that require DNA services regarding missing and unidentified persons. Turnaround times have improved. The success of the system in getting cold hits will be heavily dependent on law enforcement filing missing persons reports and submission of reference samples from putative relatives of the decedent. We recommend collecting specimens for DNA analysis early on in the postmortem investigation, submitting samples to the NMPDD laboratory or one of its participating laboratories when traditional methods for identification cannot be used or have failed, not burying bodies until a DNA profile has been obtained, and not cremating unidentified remains.

Rapid Multiplex PCR Assay To Identify Respiratory Viral Pathogens: Moving Forward Diagnosing The Common Cold

PubMed Central

Gordon, Sarah M; Elegino-Steffens, Diane U; Agee, Willie; Barnhill, Jason; Hsue, Gunther

2013-01-01

Upper respiratory tract infections (URIs) can be a serious burden to the healthcare system. The majority of URIs are viral in etiology, but definitive diagnosis can prove difficult due to frequently overlapping clinical presentations of viral and bacterial infections, and the variable sensitivity, and lengthy turn-around time of viral culture. We tested new automated nested multiplex PCR technology, the FilmArray® system, in the TAMC department of clinical investigations, to determine the feasibility of replacing the standard viral culture with a rapid turn-around system. We conducted a feasibility study using a single-blinded comparison study, comparing PCR results with archived viral culture results from a convenience sample of cryopreserved archived nasopharyngeal swabs from acutely ill ED patients who presented with complaints of URI symptoms. A total of 61 archived samples were processed. Viral culture had previously identified 31 positive specimens from these samples. The automated nested multiplex PCR detected 38 positive samples. In total, PCR was 94.5% concordant with the previously positive viral culture results. However, PCR was only 63.4% concordant with the negative viral culture results, owing to PCR detection of 11 additional viral pathogens not recovered on viral culture. The average time to process a sample was 75 minutes. We determined that an automated nested multiplex PCR is a feasible alternative to viral culture in an acute clinical setting. We were able to detect at least 94.5% as many viral pathogens as viral culture is able to identify, with a faster turn-around time. PMID:24052914

Specimen origin, type and testing laboratory are linked to longer turnaround times for HIV viral load testing in Malawi

PubMed Central

Chipungu, Geoffrey; Kim, Andrea A.; Sarr, Abdoulaye; Ali, Hammad; Mwenda, Reuben; Nkengasong, John N.; Singer, Daniel

2017-01-01

Background Efforts to reach UNAIDS’ treatment and viral suppression targets have increased demand for viral load (VL) testing and strained existing laboratory networks, affecting turnaround time. Longer VL turnaround times delay both initiation of formal adherence counseling and switches to second-line therapy for persons failing treatment and contribute to poorer health outcomes. Methods We utilized descriptive statistics and logistic regression to analyze VL testing data collected in Malawi between January 2013 and March 2016. The primary outcomes assessed were greater-than-median pretest phase turnaround time (days elapsed from specimen collection to receipt at the laboratory) and greater-than-median test phase turnaround time (days from receipt to testing). Results The median number of days between specimen collection and testing increased 3-fold between 2013 (8 days, interquartile range (IQR) = 6–16) and 2015 (24, IQR = 13–39) (p<0.001). Multivariable analysis indicated that the odds of longer pretest phase turnaround time were significantly higher for specimen collection districts without laboratories capable of conducting viral load tests (adjusted odds ratio (aOR) = 5.16; 95% confidence interval (CI) = 5.04–5.27) as well as for Malawi’s Northern and Southern regions. Longer test phase turnaround time was significantly associated with use of dried blood spots instead of plasma (aOR = 2.30; 95% CI = 2.23–2.37) and for certain testing months and testing laboratories. Conclusion Increased turnaround time for VL testing appeared to be driven in part by categorical factors specific to the phase of turnaround time assessed. Given the implications of longer turnaround time and the global effort to scale up VL testing, addressing these factors via increasing efficiencies, improving quality management systems and generally strengthening the VL spectrum should be considered essential components of controlling the HIV epidemic. PMID:28235013

Evaluation of Wet Chemical ICP-AES Elemental Analysis Methods usingSimulated Hanford Waste Samples-Phase I Interim Report

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

Coleman, Charles J.; Edwards, Thomas B.

2005-04-30

The wet chemistry digestion method development for providing process control elemental analyses of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) Melter Feed Preparation Vessel (MFPV) samples is divided into two phases: Phase I consists of: (1) optimizing digestion methods as a precursor to elemental analyses by ICP-AES techniques; (2) selecting methods with the desired analytical reliability and speed to support the nine-hour or less turnaround time requirement of the WTP; and (3) providing baseline comparison to the laser ablation (LA) sample introduction technique for ICP-AES elemental analyses that is being developed at the Savannah River National Laboratory (SRNL).more » Phase II consists of: (1) Time-and-Motion study of the selected methods from Phase I with actual Hanford waste or waste simulants in shielded cell facilities to ensure that the methods can be performed remotely and maintain the desired characteristics; and (2) digestion of glass samples prepared from actual Hanford Waste tank sludge for providing comparative results to the LA Phase II study. Based on the Phase I testing discussed in this report, a tandem digestion approach consisting of sodium peroxide fusion digestions carried out in nickel crucibles and warm mixed-acid digestions carried out in plastic bottles has been selected for Time-and-Motion study in Phase II. SRNL experience with performing this analytical approach in laboratory hoods indicates that well-trained cell operator teams will be able to perform the tandem digestions in five hours or less. The selected approach will produce two sets of solutions for analysis by ICP-AES techniques. Four hours would then be allocated for performing the ICP-AES analyses and reporting results to meet the nine-hour or less turnaround time requirement. The tandem digestion approach will need to be performed in two separate shielded analytical cells by two separate cell operator teams in order to achieve the nine-hour or less turnaround time. Because of the simplicity of the warm mixed-acid method, a well-trained cell operator team may in time be able to perform both sets of digestions. However, having separate shielded cells for each of the methods is prudent to avoid overcrowding problems that would impede a minimal turnaround time.« less

Building a new predictor for multiple linear regression technique-based corrective maintenance turnaround time.

PubMed

Cruz, Antonio M; Barr, Cameron; Puñales-Pozo, Elsa

2008-01-01

This research's main goals were to build a predictor for a turnaround time (TAT) indicator for estimating its values and use a numerical clustering technique for finding possible causes of undesirable TAT values. The following stages were used: domain understanding, data characterisation and sample reduction and insight characterisation. Building the TAT indicator multiple linear regression predictor and clustering techniques were used for improving corrective maintenance task efficiency in a clinical engineering department (CED). The indicator being studied was turnaround time (TAT). Multiple linear regression was used for building a predictive TAT value model. The variables contributing to such model were clinical engineering department response time (CE(rt), 0.415 positive coefficient), stock service response time (Stock(rt), 0.734 positive coefficient), priority level (0.21 positive coefficient) and service time (0.06 positive coefficient). The regression process showed heavy reliance on Stock(rt), CE(rt) and priority, in that order. Clustering techniques revealed the main causes of high TAT values. This examination has provided a means for analysing current technical service quality and effectiveness. In doing so, it has demonstrated a process for identifying areas and methods of improvement and a model against which to analyse these methods' effectiveness.

Performance of Mycobacterium Growth Indicator Tube BACTEC 960 with Lowenstein-Jensen method for diagnosis of Mycobacterium tuberculosis at Ethiopian National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia.

PubMed

Diriba, Getu; Kebede, Abebaw; Yaregal, Zelalem; Getahun, Muluwork; Tadesse, Mengistu; Meaza, Abyot; Dagne, Zekarias; Moga, Shewki; Dilebo, Jibril; Gudena, Kebebe; Hassen, Mulu; Desta, Kassu

2017-05-10

Bacteriological confirmed active case detection remains the corner stone for diagnosing tuberculosis. Non-radiometric liquid culture system Mycobacterium Growth Indicator Tube with automated interface had been recommended by expert groups in addition to conventional solid culture media such as Lowenstein-Jensen. However in high burden resource limited countries advanced non-radiometric based tuberculosis diagnostic methods such as MGIT 960 is limited. Therefore we have evaluated the performance of MGIT 960 system compared to LJ for recovery of Mycobacterium complex (MTBC) from clinical specimens. A cross sectional study was conducted from a total of 908 samples between January 1st, 2013 to December 31st, 2014. Clinical specimens were processed following standard procedures and the final suspension was inoculated to MGIT tubes and LJ slant. Identification and confirmation of MTBC was done by ZN staining and SD Bioline test. Data was analyzed by SPSS version 20. The sensitivity, specificity, recovery rate and the average turnaround time to recover the organism was computed. From a total of 908 clinical specimens processed using both LJ and BACTEC MGIT liquid culture methods the recovery rate for LJ and MGIT, for smear positive samples was 66.7% (74/111) and 87.4% (97/ 111) respectively while for smear negative samples was 13.4% (108/797) and 17.4% (139/797) for LJ and MGIT methods respectively. The overall recovery rate for MGIT is significantly higher than LJ methods [26% (236/908; vs. 20%, 182/908, P = 0.002)]. The average turnaround time for smear positive samples was 16 and 31 days for MGIT and LJ respectively. Turnaround time for smear negative samples was 20 and 36 days for MGIT and LJ respectively. The overall agreement between MGIT and LJ was fairly good with Kappa value of 0.59 (P < 0.001). In the present study the contamination rate for MGIT is higher than the LJ methods, 15 and 9.3% respectively. The BACTEC MGIT liquid culture system has better MTBC recovery rate with shorter turnaround time for both smear positive and negative clinical specimens compared to Conventional LJ method. However, efforts should be made in order to reduce the high contamination rate in BACTEC MGIT system and to lesser extent to LJ methods.

Decreasing laboratory turnaround time and patient wait time by implementing process improvement methodologies in an outpatient oncology infusion unit.

PubMed

Gjolaj, Lauren N; Gari, Gloria A; Olier-Pino, Angela I; Garcia, Juan D; Fernandez, Gustavo L

2014-11-01

Prolonged patient wait times in the outpatient oncology infusion unit indicated a need to streamline phlebotomy processes by using existing resources to decrease laboratory turnaround time and improve patient wait time. Using the DMAIC (define, measure, analyze, improve, control) method, a project to streamline phlebotomy processes within the outpatient oncology infusion unit in an academic Comprehensive Cancer Center known as the Comprehensive Treatment Unit (CTU) was completed. Laboratory turnaround time for patients who needed same-day lab and CTU services and wait time for all CTU patients was tracked for 9 weeks. During the pilot, the wait time from arrival to CTU to sitting in treatment area decreased by 17% for all patients treated in the CTU during the pilot. A total of 528 patients were seen at the CTU phlebotomy location, representing 16% of the total patients who received treatment in the CTU, with a mean turnaround time of 24 minutes compared with a baseline turnaround time of 51 minutes. Streamlining workflows and placing a phlebotomy station inside of the CTU decreased laboratory turnaround times by 53% for patients requiring same day lab and CTU services. The success of the pilot project prompted the team to make the station a permanent fixture. Copyright © 2014 by American Society of Clinical Oncology.

Turnaround Time for Early Infant HIV Diagnosis in Rural Zambia: A Chart Review

PubMed Central

Sutcliffe, Catherine G.; van Dijk, Janneke H.; Hamangaba, Francis; Mayani, Felix; Moss, William J.

2014-01-01

Background Early infant HIV diagnosis is challenging in sub-Saharan Africa, particularly in rural areas where laboratory capacity is limited. Specimens must be transported to central laboratories for testing, leading to delays in diagnosis and initiation of antiretroviral therapy. This study was undertaken in rural Zambia to measure the turnaround time for confirmation of HIV infection and identify delays in diagnosis. Methods Chart reviews were conducted from 2010–2012 for children undergoing early infant HIV diagnosis at Macha Hospital in Zambia. Relevant dates, receipt of drugs by mother and child for the prevention of mother-to-child transmission (PMTCT), and test results were abstracted. Results 403 infants provided 476 samples for early infant diagnosis. The median age at the “6-week” and “6-month” assessments was 8.1 weeks and 7.0 months, respectively. The majority of mothers (80%) and infants (67%) received PMTCT. The median time between sample collection and arrival at the central laboratory in Lusaka was 17 days (IQR: 10, 28); arrival at the central laboratory to testing was 6 days (IQR: 5, 11); testing to return of results to the clinic was 29 days (IQR: 17, 36); arrival of results at the clinic to return of results to the caregiver was 45 days (IQR: 24, 79). The total median time from sample collection to return of results to the caregiver was 92 days (IQR: 84, 145). The proportion of HIV PCR positive samples was 12%. The total median turnaround time was shorter for HIV PCR positive as compared to negative or invalid samples (85 vs. 92 days; p = 0.08). Conclusions Delays in processing and communicating test results were identified, particularly in returning results from the central laboratory to the clinic and from the clinic to the caregiver. A more efficient process is needed so that caregivers can be provided test results more rapidly, potentially resulting in earlier treatment initiation and better outcomes for HIV-infected infants. PMID:24475214

The freckle plot (daily turnaround time chart): a technique for timely and effective quality improvement of test turnaround times.

PubMed

Pellar, T G; Ward, P J; Tuckerman, J F; Henderson, A R

1993-06-01

Test turnaround times are often monitored on a monthly basis. However, such an interval usually means that not all causes for delay in test reporting can be unequivocally identified for institution of remedial action. We have devised a daily chart--the freckle plot--that graphically displays the test turnaround times by laboratory receipt time. Different symbols are used to designate specimens reported within the test's turnaround time limit, those within 10 min beyond that limit, and those well outside the limit. These categories are adjustable to suit different limits of stringency. Freckle plots are produced on a daily basis and can be used to track down causes for test delays. Using the 1-h turnaround time "stat" potassium test as a model, we found 16 causes for test delay, of which 9 were potentially remediable. By applying these remedies, we were able to increase test compliance, in the day shift, from 91.5% (95% confidence interval 88.8%-93.7%) to 97.6% (95% confidence interval 96.4-98.55%), which is significant at P < 10(-7). This daily plot is a useful quality assurance tool, supplementing the more conventional tests used to ensure laboratory quality improvement.

Impact of PACS on dictation turnaround time and productivity.

PubMed

Lepanto, Luigi; Paré, Guy; Aubry, David; Robillard, Pierre; Lesage, Jacques

2006-03-01

This study was conducted to measure the impact of PACS on dictation turnaround time and productivity. The radiology information system (RIS) database was interrogated to calculate the time interval between image production and dictation for every exam performed during three 90-day periods (the 3 months preceding PACS implementation, the 3 months immediately following PACS deployment, and a 3-month period 1 year after PACS implementation). Data were obtained for three exam types: chest radiographs, abdominal CT, and spine MRI. The mean dictation turnaround times obtained during the different pre- and post-PACS periods were compared using analysis of variance (ANOVA). Productivity was also determined for each period and for each exam type, and was expressed as the number of studies interpreted per full-time equivalent (FTE) radiologist. In the immediate post-PACS period, dictation turnaround time decreased 20% (p < 0.001) for radiography, but increased 13% (ns) for CT and 28% (p < 0.001) for MRI. One year after PACS was implemented, dictation turnaround time decreased 45% (p < 0.001) for radiography and 36% (p < 0.001) for MRI. For CT, 1 year post-PACS, turnaround times returned to pre-PACS levels. Productivity in the immediate post-PACS period increased 3% and 38% for radiography and CT, respectively, whereas a 6% decrease was observed for MRI. One year after implementation, productivity increased 27%, 98%, and 19% in radiography, CT, and MRI, respectively. PACS benefits, namely, shortened dictation turnaround time and increased productivity, are evident 1 year after PACS implementation. In the immediate post-PACS period, results vary with the different imaging modalities.

Possibilities or Paradoxes? How Aspiring Turnaround Principals Conceptualise Turnaround and Their Place within It

ERIC Educational Resources Information Center

Weiner, Jennie

2016-01-01

This study focuses on how a cohort of participants in a programme aimed at producing "turnaround leaders" came to understand this policy and their role within it. Using a theory of action framework, I find that, over time, participants' espoused theories of turnaround shifted in three key areas: (1) the cause of poor school performance,…

Rapid-viability PCR method for detection of live, virulent Bacillus anthracis in environmental samples.

PubMed

Létant, Sonia E; Murphy, Gloria A; Alfaro, Teneile M; Avila, Julie R; Kane, Staci R; Raber, Ellen; Bunt, Thomas M; Shah, Sanjiv R

2011-09-01

In the event of a biothreat agent release, hundreds of samples would need to be rapidly processed to characterize the extent of contamination and determine the efficacy of remediation activities. Current biological agent identification and viability determination methods are both labor- and time-intensive such that turnaround time for confirmed results is typically several days. In order to alleviate this issue, automated, high-throughput sample processing methods were developed in which real-time PCR analysis is conducted on samples before and after incubation. The method, referred to as rapid-viability (RV)-PCR, uses the change in cycle threshold after incubation to detect the presence of live organisms. In this article, we report a novel RV-PCR method for detection of live, virulent Bacillus anthracis, in which the incubation time was reduced from 14 h to 9 h, bringing the total turnaround time for results below 15 h. The method incorporates a magnetic bead-based DNA extraction and purification step prior to PCR analysis, as well as specific real-time PCR assays for the B. anthracis chromosome and pXO1 and pXO2 plasmids. A single laboratory verification of the optimized method applied to the detection of virulent B. anthracis in environmental samples was conducted and showed a detection level of 10 to 99 CFU/sample with both manual and automated RV-PCR methods in the presence of various challenges. Experiments exploring the relationship between the incubation time and the limit of detection suggest that the method could be further shortened by an additional 2 to 3 h for relatively clean samples.

Autoverification process improvement by Six Sigma approach: Clinical chemistry & immunoassay.

PubMed

Randell, Edward W; Short, Garry; Lee, Natasha; Beresford, Allison; Spencer, Margaret; Kennell, Marina; Moores, Zoë; Parry, David

2018-05-01

This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified. This information was used to identify areas for improvement and monitor the impact of changes. Use of reference range based criteria had the greatest impact on the proportion of tests autoverified. To improve AV process, reference range based criteria was replaced with extreme value limits based on a 99.5% test result interval, delta check criteria were broadened, and new specimen consistency rules were implemented. Decision guidance tools were also developed to assist staff using the AV system. The mean proportion of tests and samples autoverified improved from <62% for samples and <80% for tests, to >90% for samples and >95% for tests across all three sites. The new AV system significantly decreased turn-around time and total sample review time (to about a third), however, time spent for manual review of held samples almost tripled. There was no evidence of compromise to the quality of testing process and <1% of samples held for exceeding delta check or extreme limits required corrective action. The Six Sigma (DMAIC) process improvement methodology was successfully applied to AV systems resulting in an increase in overall test and sample AV by >90%, improved turn-around time, reduced time for manual verification, and with no obvious compromise to quality or error detection. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

PubMed

Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

2016-01-01

Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

Add Interest to Your Social Studies Curriculum without Cost.

ERIC Educational Resources Information Center

Bloom, Marion G.; And Others

1992-01-01

Lists a sampling of free materials and their sources for use by social studies teachers. Includes videos, maps, pamphlets, booklets, games, posters, and travel brochures from Norway, Saudi Arabia, Germany, and Korea among others. Provides source addresses, turnaround times, and descriptions of the materials. (DK)

Rapid-Viability PCR Method for Detection of Live, Virulent Bacillus anthracis in Environmental Samples ▿

PubMed Central

Létant, Sonia E.; Murphy, Gloria A.; Alfaro, Teneile M.; Avila, Julie R.; Kane, Staci R.; Raber, Ellen; Bunt, Thomas M.; Shah, Sanjiv R.

2011-01-01

In the event of a biothreat agent release, hundreds of samples would need to be rapidly processed to characterize the extent of contamination and determine the efficacy of remediation activities. Current biological agent identification and viability determination methods are both labor- and time-intensive such that turnaround time for confirmed results is typically several days. In order to alleviate this issue, automated, high-throughput sample processing methods were developed in which real-time PCR analysis is conducted on samples before and after incubation. The method, referred to as rapid-viability (RV)-PCR, uses the change in cycle threshold after incubation to detect the presence of live organisms. In this article, we report a novel RV-PCR method for detection of live, virulent Bacillus anthracis, in which the incubation time was reduced from 14 h to 9 h, bringing the total turnaround time for results below 15 h. The method incorporates a magnetic bead-based DNA extraction and purification step prior to PCR analysis, as well as specific real-time PCR assays for the B. anthracis chromosome and pXO1 and pXO2 plasmids. A single laboratory verification of the optimized method applied to the detection of virulent B. anthracis in environmental samples was conducted and showed a detection level of 10 to 99 CFU/sample with both manual and automated RV-PCR methods in the presence of various challenges. Experiments exploring the relationship between the incubation time and the limit of detection suggest that the method could be further shortened by an additional 2 to 3 h for relatively clean samples. PMID:21764960

A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit.

PubMed

Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J Gordon

2018-02-01

To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Time to medication administration. In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10minutes, p=0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times. Copyright © 2017 Elsevier Ltd. All rights reserved.

Benchmarking, benchmarks, or best practices? Applying quality improvement principles to decrease surgical turnaround time.

PubMed

Mitchell, L

1996-01-01

The processes of benchmarking, benchmark data comparative analysis, and study of best practices are distinctly different. The study of best practices is explained with an example based on the Arthur Andersen & Co. 1992 "Study of Best Practices in Ambulatory Surgery". The results of a national best practices study in ambulatory surgery were used to provide our quality improvement team with the goal of improving the turnaround time between surgical cases. The team used a seven-step quality improvement problem-solving process to improve the surgical turnaround time. The national benchmark for turnaround times between surgical cases in 1992 was 13.5 minutes. The initial turnaround time at St. Joseph's Medical Center was 19.9 minutes. After the team implemented solutions, the time was reduced to an average of 16.3 minutes, an 18% improvement. Cost-benefit analysis showed a potential enhanced revenue of approximately $300,000, or a potential savings of $10,119. Applying quality improvement principles to benchmarking, benchmarks, or best practices can improve process performance. Understanding which form of benchmarking the institution wishes to embark on will help focus a team and use appropriate resources. Communicating with professional organizations that have experience in benchmarking will save time and money and help achieve the desired results.

Computer-aided detection system for chest radiography: reducing report turnaround times of examinations with abnormalities.

PubMed

Kao, E-Fong; Liu, Gin-Chung; Lee, Lo-Yeh; Tsai, Huei-Yi; Jaw, Twei-Shiun

2015-06-01

The ability to give high priority to examinations with pathological findings could be very useful to radiologists with large work lists who wish to first evaluate the most critical studies. A computer-aided detection (CAD) system for identifying chest examinations with abnormalities has therefore been developed. To evaluate the effectiveness of a CAD system on report turnaround times of chest examinations with abnormalities. The CAD system was designed to automatically mark chest examinations with possible abnormalities in the work list of radiologists interpreting chest examinations. The system evaluation was performed in two phases: two radiologists interpreted the chest examinations without CAD in phase 1 and with CAD in phase 2. The time information recorded by the radiology information system was then used to calculate the turnaround times. All chest examinations were reviewed by two other radiologists and were divided into normal and abnormal groups. The turnaround times for the examinations with pathological findings with and without the CAD system assistance were compared. The sensitivity and specificity of the CAD for chest abnormalities were 0.790 and 0.697, respectively, and use of the CAD system decreased the turnaround time for chest examinations with abnormalities by 44%. The turnaround times required for radiologists to identify chest examinations with abnormalities could be reduced by using the CAD system. This system could be useful for radiologists with large work lists who wish to first evaluate the most critical studies. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Surgical pathology extradepartmental consultation practices.

PubMed

Azam, Muhammad; Nakhleh, Raouf E

2002-04-01

To document the practice parameters and case characteristics associated with personal (expert) consultations. We also examine the value, level of participant (customer) satisfaction, turnaround time, and rate of personal consultations. We asked participants in the College of American Pathologists' Q-Probes program to document cases sent for consultation during 4 months or up to 20 cases. They documented patient and specimen characteristics, the turnaround times, and the participants' levels of satisfaction with the consultation experience. One hundred eighty laboratories/surgical pathology practices. One hundred seventy-two (95.6%) were from the United States; the remainder were located in Canada and Australia. Rate and turnaround time of consultations and participant level of satisfaction. A total of 2746 consultation cases were examined for an aggregate consultation rate of 0.5% (median, 0.7%). Institutions with a higher occupied bed size and a greater number of surgical pathology cases both had lower consultation rates (P < or =.05). The median turnaround time (defined as the interval from the date on which the case was sent to the date on which the diagnosis was received) was 6 days. Twenty-nine percent and 68% of cases had a turnaround time within 3 and 7 days, respectively. Fifty-two percent of cases were sent to nationally known experts, and 32% were sent to local experts. Skin (18.0%), hematolymphoid (11.6%), and breast (9.6%) specimens were most commonly sent for consultation. In 70.5% of cases, the consultant confirmed the referring pathologist's original diagnosis, but in 15.9% of cases, the consultant also added significant information. Satisfaction rates were higher with faster turnaround times and verbal reporting. Satisfaction rates were lower for cases in which the patient or the clinician requested the consultation and in which the consultant's diagnosis was ambiguous. This study establishes a multi-institutional consultation rate of 0.5%, defines the nature of surgical pathology consultations, and demonstrates that satisfaction with consultations is associated with a faster turnaround time and receipt of additional, clinically meaningful information.

Laboratory sample turnaround times: do they cause delays in the ED?

PubMed

Gill, Dipender; Galvin, Sean; Ponsford, Mark; Bruce, David; Reicher, John; Preston, Laura; Bernard, Stephani; Lafferty, Jessica; Robertson, Andrew; Rose-Morris, Anna; Stoneham, Simon; Rieu, Romelie; Pooley, Sophie; Weetch, Alison; McCann, Lloyd

2012-02-01

Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results. © 2010 Blackwell Publishing Ltd.

The Impact of Turnaround Reform on Student Outcomes: Evidence and Insights from the Los Angeles Unified School District

ERIC Educational Resources Information Center

Strunk, Katharine O.; Marsh, Julie A.; Hashim, Ayesha K.; Bush-Mecenas, Susan; Weinstein, Tracey

2016-01-01

We examine the Los Angeles Unified School District's Public School Choice Initiative (PSCI), which sought to turnaround the district's lowest-performing schools. We ask whether school turnaround impacted student outcomes, and what explains variations in outcomes across reform cohorts. We use a Comparative Interrupted Time Series approach using…

Precise turnaround time measurement of laboratory processes using radiofrequency identification technology.

PubMed

Mayer, Horst; Brümmer, Jens; Brinkmann, Thomas

2011-01-01

To implement Lean Six Sigma in our central laboratory we conducted a project to measure single pre-analytical steps influencing turnaround time (TAT) of emergency department (ED) serum samples. The traditional approach of extracting data from the Laboratory Information System (LIS) for a retrospective calculation of a mean TAT is not suitable. Therefore, we used radiofrequency identification (RFID) chips for real time tracking of individual samples at any pre-analytical step. 1,200 serum tubes were labelled with RFID chips and were provided to the emergency department. 3 RFID receivers were installed in the laboratory: at the outlet of the pneumatic tube system, at the centrifuge, and in the analyser area. In addition, time stamps of sample entry at the automated sample distributor and communication of results from the analyser were collected from LIS. 1,023 labelled serum tubes arrived at our laboratory. 899 RFID tags were used for TAT calculation. The following transfer times were determined (median 95th percentile in min:sec): pneumatic tube system --> centrifuge (01:25/04:48), centrifuge --> sample distributor (14:06/5:33), sample distributor --> analysis system zone (02:39/15:07), analysis system zone --> result communication (12:42/22:21). Total TAT was calculated at 33:19/57:40 min:sec. Manual processes around centrifugation were identified as a major part of TAT with 44%/60% (median/95th percentile). RFID is a robust, easy to use, and error-free technology and not susceptible to interferences in the laboratory environment. With this study design we were able to measure significant variations in a single manual sample transfer process. We showed that TAT is mainly influenced by manual steps around the centrifugation process and we concluded that centrifugation should be integrated in solutions for total laboratory automation.

Experimental fusion of different versions of the total laboratory automation system and improvement of laboratory turnaround time.

PubMed

Chung, Hee-Jung; Song, Yoon Kyung; Hwang, Sang-Hyun; Lee, Do Hoon; Sugiura, Tetsuro

2018-02-25

Use of total laboratory automation (TLA) system has expanded to microbiology and hemostasis and upgraded to second and third generations. We herein report the first successful upgrades and fusion of different versions of the TLA system, thus improving laboratory turnaround time (TAT). A 21-day schedule was planned from the time of pre-meeting to installation and clinical sample application. We analyzed the monthly TAT in each menu, distribution of the "out of range for acceptable TAT" samples, and "prolonged time out of acceptable TAT," before and after the upgrade and fusion. We installed and customized hardware, middleware, and software. The one-way CliniLog 2.0 version track, 50.0-m long, was changed to a 23.2-m long one-way 2.0 version and an 18.7-m long two-way 4.0 version. The monthly TAT in the outpatient samples, before and after upgrading the TLA system, were uniformly satisfactory in the chemistry and viral marker menus. However, in the tumor marker menu, the target TAT (98.0% of samples ≤60 minutes) was not satisfied during the familiarization period. There was no significant difference in the proportion of "out of acceptable TAT" samples, before and after the TLA system upgrades (7.4‰ and 8.5‰). However, the mean "prolonged time out of acceptable TAT" in the chemistry samples was significantly shortened to 17.4 (±24.0) minutes after the fusion, from 34.5 (±43.4) minutes. Despite experimental challenges, a fusion of the TLA system shortened the "prolonged time out of acceptable TAT," indicating a distribution change in overall TAT. © 2018 Wiley Periodicals, Inc.

Impact of SMS/GPRS Printers in Reducing Time to Early Infant Diagnosis Compared With Routine Result Reporting: A Systematic Review and Meta-Analysis

PubMed Central

Markby, Jessica; Boeke, Caroline; Penazzato, Martina; Urick, Brittany; Ghadrshenas, Anisa; Harris, Lindsay; Ford, Nathan; Peter, Trevor

2017-01-01

Background: Despite significant gains made toward improving access, early infant diagnosis (EID) testing programs suffer from long test turnaround times that result in substantial loss to follow-up and mortality associated with delays in antiretroviral therapy initiation. These delays in treatment initiation are particularly impactful because of significant HIV-related infant mortality observed by 2–3 months of age. Short message service (SMS) and general packet radio service (GPRS) printers allow test results to be transmitted immediately to health care facilities on completion of testing in the laboratory. Methods: We conducted a systematic review and meta-analysis to assess the benefit of using SMS/GPRS printers to increase the efficiency of EID test result delivery compared with traditional courier paper–based results delivery methods. Results: We identified 11 studies contributing data for over 16,000 patients from East and Southern Africa. The test turnaround time from specimen collection to result received at the health care facility with courier paper–based methods was 68.0 days (n = 6835), whereas the test turnaround time with SMS/GPRS printers was 51.1 days (n = 6711), resulting in a 2.5-week (25%) reduction in the turnaround time. Conclusions: Courier paper–based EID test result delivery methods are estimated to add 2.5 weeks to EID test turnaround times in low resource settings and increase the risk that infants receive test results during or after the early peak of infant mortality. SMS/GPRS result delivery to health care facility printers significantly reduced test turnaround time and may reduce this risk. SMS/GPRS printers should be considered for expedited delivery of EID and other centralized laboratory test results. PMID:28825941

Highly Accurate Antibody Assays for Early and Rapid Detection of Tuberculosis in African and Asian Elephants

USDA-ARS?s Scientific Manuscript database

Tuberculosis (TB) in elephants is a re-emerging zoonotic disease caused primarily by Mycobacterium tuberculosis. Current methods for screening and diagnosis rely on trunk wash culture, which has serious limitations due to low test sensitivity, slow turn-around time, and variable sample quality. Inn...

Psychiatric patients turnaround times in the emergency department

PubMed Central

2005-01-01

Background To analyze the turnaround times of psychiatric patients within the Emergency Department (ED) from registration to discharge or hospitalization in a University Hospital in 2002. Methods Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. Results From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97) minutes (median 95). Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. Conclusion As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be. PMID:16351721

Turnaround Time Modeling for Conceptual Rocket Engines

NASA Technical Reports Server (NTRS)

Nix, Michael; Staton, Eric J.

2004-01-01

Recent years have brought about a paradigm shift within NASA and the Space Launch Community regarding the performance of conceptual design. Reliability, maintainability, supportability, and operability are no longer effects of design; they have moved to the forefront and are affecting design. A primary focus of this shift has been a planned decrease in vehicle turnaround time. Potentials for instituting this decrease include attacking the issues of removing, refurbishing, and replacing the engines after each flight. less, it is important to understand the operational affects of an engine on turnaround time, ground support personnel and equipment. One tool for visualizing this relationship involves the creation of a Discrete Event Simulation (DES). A DES model can be used to run a series of trade studies to determine if the engine is meeting its requirements, and, if not, what can be altered to bring it into compliance. Using DES, it is possible to look at the ways in which labor requirements, parallel maintenance versus serial maintenance, and maintenance scheduling affect the overall turnaround time. A detailed DES model of the Space Shuttle Main Engines (SSME) has been developed. Trades may be performed using the SSME Processing Model to see where maintenance bottlenecks occur, what the benefits (if any) are of increasing the numbers of personnel, or the number and location of facilities, in addition to trades previously mentioned, all with the goal of optimizing the operational turnaround time and minimizing operational cost. The SSME Processing Model was developed in such a way that it can easily be used as a foundation for developing DES models of other operational or developmental reusable engines. Performing a DES on a developmental engine during the conceptual phase makes it easier to affect the design and make changes to bring about a decrease in turnaround time and costs.

Comparison of illumigene Group A Streptococcus Assay with Culture of Throat Swabs from Children with Sore Throats in the New Zealand School-Based Rheumatic Fever Prevention Program.

PubMed

Upton, Arlo; Bissessor, Liselle; Farrell, Elizabeth; Shulman, Stanford T; Zheng, Xiaotian; Lennon, Diana

2016-01-01

Group A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

A strategy for reducing turnaround time in design optimization using a distributed computer system

NASA Technical Reports Server (NTRS)

Young, Katherine C.; Padula, Sharon L.; Rogers, James L.

1988-01-01

There is a need to explore methods for reducing lengthly computer turnaround or clock time associated with engineering design problems. Different strategies can be employed to reduce this turnaround time. One strategy is to run validated analysis software on a network of existing smaller computers so that portions of the computation can be done in parallel. This paper focuses on the implementation of this method using two types of problems. The first type is a traditional structural design optimization problem, which is characterized by a simple data flow and a complicated analysis. The second type of problem uses an existing computer program designed to study multilevel optimization techniques. This problem is characterized by complicated data flow and a simple analysis. The paper shows that distributed computing can be a viable means for reducing computational turnaround time for engineering design problems that lend themselves to decomposition. Parallel computing can be accomplished with a minimal cost in terms of hardware and software.

Predictable turn-around time for post tape-out flow

NASA Astrophysics Data System (ADS)

Endo, Toshikazu; Park, Minyoung; Ghosh, Pradiptya

2012-03-01

A typical post-out flow data path at the IC Fabrication has following major components of software based processing - Boolean operations before the application of resolution enhancement techniques (RET) and optical proximity correctin (OPC), the RET and OPC step [etch retargeting, sub-resolution assist feature insertion (SRAF) and OPC], post-OPCRET Boolean operations and sometimes in the same flow simulation based verification. There are two objectives that an IC Fabrication tapeout flow manager wants to achieve with the flow - predictable completion time and fastest turn-around time (TAT). At times they may be competing. There have been studies in the literature modeling the turnaround time from historical data for runs with the same recipe and later using that to derive the resource allocation for subsequent runs. [3]. This approach is more feasible in predominantly simulation dominated tools but for edge operation dominated flow it may not be possible especially if some processing acceleration methods like pattern matching or hierarchical processing is involved. In this paper, we suggest an alternative method of providing target turnaround time and managing the priority of jobs while not doing any upfront resource modeling and resource planning. The methodology then systematically either meets the turnaround time need and potentially lets the user know if it will not as soon as possible. This builds on top of the Calibre Cluster Management (CalCM) resource management work previously published [1][2]. The paper describes the initial demonstration of the concept.

Emergency Department Overcrowding and Ambulance Turnaround Time

PubMed Central

Lee, Yu Jin; Shin, Sang Do; Lee, Eui Jung; Cho, Jin Seong; Cha, Won Chul

2015-01-01

Objective The aims of this study were to describe overcrowding in regional emergency departments in Seoul, Korea and evaluate the effect of crowdedness on ambulance turnaround time. Methods This study was conducted between January 2010 and December 2010. Patients who were transported by 119-responding ambulances to 28 emergency centers within Seoul were eligible for enrollment. Overcrowding was defined as the average occupancy rate, which was equal to the average number of patients staying in an emergency department (ED) for 4 hours divided by the number of beds in the ED. After selecting groups for final analysis, multi-level regression modeling (MLM) was performed with random-effects for EDs, to evaluate associations between occupancy rate and turnaround time. Results Between January 2010 and December 2010, 163,659 patients transported to 28 EDs were enrolled. The median occupancy rate was 0.42 (range: 0.10-1.94; interquartile range (IQR): 0.20-0.76). Overcrowded EDs were more likely to have older patients, those with normal mentality, and non-trauma patients. Overcrowded EDs were more likely to have longer turnaround intervals and traveling distances. The MLM analysis showed that an increase of 1% in occupancy rate was associated with 0.02-minute decrease in turnaround interval (95% CI: 0.01 to 0.03). In subgroup analyses limited to EDs with occupancy rates over 100%, we also observed a 0.03 minute decrease in turnaround interval per 1% increase in occupancy rate (95% CI: 0.01 to 0.05). Conclusions In this study, we found wide variation in emergency department crowding in a metropolitan Korean city. Our data indicate that ED overcrowding is negatively associated with turnaround interval with very small practical significance. PMID:26115183

Impact of a Rapid Herpes Simplex Virus PCR Assay on Duration of Acyclovir Therapy

PubMed Central

Van, Tam T.; Mongkolrattanothai, Kanokporn; Arevalo, Melissa; Lustestica, Maryann

2017-01-01

ABSTRACT Herpes simplex virus (HSV) infections of the central nervous system (CNS) are associated with significant morbidity and mortality rates in children. This study assessed the impact of a direct HSV (dHSV) PCR assay on the time to result reporting and the duration of acyclovir therapy for children with signs and symptoms of meningitis and encephalitis. A total of 363 patients with HSV PCR results from cerebrospinal fluid (CSF) samples were included in this retrospective analysis, divided into preimplementation and postimplementation groups. For the preimplementation group, CSF testing was performed using a laboratory-developed real-time PCR assay; for the postimplementation group, CSF samples were tested using a direct sample-to-answer assay. All CSF samples were negative for HSV. Over 60% of patients from both groups were prescribed acyclovir. The average HSV PCR test turnaround time for the postimplementation group was reduced by 14.5 h (23.6 h versus 9.1 h; P < 0.001). Furthermore, 79 patients (43.6%) in the postimplementation group had dHSV PCR results reported <4 h after specimen collection. The mean time from specimen collection to acyclovir discontinuation was 17.1 h shorter in the postimplementation group (31.1 h versus 14 h; P < 0.001). The median duration of acyclovir therapy was also significantly reduced in the postimplementation group (29.2 h versus 14.3 h; P = 0.01). Our investigation suggests that implementation of rapid HSV PCR testing can decrease turnaround times and the duration of unnecessary acyclovir therapy. PMID:28275080

Impact of a Rapid Herpes Simplex Virus PCR Assay on Duration of Acyclovir Therapy.

PubMed

Van, Tam T; Mongkolrattanothai, Kanokporn; Arevalo, Melissa; Lustestica, Maryann; Dien Bard, Jennifer

2017-05-01

Herpes simplex virus (HSV) infections of the central nervous system (CNS) are associated with significant morbidity and mortality rates in children. This study assessed the impact of a direct HSV (dHSV) PCR assay on the time to result reporting and the duration of acyclovir therapy for children with signs and symptoms of meningitis and encephalitis. A total of 363 patients with HSV PCR results from cerebrospinal fluid (CSF) samples were included in this retrospective analysis, divided into preimplementation and postimplementation groups. For the preimplementation group, CSF testing was performed using a laboratory-developed real-time PCR assay; for the postimplementation group, CSF samples were tested using a direct sample-to-answer assay. All CSF samples were negative for HSV. Over 60% of patients from both groups were prescribed acyclovir. The average HSV PCR test turnaround time for the postimplementation group was reduced by 14.5 h (23.6 h versus 9.1 h; P < 0.001). Furthermore, 79 patients (43.6%) in the postimplementation group had dHSV PCR results reported <4 h after specimen collection. The mean time from specimen collection to acyclovir discontinuation was 17.1 h shorter in the postimplementation group (31.1 h versus 14 h; P < 0.001). The median duration of acyclovir therapy was also significantly reduced in the postimplementation group (29.2 h versus 14.3 h; P = 0.01). Our investigation suggests that implementation of rapid HSV PCR testing can decrease turnaround times and the duration of unnecessary acyclovir therapy. Copyright © 2017 American Society for Microbiology.

Technical and financial evaluation of assays for progesterone in canine practice in the UK.

PubMed

Moxon, R; Copley, D; England, G C W

2010-10-02

The concentration of progesterone was measured in 60 plasma samples from bitches at various stages of the oestrous cycle, using commercially available quantitative and semi-quantitative ELISA test kits, as well as by two commercial laboratories undertaking radioimmunoassay (RIA). The RIA, which was assumed to be the 'gold standard' in terms of reliability and accuracy, was the most expensive method when analysing more than one sample per week, and had the longest delay in obtaining results, but had minimal requirements for practice staff time. When compared with the RIA, the quantitative ELISA had a strong positive correlation (r=0.97, P<0.05) and a sensitivity and specificity of 70.6 per cent and 100.0 per cent, respectively, and positive and negative predictive values of 100.0 per cent and 71.0 per cent, respectively, with an overall accuracy of 90.0 per cent. This method was the least expensive when analysing five or more samples per week, but had longer turnaround times than that of the semi-quantitative ELISA and required more staff time. When compared with the RIA, the semi-quantitative ELISA had a sensitivity and specificity of 100.0 per cent and 95.5 per cent, respectively, and positive and negative predictive values of 73.9 per cent and 77.8 per cent, respectively, with an overall accuracy of 89.2 per cent. This method was more expensive than the quantitative ELISA when analysing five or more samples per week, but had the shortest turnaround time and low requirements in terms of staff time.

Rural Economic Development Consequences of the Population Turnaround in Northern Lower Michigan.

ERIC Educational Resources Information Center

West, Patrick C.; And Others

Consequences of population turnaround for rural economic development are examined in a 9-county region of Northern Lower Michigan. Data from census reports and 374 usable responses to a questionnaire mailed to a random sample of property owners drawn from 1982 county tax assessment rolls were used to test competing hypotheses about rural…

Applying Total Quality Management in Cooperative Extension.

ERIC Educational Resources Information Center

Fredendall, Lawrence D.; Lippert, Robert M.

1995-01-01

South Carolina's Agricultural Service Laboratory received responses from 252 of 500 farmers who currently use the soil testing service; 97% were pleased with accuracy, 89% with turnaround time, 18% thought the fee too high. Nonusers (100 of 520) were mainly dissatisfied with turnaround time. Total quality management methods were used to improve…

Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

PubMed

Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2014-09-01

The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

Ways to reduce patient turnaround time and improve service quality in emergency departments.

PubMed

Sinreich, David; Marmor, Yariv

2005-01-01

Recent years have witnessed a fundamental change in the function of emergency departments (EDs). The emphasis of the ED shifts from triage to saving the lives of shock-trauma rooms equipped with state-of-the-art equipment. At the same time walk-in clinics are being set up to treat ambulatory type patients. Simultaneously ED overcrowding has become a common sight in many large urban hospitals. This paper recognises that in order to provide quality treatment to all these patient types, ED process operations have to be flexible and efficient. The paper aims to examine one major benchmark for measuring service quality--patient turnaround time, claiming that in order to provide the quality treatment to which EDs aspire, this time needs to be reduced. This study starts by separating the process each patient type goes through when treated at the ED into unique components. Next, using a simple model, the impact each of these components has on the total patient turnaround time is determined. This in turn, identifies the components that need to be addressed if patient turnaround time is to be streamlined. The model was tested using data that were gathered through a comprehensive time study in six major hospitals. The analysis reveals that waiting time comprises 51-63 per cent of total patient turnaround time in the ED. Its major components are: time away for an x-ray examination; waiting time for the first physician's examination; and waiting time for blood work. The study covers several hospitals and analyses over 20,000 process components; as such the common findings may serve as guidelines to other hospitals when addressing this issue.

Implementation of a web-based medication tracking system in a large academic medical center.

PubMed

Calabrese, Sam V; Williams, Jonathan P

2012-10-01

Pharmacy workflow efficiencies achieved through the use of an electronic medication-tracking system are described. Medication dispensing turnaround times at the inpatient pharmacy of a large hospital were evaluated before and after transition from manual medication tracking to a Web-based tracking process involving sequential bar-code scanning and real-time monitoring of medication status. The transition was carried out in three phases: (1) a workflow analysis, including the identification of optimal points for medication scanning with hand-held wireless devices, (2) the phased implementation of an automated solution and associated hardware at a central dispensing pharmacy and three satellite locations, and (3) postimplementation data collection to evaluate the impact of the new tracking system and areas for improvement. Relative to the manual tracking method, electronic medication tracking allowed the capture of far more data points, enabling the pharmacy team to delineate the time required for each step of the medication dispensing process and to identify the steps most likely to involve delays. A comparison of baseline and postimplementation data showed substantial reductions in overall medication turnaround times with the use of the Web-based tracking system (time reductions of 45% and 22% at the central and satellite sites, respectively). In addition to more accurate projections and documentation of turnaround times, the Web-based tracking system has facilitated quality-improvement initiatives. Implementation of an electronic tracking system for monitoring the delivery of medications provided a comprehensive mechanism for calculating turnaround times and allowed the pharmacy to identify bottlenecks within the medication distribution system. Altering processes removed these bottlenecks and decreased delivery turnaround times.

Reliability Evaluation of Concentrator Photovoltaic Modules per IEC Qualification Specifications

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

Tamizhmani, Govindasamy

2012-12-05

This project is related to the qualification testing of new generation CPV (concentrator photovoltaics) modules at lower testing costs and lower turnaround time. In this project, the first testing program was completed for two CPV manufacturers, the second testing program was completed for two manufacturers at 65% of the actual testing cost and at less than 3 months of testing turnaround time and the third testing program was completed for two manufacturers at 65% of the actual testing cost and at less than 3 months of testing turnaround time. Due to their financial situation and restructuring, Amonix (one of themore » CPV manufacturers) intermittently terminated the test programs.« less

Financial and workflow analysis of radiology reporting processes in the planning phase of implementation of a speech recognition system

NASA Astrophysics Data System (ADS)

Whang, Tom; Ratib, Osman M.; Umamoto, Kathleen; Grant, Edward G.; McCoy, Michael J.

2002-05-01

The goal of this study is to determine the financial value and workflow improvements achievable by replacing traditional transcription services with a speech recognition system in a large, university hospital setting. Workflow metrics were measured at two hospitals, one of which exclusively uses a transcription service (UCLA Medical Center), and the other which exclusively uses speech recognition (West Los Angeles VA Hospital). Workflow metrics include time spent per report (the sum of time spent interpreting, dictating, reviewing, and editing), transcription turnaround, and total report turnaround. Compared to traditional transcription, speech recognition resulted in radiologists spending 13-32% more time per report, but it also resulted in reduction of report turnaround time by 22-62% and reduction of marginal cost per report by 94%. The model developed here helps justify the introduction of a speech recognition system by showing that the benefits of reduced operating costs and decreased turnaround time outweigh the cost of increased time spent per report. Whether the ultimate goal is to achieve a financial objective or to improve operational efficiency, it is important to conduct a thorough analysis of workflow before implementation.

Turnaround Time and Market Capacity in Contract Cheating

ERIC Educational Resources Information Center

Wallace, Melisa J.; Newton, Philip M.

2014-01-01

Contract cheating is the process whereby students auction off the opportunity for others to complete assignments for them. It is an apparently widespread yet under-researched problem. One suggested strategy to prevent contract cheating is to shorten the turnaround time between the release of assignment details and the submission date, thus making…

Comparison of turnaround time and total cost of HIV testing before and after implementation of the 2014 CDC/APHL Laboratory Testing Algorithm for diagnosis of HIV infection.

PubMed

Chen, Derrick J; Yao, Joseph D

2017-06-01

Updated recommendations for HIV diagnostic laboratory testing published by the Centers for Disease Control and Prevention and the Association of Public Health Laboratories incorporate 4th generation HIV immunoassays, which are capable of identifying HIV infection prior to seroconversion. The purpose of this study was to compare turnaround time and cost between 3rd and 4th generation HIV immunoassay-based testing algorithms for initially reactive results. The clinical microbiology laboratory database at Mayo Clinic, Rochester, MN was queried for 3rd generation (from November 2012 to May 2014) and 4th generation (from May 2014 to November 2015) HIV immunoassay results. All results from downstream supplemental testing were recorded. Turnaround time (defined as the time of initial sample receipt in the laboratory to the time the final supplemental test in the algorithm was resulted) and cost (based on 2016 Medicare reimbursement rates) were assessed. A total of 76,454 and 78,998 initial tests were performed during the study period using the 3rd generation and 4th generation HIV immunoassays, respectively. There were 516 (0.7%) and 581 (0.7%) total initially reactive results, respectively. Of these, 304 (58.9%) and 457 (78.7%) were positive by supplemental testing. There were 10 (0.01%) cases of acute HIV infection identified with the 4th generation algorithm. The most frequent tests performed to confirm an HIV-positive case using the 3rd generation algorithm, which were reactive initial immunoassay and positive HIV-1 Western blot, took a median time of 1.1 days to complete at a cost of $45.00. In contrast, the most frequent tests performed to confirm an HIV-positive case using the 4th generation algorithm, which included a reactive initial immunoassay and positive HIV-1/-2 antibody differentiation immunoassay for HIV-1, took a median time of 0.4 days and cost $63.25. Overall median turnaround time was 2.2 and 1.5 days, and overall median cost was $63.90 and $72.50 for 3rd and 4th generation algorithms, respectively. Both 3rd and 4th generation HIV immunoassays had similar total numbers of tests performed and positivity rates during the study period. A greater proportion of reactive 4th generation immunoassays were confirmed to be positive, and the 4th generation algorithm identified several cases of acute HIV infection that would have been missed by the 3rd generation algorithm. The 4th generation algorithm had a more rapid turnaround time but higher cost for confirmed positive HIV infections and overall, compared to the 3rd generation algorithm. Copyright © 2017 Elsevier B.V. All rights reserved.

Process improvement for regulatory analyses of custom-blend fertilizers.

PubMed

Wegner, Keith A

2014-01-01

Chemical testing of custom-blend fertilizers is essential to ensure that the products meet the formulation requirements. For purposes of proper crop nutrition and consumer protection, regulatory oversight promotes compliance and particular attention to blending and formulation specifications. Analyses of custom-blend fertilizer products must be performed and reported within a very narrow window in order to be effective. The Colorado Department of Agriculture's Biochemistry Laboratory is an ISO 17025 accredited facility and conducts analyses of custom-blend fertilizer products primarily during the spring planting season. Using the Lean Six Sigma (LSS) process, the Biochemistry Laboratory has reduced turnaround times from as much as 45 days to as little as 3 days. The LSS methodology focuses on waste reduction through identifying: non-value-added steps, unneeded process reviews, optimization of screening and confirmatory analyses, equipment utilization, nonessential reporting requirements, and inefficient personnel deployment. Eliminating these non-value-added activities helped the laboratory significantly shorten turnaround time and reduce costs. Key improvement elements discovered during the LSS process included: focused sample tracking, equipment redundancy, strategic supply stocking, batch size optimization, critical sample paths, elimination of nonessential QC reviews, and more efficient personnel deployment.

Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time.

PubMed

Lagacé-Wiens, Philippe R S; Adam, Heather J; Karlowsky, James A; Nichol, Kimberly A; Pang, Paulette F; Guenther, Jodi; Webb, Amanda A; Miller, Crystal; Alfa, Michelle J

2012-10-01

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry represents a revolution in the rapid identification of bacterial and fungal pathogens in the clinical microbiology laboratory. Recently, MALDI-TOF has been applied directly to positive blood culture bottles for the rapid identification of pathogens, leading to reductions in turnaround time and potentially beneficial patient impacts. The development of a commercially available extraction kit (Bruker Sepsityper) for use with the Bruker MALDI BioTyper has facilitated the processing required for identification of pathogens directly from positive from blood cultures. We report the results of an evaluation of the accuracy, cost, and turnaround time of this method for 61 positive monomicrobial and 2 polymicrobial cultures representing 26 species. The Bruker MALDI BioTyper with the Sepsityper gave a valid (score, >1.7) identification for 85.2% of positive blood cultures with no misidentifications. The mean reduction in turnaround time to identification was 34.3 h (P < 0.0001) in the ideal situation where MALDI-TOF was used for all blood cultures and 26.5 h in a more practical setting where conventional identification or identification from subcultures was required for isolates that could not be directly identified by MALDI-TOF. Implementation of a MALDI-TOF-based identification system for direct identification of pathogens from blood cultures is expected to be associated with a marginal increase in operating costs for most laboratories. However, the use of MALDI-TOF for direct identification is accurate and should result in reduced turnaround time to identification.

BetaScint{trademark} fiber-optic sensor for detecting strontium-90 and uranium-238 in soil. Innovative technology summary report

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

NONE

1998-12-01

Accurate measurements of radioactivity in soils contaminated with Strontium-90 (Sr-90) or Uranium-238 (U-238) are essential for many DOE site remediation programs. These crucial measurements determine if excavation and soil removal is necessary, where remediation efforts should be focused, and/or if a site has reached closure. Measuring soil contamination by standard EPA laboratory methods typically takes a week (accelerated analytical test turnaround) or a month (standard analytical test turnaround). The time delay extends to operations involving heavy excavation equipment and associated personnel which are the main costs of remediation. This report describes an application of the BetaScint{trademark} fiber-optic sensor that measuresmore » Sr-90 or U-238 contamination in soil samples on site in about 20 minutes, at a much lower cost than time-consuming laboratory methods, to greatly facilitate remediation. This report describes the technology, its performance, its uses, cost, regulatory and policy issues, and lessons learned.« less

Impact of an in-house emergency radiologist on report turnaround time.

PubMed

Lamb, Leslie; Kashani, Paria; Ryan, John; Hebert, Guy; Sheikh, Adnan; Thornhill, Rebecca; Fasih, Najla

2015-01-01

One of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow. The purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time. Preliminary and final report turnaround times, provided by the radiology resident and staff, respectively, for patients undergoing computed tomography or ultrasonography of their abdomen/pelvis in 2008 (before the implementation of emergency radiology in-house staff service) were compared to those performed during the same time frame in 2009 and 2010 (after staffing protocols were changed). A total of 1,624 reports were reviewed. Overall, there was no statistically significant decrease in the preliminary report turnaround times between 2008 and 2009 (p = 0.1102), 2009 and 2010 (p = 0.6232), or 2008 and 2010 (p = 0.0890), although times consistently decreased from a median of 2.40 hours to 2.08 hours to 2.05 hours (2008 to 2009 to 2010). There was a statistically significant decrease in final report turnaround times between 2008 and 2009 (p < 0.0001), 2009 and 2010 (p < 0.0011), and 2008 and 2010 (p < 0.0001). Median final report times decreased from 5.00 hours to 3.08 hours to 2.75 hours in 2008, 2009, and 2010, respectively. There was also a significant decrease in the time interval between preliminary and final reports between 2008 and 2009 (p < 0.0001) and 2008 and 2010 (p < 0.0001) but no significant change between 2009 and 2010 (p = 0.4144). Our results indicate that the presence of a dedicated ED radiologist significantly reduces final report turnaround time and thus may positively impact the time to ED patient disposition. Patient care is improved when attending radiologists are immediately available to read complex films, both in terms of health care outcomes and regarding the need for repeat testing. Providing emergency physicians with accurate imaging findings as rapidly as possible facilitates effective and timely management and thus optimizes patient care.

Ozone impact minimization through coordinated scheduling of turnaround operations from multiple olefin plants in an ozone nonattainment area

NASA Astrophysics Data System (ADS)

Ge, Sijie; Wang, Sujing; Xu, Qiang; Ho, Thomas

2018-03-01

Turnaround operations (start-up and shutdown) are critical operations in olefin plants, which emit large quantities of VOCs, NOx and CO. The emission has great potentials to impact the ozone level in ozone nonattainment areas. This study demonstrates a novel practice to minimize the ozone impact through coordinated scheduling of turnaround operations from multiple olefin plants located in Houston, Texas, an ozone nonattainment area. The study considered two olefin plants scheduled to conduct turnaround operations: one start-up and one shutdown, simultaneously on the same day within a five-hour window. Through dynamic simulations of the turnaround operations using ASPEN Plus Dynamics and air quality simulations using CAMx, the study predicts the ozone impact from the combined effect of the two turnaround operations under different starting-time scenarios. The simulations predict that the ozone impact from planned turnaround operations ranges from a maximum of 11.4 ppb to a minimum of 1.4 ppb. Hence, a reduction of up to 10.0 ppb can be achieved on a single day based on the selected two simulation days. This study demonstrates a cost-effective and environmentally benign ozone control practice for relevant stakeholders, including environmental agencies, regional plant operators, and local communities.

Recent development in software and automation tools for high-throughput discovery bioanalysis.

PubMed

Shou, Wilson Z; Zhang, Jun

2012-05-01

Bioanalysis with LC-MS/MS has been established as the method of choice for quantitative determination of drug candidates in biological matrices in drug discovery and development. The LC-MS/MS bioanalytical support for drug discovery, especially for early discovery, often requires high-throughput (HT) analysis of large numbers of samples (hundreds to thousands per day) generated from many structurally diverse compounds (tens to hundreds per day) with a very quick turnaround time, in order to provide important activity and liability data to move discovery projects forward. Another important consideration for discovery bioanalysis is its fit-for-purpose quality requirement depending on the particular experiments being conducted at this stage, and it is usually not as stringent as those required in bioanalysis supporting drug development. These aforementioned attributes of HT discovery bioanalysis made it an ideal candidate for using software and automation tools to eliminate manual steps, remove bottlenecks, improve efficiency and reduce turnaround time while maintaining adequate quality. In this article we will review various recent developments that facilitate automation of individual bioanalytical procedures, such as sample preparation, MS/MS method development, sample analysis and data review, as well as fully integrated software tools that manage the entire bioanalytical workflow in HT discovery bioanalysis. In addition, software tools supporting the emerging high-resolution accurate MS bioanalytical approach are also discussed.

Assessing School Turnaround: Evidence from Ohio

ERIC Educational Resources Information Center

Player, Daniel; Katz, Veronica

2016-01-01

Policy makers have struggled to find successful approaches to address concentrated, persistent low school achievement. While NCLB and the School Improvement Grant (SIG) program have devoted significant time and attention to turnaround, very little empirical evidence substantiates whether and how these efforts work. This study employs a comparative…

Combining Quick-Turnaround and Batch Workloads at Scale

NASA Technical Reports Server (NTRS)

Matthews, Gregory A.

2012-01-01

NAS uses PBS Professional to schedule and manage the workload on Pleiades, an 11,000+ node 1B cluster. At this scale the user experience for quick-turnaround jobs can degrade, which led NAS initially to set up two separate PBS servers, each dedicated to a particular workload. Recently we have employed PBS hooks and scheduler modifications to merge these workloads together under one PBS server, delivering sub-1-minute start times for the quick-turnaround workload, and enabling dynamic management of the resources set aside for that workload.

Computerised pathology test order entry reduces laboratory turnaround times and influences tests ordered by hospital clinicians: a controlled before and after study

PubMed Central

Westbrook, J I; Georgiou, A; Dimos, A; Germanos, T

2006-01-01

Objective To assess the impact of a computerised pathology order entry system on laboratory turnaround times and test ordering within a teaching hospital. Methods A controlled before and after study compared test assays ordered from 11 wards two months before (n = 97 851) and after (n = 113 762) the implementation of a computerised pathology order entry system (Cerner Millennium Powerchart). Comparisons were made of laboratory turnaround times, frequency of tests ordered and specimens taken, proportions of patients having tests, average number per patient, and percentage of gentamicin and vancomycin specimens labelled as random. Results Intervention wards experienced an average decrease in turnaround of 15.5 minutes/test assay (range 73.8 to 58.3 minutes; p<0.001). Reductions were significant for prioritised and non‐prioritised tests, and for those done within and outside business hours. There was no significant change in the average number of tests (p = 0.228), or specimens per patient (p = 0.324), and no change in turnaround time for the control ward (p = 0.218). Use of structured order screens enhanced data provided to laboratories. Removing three test assays from the liver function order set resulted in significantly fewer of these tests being done. Conclusions Computerised order entry systems are an important element in achieving faster test results. These systems can influence test ordering patterns through structured order screens, manipulation of order sets, and analysis of real time data to assess the impact of such changes, not possible with paper based systems. The extent to which improvements translate into improved patient outcomes remains to be determined. A potentially limiting factor is clinicians' capacity to respond to, and make use of, faster test results. PMID:16461564

A brief overview on radon measurements in drinking water.

PubMed

Jobbágy, Viktor; Altzitzoglou, Timotheos; Malo, Petya; Tanner, Vesa; Hult, Mikael

2017-07-01

The aim of this paper is to present information about currently used standard and routine methods for radon analysis in drinking waters. An overview is given about the current situation and the performance of different measurement methods based on literature data. The following parameters are compared and discussed: initial sample volume and sample preparation, detection systems, minimum detectable activity, counting efficiency, interferences, measurement uncertainty, sample capacity and overall turnaround time. Moreover, the parametric levels for radon in drinking water from the different legislations and directives/guidelines on radon are presented. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

PubMed

Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

2016-01-01

Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist's work station (caused by a preference for microbiological testing prior to CSF chemistry). A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

No Time to Lose: Turnaround Leader Performance Assessment

ERIC Educational Resources Information Center

Rhim, Lauren Morando

2012-01-01

Effective leadership is critical to successful school turnaround efforts. Yet, district leaders have historically been hesitant to hold leaders accountable for bold change efforts. As federal and state dollars flow to districts and individual schools charged with embarking upon transformative change efforts, districts must adopt a laser-sharp…

Evaluation of second-generation sequencing of 19 dilated cardiomyopathy genes for clinical applications.

PubMed

Gowrisankar, Sivakumar; Lerner-Ellis, Jordan P; Cox, Stephanie; White, Emily T; Manion, Megan; LeVan, Kevin; Liu, Jonathan; Farwell, Lisa M; Iartchouk, Oleg; Rehm, Heidi L; Funke, Birgit H

2010-11-01

Medical sequencing for diseases with locus and allelic heterogeneities has been limited by the high cost and low throughput of traditional sequencing technologies. "Second-generation" sequencing (SGS) technologies allow the parallel processing of a large number of genes and, therefore, offer great promise for medical sequencing; however, their use in clinical laboratories is still in its infancy. Our laboratory offers clinical resequencing for dilated cardiomyopathy (DCM) using an array-based platform that interrogates 19 of more than 30 genes known to cause DCM. We explored both the feasibility and cost effectiveness of using PCR amplification followed by SGS technology for sequencing these 19 genes in a set of five samples enriched for known sequence alterations (109 unique substitutions and 27 insertions and deletions). While the analytical sensitivity for substitutions was comparable to that of the DCM array (98%), SGS technology performed better than the DCM array for insertions and deletions (90.6% versus 58%). Overall, SGS performed substantially better than did the current array-based testing platform; however, the operational cost and projected turnaround time do not meet our current standards. Therefore, efficient capture methods and/or sample pooling strategies that shorten the turnaround time and decrease reagent and labor costs are needed before implementing this platform into routine clinical applications.

Technical evaluation of the novel preanalytical module on instrumentation laboratory ACL TOP: advancing automation in hemostasis testing.

PubMed

Lippi, Giuseppe; Ippolito, Luigi; Favaloro, Emmanuel J

2013-10-01

Automation in hemostasis testing is entering an exciting and unprecedented phase. This study was planned to assess the performance of the new preanalytical module on the hemostasis testing system Instrumentation Laboratory ACL TOP. The evaluation included interference studies to define reliable thresholds for rejecting samples with significant concentrations of interfering substances; within-run imprecision studies of plasma indices on four different interference degrees for each index; comparison studies with reference measures of hemolysis index, bilirubin, and triglycerides on clinical chemistry analyzers; and calculation of turnaround time with and without automatic performance of preanalytical check. The upper limits for sample rejection according to our interference studies were 3.6 g/L for hemoglobin, 13.6 mg/dL for bilirubin, and 1454 mg/dL for triglycerides. We found optimal precision for all indices (0.6% to 3.1% at clinically relevant thresholds) and highly significant correlations with reference measures on clinical chemistry analyzers (from 0.985 to 0.998). The limited increase of turnaround time (i.e., +3% and +5% with or without cap-piercing), coupled with no adjunctive costs over performance of normal coagulation assays, contribute to make the automatic check of plasma indices on ACL TOP a reliable and practical approach for improving testing quality and safeguarding patient safety.

Effectiveness of Specimen Collection Technology in the Reduction of Collection Turnaround Time and Mislabeled Specimens in Emergency, Medical-Surgical, Critical Care, and Maternal Child Health Departments.

PubMed

Saathoff, April M; MacDonald, Ryan; Krenzischek, Erundina

2018-03-01

The objective of this study was to evaluate the impact of specimen collection technology implementation featuring computerized provider order entry, positive patient identification, bedside specimen label printing, and barcode scanning on the reduction of mislabeled specimens and collection turnaround times in the emergency, medical-surgical, critical care, and maternal child health departments at a community teaching hospital. A quantitative analysis of a nonrandomized, pre-post intervention study design evaluated the statistical significance of reduction of mislabeled specimen percentages and collection turnaround times affected by the implementation of specimen collection technology. Mislabeled specimen percentages in all areas decreased from an average of 0.020% preimplementation to an average of 0.003% postimplementation, with a P < .001. Collection turnaround times longer than 60 minutes decreased after the implementation of specimen collection technology by an average of 27%, with a P < .001. Specimen collection and identification errors are a significant problem in healthcare, contributing to incorrect diagnoses, delayed care, lack of essential treatments, and patient injury or death. Collection errors can also contribute to an increased length of stay, increased healthcare costs, and decreased patient satisfaction. Specimen collection technology has structures in place to prevent collection errors and improve the overall efficiency of the specimen collection process.

Improving the Discharge Process to Optimize Patient Throughput in an Academic Teaching Hospital and Level I Trauma Center

DTIC Science & Technology

2004-02-22

order to minimize Emergency Center overcrowding and ambulance diversions. The purpose of this study was to identify impeding systematic delays in the...turnaround times. A pilot study was conducted on two medicine and two surgery inpatient nursing units to analyze bed turnaround times and discharge times of...to the BTGH executive leadership who identified a need for this study : Mr. George Masi, Associate Administrator; Ms. Beth De Guzman, Chief Nursing

A point-of-care chemistry test for reduction of turnaround and clinical decision time.

PubMed

Lee, Eui Jung; Shin, Sang Do; Song, Kyoung Jun; Kim, Seong Chun; Cho, Jin Seong; Lee, Seung Chul; Park, Ju Ok; Cha, Won Chul

2011-06-01

Our study compared clinical decision time between patients managed with a point-of-care chemistry test (POCT) and patients managed with the traditional central laboratory test (CLT). This was a randomized controlled multicenter trial in the emergency departments (EDs) of 5 academic teaching hospitals. We randomly assigned patients to POCT or CLT stratified by the Emergency Severity Index. A POCT chemistry analyzer (Piccolo; Abaxis, Inc, Union City, Calif), which is able to test liver panel, renal panel, pancreas enzymes, lipid panel, electrolytes, and blood gases, was set up in each ED. Primary and secondary end point was turnaround time and door-to-clinical-decision time. The total 2323 patients were randomly assigned to the POCT group (n = 1167) or to the CLT group (n = 1156). All of the basic characteristics were similar in the 2 groups. The turnaround time (median, interquartile range [IQR]) of the POCT group was shorter than that of the CLT group (14, 12-19 versus 55, 45-69 minutes; P < .0001). The median (IQR) door-to-clinical-decision time was also shorter in the POCT compared with the CLT group (46, 33-61 versus 86, 68-107 minutes; P < .0001). The proportion of patients who had new decisions within 60 minutes was 72.8% for the POCT group and 12.5% for the CLT group (P < .0001). A POCT chemistry analyzer in the ED shortens the test turnaround and ED clinical decision times compared with CLT. Copyright © 2011 Elsevier Inc. All rights reserved.

Estimating the Turn-around Radii of Six Isolated Galaxy Groups in the Local Universe

NASA Astrophysics Data System (ADS)

Lee, Jounghun

2018-03-01

Estimates of the turn-around radii of six isolated galaxy groups in the nearby universe are presented. From the Tenth Data Release of the Sloan Digital Sky Survey, we first select those isolated galaxy groups at redshifts z ≤ 0.05 in the mass range [0.3–1] × {10}14 {h}-1 {M}ȯ whose nearest-neighbor groups are located at distances larger than 15 times their virial radii. Then, we search for a gravitationally interacting web-like structure around each isolated group, which appears as an inclined streak pattern in the anisotropic spatial distribution of the neighboring field galaxies. Out of 59 isolated groups, only seven are found to possess such web-like structures in their neighbor zones, but one of them turns out to be NGC 5353/4, whose turn-around radius was already measured in a previous work and was thus excluded from our analysis. Applying the Turn-around Radius Estimator algorithm devised by Lee et al. to the identified web-like structures of the remaining six target groups, we determine their turn-around radii and show that three out of the six targets have larger turn-around radii than the spherical bound limit predicted by Planck cosmology. We discuss possible sources of the apparent violations of the three groups, including the underestimated spherical bound limit due to the approximation of the turn-around mass by the virial mass.

Series Overview. Sustaining School Turnaround at Scale. Brief 1

ERIC Educational Resources Information Center

Education Resource Strategies, 2012

2012-01-01

Members of the non-profit organization Education Resource Strategies (ERS) have worked for over a decade with leaders of urban school systems to help them organize talent, time and technology to support great schools at scale. One year into the Federal program they are noticing significant differences in district turnaround approaches, engagement…

Testing ΛCDM cosmology at turnaround: where to look for violations of the bound?

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

Tanoglidis, D.; Pavlidou, V.; Tomaras, T.N., E-mail: dtanogl@physics.uoc.gr, E-mail: pavlidou@physics.uoc.gr, E-mail: tomaras@physics.uoc.gr

In ΛCDM cosmology, structure formation is halted shortly after dark energy dominates the mass/energy budget of the Universe. A manifestation of this effect is that in such a cosmology the turnaround radius—the non-expanding mass shell furthest away from the center of a structure— has an upper bound. Recently, a new, local, test for the existence of dark energy in the form of a cosmological constant was proposed based on this turnaround bound. Before designing an experiment that, through high-precision determination of masses and —independently— turnaround radii, will challenge ΛCDM cosmology, we have to answer two important questions: first, when turnaround-scalemore » structures are predicted to be close enough to their maximum size, so that a possible violation of the bound may be observable. Second, which is the best mass scale to target for possible violations of the bound. These are the questions we address in the present work. Using the Press-Schechter formalism, we find that turnaround structures have in practice already stopped forming, and consequently, the turnaround radius of structures must be very close to the maximum value today. We also find that the mass scale of ∼ 10{sup 13} M{sub ⊙} characterizes the turnaround structures that start to form in a statistically important number density today —and even at an infinite time in the future, since structure formation has almost stopped. This mass scale also separates turnaround structures with qualitatively different cosmological evolution: smaller structures are no longer readjusting their mass distribution inside the turnaround scale, they asymptotically approach their ultimate abundance from higher values, and they are common enough to have, at some epoch, experienced major mergers with structures of comparable mass; larger structures exhibit the opposite behavior. We call this mass scale the transitional mass scale and we argue that it is the optimal for the purpose outlined above. As a corollary, we explain the different accretion behavior of small and larger structures observed in already conducted numerical simulations.« less

The impact of closed-loop electronic medication management on time to first dose: a comparative study between paper and digital hospital environments.

PubMed

Austin, Jodie A; Smith, Ian R; Tariq, Amina

2018-01-22

Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8-57 min versus 120 min, 30-180 min, P < 0.001). For time-critical medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time. © 2018 Royal Pharmaceutical Society.

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital

PubMed Central

Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

2016-01-01

Introduction Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. Materials and methods A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. Results A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P < 0.05). CSF chemistry requests without the appropriate number of CSF sample tubes were significantly associated with delays in movement of samples from the labelling area to the technologist’s work station (caused by a preference for microbiological testing prior to CSF chemistry). Conclusion A laboratory-based clinical audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction. PMID:27346964

Connecting Hearts in the Workplace

ERIC Educational Resources Information Center

Ulrich, Dave; Woodson, Belinda A.

2011-01-01

Lots of talk is taking place in organizations today about turnaround and transformation. Turnaround is not transformation. Turnaround is public statements; transformation is personal commitments. Turnaround focuses on cutting costs; transformation builds an emotional bond. Turnaround changes structures and reporting relationships; transformation…

An improved APU for the Space Shuttle Orbiter

NASA Technical Reports Server (NTRS)

Mckenna, R.; Hagemann, D.; Loken, G.; Jonakin, J.; Baughman, J.

1985-01-01

The Space Shuttle Orbiter Auxiliary Power Unit has operated successfully on all four orbiter vehicles and all missions. The current Auxiliary Power Unit (APU) operational life is limited to 12 missions, and the APU turnaround time between flights is longer than originally anticipated. The objective of the Improved APU program is to increase life to 50 missions, reduce installed vehicle weight by 134 lb., and reduce turnaround time. This paper describes the design changes incorporated into the improved APU and the associated development testing.

Apollo/Saturn 5 space vehicle countdown. Volume 2: Turnaround from scrub

NASA Technical Reports Server (NTRS)

1972-01-01

The procedures required to prepare a space vehicle for subsequent launch attempt after cancelling lift-off activities are presented. The cancellation must occur after the start of cryogenic loading, but prior to initiation of ignition sequences. The sequence of operations necessary to return the space vehicle to a predetermined configuration at which time the launch count can be resumed or rescheduled for following launch opportunities is developed. The considerations and constraints that are the basis for the scrub/turnaround times are described.

Evolution of a residue laboratory network and the management tools for monitoring its performance.

PubMed

Lins, E S; Conceição, E S; Mauricio, A De Q

2012-01-01

Since 2005 the National Residue & Contaminants Control Plan (NRCCP) in Brazil has been considerably enhanced, increasing the number of samples, substances and species monitored, and also the analytical detection capability. The Brazilian laboratory network was forced to improve its quality standards in order to comply with the NRCP's own evolution. Many aspects such as the limits of quantification (LOQs), the quality management systems within the laboratories and appropriate method validation are in continuous improvement, generating new scenarios and demands. Thus, efficient management mechanisms for monitoring network performance and its adherence to the established goals and guidelines are required. Performance indicators associated to computerised information systems arise as a powerful tool to monitor the laboratories' activity, making use of different parameters to describe this activity on a day-to-day basis. One of these parameters is related to turnaround times, and this factor is highly affected by the way each laboratory organises its management system, as well as the regulatory requirements. In this paper a global view is presented of the turnaround times related to the type of analysis, laboratory, number of samples per year, type of matrix, country region and period of the year, all these data being collected from a computerised system called SISRES. This information gives a solid background to management measures aiming at the improvement of the service offered by the laboratory network.

Scholars Reaching Outside Education for School Fixes

ERIC Educational Resources Information Center

Viadero, Debra

2007-01-01

In recent years, a handful of education scholars have begun to cast a wider net for advice on how to engineer successful school turnarounds. The need for turnaround strategies that work is more timely than ever. Under the federal No Child Left Behind Act, the list of schools identified to be in need of help grows longer by the year, making…

Implications of Perioperative Team Setups for Operating Room Management Decisions.

PubMed

Doll, Dietrich; Kauf, Peter; Wieferich, Katharina; Schiffer, Ralf; Luedi, Markus M

2017-01-01

Team performance has been studied extensively in the perioperative setting, but the managerial impact of interprofessional team performance remains unclear. We hypothesized that the interplay between anesthesiologists and surgeons would affect operating room turnaround times, and teams that worked together over time would become more efficient. We analyzed 13,632 surgical cases at our hospital that involved 64 surgeons and 48 anesthesiologists. We detrended and adjusted the data for potential confounders including age, American Society of Anesthesiologists physical status, and surgical list (scheduled cases of specific surgical specialties). The surgical lists were categorized as ear, nose, and throat surgery; trauma surgery; general surgery; and gynecology. We assessed the relationship between turnaround times and assignment of different anesthesiologists to specific surgeons using a Monte Carlo simulation. We found significant differences in team performances among the different surgical lists but no team learning. We constructed managerial decision tables for the assignment of anesthesiologists to specific surgeons at our hospital. We defined a decision algorithm based on these tables. Our analysis indicated that had this algorithm been used in staffing the operating room for the surgical cases represented in our data, median turnaround times would have a reduction potential of 6.8% (95% confidence interval 6.3% to 7.1%). A surgeon is usually predefined for scheduled surgeries (surgical list). Allocation of the right anesthesiologist to a list and to a surgeon can affect the team performance; thus, this assignment has managerial implications regarding the operating room efficiency affecting turnaround times and thus potentially overutilized time of a list at our hospital.

Timeliness “at a glance”: assessing the turnaround time through the six sigma metrics.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

Almost thirty years of systematic analysis have proven the turnaround time to be a fundamental dimension for the clinical laboratory. Several indicators are to date available to assess and report quality with respect to timeliness, but they sometimes lack the communicative immediacy and accuracy. The six sigma is a paradigm developed within the industrial domain for assessing quality and addressing goal and issues. The sigma level computed through the Z-score method is a simple and straightforward tool which delivers quality by a universal dimensionless scale and allows to handle non-normal data. Herein we report our preliminary experience in using the sigma level to assess the change in urgent (STAT) test turnaround time due to the implementation of total automation. We found that the Z-score method is a valuable and easy to use method for assessing and communicating the quality level of laboratory timeliness, providing a good correspondence with the actual change in efficiency which was retrospectively observed.

Transforming Turnaround Schools in China: A Review

ERIC Educational Resources Information Center

Liu, Peng

2017-01-01

This article reviews the literature on how Chinese turnaround schools are improved in practice. It starts by defining turnaround schools in the Chinese context, and then discusses the essential reasons why such schools exist. Approaches to improving turnaround schools, successful experiences of transforming turnaround schools, and the challenges…

Wildlife specimen collection, preservation, and shipment

USGS Publications Warehouse

White, C. LeAnn; Dusek, Robert J.; Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

2015-01-01

Prior to collecting samples, it is important to determine the capabilities and submission criteria of the laboratory receiving the samples. Some laboratories may specialize in a limited number of tests, be equipped to accept only certain types of tissues (instead of entire carcasses), or specialize in particular species or group of animals (e.g., reptiles, birds, mammals). Diagnostic laboratories have specific requirements regarding preparation, labeling, and shipping of samples. Adherence to these requirements helps ensure the usefulness of any submitted specimens. Although laboratories may vary in the cost and turnaround times for diagnostic tests, some laboratories may be able to prioritize samples and accommodate accelerated time frames if communicated at the time of submission. Keeping a prepacked kit with basic carcass-collection supplies, including a paper copy of the specimen history form (available for download from the Web sites of most diagnostic laboratories), in the office or vehicle will decrease the chances of forgetting an essential item and decrease response time for arriving at an event.

Root Cause Analysis and Subsequent Intervention to Improve First Dose Antibiotic Turnaround Time for Hospitalized Pediatric Patients

PubMed Central

Dee, Abigail A.; Kelly, Brian; Hampp, Christian

2010-01-01

OBJECTIVE Antibiotic timing is used as a quality standard for hospital accreditation and is an important quality measure. The study aim was to identify barriers in the process of first dose antibiotic administration on the pediatric floors at a tertiary healthcare center and carry out and test an intervention to improve turnaround time to less than one hour. METHODS We conducted a quasi-experimental pre-post study of hospitalized pediatric patients up to 18 years of age initiated on intravenous antibiotics. Every order for a first dose intravenous antibiotic was assessed on all pediatric floors (10/2008). Orders that did not meet the overall turnaround time goal of ≤ 1 hour were identified. A root cause analysis (RCA) was performed to identify reasons for delayed antibiotic administration. Barriers identified in the RCA were used to develop interventions (03/2009) to improve compliance, and the proportion of orders that met the goal was compared pre- (10/2008–02/2009) and post-intervention (04/2009–05/2009). RESULTS During the pre-intervention assessment period, 32 out of 46 total physician orders for a first dose intravenous antibiotic did not meet the one-hour overall turnaround goal. A main reason for delay was failure to label antibiotic orders as first dose. We designed an intervention that included antibiotic audits and individualized feedback to prescribers. The mean ± SD time from the written physician order to drug administration was 228 ± 58 minutes; timing improved to 55 ± 4 minutes after the intervention. The proportion of antibiotics administered within one hour improved from 42.2% to 63% (p=0.0015). CONCLUSIONS We identified system barriers associated with delayed antibiotic administration. Antibiotic timing was improved after continued surveillance and individualized feedback to providers. PMID:22477810

Incorporating BEAMing technology as a liquid biopsy into clinical practice for the management of colorectal cancer patients: an expert taskforce review.

PubMed

García-Foncillas, J; Alba, E; Aranda, E; Díaz-Rubio, E; López-López, R; Tabernero, J; Vivancos, A

2017-12-01

The importance of mutation identification for advanced colorectal cancer treatment with anti-epidermal growth factor receptor agents is well established. However, due to delays in turnaround time, low-quality tissue samples, and/or lack of standardization of testing methods a significant proportion of patients are being treated without the information that Kirsten rat sarcoma and neuroblastoma rat sarcoma (RAS) testing can provide. The detection of mutated circulating tumor DNA by BEAMing technology addresses this gap in care and allows these patients to receive international guideline-recommended expanded RAS testing with rapid turnaround times. Furthermore, the overall concordance between OncoBEAM RAS colorectal cancer testing and standard of care tissue testing is very high (93.3%). This article presents an overview of the clinical utility and potential applications of this minimally invasive method, such as early detection of emergent resistance to anti-epidermal growth factor receptor therapy. If appropriately implemented, BEAMing technology holds considerable promise to enhance the quality of patient care and improve clinical outcomes. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Development and validation of a fast and simple multi-analyte procedure for quantification of 40 drugs relevant to emergency toxicology using GC-MS and one-point calibration.

PubMed

Meyer, Golo M J; Weber, Armin A; Maurer, Hans H

2014-05-01

Diagnosis and prognosis of poisonings should be confirmed by comprehensive screening and reliable quantification of xenobiotics, for example by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS). The turnaround time should be short enough to have an impact on clinical decisions. In emergency toxicology, quantification using full-scan acquisition is preferable because this allows screening and quantification of expected and unexpected drugs in one run. Therefore, a multi-analyte full-scan GC-MS approach was developed and validated with liquid-liquid extraction and one-point calibration for quantification of 40 drugs relevant to emergency toxicology. Validation showed that 36 drugs could be determined quickly, accurately, and reliably in the range of upper therapeutic to toxic concentrations. Daily one-point calibration with calibrators stored for up to four weeks reduced workload and turn-around time to less than 1 h. In summary, the multi-analyte approach with simple liquid-liquid extraction, GC-MS identification, and quantification over fast one-point calibration could successfully be applied to proficiency tests and real case samples. Copyright © 2013 John Wiley & Sons, Ltd.

Recent Advances in Point-of-Care Diagnostics for Cardiac Markers

PubMed Central

2014-01-01

National and international cardiology guidelines have recommended a 1-hour turnaround time for reporting results of cardiac troponin to emergency department personnel, measured from the time of blood collection to reporting. Use of point-of-care testing (POCT) can reduce turnaround times for cardiac markers, but current devices are not as precise or sensitive as central laboratory assays. The gap is growing as manufacturers of mainframe immunoassay instruments have or will release troponin assays that are even higher than those currently available. These assays have analytical sensitivity that enables detection of nearly 100% of all healthy subjects which is not possible for current POCT assays. Use of high sensitivity troponin results in a lower value for the 99th percentile of a healthy population. Clinically, this enables for the detection of more cases of myocardial injury. In order to compete analytically, next generation POCT assays will to make technologic advancements, such as the use of microfluidic to better control sample delivery, nanoparticles or nanotubes to increase the surface-to-volume ratios for analytes and antibodies, and novel detection schemes such as chemiluminescence and electrochemical detectors to enhance analytical sensitivity. Multi-marker analysis using POCT is also on the horizon for tests that complement cardiac troponin. PMID:27683464

Conventional early infant diagnosis in Lesotho from specimen collection to results usage to manage patients: Where are the bottlenecks?

PubMed Central

Hoffman, Heather J.; Isavwa, Anthony; Mokone, Mafusi; Foso, Matokelo; Safrit, Jeffrey T.; Mofenson, Lynne M.; Tylleskär, Thorkild

2017-01-01

Introduction Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade. Methods We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means (with 95% CI) were calculated and compared by region using linear mixed models. Results 1,187 individual infant records from 25 facilities were reviewed. Overall, early infant diagnosis turnaround time was 61.7 days (95%CI: 55.3–68.7). Mean time from specimen collection to district laboratory was 14 days (95%CI: 12.1–16.1); from district to central laboratory, 2 days (95%CI 0.8–5.2); results from central laboratory to district hospital, 23.3 days (95%CI: 18.7–29.0); from district hospital to health facility, 3.2 days (95%CI 1.9–5.5); and from health facility to caregiver, 10.4 days (95%CI, 7.9–13.5). Mean times from specimen transfer to the central laboratory and for result transfer from central laboratory to district hospital were significantly shorter in the Lowlands Region (0.9 and 16.2 days, respectively), compared to Highlands Region (6.0 [P = 0.030] and 34.3 days [P = 0.0099]. Turnaround time from blood draw to receipt of results was significantly shorter for HIV infected infants compared to HIV uninfected infants [p = 0.0036] at an average of 47.1 days (95%CI: 38.9–56.9) and 62 days (95%CI: 55.9–68.7) respectively. Of 47 HIV-infected infants, 36 were initiated on antiretroviral therapy at an average of 1.3 days (95%CI: 0.3, 5.7) after caregiver received the result. Conclusion HIV-infected infants received results earlier and were rapidly initiated on antiretroviral therapy once the result was delivered to caregiver. However, average early infant diagnosis turnaround time was two months; the longest period of delay was transfer of results from central laboratory to district hospital. Turnaround time of results based on geographical regions or between hospitals and health centres varied but did not reach statistical significance. PMID:29016634

An evaluation of superminicomputers for thermal analysis

NASA Technical Reports Server (NTRS)

Storaasli, O. O.; Vidal, J. B.; Jones, G. K.

1962-01-01

The feasibility and cost effectiveness of solving thermal analysis problems on superminicomputers is demonstrated. Conventional thermal analysis and the changing computer environment, computer hardware and software used, six thermal analysis test problems, performance of superminicomputers (CPU time, accuracy, turnaround, and cost) and comparison with large computers are considered. Although the CPU times for superminicomputers were 15 to 30 times greater than the fastest mainframe computer, the minimum cost to obtain the solutions on superminicomputers was from 11 percent to 59 percent of the cost of mainframe solutions. The turnaround (elapsed) time is highly dependent on the computer load, but for large problems, superminicomputers produced results in less elapsed time than a typically loaded mainframe computer.

Setting the Bar for School Turnaround: How Ambitious, Public Goals Can Drive School Turnaround

ERIC Educational Resources Information Center

Stanton, Larry; Segal, Alison

2013-01-01

A state education agency (SEA) can pull a powerful lever for school turnaround by setting goals publicly and releasing reports on progress toward those goals at turnaround schools to build public support for turnaround efforts. SEAs can gather information for reporting from data they already have available. This report clarifies indicators and…

Collection, transport and general processing of clinical specimens in Microbiology laboratory.

PubMed

Sánchez-Romero, M Isabel; García-Lechuz Moya, Juan Manuel; González López, Juan José; Orta Mira, Nieves

2018-02-06

The interpretation and the accuracy of the microbiological results still depend to a great extent on the quality of the samples and their processing within the Microbiology laboratory. The type of specimen, the appropriate time to obtain the sample, the way of sampling, the storage and transport are critical points in the diagnostic process. The availability of new laboratory techniques for unusual pathogens, makes necessary the review and update of all the steps involved in the processing of the samples. Nowadays, the laboratory automation and the availability of rapid techniques allow the precision and turn-around time necessary to help the clinicians in the decision making. In order to be efficient, it is very important to obtain clinical information to use the best diagnostic tools. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Rapid Waterborne Pathogen Detection with Mobile Electronics.

PubMed

Wu, Tsung-Feng; Chen, Yu-Chen; Wang, Wei-Chung; Kucknoor, Ashwini S; Lin, Che-Jen; Lo, Yu-Hwa; Yao, Chun-Wei; Lian, Ian

2017-06-09

Pathogen detection in water samples, without complex and time consuming procedures such as fluorescent-labeling or culture-based incubation, is essential to public safety. We propose an immunoagglutination-based protocol together with the microfluidic device to quantify pathogen levels directly from water samples. Utilizing ubiquitous complementary metal-oxide-semiconductor (CMOS) imagers from mobile electronics, a low-cost and one-step reaction detection protocol is developed to enable field detection for waterborne pathogens. 10 mL of pathogen-containing water samples was processed using the developed protocol including filtration enrichment, immune-reaction detection and imaging processing. The limit of detection of 10 E. coli O157:H7 cells/10 mL has been demonstrated within 10 min of turnaround time. The protocol can readily be integrated into a mobile electronics such as smartphones for rapid and reproducible field detection of waterborne pathogens.

Customized laboratory information management system for a clinical and research leukemia cytogenetics laboratory.

PubMed

Bakshi, Sonal R; Shukla, Shilin N; Shah, Pankaj M

2009-01-01

We developed a Microsoft Access-based laboratory management system to facilitate database management of leukemia patients referred for cytogenetic tests in regards to karyotyping and fluorescence in situ hybridization (FISH). The database is custom-made for entry of patient data, clinical details, sample details, cytogenetics test results, and data mining for various ongoing research areas. A number of clinical research laboratoryrelated tasks are carried out faster using specific "queries." The tasks include tracking clinical progression of a particular patient for multiple visits, treatment response, morphological and cytogenetics response, survival time, automatic grouping of patient inclusion criteria in a research project, tracking various processing steps of samples, turn-around time, and revenue generated. Since 2005 we have collected of over 5,000 samples. The database is easily updated and is being adapted for various data maintenance and mining needs.

Air Cargo Transportation Route Choice Analysis

NASA Technical Reports Server (NTRS)

Obashi, Hiroshi; Kim, Tae-Seung; Oum, Tae Hoon

2003-01-01

Using a unique feature of air cargo transshipment data in the Northeast Asian region, this paper identifies the critical factors that determine the transshipment route choice. Taking advantage of the variations in the transport characteristics in each origin-destination airports pair, the paper uses a discrete choice model to describe the transshipping route choice decision made by an agent (i.e., freight forwarder, consolidator, and large shipper). The analysis incorporates two major factors, monetary cost (such as line-haul cost and landing fee) and time cost (i.e., aircraft turnaround time, including loading and unloading time, custom clearance time, and expected scheduled delay), along with other controls. The estimation method considers the presence of unobserved attributes, and corrects for resulting endogeneity by use of appropriate instrumental variables. Estimation results find that transshipment volumes are more sensitive to time cost, and that the reduction in aircraft turnaround time by 1 hour would be worth the increase in airport charges by more than $1000. Simulation exercises measures the impacts of alternative policy scenarios for a Korean airport, which has recently declared their intention to be a future regional hub in the Northeast Asian region. The results suggest that reducing aircraft turnaround time at the airport be an effective strategy, rather than subsidizing to reduce airport charges.

Factors associated with long turnaround time for early infant diagnosis of HIV in Myanmar.

PubMed

Thiha, Soe; Shewade, Hemant Deepak; Philip, Sairu; Aung, Thet Ko; Kyaw, Nang Thu Thu; Oo, Myo Minn; Kyaw, Khine Wut Yee; Wint War, May; Oo, Htun Nyunt

2017-01-01

A previous review of early infant diagnosis (EID) using polymerase chain reaction technology (PCR) under integrated HIV care (IHC) program in Myanmar revealed a low uptake of timely (within 6 to 8 weeks of babies' age) EID and a long turnaround time (TAT) of receiving results. This study aimed to determine the proportion and factors associated with the composite outcome of a long TAT (≥7 weeks; from sample collection to receipt of result by mother) or nonreceipt of result among HIV-exposed babies whose blood samples were collected for PCR at <9 months of age under the IHC program, Myanmar (2013-15). Cohort study involving record review of routinely collected data. A predictive Poisson regression model with robust variance estimates was fitted for risk factors of long TAT or nonreceipt of result. Blood samples of 1 000 babies were collected; among them, long TAT or nonreceipt of results was seen in 690 (69%), and this was more than 50% across all subgroups. Babies with a mother's CD4 count of 100-350 cells/mm 3 at enrollment [adjusted RR (0.95 confidence intervals, CI): 0.8 (0.7, 0.9)] had a 20% lower risk of long TAT or nonreceipt of results when compared with ≥350 cells/mm 3 . Distance between ART center and PCR facility ≥105 km [adjusted RR (0.95 CI): 1.2 (1.1, 1.4)], when compared with <105 km, was associated with 20% higher risk of long TAT or nonreceipt of results. The proportion of babies with long TAT or nonreceipt of result by the mother was high. Point-of-care testing for EID may reduce TAT/nonreceipt of results by the mother. Health system, laboratory, and logistic factors such as sample transportation, laboratory procedures, and result dispatching associated with long TAT should be further explored.

Single-Center Experience with a Targeted Next Generation Sequencing Assay for Assessment of Relevant Somatic Alterations in Solid Tumors.

PubMed

Paasinen-Sohns, Aino; Koelzer, Viktor H; Frank, Angela; Schafroth, Julian; Gisler, Aline; Sachs, Melanie; Graber, Anne; Rothschild, Sacha I; Wicki, Andreas; Cathomas, Gieri; Mertz, Kirsten D

2017-03-01

Companion diagnostics rely on genomic testing of molecular alterations to enable effective cancer treatment. Here we report the clinical application and validation of the Oncomine Focus Assay (OFA), an integrated, commercially available next-generation sequencing (NGS) assay for the rapid and simultaneous detection of single nucleotide variants, short insertions and deletions, copy number variations, and gene rearrangements in 52 cancer genes with therapeutic relevance. Two independent patient cohorts were investigated to define the workflow, turnaround times, feasibility, and reliability of OFA targeted sequencing in clinical application and using archival material. Cohort I consisted of 59 diagnostic clinical samples from the daily routine submitted for molecular testing over a 4-month time period. Cohort II consisted of 39 archival melanoma samples that were up to 15years old. Libraries were prepared from isolated nucleic acids and sequenced on the Ion Torrent PGM sequencer. Sequencing datasets were analyzed using the Ion Reporter software. Genomic alterations were identified and validated by orthogonal conventional assays including pyrosequencing and immunohistochemistry. Sequencing results of both cohorts, including archival formalin-fixed, paraffin-embedded material stored up to 15years, were consistent with published variant frequencies. A concordance of 100% between established assays and OFA targeted NGS was observed. The OFA workflow enabled a turnaround of 3½ days. Taken together, OFA was found to be a convenient tool for fast, reliable, broadly applicable and cost-effective targeted NGS of tumor samples in routine diagnostics. Thus, OFA has strong potential to become an important asset for precision oncology. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Relegation and Reversion: Longitudinal Analysis of School Turnaround and Decline

ERIC Educational Resources Information Center

Hochbein, Craig

2012-01-01

School turnaround has become a popular strategy for improvement of chronically low-performing schools. Research related to school turnaround has relied substantially upon case studies. These case studies often focus on successful turnarounds and report immediate outcomes, failing to provide information about the sustainability of the results. In…

The role of monitoring interpretive rates, concordance between cytotechnologist and pathologist interpretations before sign-out, and turnaround time in gynecologic cytology quality assurance: findings from the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference working group 1.

PubMed

Clary, Karen M; Davey, Diane D; Naryshkin, Sonya; Austin, R Marshall; Thomas, Nicole; Chmara, Beth Anne; Sugrue, Chiara; Tworek, Joseph

2013-02-01

The College of American Pathologists (CAP) conducted a national survey of gynecologic cytology quality assurance (QA) practices. Experts in gynecologic cytology were asked to join 5 working groups that studied the survey data on different aspects of QA. Evaluating the survey data and follow-up questions online, together with a review of pertinent literature, the working groups developed a series of preliminary statements on good laboratory practices in cytology QA. These were presented at a consensus conference and electronic voting occurred. To evaluate a set of QA monitors in gynecologic cytology. Working group 1 evaluated (1) monitoring interpretive rate categories for Papanicolaou tests (Pap tests), (2) concordance of cytotechnologist and pathologist interpretations before sign-out, and (3) turnaround time for Pap tests. The statements are based on a survey of gynecologic cytology QA practice patterns and of opinions from working group members and consensus conference attendees. The outcomes of this process demonstrate the current state of practice patterns in gynecologic cytology QA. Monitoring interpretive rates for all Bethesda System categories is potentially useful, and it is most useful to monitor interpretive rates for cytotechnologists individually and in comparison to the entire laboratory. Laboratories need to determine what level of discrepancy between cytotechnologist and pathologist interpretations of Pap tests is important to track. Laboratories should consider formalizing procedures and policies to adjudicate such discrepant interpretations. Turnaround time should be monitored in gynecologic cytology, but individual laboratories should determine how to measure and use turnaround time internally.

24/7/365 in-house radiologist coverage: effect on resident education.

PubMed

Collins, Jannette; Gruppen, Larry D; Bailey, Janet E; Bokhari, Syed Ahmad Jamal; Paladin, Angelisa M; Robbins, Jessica; White, Richard D

2014-07-01

To compare programs with and without 24-hour/7 days a week/365 days a year (24/7/365) in-house radiologist coverage regarding resident perceptions of their on-call experience, volume of resident dictations on call, and report turnaround time. Residents from six academic radiology departments were invited to participate in an 11-item online survey. Survey items were related to workload, level of autonomy, faculty feedback, comfort level, faculty supervision, and overall educational experience while on call from 8 pm to 8 am. Each site provided data on imaging volume, radiologist coverage, volume of examinations dictated by residents, number of residents on call, and report turnaround time from 8 pm to 8 am. F-ratios and eta-squares were calculated to determine the relationships between dependent and independent variables. A P value < .05 was considered statistically significant. A total of 146 (67%) of 217 residents responded. Residents in programs with 24/7/365 in-house radiologist coverage dictated a lower percentage of examinations (46%) compared with other residents (81%) and rated faculty feedback more positively (mean 3.8 vs. 3.3) but rated their level of autonomy (mean 3.6 vs. 4.5) and educational experience (mean 3.6 vs. 4.2) more negatively (all P < .05). Report turnaround time was lower in programs with 24/7/365 coverage than those without (mean 1.7 hours vs. 9.1 hours). The majority of resident comments were negative and related to loss of autonomy with 24/7/365 coverage. More rapid report turnaround time related to 24/7/365 coverage may come at the expense of resident education. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Laboratory Automation and Intra-Laboratory Turnaround Time: Experience at the University Hospital Campus Bio-Medico of Rome.

PubMed

Angeletti, Silvia; De Cesaris, Marina; Hart, Jonathan George; Urbano, Michele; Vitali, Massimiliano Andrea; Fragliasso, Fulvio; Dicuonzo, Giordano

2015-12-01

Intra-laboratory turnaround time (TAT) is a key indicator of laboratory performance. Improving TAT is a complex task requiring staff education, equipment acquisition, and adequate TAT monitoring. The aim of the present study was to evaluate the intra-laboratory TAT after laboratory automation implementation (June 2013-June 2014) and to compare it to that in the preautomation period (July 2012-May 2013). Intra-laboratory TAT was evaluated both as the mean TAT registered and the percentage of outlier (OP) exams. The mean TAT was 36, 38, and 34 min during the study periods, respectively. These values respected the goal TAT established at 45 min. The OP, calculated at 45 min as well as at 60 min, decreased from 26 to 21 and from 11 to 5, respectively. From a focused analysis on blood count cell, troponin I, and prothrombin (PT) test, TAT improvement was more evident for tests requiring longer preanalytical process. The follow-up of TAT from June 2013 to June 2014 revealed the reduction of the mean TAT as well as of the OP exams after automation implementation and that automation more strongly affects the test in the preanalytical phase including centrifugation of the sample, such as troponin I and PT. © 2015 Society for Laboratory Automation and Screening.

School Turnaround Principals: What Does Initial Research Literature Suggest They Are Doing to Be Successful?

ERIC Educational Resources Information Center

Meyers, Coby V.; Hambrick Hitt, Dallas

2017-01-01

As the research literature on principals leading school turnaround grows, determining whether or not real differences between good, even effective, principals and turnaround principals becomes increasingly important. Recent federal government policy and investment established turnaround models that emphasize the role of the school principal,…

Characteristics of Occupational Exposure to Benzene during Turnaround in the Petrochemical Industries.

PubMed

Chung, Eun-Kyo; Shin, Jung-Ah; Lee, Byung-Kyu; Kwon, Jiwoon; Lee, Naroo; Chung, Kwang-Jae; Lee, Jong-Han; Lee, In-Seop; Kang, Seong-Kyu; Jang, Jae-Kil

2010-09-01

The level of benzene exposure in the petrochemical industry during regular operation has been well established, but not in turnaround (TA), where high exposure may occur. In this study, the characteristics of occupational exposure to benzene during TA in the petrochemical companies were investigated in order to determine the best management strategies and improve the working environment. This was accomplished by evaluating the exposure level for the workers working in environments where benzene was being produced or used as an ingredient during the unit process. From 2003 to 2008, a total of 705 workers in three petrochemical companies in Korea were studied. Long- and short-term (< 1 hr) samples were taken during TAs. TA was classified into three stages: shut-down, maintenance and start-up. All works were classified into 12 occupation categories. The long-term geometric mean (GM) benzene exposure level was 0.025 (5.82) ppm (0.005-42.120 ppm) and the short-term exposure concentration during TA was 0.020 (17.42) ppm (0.005-61.855 ppm). The proportions of TA samples exceeding the time-weighted average, occupational exposure level (TWA-OEL in Korea, 1 ppm) and the short-term exposure limit (STEL-OEL, 5 ppm) were 4.1% (20 samples of 488) and 6.0% (13 samples of 217), respectively. The results for the benzene exposure levels and the rates of exceeding the OEL were both statistically significant (p < 0.05). Among the 12 job categories of petrochemical workers, mechanical engineers, plumbers, welders, fieldman and scaffolding workers exhibited long-term samples that exceeded the OEL of benzene, and the rate of exceeding the OEL was statistically significant for the first two occupations (p < 0.05). These findings suggest that the periodic work environment must be assessed during non-routine works such as TA.

A Sensitive Branched DNA HIV-1 Signal Amplification Viral Load Assay with Single Day Turnaround

PubMed Central

Baumeister, Mark A.; Zhang, Nan; Beas, Hilda; Brooks, Jesse R.; Canchola, Jesse A.; Cosenza, Carlo; Kleshik, Felix; Rampersad, Vinod; Surtihadi, Johan; Battersby, Thomas R.

2012-01-01

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) (“Versant Assay”) currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16–18 h to 2.5 h, composition of only the “Lysis Diluent” solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements. PMID:22479381

A sensitive branched DNA HIV-1 signal amplification viral load assay with single day turnaround.

PubMed

Baumeister, Mark A; Zhang, Nan; Beas, Hilda; Brooks, Jesse R; Canchola, Jesse A; Cosenza, Carlo; Kleshik, Felix; Rampersad, Vinod; Surtihadi, Johan; Battersby, Thomas R

2012-01-01

Branched DNA (bDNA) is a signal amplification technology used in clinical and research laboratories to quantitatively detect nucleic acids. An overnight incubation is a significant drawback of highly sensitive bDNA assays. The VERSANT® HIV-1 RNA 3.0 Assay (bDNA) ("Versant Assay") currently used in clinical laboratories was modified to allow shorter target incubation, enabling the viral load assay to be run in a single day. To dramatically reduce the target incubation from 16-18 h to 2.5 h, composition of only the "Lysis Diluent" solution was modified. Nucleic acid probes in the assay were unchanged. Performance of the modified assay (assay in development; not commercially available) was evaluated and compared to the Versant Assay. Dilution series replicates (>950 results) were used to demonstrate that analytical sensitivity, linearity, accuracy, and precision for the shorter modified assay are comparable to the Versant Assay. HIV RNA-positive clinical specimens (n = 135) showed no significant difference in quantification between the modified assay and the Versant Assay. Equivalent relative quantification of samples of eight genotypes was demonstrated for the two assays. Elevated levels of several potentially interfering endogenous substances had no effect on quantification or specificity of the modified assay. The modified assay with drastically improved turnaround time demonstrates the viability of signal-amplifying technology, such as bDNA, as an alternative to the PCR-based assays dominating viral load monitoring in clinical laboratories. Highly sensitive bDNA assays with a single day turnaround may be ideal for laboratories with especially stringent cost, contamination, or reliability requirements.

Shuttle's 160 hour ground turnaround - A design driver

NASA Technical Reports Server (NTRS)

Widick, F.

1977-01-01

Turnaround analysis added a new dimension to the Space Program with the advent of the Space Shuttle. The requirement to turn the flight hardware around in 160 working hours from landing to launch was a significant design driver and a useful tool in forcing the integration of flight and ground systems design to permit an efficient ground operation. Although there was concern that time constraints might increase program costs, the result of the analysis was to minimize facility requirements and simplify operations with resultant cost savings.

An Integrated Gate Turnaround Management Concept Leveraging Big Data/Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William; Chachad, Girish; Hochstetler, Ronald

2016-01-01

The Integrated Gate Turnaround Management (IGTM) concept was developed to improve the gate turnaround performance at the airport by leveraging relevant historical data to support optimization of airport gate operations, which include: taxi to the gate, gate services, push back, taxi to the runway, and takeoff, based on available resources, constraints, and uncertainties. By analyzing events of gate operations, primary performance dependent attributes of these events were identified for the historical data analysis such that performance models can be developed based on uncertainties to support descriptive, predictive, and prescriptive functions. A system architecture was developed to examine system requirements in support of such a concept. An IGTM prototype was developed to demonstrate the concept using a distributed network and collaborative decision tools for stakeholders to meet on time pushback performance under uncertainties.

Rebuilding Organizational Capacity in Turnaround Schools: Insights from the Corporate, Government, and Non-Profit Sectors

ERIC Educational Resources Information Center

Murphy, Joseph; Meyers, Coby V.

2009-01-01

In this article, we provide a grounded narrative of capacity building in the turnaround equation by exploring the turnaround literature outside of education and applying it to troubled schools. Our analysis is based upon reviews of: (1) 14 comprehensive, historical volumes that examine the turnaround phenomenon; (2) 16 book-length analyses of…

Turnaround Schools as a U-Turn for Student Achievement: The Rotary of School Reform Efforts

ERIC Educational Resources Information Center

Mette, Ian M.

2012-01-01

This case study presents data to support the notion that turnaround school policy can improve the efficiency of how traditionally low-performing schools function. The schools that were successful in implementing the UVA Turnaround Program training developed a clear understanding of the expectations for participating in the UVA Turnaround Program…

Lead Turnaround Partners: How the Emerging Marketplace of Lead Turnaround Partners Is Changing School Improvement

ERIC Educational Resources Information Center

Corbett, Julie

2011-01-01

This report describes the use of Lead Turnaround Partners (LTPs) in the current School Improvement Grant (SIG) program and provides the results of document review, surveys, and interviews with eight State Education Agencies and seven Lead Turnaround Partner organizations. The study focuses on the implementation of the transformation and turnaround…

Communication gaps in nursing home transfers to the ED: impact on turnaround time, disposition, and diagnostic testing.

PubMed

Nelson, Drew; Washton, Danae; Jeanmonod, Rebecca

2013-04-01

This study aims to determine the source of communication gaps in history of present illness (HPI), medical history, and advanced directives in nursing home (NH) patients transferred to the emergency department (ED). We also attempt to determine if these gaps create differences in patient turnaround time (TAT), disposition decision, or diagnostic testing. A convenience sample of patients transferred from NHs to a level 1 community trauma center was enrolled by the physicians caring for them. The physicians assessed the adequacy and source of the history for each patient. The patient's chart was then retrospectively reviewed to determine disposition, ED TAT, and diagnostic tests ordered. One hundred patients were enrolled. Physicians found that NH paperwork contained adequate HPI 35% of the time. Patients could provide their own HPI 28% of the time. In 32% of patients, adequate HPI could not be obtained from the patient, NH paperwork, or NH personnel. Comparing patients in whom adequate HPI was available (n = 68) to those in whom HPI was not available (n = 32), there was no difference in TAT (146 vs 173 minutes, P = .22), admissions (60% vs 66%, P = .66), or diagnostic testing (P = .89-1.0). Emergency department physicians often do not have adequate HPI in patients transferred from NHs. The absence of adequate information does not affect patient TAT, disposition decision, or ED diagnostic testing. Copyright © 2013 Elsevier Inc. All rights reserved.

Multiple pre- and post-analytical lean approaches to the improvement of the laboratory turnaround time in a large core laboratory.

PubMed

Lou, Amy H; Elnenaei, Manal O; Sadek, Irene; Thompson, Shauna; Crocker, Bryan D; Nassar, Bassam A

2017-10-01

Core laboratory (CL), as a new business model, facilitates consolidation and integration of laboratory services to enhance efficiency and reduce costs. This study evaluates the impact of total laboratory automation system (TLA), electric track vehicle (ETV) system and auto-verification (AV) of results on overall turnaround time (TAT) (phlebotomy to reporting TAT: PR-TAT) within a CL setting. Mean, median and percentage of outlier (OP) for PR-TAT were compared for pre- and post-CL eras using five representative tests based on different request priorities. Comparison studies were also carried out on the intra-laboratory TAT (in-lab to reporting TAT: IR-TAT) and the delivery TAT (phlebotomy to in-lab TAT: PI-TAT) to reflect the efficiency of the TLA (both before and after introducing result AV) and ETV systems respectively. Median PR-TATs for the urgent samples were reduced on average by 16% across all representative analytes. Median PR-TATs for the routine samples were curtailed by 51%, 50%, 49%, 34% and 22% for urea, potassium, thyroid stimulating hormone (TSH), complete blood count (CBC) and prothrombin time (PT) respectively. The shorter PR-TAT was attributed to a significant reduction of IR-TAT through the TLA. However, the median PI-TAT was delayed when the ETV was used. Application of various AV rules shortened the median IR-TATs for potassium and urea. However, the OP of PR-TAT for the STAT requests exceeding 60min were all higher than those from the pre-CL era. TLA and auto-verification rules help to efficiently manage substantial volumes of urgent and routine samples. However, the ETV application as it stands shows a negative impact on the PR-TAT. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

A Rapid, High-Quality, Cost-Effective, Comprehensive and Expandable Targeted Next-Generation Sequencing Assay for Inherited Heart Diseases.

PubMed

Wilson, Kitchener D; Shen, Peidong; Fung, Eula; Karakikes, Ioannis; Zhang, Angela; InanlooRahatloo, Kolsoum; Odegaard, Justin; Sallam, Karim; Davis, Ronald W; Lui, George K; Ashley, Euan A; Scharfe, Curt; Wu, Joseph C

2015-09-11

Thousands of mutations across >50 genes have been implicated in inherited cardiomyopathies. However, options for sequencing this rapidly evolving gene set are limited because many sequencing services and off-the-shelf kits suffer from slow turnaround, inefficient capture of genomic DNA, and high cost. Furthermore, customization of these assays to cover emerging targets that suit individual needs is often expensive and time consuming. We sought to develop a custom high throughput, clinical-grade next-generation sequencing assay for detecting cardiac disease gene mutations with improved accuracy, flexibility, turnaround, and cost. We used double-stranded probes (complementary long padlock probes), an inexpensive and customizable capture technology, to efficiently capture and amplify the entire coding region and flanking intronic and regulatory sequences of 88 genes and 40 microRNAs associated with inherited cardiomyopathies, congenital heart disease, and cardiac development. Multiplexing 11 samples per sequencing run resulted in a mean base pair coverage of 420, of which 97% had >20× coverage and >99% were concordant with known heterozygous single nucleotide polymorphisms. The assay correctly detected germline variants in 24 individuals and revealed several polymorphic regions in miR-499. Total run time was 3 days at an approximate cost of $100 per sample. Accurate, high-throughput detection of mutations across numerous cardiac genes is achievable with complementary long padlock probe technology. Moreover, this format allows facile insertion of additional probes as more cardiomyopathy and congenital heart disease genes are discovered, giving researchers a powerful new tool for DNA mutation detection and discovery. © 2015 American Heart Association, Inc.

District Readiness to Support School Turnaround: A Users' Guide to Inform the Work of State Education Agencies and Districts

ERIC Educational Resources Information Center

Player, Daniel; Hambrick Hitt, Dallas; Robinson, William

2014-01-01

This guide provides state education agencies (SEAs) and districts (LEAs) with guidance about how to assess the district's readiness to support school turnaround initiatives. Often, school turnaround efforts focus only on the school's structure and leadership. Rarely do policymakers or practitioners think about school turnaround as a system-level…

School Turnaround: Cristo Rey Boston High School Case Study

ERIC Educational Resources Information Center

Thielman, Jeff

2012-01-01

The mandates of the federal No Child Left Behind Law, including the threat of closing a school for underperformance, have led to multiple public school turnaround attempts. Because turnaround is a relatively new area of focus in education, there is limited research on what does and does not work, and even the definition of turnaround is a work in…

The University of Colorado OSO-8 spectrometer experiment. IV - Mission operations

NASA Technical Reports Server (NTRS)

Hansen, E. R.; Bruner, E. C., Jr.

1979-01-01

The remote operation of two high-resolution ultraviolet spectrometers on the OSO-8 satellite is discussed. Mission operations enabled scientific observers to plan observations based on current solar data, interact with the observing program using real- or near real-time data and commands, evaluate quick-look instrument data, and analyze the observations for publication. During routine operations, experiments were planned a day prior to their execution, and the data from these experiments received a day later. When a shorter turnaround was required, a real-time mode was available. Here, the real-time data and command links into the remote control center were used to evaluate experiment operation and make satellite pointing or instrument configuration changes with a 1-90 minute turnaround.

Ten years of R&D and full automation in molecular diagnosis.

PubMed

Greub, Gilbert; Sahli, Roland; Brouillet, René; Jaton, Katia

2016-01-01

A 10-year experience of our automated molecular diagnostic platform that carries out 91 different real-time PCR is described. Progresses and future perspectives in molecular diagnostic microbiology are reviewed: why automation is important; how our platform was implemented; how homemade PCRs were developed; the advantages/disadvantages of homemade PCRs, including the critical aspects of troubleshooting and the need to further reduce the turnaround time for specific samples, at least for defined clinical settings such as emergencies. The future of molecular diagnosis depends on automation, and in a novel perspective, it is time now to fully acknowledge the true contribution of molecular diagnostic and to reconsider the indication for PCR, by also using these tests as first-line assays.

Windows of National Opportunity: An Excerpt from the Center on School Turnaround's Report on State Supports for Turnaround

ERIC Educational Resources Information Center

Scott, Caitlin; Lasley, Nora

2014-01-01

In 2014, state and national leaders found many aspects of turning around America's low-performing schools even more daunting than in the previous year. These views were revealed in the Center on School Turnaround's (CST's) 2014 February/March survey of school turnaround leaders in State Education Agencies (SEA) and directors of the nation's…

Extending laboratory automation to the wards: effect of an innovative pneumatic tube system on diagnostic samples and transport time.

PubMed

Suchsland, Juliane; Winter, Theresa; Greiser, Anne; Streichert, Thomas; Otto, Benjamin; Mayerle, Julia; Runge, Sören; Kallner, Anders; Nauck, Matthias; Petersmann, Astrid

2017-02-01

The innovative pneumatic tube system (iPTS) transports one sample at a time without the use of cartridges and allows rapid sending of samples directly into the bulk loader of a laboratory automation system (LAS). We investigated effects of the iPTS on samples and turn-around time (TAT). During transport, a mini data logger recorded the accelerations in three dimensions and reported them in arbitrary area under the curve (AUC) units. In addition representative quantities of clinical chemistry, hematology and coagulation were measured and compared in 20 blood sample pairs transported by iPTS and courier. Samples transported by iPTS were brought to the laboratory (300 m) within 30 s without adverse effects on the samples. The information retrieved from the data logger showed a median AUC of 7 and 310 arbitrary units for courier and iPTS transport, respectively. This is considerably below the reported limit for noticeable hemolysis of 500 arbitrary units. iPTS reduces TAT by reducing the hands-on time and a fast transport. No differences in the measurement results were found for any of the investigated 36 analytes between courier and iPTS transport. Based on these findings the iPTS was cleared for clinical use in our hospital.

Analysis of munitions constituents in groundwater using a field-portable GC-MS.

PubMed

Bednar, A J; Russell, A L; Hayes, C A; Jones, W T; Tackett, P; Splichal, D E; Georgian, T; Parker, L V; Kirgan, R A; MacMillan, D K

2012-05-01

The use of munitions constituents (MCs) at military installations can produce soil and groundwater contamination that requires periodic monitoring even after training or manufacturing activities have ceased. Traditional groundwater monitoring methods require large volumes of aqueous samples (e.g., 2-4 L) to be shipped under chain of custody, to fixed laboratories for analysis. The samples must also be packed on ice and shielded from light to minimize degradation that may occur during transport and storage. The laboratory's turn-around time for sample analysis and reporting can be as long as 45 d. This process hinders the reporting of data to customers in a timely manner; yields data that are not necessarily representative of current site conditions owing to the lag time between sample collection and reporting; and incurs significant shipping costs for samples. The current work compares a field portable Gas Chromatograph-Mass Spectrometer (GC-MS) for analysis of MCs on-site with traditional laboratory-based analysis using High Performance Liquid Chromatography with UV absorption detection. The field method provides near real-time (within ~1 h of sampling) concentrations of MCs in groundwater samples. Mass spectrometry provides reliable confirmation of MCs and a means to identify unknown compounds that are potential false positives for methods with UV and other non-selective detectors. Published by Elsevier Ltd.

Paper-based tuberculosis diagnostic devices with colorimetric gold nanoparticles

NASA Astrophysics Data System (ADS)

Tsai, Tsung-Ting; Shen, Shu-Wei; Cheng, Chao-Min; Chen, Chien-Fu

2013-08-01

A colorimetric sensing strategy employing gold nanoparticles and a paper assay platform has been developed for tuberculosis diagnosis. Unmodified gold nanoparticles and single-stranded detection oligonucleotides are used to achieve rapid diagnosis without complicated and time-consuming thiolated or other surface-modified probe preparation processes. To eliminate the use of sophisticated equipment for data analysis, the color variance for multiple detection results was simultaneously collected and concentrated on cellulose paper with the data readout transmitted for cloud computing via a smartphone. The results show that the 2.6 nM tuberculosis mycobacterium target sequences extracted from patients can easily be detected, and the turnaround time after the human DNA is extracted from clinical samples was approximately 1 h.

Turbomachinery CFD on parallel computers

NASA Technical Reports Server (NTRS)

Blech, Richard A.; Milner, Edward J.; Quealy, Angela; Townsend, Scott E.

1992-01-01

The role of multistage turbomachinery simulation in the development of propulsion system models is discussed. Particularly, the need for simulations with higher fidelity and faster turnaround time is highlighted. It is shown how such fast simulations can be used in engineering-oriented environments. The use of parallel processing to achieve the required turnaround times is discussed. Current work by several researchers in this area is summarized. Parallel turbomachinery CFD research at the NASA Lewis Research Center is then highlighted. These efforts are focused on implementing the average-passage turbomachinery model on MIMD, distributed memory parallel computers. Performance results are given for inviscid, single blade row and viscous, multistage applications on several parallel computers, including networked workstations.

A Simulation Based Approach for Contingency Planning for Aircraft Turnaround Operation System Activities in Airline Hubs

NASA Technical Reports Server (NTRS)

Adeleye, Sanya; Chung, Christopher

2006-01-01

Commercial aircraft undergo a significant number of maintenance and logistical activities during the turnaround operation at the departure gate. By analyzing the sequencing of these activities, more effective turnaround contingency plans may be developed for logistical and maintenance disruptions. Turnaround contingency plans are particularly important as any kind of delay in a hub based system may cascade into further delays with subsequent connections. The contingency sequencing of the maintenance and logistical turnaround activities were analyzed using a combined network and computer simulation modeling approach. Experimental analysis of both current and alternative policies provides a framework to aid in more effective tactical decision making.

Teacher Pay-for-Performance in School Turnaround: How Bonuses and Differentiated Pay Scales Can Help Support School Turnaround. Meeting the Turnaround Challenge: Strategies, Resources & Tools to Transform a Framework into Practice

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2009

2009-01-01

Given the importance of good teaching and leadership for school success, turnaround schools should think carefully about how to structure professional environments that reward and motivate excellence. A system of "Pay-for-Contribution" that includes tools such as hard-to-staff and skill shortage pay, performance pay, and/or retention…

Parallel computation of GA search for the artery shape determinants with CFD

NASA Astrophysics Data System (ADS)

Himeno, M.; Noda, S.; Fukasaku, K.; Himeno, R.

2010-06-01

We studied which factors play important role to determine the shape of arteries at the carotid artery bifurcation by performing multi-objective optimization with computation fluid dynamics (CFD) and the genetic algorithm (GA). To perform it, the most difficult problem is how to reduce turn-around time of the GA optimization with 3D unsteady computation of blood flow. We devised two levels of parallel computation method with the following features: level 1: parallel CFD computation with appropriate number of cores; level 2: parallel jobs generated by "master", which finds quickly available job cue and dispatches jobs, to reduce turn-around time. As a result, the turn-around time of one GA trial, which would have taken 462 days with one core, was reduced to less than two days on RIKEN supercomputer system, RICC, with 8192 cores. We performed a multi-objective optimization to minimize the maximum mean WSS and to minimize the sum of circumference for four different shapes and obtained a set of trade-off solutions for each shape. In addition, we found that the carotid bulb has the feature of the minimum local mean WSS and minimum local radius. We confirmed that our method is effective for examining determinants of artery shapes.

Validation of Clinical Testing for Warfarin Sensitivity

PubMed Central

Langley, Michael R.; Booker, Jessica K.; Evans, James P.; McLeod, Howard L.; Weck, Karen E.

2009-01-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 −1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses. PMID:19324988

Validation of clinical testing for warfarin sensitivity: comparison of CYP2C9-VKORC1 genotyping assays and warfarin-dosing algorithms.

PubMed

Langley, Michael R; Booker, Jessica K; Evans, James P; McLeod, Howard L; Weck, Karen E

2009-05-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 -1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses.

Whole Air Sampling During NASA's March-April 1999 Pacific Exploratory Expedition (PEM-Tropics B)

NASA Technical Reports Server (NTRS)

Blake, Donald R.

2001-01-01

University of California, Irvine (UCI) collected more than 4500 samples whole air samples collected over the remote Pacific Ocean during NASA's Global Tropospheric Experiment (GTE) Pacific Exploratory Mission-Tropics B (PEM-Tropics B) in March and early April 1999. Approximately 140 samples during a typical 8-hour DC-8 flight, and 120 canisters for each 8-hour flight aboard the P-3B. These samples were obtained roughly every 3-7 min during horizontal flight legs and 1-3 min during vertical legs. The filled canisters were analyzed in the laboratory at UCI within ten days of collection. The mixing ratios of 58 trace gases comprising hydrocarbons, halocarbons, alkyl nitrates and DMS were reported (and archived) for each sample. Two identical analytical systems sharing the same standards were operated simultaneously around the clock to improve canister turn-around time and to keep our measurement precision optimal. This report presents a summary of the results for sample collected.

Manned Orbital Transfer Vehicle (MOTV). Volume 5: Turnaround analysis

NASA Technical Reports Server (NTRS)

Boyland, R. E.; Sherman, S. W.; Morfin, H. W.

1979-01-01

The development of a low-cost reliable turnaround process to employ the MOTV in enhancing the utilization of the geosynchronous space region is analyzed. It is indicated that a routine effective turnaround/maintenance plan must make maximum use of flight data for maintenance planning, a high degree of test automation, and MOTV maintainability features in order to minimize tests, facilitate repair, and reduce manpower requirements. An effective turnaround plan provides a payback of reduced risks.

The Henry Ford Production System: LEAN Process Redesign Improves Service in the Molecular Diagnostic Laboratory

PubMed Central

Cankovic, Milena; Varney, Ruan C.; Whiteley, Lisa; Brown, Ron; D'Angelo, Rita; Chitale, Dhananjay; Zarbo, Richard J.

2009-01-01

Accurate and timely molecular test results play an important role in patient management; consequently, there is a customer expectation of short testing turnaround times. Baseline data analysis revealed that the greatest challenge to timely result generation occurred in the preanalytic phase of specimen collection and transport. Here, we describe our efforts to improve molecular testing turnaround times by focusing primarily on redesign of preanalytic processes using the principles of LEAN production. Our goal was to complete greater than 90% of the molecular tests in less than 3 days. The project required cooperation from different laboratory disciplines as well as individuals outside of the laboratory. The redesigned processes involved defining and standardizing the protocols and approaching blood and tissue specimens as analytes for molecular testing. The LEAN process resulted in fewer steps, approaching the ideal of a one-piece flow for specimens through collection/retrieval, transport, and different aspects of the testing process. The outcome of introducing the LEAN process has been a 44% reduction in molecular test turnaround time for tissue specimens, from an average of 2.7 to 1.5 days. In addition, extending LEAN work principles to the clinician suppliers has resulted in a markedly increased number of properly collected and shipped blood specimens (from 50 to 87%). These continuous quality improvements were accomplished by empowered workers in a blame-free environment and are now being sustained with minimal management involvement. PMID:19661386

Multiprocessing on supercomputers for computational aerodynamics

NASA Technical Reports Server (NTRS)

Yarrow, Maurice; Mehta, Unmeel B.

1990-01-01

Very little use is made of multiple processors available on current supercomputers (computers with a theoretical peak performance capability equal to 100 MFLOPs or more) in computational aerodynamics to significantly improve turnaround time. The productivity of a computer user is directly related to this turnaround time. In a time-sharing environment, the improvement in this speed is achieved when multiple processors are used efficiently to execute an algorithm. The concept of multiple instructions and multiple data (MIMD) through multi-tasking is applied via a strategy which requires relatively minor modifications to an existing code for a single processor. Essentially, this approach maps the available memory to multiple processors, exploiting the C-FORTRAN-Unix interface. The existing single processor code is mapped without the need for developing a new algorithm. The procedure for building a code utilizing this approach is automated with the Unix stream editor. As a demonstration of this approach, a Multiple Processor Multiple Grid (MPMG) code is developed. It is capable of using nine processors, and can be easily extended to a larger number of processors. This code solves the three-dimensional, Reynolds averaged, thin-layer and slender-layer Navier-Stokes equations with an implicit, approximately factored and diagonalized method. The solver is applied to generic oblique-wing aircraft problem on a four processor Cray-2 computer. A tricubic interpolation scheme is developed to increase the accuracy of coupling of overlapped grids. For the oblique-wing aircraft problem, a speedup of two in elapsed (turnaround) time is observed in a saturated time-sharing environment.

Practical issues in implementing whole-genome-sequencing in routine diagnostic microbiology.

PubMed

Rossen, J W A; Friedrich, A W; Moran-Gilad, J

2018-04-01

Next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology adopted in microbiology, the integration of NGS into clinical and routine workflows must be carefully managed. To review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. Review of the literature and expert opinion. In this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory. In addition, as the microbiology laboratories have to adhere to various national and international regulations and criteria for their accreditation, we deliberate on quality control issues for using WGS in microbiology, including the importance of proficiency testing. Furthermore, the current and future place of this technology in the diagnostic hierarchy of microbiology is described as well as the necessity of maintaining backwards compatibility with already established methods. Finally, we speculate on the question of whether WGS can entirely replace routine microbiology in the future and the tension between the fact that most sequencers are designed to process multiple samples in parallel whereas for optimal diagnosis a one-by-one processing of the samples is preferred. Special reference is made to the cost and turnaround time of WGS in diagnostic laboratories. Further development is required to improve the workflow for WGS, in particular to shorten the turnaround time, reduce costs, and streamline downstream data analyses. Only when these processes reach maturity will reliance on WGS for routine patient management and infection control management become feasible, enabling the transformation of clinical microbiology into a genome-based and personalized diagnostic field. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Keys to Sustaining Successful School Turnarounds

ERIC Educational Resources Information Center

Duke, Daniel L.

2006-01-01

To identify the changes associated with the school turnaround process, this article reviewed 15 case studies of elementary school turnaround initiatives that sustained improvements for at least two years. Changes were clustered into eight categories: leadership, school policy, programs, organizational processes, staffing, classroom practices,…

"Turnaround" as Shock Therapy: Race, Neoliberalism, and School Reform

ERIC Educational Resources Information Center

Johnson, Amanda Walker

2013-01-01

"Turnaround" strategies of educational reform promise that school closure, reconstitution, privatizing, and reopening them will bring miraculous results. Questioning the implications, this article situates "turnaround" strategies locally, following the closure of a predominantly minority high school in 2008, in Austin, Texas.…

Building the community voice into planning: 25 years of methods development in social audit

PubMed Central

2011-01-01

Health planners and managers make decisions based on their appreciation of causality. Social audits question the assumptions behind this and try to improve quality of available evidence. The method has its origin in the follow-up of Bhopal survivors in the 1980s, where “cluster cohorts” tracked health events over time. In social audit, a representative panel of sentinel sites are the framework to follow the impact of health programmes or reforms. The epidemiological backbone of social audit tackles causality in a calculated way, balancing computational aspects with appreciation of the limits of the science. Social audits share findings with planners at policy level, health services providers, and users in the household, where final decisions about use of public services rest. Sharing survey results with sample communities and service workers generates a second order of results through structured discussions. Aggregation of these evidence-based community-led solutions across a representative sample provides a rich substrate for decisions. This socialising of evidence for participatory action (SEPA) involves a different skill set but quality control and rigour are still important. Early social audits addressed settings without accepted sample frames, the fundamentals of reproducible questionnaires, and the logistics of data turnaround. Feedback of results to stakeholders was at CIET insistence – and at CIET expense. Later social audits included strong SEPA components. Recent and current social audits are institutionalising high level research methods in planning, incorporating randomisation and experimental designs in a rigorous approach to causality. The 25 years have provided a number of lessons. Social audit reduces the arbitrariness of planning decisions, and reduces the wastage of simply allocating resources the way they were in past years. But too much evidence easily exceeds the uptake capacity of decision takers. Political will of governments often did not match those of donors with interest conditioned by political cycles. Some reforms have a longer turnaround than the political cycle; short turnaround interventions can develop momentum. Experience and specialisation made social audit seem more simple than it is. The core of social audit, its mystique, is not easily taught or transferred. Yet teams in Mexico, Nicaragua, Canada, southern Africa, and Pakistan all have more than a decade of experience in social audit, their in-service training supported by a customised Masters programme. PMID:22376121

Building the community voice into planning: 25 years of methods development in social audit.

PubMed

Andersson, Neil

2011-12-21

Health planners and managers make decisions based on their appreciation of causality. Social audits question the assumptions behind this and try to improve quality of available evidence. The method has its origin in the follow-up of Bhopal survivors in the 1980s, where "cluster cohorts" tracked health events over time. In social audit, a representative panel of sentinel sites are the framework to follow the impact of health programmes or reforms. The epidemiological backbone of social audit tackles causality in a calculated way, balancing computational aspects with appreciation of the limits of the science.Social audits share findings with planners at policy level, health services providers, and users in the household, where final decisions about use of public services rest. Sharing survey results with sample communities and service workers generates a second order of results through structured discussions. Aggregation of these evidence-based community-led solutions across a representative sample provides a rich substrate for decisions. This socialising of evidence for participatory action (SEPA) involves a different skill set but quality control and rigour are still important.Early social audits addressed settings without accepted sample frames, the fundamentals of reproducible questionnaires, and the logistics of data turnaround. Feedback of results to stakeholders was at CIET insistence--and at CIET expense. Later social audits included strong SEPA components. Recent and current social audits are institutionalising high level research methods in planning, incorporating randomisation and experimental designs in a rigorous approach to causality.The 25 years have provided a number of lessons. Social audit reduces the arbitrariness of planning decisions, and reduces the wastage of simply allocating resources the way they were in past years. But too much evidence easily exceeds the uptake capacity of decision takers. Political will of governments often did not match those of donors with interest conditioned by political cycles. Some reforms have a longer turnaround than the political cycle; short turnaround interventions can develop momentum. Experience and specialisation made social audit seem more simple than it is. The core of social audit, its mystique, is not easily taught or transferred. Yet teams in Mexico, Nicaragua, Canada, southern Africa, and Pakistan all have more than a decade of experience in social audit, their in-service training supported by a customised Masters programme.

Programing techniques for CDC equipment

NASA Technical Reports Server (NTRS)

Newsom, J. R.; Tiffany, S. H.

1979-01-01

Five techniques reduce core requirements for fast batch turnaround time and interactive-terminal capability. Same techniques increase program versatility, decrease problem-configuration dependence, and facilitate interprogram communication.

Operational Efficiency and Productivity Improvement Initiatives in a Large Cardiac Catheterization Laboratory.

PubMed

Reed, Grant W; Hantz, Scott; Cunningham, Rebecca; Krishnaswamy, Amar; Ellis, Stephen G; Khot, Umesh; Rak, Joe; Kapadia, Samir R

2018-02-26

This study sought to report outcomes from an efficiency improvement project in a large cardiac cath lab. Operational inefficiencies are common in the cath lab, yet solutions are challenging. A detailed report describing and providing solutions for these inefficiencies may be valuable in guiding improvements in productivity. In this observational study, the authors report metrics of efficiency before and after a cath lab quality improvement program in June 2014. Main outcomes included lab room start times, room turnaround times, laboratory use, and employee satisfaction. Time series analysis was used to assess trend over time. Chi-square testing and analysis of variance were used to assess change before and after the initiative. The principal changes included implementation of a pyramidal nursing schedule, increased use of an electronic scheduling system, and increased utilization of a preparation and recovery area. Comparing before with after the program, start times improved an average of 17 min, and on-time starts improved from 61.8% to 81.7% (p = 0.0024). Turnaround times improved from 20.5 min to 16.4 min (trend p < 0.0001), and the proportion of days at full lab utilization improved from 7.7% to 77.3% (p < 0.00001). There were no increases in overtime, night, or weekend cases. There was a reduction in full time employees from 36.1 in 2013 to 29.6 in 2016, with an improvement in employee satisfaction. A systematic approach to reducing inefficiencies can improve cath lab start times, turnaround times, and overall productivity. This knowledge may be helpful in assisting other cath labs in similar efficiency improvement initiatives. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

National Combustion Code Parallel Performance Enhancements

NASA Technical Reports Server (NTRS)

Quealy, Angela; Benyo, Theresa (Technical Monitor)

2002-01-01

The National Combustion Code (NCC) is being developed by an industry-government team for the design and analysis of combustion systems. The unstructured grid, reacting flow code uses a distributed memory, message passing model for its parallel implementation. The focus of the present effort has been to improve the performance of the NCC code to meet combustor designer requirements for model accuracy and analysis turnaround time. Improving the performance of this code contributes significantly to the overall reduction in time and cost of the combustor design cycle. This report describes recent parallel processing modifications to NCC that have improved the parallel scalability of the code, enabling a two hour turnaround for a 1.3 million element fully reacting combustion simulation on an SGI Origin 2000.

Space transportation system shuttle turnabout analysis report

NASA Technical Reports Server (NTRS)

Reedy, R. E.

1979-01-01

The progress made and the problems encountered by the various program elements of the shuttle program in achieving the 160 hour ground turnaround goal are presented and evaluated. Task assessment time is measured against the program allocation time.

The Big U-Turn

ERIC Educational Resources Information Center

Hassel, Emily Ayscue; Hassel, Bryan C.

2009-01-01

This article explains what the authors know, from plentiful cross-sector research, about how to engineer turnarounds within existing organizations. It then identifies two critical policy issues that states and districts must address to accelerate the prevalence of real, successful turnarounds in education. Effective turnaround leaders follow a…

Sample-to-answer palm-sized nucleic acid testing device towards low-cost malaria mass screening.

PubMed

Choi, Gihoon; Prince, Theodore; Miao, Jun; Cui, Liwang; Guan, Weihua

2018-05-19

The effectiveness of malaria screening and treatment highly depends on the low-cost access to the highly sensitive and specific malaria test. We report a real-time fluorescence nucleic acid testing device for malaria field detection with automated and scalable sample preparation capability. The device consists a compact analyzer and a disposable microfluidic reagent compact disc. The parasite DNA sample preparation and subsequent real-time LAMP detection were seamlessly integrated on a single microfluidic compact disc, driven by energy efficient non-centrifuge based magnetic field interactions. Each disc contains four parallel testing units which could be configured either as four identical tests or as four species-specific tests. When configured as species-specific tests, it could identify two of the most life-threatening malaria species (P. falciparum and P. vivax). The NAT device is capable of processing four samples simultaneously within 50 min turnaround time. It achieves a detection limit of ~0.5 parasites/µl for whole blood, sufficient for detecting asymptomatic parasite carriers. The combination of the sensitivity, specificity, cost, and scalable sample preparation suggests the real-time fluorescence LAMP device could be particularly useful for malaria screening in the field settings. Copyright © 2018 Elsevier B.V. All rights reserved.

Multiprocessing on supercomputers for computational aerodynamics

NASA Technical Reports Server (NTRS)

Yarrow, Maurice; Mehta, Unmeel B.

1991-01-01

Little use is made of multiple processors available on current supercomputers (computers with a theoretical peak performance capability equal to 100 MFLOPS or more) to improve turnaround time in computational aerodynamics. The productivity of a computer user is directly related to this turnaround time. In a time-sharing environment, such improvement in this speed is achieved when multiple processors are used efficiently to execute an algorithm. The concept of multiple instructions and multiple data (MIMD) is applied through multitasking via a strategy that requires relatively minor modifications to an existing code for a single processor. This approach maps the available memory to multiple processors, exploiting the C-Fortran-Unix interface. The existing code is mapped without the need for developing a new algorithm. The procedure for building a code utilizing this approach is automated with the Unix stream editor.

Cutting medical transcription costs.

PubMed

Forsman, John A

2003-07-01

Home-based, production-based medical transcription represents a substantial cost-saving opportunity. Fewer employees are required. Office space is not needed. Outsourcing costs are eliminated. Turnaround time is reduced.

Scaling School Turnaround

ERIC Educational Resources Information Center

Herman, Rebecca

2012-01-01

This article explores the research on turning around low performing schools to summarize what we know, what we don't know, and what this means for scaling school turnaround efforts. "School turnaround" is defined here as quick, dramatic gains in academic achievement for persistently low performing schools. The article first considers the…

The Turnaround Fallacy

ERIC Educational Resources Information Center

Smarick, Andy

2010-01-01

For as long as there have been struggling schools in America's cities, there have been efforts to turn them around. But overall, school turnaround efforts have consistently fallen far short of hopes and expectations. Quite simply, turnarounds are not a scalable strategy for fixing America's troubled urban school systems. Fortunately, findings from…

Role of Superintendent in District Turnaround

ERIC Educational Resources Information Center

Evans, James, Jr.

2014-01-01

The purpose of this research study was to evaluate the role of the superintendent in the turnaround process in persistently low achieving school districts. This research identified common threads, principles, and suggestions on turnaround processes and the role of the superintendent through examination of research on leadership and school…

Human Capital in Turnaround Schools

ERIC Educational Resources Information Center

Ferris, Kristen

2012-01-01

Finding, keeping and supporting great educators presents the single biggest challenge to successful school turnarounds. Without teachers and administrators who bring the needed combination of skills and passion, nothing else will achieve the desired effect. The turnaround model supported by the U.S. Department of Education School Improvement Grant…

Turnaround Arts Initiative: Summary of Key Findings

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Silk, Yael; Reddy, Prateek; Rahman, Nadiv

2015-01-01

Turnaround Arts is a public-private partnership that aims to test the hypothesis that strategically implementing high-quality and integrated arts education programming in high-poverty, chronically underperforming schools adds significant value to school-wide reform. In 2014, the Turnaround Arts initiative completed an evaluation report covering…

Accelerator mass spectrometry of strontium-90 for homeland security, environmental monitoring and human health

NASA Astrophysics Data System (ADS)

Tumey, Scott J.; Brown, Thomas A.; Hamilton, Terry E.; Hillegonds, Darren J.

2008-05-01

Strontium-90 is one of the most hazardous materials managed by agencies charged with protecting the public from radiation. Traditional radiometric methods have been limited by low sample throughput and slow turnaround times. Mass spectrometry offers the advantage of shorter analysis times and the ability to measure samples immediately after processing, however conventional mass spectrometric techniques are susceptible to molecular isobaric interferences that limit their overall sensitivity. In contrast, accelerator mass spectrometry is insensitive to molecular interferences and we have therefore begun developing a method for determination of 90Sr by accelerator mass spectrometry. Despite a pervasive interference from 90Zr, our initial development has yielded an instrumental background of ∼108 atoms (75 mBq) per sample. Further refinement of our system (e.g. redesign of our detector, use of alternative target materials) is expected to push the background below 106 atoms, close to the theoretical limit for AMS. Once we have refined our system and developed suitable sample preparation protocols, we will utilize our capability in applications to homeland security, environmental monitoring and human health.

Impact of Glucose Measurement Processing Delays on Clinical Accuracy and Relevance

PubMed Central

Jangam, Sujit R.; Hayter, Gary; Dunn, Timothy C.

2013-01-01

Background In a hospital setting, glucose is often measured from venous blood in the clinical laboratory. However, laboratory glucose measurements are typically not available in real time. In practice, turn-around times for laboratory measurements can be minutes to hours. This analysis assesses the impact of turn-around time on the effective clinical accuracy of laboratory measurements. Methods Data obtained from an earlier study with 58 subjects with type 1 diabetes mellitus (T1DM) were used for this analysis. In the study, glucose measurements using a YSI glucose analyzer were obtained from venous blood samples every 15 min while the subjects were at the health care facility. To simulate delayed laboratory results, each YSI glucose value from a subject was paired with one from a later time point (from the same subject) separated by 15, 30, 45, and 60 min. To assess the clinical accuracy of a delayed YSI result relative to a real-time result, the percentage of YSI pairs that meet the International Organization for Standardization (ISO) 15197:2003(E) standard for glucose measurement accuracy (±15 mg/dl for blood glucose < 75 mg/dl, ±20% for blood glucose ≥ 75 mg/dl) was calculated. Results It was observed that delays of 15 min or more reduce clinical accuracy below the ISO 15197:2003(E) recommendation of 95%. The accuracy was less than 65% for delays of 60 min. Conclusion This analysis suggests that processing delays in glucose measurements reduce the clinical relevance of results in patients with T1DM and may similarly degrade the clinical value of measurements in other patient populations. PMID:23759399

Impact of glucose measurement processing delays on clinical accuracy and relevance.

PubMed

Jangam, Sujit R; Hayter, Gary; Dunn, Timothy C

2013-05-01

In a hospital setting, glucose is often measured from venous blood in the clinical laboratory. However, laboratory glucose measurements are typically not available in real time. In practice, turn-around times for laboratory measurements can be minutes to hours. This analysis assesses the impact of turn-around time on the effective clinical accuracy of laboratory measurements. Data obtained from an earlier study with 58 subjects with type 1 diabetes mellitus (T1DM) were used for this analysis. In the study, glucose measurements using a YSI glucose analyzer were obtained from venous blood samples every 15 min while the subjects were at the health care facility. To simulate delayed laboratory results, each YSI glucose value from a subject was paired with one from a later time point (from the same subject) separated by 15, 30, 45, and 60 min. To assess the clinical accuracy of a delayed YSI result relative to a real-time result, the percentage of YSI pairs that meet the International Organization for Standardization (ISO) 15197:2003(E) standard for glucose measurement accuracy (±15 mg/dl for blood glucose < 75 mg/dl, ±20% for blood glucose ≥ 75 mg/dl) was calculated. It was observed that delays of 15 min or more reduce clinical accuracy below the ISO 15197:2003(E) recommendation of 95%. The accuracy was less than 65% for delays of 60 min. This analysis suggests that processing delays in glucose measurements reduce the clinical relevance of results in patients with T1DM and may similarly degrade the clinical value of measurements in other patient populations. © 2013 Diabetes Technology Society.

Five Myths of School Turnaround Policy and Practice

ERIC Educational Resources Information Center

Meyers, Coby V.; Smylie, Mark A.

2017-01-01

Despite the intensity of funding and numerous intervention efforts in recent school turnaround initiatives, many perspectives, practices, and policies specific to school turnaround appear to be at odds with organizational theory. Yet, many actors in research, policy, and practice arenas appear convinced that their steadfastness will eventually be…

Turnaround as Reform: Opportunity for Meaningful Change or Neoliberal Posturing?

ERIC Educational Resources Information Center

Mette, Ian M.

2013-01-01

This study explores the neoliberal agenda of turnaround school reform efforts in America by examining the application and transformation of a Midwest State Turnaround Schools Project for the public school system. Perceptions of administrators and state-level policy actors are considered. Data were collected from 13 participants during the…

Using Competencies to Improve School Turnaround Principal Success

ERIC Educational Resources Information Center

Steiner, Lucy; Hassel, Emily Ayscue

2011-01-01

This paper aims first to shed light on one element of leadership: the characteristics--or "competencies"--of turnaround leaders who succeed in driving rapid, dramatic change. Second, it recounts the elements of support that districts must provide these leaders to enable and sustain a portfolio of successful school turnarounds.…

School Turnarounds: Resisting the Hype, Giving Them Hope. Education Outlook No. 2

ERIC Educational Resources Information Center

Hess, Frederick M.; Gift, Thomas

2009-01-01

Education reformers are abuzz over school "turnarounds," a simple idea that has undeniable appeal. School turnarounds offer the opportunity to take familiar educational institutions and improve them through coaching, mentoring, capacity building, best practices, and other existing tools. Unlike most reform efforts, which focus on incremental…

Common Leadership Responsibilities of Principals of Successful Turnaround Model Schools

ERIC Educational Resources Information Center

Fullwood, Jezelle

2016-01-01

Purpose: The purpose of this qualitative study was to discover which leadership responsibilities, within the domains of trust, communication, learning, and shared leadership, did elementary and middle school principals of successful turnaround schools commonly perceive as most necessary to lead a turnaround intervention model school. Themes were…

School Turnaround Fever: The Paradoxes of a Historical Practice Promoted as a New Reform

ERIC Educational Resources Information Center

Peck, Craig; Reitzug, Ulrich C.

2014-01-01

School "turnaround" has received significant attention recently in education literature and policy action, especially as a means to dramatically improve urban education. In current common education usage, "turnaround" refers to the rapid, significant improvement in the academic achievement of persistently low-achieving schools.…

Turnaround operations analysis for OTV. Volume 2: Detailed technical report

NASA Technical Reports Server (NTRS)

1988-01-01

The objectives and accomplishments were to adapt and apply the newly created database of Shuttle/Centaur ground operations. Previously defined turnaround operations analyses were to be updated for ground-based OTVs (GBOTVs) and space-based OTVs (SBOTVs), design requirements identified for both OTV and Space Station accommodations hardware, turnaround operations costs estimated, and a technology development plan generated to develop the required capabilities. Technical and programmatic data were provided for NASA pertinent to OTV round and space operations requirements, turnaround operations, task descriptions, timelines and manpower requirements, OTV modular design and booster and Space Station interface requirements. SBOTV accommodations development schedule, cost and turnaround operations requirements, and a technology development plan for ground and space operations and space-based accommodations facilities and support equipment. Significant conclusion are discussed.

Expectations Among Academic Clinicians of Inpatient Imaging Turnaround Time: Does it Correlate with Satisfaction?

PubMed

Chan, Keith T; Carroll, Tamara; Linnau, Ken F; Lehnert, Bruce

2015-11-01

Imaging report turnaround time (RTAT) is an important measure of radiology performance and has become the leading priority in customer satisfaction surveys conducted among nonradiologists, who may not be familiar with the imaging workflow. Our aim was to assess physicians' expected RTAT for commonly ordered studies and determine if satisfaction correlates with met expectations. Retrospective review of inpatient imaging was conducted at a single academic institution, and RTAT for 18,414 studies was calculated. Examinations were grouped by study type, priority, and time of day. A cross-sectional survey instrument was completed by 48 internal medicine and surgery resident physicians with questions regarding RTAT and their level of satisfaction with various examinations. Actual RTAT ranged from 1.6 to 26.0 hours, with chest radiographs and computed tomographies generally faster than magnetic resonance images and ultrasounds. Urgent (STAT) examinations and those ordered during business hours have shorter RTAT. The time for image interpretation largely contributed to the RTAT because of the lack of night-time radiology coverage. Referring physician expectations were consistently shorter than actual RTAT, ranging from 30 minutes to 24 hours. Overall satisfaction scores were inversely correlated with RTAT, with a strong correlation to the time from study order to imaging (r(2) = 0.63) and a weak correlation to the image interpretation time (r(2) = 0.17). Satisfaction scores did not correlate with whether the actual RTAT met expectations (r(2) = 0.06). Referring physician satisfaction is likely multifactorial. Although RTAT has been reported as a priority, shortening turnaround time alone may not directly improve clinician satisfaction. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Voice recognition technology implementation in surgical pathology: advantages and limitations.

PubMed

Singh, Meenakshi; Pal, Timothy R

2011-11-01

Voice recognition technology (VRT) has been in use for medical transcription outside of laboratories for many years, and in recent years it has evolved to a level where it merits consideration by surgical pathologists. To determine the feasibility and impact of making a transition from a transcriptionist-based service to VRT in surgical pathology. We have evaluated VRT in a phased manner for sign out of general and subspecialty surgical pathology cases after conducting a pilot study. We evaluated the effect on turnaround time, workflow, staffing, typographical error rates, and the overall ability of VRT to be adapted for use in surgical pathology. The stepwise implementation of VRT has resulted in real-time sign out of cases and improvement in average turnaround time from 4 to 3 days. The percentage of cases signed out in 1 day improved from 22% to 37%. Amendment rates for typographical errors have decreased. Use of templates and synoptic reports has been facilitated. The transcription staff has been reassigned to other duties and is successfully assisting in other areas. Resident involvement and exposure to complete case sign out has been achieved resulting in a positive impact on resident education. Voice recognition technology allows for a seamless workflow in surgical pathology, with improvements in turnaround time and a positive impact on competency-based resident education. Individual practices may assess the value of VRT and decide to implement it, potentially with gains in many aspects of their practice.

Characteristics of Occupational Exposure to Benzene during Turnaround in the Petrochemical Industries

PubMed Central

Shin, Jung-Ah; Lee, Byung-Kyu; Kwon, Jiwoon; Lee, Naroo; Chung, Kwang-Jae; Lee, Jong-Han; Lee, In-Seop; Kang, Seong-Kyu; Jang, Jae-Kil

2010-01-01

Objectives The level of benzene exposure in the petrochemical industry during regular operation has been well established, but not in turnaround (TA), where high exposure may occur. In this study, the characteristics of occupational exposure to benzene during TA in the petrochemical companies were investigated in order to determine the best management strategies and improve the working environment. This was accomplished by evaluating the exposure level for the workers working in environments where benzene was being produced or used as an ingredient during the unit process. Methods From 2003 to 2008, a total of 705 workers in three petrochemical companies in Korea were studied. Long- and short-term (< 1 hr) samples were taken during TAs. TA was classified into three stages: shut-down, maintenance and start-up. All works were classified into 12 occupation categories. Results The long-term geometric mean (GM) benzene exposure level was 0.025 (5.82) ppm (0.005-42.120 ppm) and the short-term exposure concentration during TA was 0.020 (17.42) ppm (0.005-61.855 ppm). The proportions of TA samples exceeding the time-weighted average, occupational exposure level (TWA-OEL in Korea, 1 ppm) and the short-term exposure limit (STEL-OEL, 5 ppm) were 4.1% (20 samples of 488) and 6.0% (13 samples of 217), respectively. The results for the benzene exposure levels and the rates of exceeding the OEL were both statistically significant (p < 0.05). Among the 12 job categories of petrochemical workers, mechanical engineers, plumbers, welders, fieldman and scaffolding workers exhibited long-term samples that exceeded the OEL of benzene, and the rate of exceeding the OEL was statistically significant for the first two occupations (p < 0.05). Conclusion These findings suggest that the periodic work environment must be assessed during non-routine works such as TA. PMID:22953163

Change through persuasion.

PubMed

Garvin, David A; Roberto, Michael A

2005-02-01

Faced with the need for a massive change, most managers respond predictably. They revamp the organization's strategy, shift around staff, and root out inefficiencies. They then wait patiently for performance to improve--only to be bitterly disappointed because they've failed to adequately prepare employees for the change. In this article, the authors contend that to make change stick, leaders must conduct an effective persuasion campaign-one that begins weeks or months before the turn-around plan is set in concrete. Like a political campaign, a persuasion campaign is largely one of differentiation from the past. Turnaround leaders must convince people that the organization is truly on its deathbed-or, at the very least, that radical changes are required if the organization is to survive and thrive. (This is a particularly difficult challenge when years of persistent problems have been accompanied by few changes in the status quo.) And they must demonstrate through word and deed that they are the right leaders with the right plan. Accomplishing all this calls for a four-part communications strategy. Prior to announcing a turnaround plan, leaders need to set the stage for employees' acceptance of it. At the time of delivery, they must present a framework through which employees can interpret information and messages about the plan. As time passes, they must manage the mood so that employees' emotional states support implementation and follow-through. And at critical intervals, they must provide reinforcement to ensure that the desired changes take hold and that there's no backsliding. Using the example of the dramatic turn-around at Boston's Beth Israel Deaconess Medical Center, the authors elucidate the inner workings of a successful change effort.

Turnaround Necessities: Basic Conditions for an Effective, Sustainable, and Scalable School Turnaround

ERIC Educational Resources Information Center

Robinson, William S.; Buntrock, LeAnn M.

2011-01-01

Turning around chronically low-performing schools is challenging work requiring fundamental rethinking of the change process, and a systemic rather than school-by-school approach. Without a doubt, high-impact school leaders are critical to turnaround success, and pockets of success around the country demonstrate this. However, transformational and…

The State Role in School Turnaround: Emerging Best Practices

ERIC Educational Resources Information Center

Rhim, Lauren Morando, Ed.; Redding, Sam, Ed.

2014-01-01

This publication explores the role of the state education agency (SEA) in school turnaround efforts. An emphasis is placed on practical application of research and best practices related to the SEA's critical leadership role in driving and supporting successful school turnaround efforts. The publication is organized around the four goals of…

The Tenure of Private College and University Presidents

ERIC Educational Resources Information Center

Langbert, Mitchell

2012-01-01

This study fills several gaps. Most turnaround studies ignore post-turnaround executive rewards, and most studies of executive rewards ignore both the effects on rewards of achieving a turnaround and length of service, or tenure, as an element of the reward structure. Previous research about the length of college presidents' tenure in office has…

Sustaining Turnaround at the School and District Levels: The High Reliability Schools Project at Sandfields Secondary School

ERIC Educational Resources Information Center

Schaffer, Eugene; Reynolds, David; Stringfield, Sam

2012-01-01

Beginning from 1 high-poverty, historically low-achieving secondary school's successful turnaround work, this article provides data relative to a successful school turnaround, the importance of external and system-level supports, and the importance of building for sustainable institutionalization of improvements. The evidence suggests the…

Faculty Stakeholders' Perceptions of Leadership and Engagement in an Organizational Turnaround in Higher Education

ERIC Educational Resources Information Center

Brownell, Eileen Vlacancich

2016-01-01

This qualitative study represents an exploration into how faculty stakeholders in higher education experienced leadership actions and their own engagement with an organizational turnaround. Turnaround efforts were aimed at revitalization throughout the institution but little has been studied about faculty experience in this context. An interview…

Progress Report 2013. Turnaround Arts Initiative

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Joyce, Katie; Silk, Yael

2013-01-01

This interim progress report provides a look at Turnaround Arts schools in their first year, including: (1) a summary of the evaluation design and research questions; (2) a preliminary description of strategies used to introduce the arts in Turnaround Arts schools; and (3) a summary of school reform indicators and student achievement data at…

Theoretical Considerations and Standards for the Use of Turnarounds.

ERIC Educational Resources Information Center

Olson, Clark D.

The term "turnaround" has taken a permanent place among the intercollegiate debate jargon. All too often, the first affirmative rebuttalists charge "turnaround" for every plan or response they do not know how to label properly. After so many "false alarms," judges are too weary or aggravated to notice the real thing,…

Robotics and Automation for Flight Deck Aircraft Servicing

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

Chesser, J.B.; Draper, J.V.; Pin, F.G.

1999-03-01

One of the missions of the Future Aircraft Carriers Program is to investigate methods that would improve aircraft turnaround servicing activities on carrier decks. The major objectives and criteria for evaluating alternative aircraft servicing methods are to reduce workload requirements, turnaround times (TAT), and life-cycle costs (LCC). Technologies in the field of Robotics and Automation (R and A) have the potential to significantly contribute to these objectives. The objective of this study was to investigate aircraft servicing functions on carrier decks which would offer the potentially most significant payoff if improved by various R and A technologies. Improvement in thismore » case means reducing workload, time and LCC. This objective was accomplished using a ''bottom-up'' formalized approach as described in the following.« less

Real time application of whole genome sequencing for outbreak investigation - What is an achievable turnaround time?

PubMed

McGann, Patrick; Bunin, Jessica L; Snesrud, Erik; Singh, Seema; Maybank, Rosslyn; Ong, Ana C; Kwak, Yoon I; Seronello, Scott; Clifford, Robert J; Hinkle, Mary; Yamada, Stephen; Barnhill, Jason; Lesho, Emil

2016-07-01

Whole genome sequencing (WGS) is increasingly employed in clinical settings, though few assessments of turnaround times (TAT) have been performed in real-time. In this study, WGS was used to investigate an unfolding outbreak of vancomycin resistant Enterococcus faecium (VRE) among 3 patients in the ICU of a tertiary care hospital. Including overnight culturing, a TAT of just 48.5 h for a comprehensive report was achievable using an Illumina Miseq benchtop sequencer. WGS revealed that isolates from patient 2 and 3 differed from that of patient 1 by a single nucleotide polymorphism (SNP), indicating nosocomial transmission. However, the unparalleled resolution provided by WGS suggested that nosocomial transmission involved two separate events from patient 1 to patient 2 and 3, and not a linear transmission suspected by the time line. Rapid TAT's are achievable using WGS in the clinical setting and can provide an unprecedented level of resolution for outbreak investigations. Published by Elsevier Inc.

Development and Validation of a Real-Time PCR Assay for Rapid Detection of Candida auris from Surveillance Samples

PubMed Central

Leach, L.; Zhu, Y.

2017-01-01

ABSTRACT Candida auris is an emerging multidrug-resistant yeast causing invasive health care-associated infection with high mortality worldwide. Rapid identification of C. auris is of primary importance for the implementation of public health measures to control the spread of infection. To achieve these goals, we developed and validated a TaqMan-based real-time PCR assay targeting the internal transcribed spacer 2 (ITS2) region of the ribosomal gene. The assay was highly specific, reproducible, and sensitive, with the detection limit of 1 C. auris CFU/PCR. The performance of the C. auris real-time PCR assay was evaluated by using 623 surveillance samples, including 365 patient swabs and 258 environmental sponges. Real-time PCR yielded positive results from 49 swab and 58 sponge samples, with 89% and 100% clinical sensitivity with regard to their respective culture-positive results. The real-time PCR also detected C. auris DNA from 1% and 12% of swab and sponge samples with culture-negative results, indicating the presence of dead or culture-impaired C. auris. The real-time PCR yielded results within 4 h of sample processing, compared to 4 to 14 days for culture, reducing turnaround time significantly. The new real-time PCR assay allows for accurate and rapid screening of C. auris and can increase effective control and prevention of this emerging multidrug-resistant fungal pathogen in health care facilities. PMID:29187562

Development and Validation of a Real-Time PCR Assay for Rapid Detection of Candida auris from Surveillance Samples.

PubMed

Leach, L; Zhu, Y; Chaturvedi, S

2018-02-01

Candida auris is an emerging multidrug-resistant yeast causing invasive health care-associated infection with high mortality worldwide. Rapid identification of C. auris is of primary importance for the implementation of public health measures to control the spread of infection. To achieve these goals, we developed and validated a TaqMan-based real-time PCR assay targeting the internal transcribed spacer 2 ( ITS 2) region of the ribosomal gene. The assay was highly specific, reproducible, and sensitive, with the detection limit of 1 C. auris CFU/PCR. The performance of the C. auris real-time PCR assay was evaluated by using 623 surveillance samples, including 365 patient swabs and 258 environmental sponges. Real-time PCR yielded positive results from 49 swab and 58 sponge samples, with 89% and 100% clinical sensitivity with regard to their respective culture-positive results. The real-time PCR also detected C. auris DNA from 1% and 12% of swab and sponge samples with culture-negative results, indicating the presence of dead or culture-impaired C. auris The real-time PCR yielded results within 4 h of sample processing, compared to 4 to 14 days for culture, reducing turnaround time significantly. The new real-time PCR assay allows for accurate and rapid screening of C. auris and can increase effective control and prevention of this emerging multidrug-resistant fungal pathogen in health care facilities. Copyright © 2018 Leach et al.

Evaluation of a pulsed xenon ultraviolet light device for isolation room disinfection in a United Kingdom hospital.

PubMed

Hosein, Ian; Madeloso, Rosie; Nagaratnam, Wijayaratnam; Villamaria, Frank; Stock, Eileen; Jinadatha, Chetan

2016-09-01

Pathogen transmission from contaminated surfaces can cause hospital-associated infections. Although pulsed xenon ultraviolet (PX-UV) light devices have been shown to decrease hospital room bioburden in the United States, their effectiveness in United Kingdom (UK) hospitals is less understood. Forty isolation rooms at the Queens Hospital (700 beds) in North London, UK, were sampled for aerobic bacteria after patient discharge, after manual cleaning with a hypochlorous acid-troclosene sodium solution, and after PX-UV disinfection. PX-UV device efficacy on known organisms was tested by exposing inoculated agar plates in a nonpatient care area. Turnaround times for device usage were recorded, and a survey of hospital staff for perceptions of the device was undertaken. After PX-UV disinfection, the bacterial contamination measured in colony forming units (CFU) decreased by 78.4%, a 91% reduction from initial bioburden levels prior to terminal cleaning. PX-UV exposure resulted in a 5-log CFU reduction for multidrug-resistant organisms (MDROs) on spiked plates. The average device turnaround time was 1 hour, with minimal impact on patient throughput. Ward staff were enthusiastic about device deployment, and device operators reported physical comfort in usage. PX-UV use decreased bioburden in patient discharge rooms and on agar plates spiked with MDROs. The implementation of the PX-UV device was well received by hospital cleaning and ward staff, with minimal disruption to patient flow. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

If you text them, they will come: using the HIV infant tracking system to improve early infant diagnosis quality and retention in Kenya.

PubMed

Finocchario-Kessler, Sarah; Gautney, Brad J; Khamadi, Samoel; Okoth, Vincent; Goggin, Kathy; Spinler, Jennifer K; Mwangi, Anne; Kimanga, Davies; Clark, Kristine F; Olungae, Helen D; Preidis, Geoffrey A

2014-07-01

The objective of this study is to evaluate the impact of the HIV Infant Tracking System (HITSystem) for quality improvement of early infant diagnosis (EID) of HIV services. This observational pilot study compared 12 months of historical preintervention EID outcomes at one urban and one peri-urban government hospital in Kenya to 12 months of intervention data to assess retention and time throughout the EID cascade of care. Mother-infant pairs enrolled in EID at participating hospitals before (n = 320) and during (n = 523) the HITSystem pilot were eligible to participate. The HITSystem utilizes Internet-based coordination of the multistep PCR cycle, automated alerts to trigger prompt action from providers and laboratory technicians, and text messaging to notify mothers when results are ready or additional action is needed. The main outcome measures were retention throughout EID services, meeting time-sensitive targets and improving results turn-around time, and increasing early antiretroviral therapy (ART) initiation among HIV-infected infants. The HITSystem was associated with an increase in the proportion of HIV-exposed infants retained in EID care at 9 months postnatal (45.1-93.0% urban; 43.2-94.1% peri-urban), a decrease in turn-around times between sample collection, PCR results and notification of mothers in both settings, and a significant increase in the proportion of HIV-infected infants started on antiretroviral therapy at each hospital(14 vs. 100% urban; 64 vs. 100% peri-urban). The HITSystem maximizes the use of easily accessible technology to improve the quality and efficiency of EID services in resource-limited settings.

A field-deployable mobile molecular diagnostic system for malaria at the point of need.

PubMed

Choi, Gihoon; Song, Daniel; Shrestha, Sony; Miao, Jun; Cui, Liwang; Guan, Weihua

2016-11-01

In response to the urgent need of a field-deployable and highly sensitive malaria diagnosis, we developed a standalone, "sample-in-answer-out" molecular diagnostic system (AnyMDx) to enable quantitative molecular analysis of blood-borne malaria in low resource areas. The system consists of a durable battery-powered analyzer and a disposable microfluidic compact disc loaded with reagents ready for use. A low power thermal module and a novel fluorescence-sensing module are integrated into the analyzer for real-time monitoring of loop-mediated isothermal nucleic acid amplification (LAMP) of target parasite DNA. With 10 μL of raw blood sample, the AnyMDx system automates the nucleic acid sample preparation and subsequent LAMP and real-time detection. Under laboratory conditions with whole-blood samples spiked with cultured Plasmodium falciparum, we achieved a detection limit of ∼0.6 parasite per μL, much lower than those for the conventional microscopy and rapid diagnostic tests (∼50-100 parasites per μL). The turnaround time from sample to answer is less than 40 minutes. The AnyMDx is user-friendly requiring minimal technological training. The analyzer and the disposable reagent compact discs are cost-effective, making AnyMDx a potential tool for malaria molecular diagnosis under field settings for malaria elimination.

School Turnaround in North Carolina: A Regression Discontinuity Analysis. Working Paper 156

ERIC Educational Resources Information Center

Heissel, Jennifer A.; Ladd, Helen F.

2016-01-01

This paper examines the effect of school turnaround in North Carolina elementary and middle schools. Using a regression discontinuity design, we find that turnaround led to a drop in average school-level math and reading passing rates and an increased concentration of low-income students in treated schools. We use teacher survey data to examine…

On the Edge: A Study of Small Private Colleges That Have Made a Successful Financial Turnaround

ERIC Educational Resources Information Center

Carey, Amy Bragg

2014-01-01

This article describes a qualitative study that involved two small private universities, examining their process of transformation from institutions headed toward closure to institutions that underwent a successful turnaround. The primary questions that guided the study included the issues and circumstances that led to the need for a turnaround,…

Using Federal Education Formula Funds for School Turnaround Initiatives: Opportunities for State Education Agencies

ERIC Educational Resources Information Center

Junge, Melissa; Krvaric, Sheara

2016-01-01

Much has been written on the subject of school turnaround, but relatively little about how to "pay for" turnaround-related work. Turning around low-performing schools not only requires changing instructional and related practices, but changing spending patterns as well. Too often education dollars are spent on the same costs from…

Dancing in a Minefield: An Analysis of Turnaround Specialists in Arizona Schools

ERIC Educational Resources Information Center

McMillie, Kyann L.

2010-01-01

In 2008, educational leaders from the Arizona Department of Education (ADE) assigned a group of turnaround specialists to work in four failing public schools in a large, urban school district in Phoenix, Arizona in hopes of improving those schools. The utilization of turnaround specialists in failing schools was Arizona's method of enacting…

School Turnaround Teachers: Selection Toolkit. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

This toolkit includes these separate sections: (1) Selection Preparation Guide; (2) Day-of-Interview Tools; (3) Candidate Rating Tools; and (4) Candidate Comparison and Decision Tools. Each of the sections is designed to be used at different stages of the selection process. The first section provides turnaround teacher competencies that are the…

On the Edge: A Study of Small Private Colleges That Have Made a Successful Financial Turnaround

ERIC Educational Resources Information Center

Carey, Amy Bragg

2013-01-01

This dissertation was a qualitative research study regarding two small private universities and their process of transformation from an institution headed toward closure to a successful turnaround. The primary questions that guided the study included the factors and persons that contributed to the institutional turnaround, the issues and…

The Effect of Locus of Control on School Turnaround

ERIC Educational Resources Information Center

Walston, Bradford

2012-01-01

This research focused on the school turnaround process in six turnaround elementary schools located in urban and rural areas of the state of North Carolina. The purpose of the study was to learn about the challenges facing the six schools, the process of improving student achievement, and, more specifically, the degree to which adaptive leadership…

Sources of Information for Evaluating Rural Development: An Overview.

ERIC Educational Resources Information Center

Grayburn, Laura; And Others

Designed to help rural development evaluators and other social scientists use their bibliographic search time more efficiently, this information guide presents the following: (1) detailed information on computerized information retrieval systems, including name, location, subject matter, turnaround time, cost, availability, and utility…

Introduction of a dermatophyte polymerase chain reaction assay to the diagnostic mycology service in Scotland.

PubMed

Alexander, C L; Shankland, G S; Carman, W; Williams, C

2011-05-01

Dermatophytes are the major cause of superficial mycoses in samples submitted to Clinical Mycology, Glasgow. The most prevalent species is Trichophyton rubrum as identified classically by microscopy and culture. Recent advances in polymerase chain reaction (PCR) technology were examined for the feasibility of introducing a T. rubrum real-time PCR assay into a routine diagnostic service. To improve the diagnostic mycology service by the introduction of a real-time PCR test for T. rubrum. The DNA from 4972 nail and skin samples was obtained using the Qiagen QIAsymphony automated extractor. This DNA was subjected to real-time PCR using T. rubrum-specific primers and a probe. During phase 1 of the study, 862 samples were analysed; 446 of 470 specimens that grew T. rubrum were detected by PCR. Out of 4110 samples analysed during phase 2, 753 T. rubrum infections were diagnosed and reported within 72 h. A total of 3357 samples were negative for a fungal infection by PCR and microscopy; these were also reported within 72 h. A vast reduction in the turnaround times can be achieved using this technique as opposed to classical methods. Samples which are PCR negative but microscopy positive are still subjected to culture. Screening samples for their suitability for PCR prior to processing eliminates the application of PCR for T. rubrum on inappropriate samples such those from the scalp or pityriasis versicolor. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Comparison of direct selective versus nonselective agar media plus LIM broth enrichment for determination of group B streptococcus colonization status in pregnant women.

PubMed

Elsayed, Sameer; Gregson, Daniel B; Church, Deirdre L

2003-06-01

Group B streptococcus (GBS) is the most common cause of early-onset neonatal sepsis in developed countries, and determination of the GBS colonization status in pregnant patients near term is essential for the provision of prophylactic measures to prevent early-onset disease. To determine if GBS recovery rates and/or result turnaround times for vaginal or combined vaginal/rectal swab specimens from pregnant patients near term are enhanced if swabs are inoculated initially onto selective versus nonselective agar media, in addition to the standard Centers for Disease Control and Prevention method. Prospective laboratory analysis. Urban health region/centralized diagnostic microbiology laboratory. Pregnant women presenting for routine obstetrical care and collection of vaginal or combined vaginal/rectal swab specimens for GBS testing at 35 to 37 weeks' gestation. Culture of specimens directly onto selective (5% sheep blood with colistin and nalidixic acid) or nonselective (5% sheep blood) agar media, in addition to LIM broth enrichment and terminal subculture. Group B streptococcus recovery rate and culture result turnaround time. A total of 639 specimens were tested, with 128 (20%) positive for GBS. Sixty-three isolates were recovered on direct agar media at 24 hours, of which 16 (12.5%) were isolated on selective plates only. An additional 38 isolates were recovered at 48 hours from direct plates. Twenty-seven (21.1%) isolates that failed to grow on direct plates were recovered from the LIM broth subculture only. Three (2.3%) isolates not recovered from LIM broths were detected at 48 hours on the direct selective (2 isolates) and nonselective (1 isolate) agar plates. A 24-hour result turnaround time was achieved for 63 (49.2%) and 47 (36.7%) of the 128 culture-positive specimens for direct selective and nonselective plates, respectively (chi2 = 76.63, P <.001). Use of direct selective agar media, in addition to LIM broth enrichment, for the determination of the GBS colonization status in pregnant patients near term results in decreased turnaround time for reporting positive results.

Lean management in academic surgery.

PubMed

Collar, Ryan M; Shuman, Andrew G; Feiner, Sandra; McGonegal, Amy K; Heidel, Natalie; Duck, Mary; McLean, Scott A; Billi, John E; Healy, David W; Bradford, Carol R

2012-06-01

Lean is a management system designed to enhance productivity by eliminating waste. Surgical practice offers many opportunities for improving efficiency. Our objective was to determine whether systematic implementation of lean thinking in an academic otolaryngology operating room improves efficiency and profitability and preserves team morale and educational opportunities. In an 18-month prospective quasi-experimental study, a multidisciplinary task force systematically implemented lean thinking within an otolaryngology operating room of an academic health system. Operating room turnover time and turnaround time were measured during a baseline period; an observer-effect period in which workers were made aware that their efficiency was being measured but before implementing lean changes; and an intervention period after redesign principles had been used. The impact on teamwork, morale, and surgical resident education were measured during the baseline and intervention periods through validated surveys. A profit model was applied to estimate the financial implications of the study. There was no difference between the baseline and observer-effect periods of the study for turnover time (p = 0.98) or turnaround time (p = 0.20). During the intervention period, the mean turnover time and turnaround time were significantly shorter than during the baseline period (29 vs 38 minutes; p < 0.001 and 69 vs 89 minutes; p < 0.001, respectively). The composite morale score suggested improved morale after implementation (p = 0.011). Educational metrics were unchanged before and after implementation. The annual opportunity revenue for the involved operating room is $330,000; when extrapolated throughout the operating rooms, lean thinking could create 6,500 hours of capacity annually. Application of lean management techniques to a single operating room and surgical service improved operating room efficiency and morale, sustained resident education, and can provide considerable financial gains when scaled to an entire academic surgical suite. Copyright © 2012. Published by Elsevier Inc.

Optimal turnaround time for direct identification of microorganisms by mass spectrometry in blood culture.

PubMed

Randazzo, Adrien; Simon, Marc; Goffinet, Pierre; Classen, Jean-François; Hougardy, Nicolas; Pierre, Pascal; Kinzinger, Philippe; Mauel, Etienne; Goffinet, Jean-Sébastien

2016-11-01

During the past few years, several studies describing direct identification of bacteria from blood culture using mass spectrometry have been published. These methods cannot, however, be easily integrated into a common laboratory workflow because of the high hands-on time they require. In this paper, we propose a new method of identification with a short hands-on time and a turnaround time shorter than 15min. Positive blood bottles were homogenised and 600μL of blood were transferred to an Eppendorf tube where 600μL of lysis buffer were added. After homogenisation, a centrifugation step of 4min at 10,500g was performed and the supernatant was discarded. The pellet was then washed and loaded in quadruplicate into wells of a Vitek® MS-DS plate. Each well was covered with a saturated matrix solution and a MALDI-TOF mass spectrometry analysis was performed. Species were identified using the software Myla 3.2.0-2. We analysed 266 positive blood culture bottles. A microorganism grew in 261 cultures, while five bottles remained sterile after 48h of incubation in subculture. Our method reaches a probability of detection at the species level of 77.8% (203/261) with a positive predictive value of 99.5% (202/203). We developed a new method for the identification of microorganisms using mass spectrometry, directly performed from a positive blood culture. This method has short hands-on time and turnaround time and can easily take place in the workflow of a laboratory, with comparable results in performance with other methods reported in the literature. Copyright © 2016 Elsevier B.V. All rights reserved.

An economic analysis for optimal distributed computing resources for mask synthesis and tape-out in production environment

NASA Astrophysics Data System (ADS)

Cork, Chris; Lugg, Robert; Chacko, Manoj; Levi, Shimon

2005-06-01

With the exponential increase in output database size due to the aggressive optical proximity correction (OPC) and resolution enhancement technique (RET) required for deep sub-wavelength process nodes, the CPU time required for mask tape-out continues to increase significantly. For integrated device manufacturers (IDMs), this can impact the time-to-market for their products where even a few days delay could have a huge commercial impact and loss of market window opportunity. For foundries, a shorter turnaround time provides a competitive advantage in their demanding market, too slow could mean customers looking elsewhere for these services; while a fast turnaround may even command a higher price. With FAB turnaround of a mature, plain-vanilla CMOS process of around 20-30 days, a delay of several days in mask tapeout would contribute a significant fraction to the total time to deliver prototypes. Unlike silicon processing, masks tape-out time can be decreased by simply purchasing extra computing resources and software licenses. Mask tape-out groups are taking advantage of the ever-decreasing hardware cost and increasing power of commodity processors. The significant distributability inherent in some commercial Mask Synthesis software can be leveraged to address this critical business issue. Different implementations have different fractions of the code that cannot be parallelized and this affects the efficiency with which it scales, as is described by Amdahl"s law. Very few are efficient enough to allow the effective use of 1000"s of processors, enabling run times to drop from days to only minutes. What follows is a cost aware methodology to quantify the scalability of this class of software, and thus act as a guide to estimating the optimal investment in terms of hardware and software licenses.

Differences in the Policies, Programs, and Practices (PPPs) and Combination of PPPs across Turnaround, Moderately Improving, and Not Improving Schools

ERIC Educational Resources Information Center

Herman, Rebecca; Huberman, Mette

2012-01-01

The TALPS study aims to build on the existing research base to develop promising methodologies to identify chronically low-performing and turnaround schools, as well as to identify promising strategies for turning around chronically low-performing schools. By looking specifically at schools identified as turnaround, in comparison to nonturnaround…

Academic Turnarounds: Restoring Vitality to Challenged American Colleges and Universities. ACE/Praeger Series on Higher Education

ERIC Educational Resources Information Center

MacTaggart, Terrence, Ed.

2007-01-01

This book discusses the early indicators of a college or university's need for a turnaround. It outlines financial trends and other indicators of distress, as well as benchmarks for the various stages of an effective turnaround strategy. The book will help trustees, presidents, and faculty members diagnose whether they are in denial about the true…

78 FR 48464 - Comment request for Information Collection for Quick Turnaround Surveys of All Statutes and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-08

... employment and training or related activities. Each survey will be designed on an ad hoc basis and will focus... basis. ETA will make every effort to coordinate the quick turnaround surveys with other research it is... Collection for Quick Turnaround Surveys of All Statutes and Programs for Which the Employment and Training...

Trace DNA Sampling Success from Evidence Items Commonly Encountered in Forensic Casework.

PubMed

Dziak, Renata; Peneder, Amy; Buetter, Alicia; Hageman, Cecilia

2018-05-01

Trace DNA analysis is a significant part of a forensic laboratory's workload. Knowing optimal sampling strategies and item success rates for particular item types can assist in evidence selection and examination processes and shorten turnaround times. In this study, forensic short tandem repeat (STR) casework results were reviewed to determine how often STR profiles suitable for comparison were obtained from "handler" and "wearer" areas of 764 items commonly submitted for examination. One hundred and fifty-five (155) items obtained from volunteers were also sampled. Items were analyzed for best sampling location and strategy. For casework items, headwear and gloves provided the highest success rates. Experimentally, eyeglasses and earphones, T-shirts, fabric gloves and watches provided the highest success rates. Eyeglasses and latex gloves provided optimal results if the entire surfaces were swabbed. In general, at least 10%, and up to 88% of all trace DNA analyses resulted in suitable STR profiles for comparison. © 2017 American Academy of Forensic Sciences.

Transfer of patients with ST-elevation myocardial infarction for primary percutaneous coronary intervention: a province-wide evaluation of "door-in to door-out" delays at the first hospital.

PubMed

Lambert, Laurie J; Brown, Kevin A; Boothroyd, Lucy J; Segal, Eli; Maire, Sébastien; Kouz, Simon; Ross, Dave; Harvey, Richard; Rinfret, Stéphane; Xiao, Yongling; Nasmith, James; Bogaty, Peter

2014-06-24

Interhospital transfer of patients with ST-elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PPCI) is associated with longer delays to reperfusion, related in part to turnaround ("door in" to "door out," or DIDO) time at the initial hospital. As part of a systematic, province-wide evaluation of STEMI care, we examined DIDO times and associations with patient, hospital, and process-of-care factors. We performed medical chart review for STEMI patients transferred for PPCI during a 6-month period (October 1, 2008, through March 31, 2009) and linked these data to ambulance service databases. Two core laboratory cardiologists reviewed presenting ECGs to identify left bundle-branch block and, in the absence of left bundle-branch block, definite STEMI (according to both cardiologists) or an ambiguous reading. Median DIDO time was 51 minutes (25th to 75th percentile: 35-82 minutes); 14.1% of the 988 patients had a timely DIDO interval (≤30 minutes as recommended by guidelines). The data-to-decision delay was the major contributor to DIDO time. Female sex, more comorbidities, longer symptom duration, arrival by means other than ambulance, arrival at a hospital not exclusively transferring for PPCI, arrival at a center with a low STEMI volume, and an ambiguous ECG were independently associated with longer DIDO time. When turnaround was timely, 70% of patients received timely PPCI (door-to-device time ≤90 minutes) versus 14% if turnaround was not timely (P<0.0001). Benchmark DIDO times for STEMI patients transferred for PPCI were rarely achieved. Interventions aimed at facilitating the transfer decision, particularly in cases of ECGs that are difficult to interpret, are likely to have the best impact on reducing delay to reperfusion. © 2014 American Heart Association, Inc.

An Integrated Gate Turnaround Management Concept Leveraging Big Data Analytics for NAS Performance Improvements

NASA Technical Reports Server (NTRS)

Chung, William W.; Ingram, Carla D.; Ahlquist, Douglas Kurt; Chachad, Girish H.

2016-01-01

"Gate Turnaround" plays a key role in the National Air Space (NAS) gate-to-gate performance by receiving aircraft when they reach their destination airport, and delivering aircraft into the NAS upon departing from the gate and subsequent takeoff. The time spent at the gate in meeting the planned departure time is influenced by many factors and often with considerable uncertainties. Uncertainties such as weather, early or late arrivals, disembarking and boarding passengers, unloading/reloading cargo, aircraft logistics/maintenance services and ground handling, traffic in ramp and movement areas for taxi-in and taxi-out, and departure queue management for takeoff are likely encountered on the daily basis. The Integrated Gate Turnaround Management (IGTM) concept is leveraging relevant historical data to support optimization of the gate operations, which include arrival, at the gate, departure based on constraints (e.g., available gates at the arrival, ground crew and equipment for the gate turnaround, and over capacity demand upon departure), and collaborative decision-making. The IGTM concept provides effective information services and decision tools to the stakeholders, such as airline dispatchers, gate agents, airport operators, ramp controllers, and air traffic control (ATC) traffic managers and ground controllers to mitigate uncertainties arising from both nominal and off-nominal airport gate operations. IGTM will provide NAS stakeholders customized decision making tools through a User Interface (UI) by leveraging historical data (Big Data), net-enabled Air Traffic Management (ATM) live data, and analytics according to dependencies among NAS parameters for the stakeholders to manage and optimize the NAS performance in the gate turnaround domain. The application will give stakeholders predictable results based on the past and current NAS performance according to selected decision trees through the UI. The predictable results are generated based on analysis of the unique airport attributes (e.g., runway, taxiway, terminal, and gate configurations and tenants), and combined statistics from past data and live data based on a specific set of ATM concept-of-operations (ConOps) and operational parameters via systems analysis using an analytic network learning model. The IGTM tool will then bound the uncertainties that arise from nominal and off-nominal operational conditions with direct assessment of the gate turnaround status and the impact of a certain operational decision on the NAS performance, and provide a set of recommended actions to optimize the NAS performance by allowing stakeholders to take mitigation actions to reduce uncertainty and time deviation of planned operational events. An IGTM prototype was developed at NASA Ames Simulation Laboratories (SimLabs) to demonstrate the benefits and applicability of the concept. A data network, using the System Wide Information Management (SWIM)-like messaging application using the ActiveMQ message service, was connected to the simulated data warehouse, scheduled flight plans, a fast-time airport simulator, and a graphic UI. A fast-time simulation was integrated with the data warehouse or Big Data/Analytics (BAI), scheduled flight plans from Aeronautical Operational Control AOC, IGTM Controller, and a UI via a SWIM-like data messaging network using the ActiveMQ message service, illustrated in Figure 1, to demonstrate selected use-cases showing the benefits of the IGTM concept on the NAS performance.

Patient flow improvement for an ophthalmic specialist outpatient clinic with aid of discrete event simulation and design of experiment.

PubMed

Pan, Chong; Zhang, Dali; Kon, Audrey Wan Mei; Wai, Charity Sue Lea; Ang, Woo Boon

2015-06-01

Continuous improvement in process efficiency for specialist outpatient clinic (SOC) systems is increasingly being demanded due to the growth of the patient population in Singapore. In this paper, we propose a discrete event simulation (DES) model to represent the patient and information flow in an ophthalmic SOC system in the Singapore National Eye Centre (SNEC). Different improvement strategies to reduce the turnaround time for patients in the SOC were proposed and evaluated with the aid of the DES model and the Design of Experiment (DOE). Two strategies for better patient appointment scheduling and one strategy for dilation-free examination are estimated to have a significant impact on turnaround time for patients. One of the improvement strategies has been implemented in the actual SOC system in the SNEC with promising improvement reported.

Performance Evaluation of the Sysmex CS-5100 Automated Coagulation Analyzer.

PubMed

Chen, Liming; Chen, Yu

2015-01-01

Coagulation testing is widely applied clinically, and laboratories increasingly demand automated coagulation analyzers with short turn-around times and high-throughput. The purpose of this study was to evaluate the performance of the Sysmex CS-5100 automated coagulation analyzer for routine use in a clinical laboratory. The prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (Fbg), and D-dimer were compared between the Sysmex CS-5100 and Sysmex CA-7000 analyzers, and the imprecision, comparison, throughput, STAT function, and performance for abnormal samples were measured in each. The within-run and between-run coefficients of variation (CV) for the PT, APTT, INR, and D-dimer analyses showed excellent results both in the normal and pathologic ranges. The correlation coefficients between the Sysmex CS-5100 and Sysmex CA-7000 were highly correlated. The throughput of the Sysmex CS-5100 was faster than that of the Sysmex CA-7000. There was no interference at all by total bilirubin concentrations and triglyceride concentrations in the Sysmex CS-5100 analyzer. We demonstrated that the Sysmex CS-5100 performs with satisfactory imprecision and is well suited for coagulation analysis in laboratories processing large sample numbers and icteric and lipemic samples.

The Turnaround Challenge: Why America's Best Opportunity to Dramatically Improve Student Achievement Lies in Our Worst-Performing Schools. Supplement to the Main Report

ERIC Educational Resources Information Center

Calkins, Andrew; Guenther, William; Belfiore, Grace; Lash, Dave

2007-01-01

The turnaround recommendations and framework in "The Turnaround Challenge" grew out of both new research and synthesis of extensive existing research, as carried out by Mass Insight Education & Research Institute and its partners since September 2005. If the main report is the tip of the proverbial iceberg, this supplement represents…

"I've Never Seen People Work So Hard!" Teachers' Working Conditions in the Early Stages of School Turnaround

ERIC Educational Resources Information Center

Cucchiara, Maia Bloomfield; Rooney, Erin; Robertson-Kraft, Claire

2015-01-01

School turnaround--a reform strategy that strives for quick and dramatic transformation of low-performing schools--has gained prominence in recent years. This study uses interviews and focus groups conducted with 86 teachers in 13 schools during the early stages of school turnaround in a large urban district to examine teachers' perceptions of the…

Artificial Neural Network for Total Laboratory Automation to Improve the Management of Sample Dilution.

PubMed

Ialongo, Cristiano; Pieri, Massimo; Bernardini, Sergio

2017-02-01

Diluting a sample to obtain a measure within the analytical range is a common task in clinical laboratories. However, for urgent samples, it can cause delays in test reporting, which can put patients' safety at risk. The aim of this work is to show a simple artificial neural network that can be used to make it unnecessary to predilute a sample using the information available through the laboratory information system. Particularly, the Multilayer Perceptron neural network built on a data set of 16,106 cardiac troponin I test records produced a correct inference rate of 100% for samples not requiring predilution and 86.2% for those requiring predilution. With respect to the inference reliability, the most relevant inputs were the presence of a cardiac event or surgery and the result of the previous assay. Therefore, such an artificial neural network can be easily implemented into a total automation framework to sensibly reduce the turnaround time of critical orders delayed by the operation required to retrieve, dilute, and retest the sample.

[A comparative study of maintenance services using the data-mining technique].

PubMed

Cruz, Antonio M; Aguilera-Huertas, Wilmer A; Días-Mora, Darío A

2009-08-01

The main goal in this research was comparing two hospitals' maintenance service quality. One of them had a contract service; the other one had an in-house maintenance service. The authors followed the next stages when conducting this research: domain understanding, data characterisation and sample reduction, insight characterisation and building the TAT predictor. Multiple linear regression and clustering techniques were used for improving the efficiency of corrective maintenance tasks in a clinical engineering department (CED). The indicator being studied was turnaround time (TAT). The institution having an in-house maintenance service had better quality indicators than the contract maintenance service. There was lineal dependence between availability and service productivity.

Ditching the Disc: The Effects of Cloud-Based Image Sharing on Department Efficiency and Report Turnaround Times in Mammography.

PubMed

Morgan, Matthew B; Young, Elizabeth; Harada, Scott; Winkler, Nicole; Riegert, Joanna; Jones, Tony; Hu, Nan; Stein, Matthew

2017-12-01

In screening mammography, accessing prior examination images is crucial for accurate diagnosis and avoiding false-positives. When women visit multiple institutions for their screens, these "outside" examinations must be retrieved for comparison. Traditionally, prior images are obtained by faxing requests to other institutions and waiting for standard mail (film or CD-ROM), which can greatly delay report turnaround times. Recently, advancements in cloud-based image transfer technology have opened up more efficient options for examination transfer between institutions. The objective of this study was to evaluate the effect of cloud-based image transfer on mammography department workflow, time required to obtain prior images, and report turnaround times. Sixty screening examinations requiring prior images were placed into two groups (30 each). The control group used the standard institutional protocol for requesting prior images: faxing requests and waiting for mailed examinations. The experimental group used a cloud-based transfer for both requesting and receiving examinations. The mean number of days between examination request and examination receipt was measured for both groups and compared. The mean number of days from examination request to receipt was 6.08 days (SD 3.50) in the control group compared with 3.16 days (SD 3.95) in the experimental group. Using a cloud-based image transfer to obtain prior mammograms resulted in an average reduction of 2.92 days (P = .0361; 95% confidence interval 0.20-5.65) between examination request and receipt. This improvement in system efficiency is relevant for interpreting radiologists working to improve reporting times and for patients anxious to receive their mammography results. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Comparison of Three Commercial Online Vendors.

ERIC Educational Resources Information Center

Hoover, Ryan E.

1979-01-01

Compares database update currency, number of hits, elapsed time, number of offline prints or online types, offline print turnaround time, vendor rates, total search cost, and discounted search cost based on vendor discount rates for five simple searches run on three major commercial vendors' online systems. (CWM)

Accelerator mass spectrometry of Strontium-90 for homeland security, environmental monitoring, and human health

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

Tumey, S J; Brown, T A; Hamilton, T F

2008-03-03

Strontium-90 is one of the most hazardous materials managed by agencies charged with protecting the public from radiation. Traditional radiometric methods have been limited by low sample throughput and slow turnaround times. Mass spectrometry offers the advantage of shorter analysis times and the ability to measure samples immediately after processing, however conventional mass spectrometric techniques are susceptible to molecular isobaric interferences that limit their overall sensitivity. In contrast, accelerator mass spectrometry is insensitive to molecular interferences and we have therefore begun developing a method for determination of {sup 90}Sr by accelerator mass spectrometry. Despite a pervasive interference from {sup 90}Zr,more » our initial development has yielded an instrumental background of {approx} 10{sup 8} atoms (75 mBq) per sample. Further refinement of our system (e.g., redesign of our detector, use of alternative target materials) is expected to push the background below 10{sup 6} atoms, close to the theoretical limit for AMS. Once we have refined our system and developed suitable sample preparation protocols, we will utilize our capability in applications to homeland security, environmental monitoring, and human health.« less

BIOSENSORS FOR ENVIRONMENTAL APPLICATIONS

EPA Science Inventory

A review, with 19 references, is given on challenges and possible opportunities for the development of biosensors for environmental monitoring applications. The high cost and slow turnaround times typically associated with the measurement of regulated pollutants clearly indicates...

75 FR 15726 - Comment Request for Information Collection for Quick Turnaround Surveys of the Workforce...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-30

... requested data can be provided in the desired format, reporting burden (time and financial resources) is... respondents can be properly assessed. Currently, the Employment and Training [[Page 15727

The First 90 Days of the New Middle School Principal in a Turnaround School: In-Depth Case Study of the Transition Period (First 90 Days)

ERIC Educational Resources Information Center

Baeza, Marco A.

2010-01-01

This study analyzed skills, strategies, and theories that new middle school principals used to be successful during their transition period (the first 90 days) in turnaround schools. Based on research on transitions, three research questions guided the study: 1. Do middle school principals in a turnaround school situation find the transition…

Improving preanalytic processes using the principles of lean production (Toyota Production System).

PubMed

Persoon, Thomas J; Zaleski, Sue; Frerichs, Janice

2006-01-01

The basic technologies used in preanalytic processes for chemistry tests have been mature for a long time, and improvements in preanalytic processes have lagged behind improvements in analytic and postanalytic processes. We describe our successful efforts to improve chemistry test turnaround time from a central laboratory by improving preanalytic processes, using existing resources and the principles of lean production. Our goal is to report 80% of chemistry tests in less than 1 hour and to no longer recognize a distinction between expedited and routine testing. We used principles of lean production (the Toyota Production System) to redesign preanalytic processes. The redesigned preanalytic process has fewer steps and uses 1-piece flow to move blood samples through the accessioning, centrifugation, and aliquoting processes. Median preanalytic processing time was reduced from 29 to 19 minutes, and the laboratory met the goal of reporting 80% of chemistry results in less than 1 hour for 11 consecutive months.

Software Certification and Software Certificate Management Systems

NASA Technical Reports Server (NTRS)

Denney, Ewen; Fischer, Bernd

2005-01-01

Incremental certification and re-certification of code as it is developed and modified is a prerequisite for applying modem, evolutionary development processes, which are especially relevant for NASA. For example, the Columbia Accident Investigation Board (CAIB) report 121 concluded there is "the need for improved and uniform statistical sampling, audit, and certification processes". Also, re-certification time has been a limiting factor in making changes to Space Shuttle code close to launch time. This is likely to be an even bigger problem with the rapid turnaround required in developing NASA s replacement for the Space Shuttle, the Crew Exploration Vehicle (CEV). Hence, intelligent development processes are needed which place certification at the center of development. If certification tools provide useful information, such as estimated time and effort, they are more likely to be adopted. The ultimate impact of such a tool will be reduced effort and increased reliability.

Analysis of STAT laboratory turnaround times before and after conversion of the hospital information system.

PubMed

Lowe, Gary R; Griffin, Yolanda; Hart, Michael D

2014-08-01

Modern electronic health record systems (EHRS) reportedly offer advantages including improved quality, error prevention, cost reduction, and increased efficiency. This project reviewed the impact on specimen turnaround times (TAT) and percent compliance for specimens processed in a STAT laboratory after implementation of an upgraded EHRS. Before EHRS implementation, laboratory personnel received instruction and training for specimen processing. One laboratory member per shift received additional training. TAT and percent compliance data sampling occurred 4 times monthly for 13 months post-conversion and were compared with the mean of data collected for 3 months pre-conversion. Percent compliance was gauged using a benchmark of reporting 95% of all specimens within 7 min from receipt. Control charts were constructed for TAT and percent compliance with control limits set at 2 SD and applied continuously through the data collection period. TAT recovered to pre-conversion levels by the 6th month post-conversion. Percent compliance consistently returned to pre-conversion levels by the 10th month post-conversion. Statistical analyses revealed the TAT were significantly longer for 3 months post-conversion (P < .001) compared with pre-conversion levels. Statistical significance was not observed for subsequent groups. Percent compliance results were significantly lower for 6 months post-conversion (P < .001). Statistical significance was not observed for subsequent groups. Extensive efforts were made to train and prepare personnel for challenges expected after the EHRS upgrade. Specific causes identified with the upgraded EHRS included multiple issues involving personnel and the EHRS. These data suggest that system and user issues contributed to delays in returning to pre-conversion TAT and percent compliance levels following the upgrade in the EHRS.

Evaluation of the impact of a total automation system in a large core laboratory on turnaround time.

PubMed

Lou, Amy H; Elnenaei, Manal O; Sadek, Irene; Thompson, Shauna; Crocker, Bryan D; Nassar, Bassam

2016-11-01

Growing financial and workload pressures on laboratories coupled with user demands for faster turnaround time (TAT) has steered the implementation of total laboratory automation (TLA). The current study evaluates the impact of a complex TLA on core laboratory efficiency through the analysis of the In-lab to Report TAT (IR-TAT) for five representative tests based on the different requested priorities. Mean, median and outlier percentages (OP) for IR-TAT were determined following TLA implementation and where possible, compared to the pre-TLA era. The shortest mean IR-TAT via the priority lanes of the TLA was 22min for Complete Blood Count (CBC), followed by 34min, 39min and 40min for Prothrombin time (PT), urea and potassium testing respectively. The mean IR-TAT for STAT CBC loaded directly on to the analyzers was 5min shorter than that processed via the TLA. The mean IR-TATs for both STAT potassium and urea via offline centrifugation were comparable to that processed by the TLA. The longest mean IR-TAT via regular lanes of the TLA was 62min for Thyroid-Stimulating Hormone (TSH) while the shortest was 17min for CBC. All parameters for IR-TAT for CBC and PT tests decreased significantly post- TLA across all requested priorities in particular the outlier percentage (OP) at 30 and 60min. TLA helps to efficiently manage substantial volumes of samples across all requested priorities. Manual processing for small STAT volumes, at both the initial centrifugation stage and front loading directly on to analyzers, is however likely to yield the shortest IR-TAT. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day-zero...) Package Services mail accepted at origin before the day-zero Critical Entry Time is 3 days, for each... Center (NDC) Package Services mail accepted at origin before the day-zero Critical Entry Time is 4 days...

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day-zero Critical Entry Time... origin before the day-zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... before the day-zero Critical Entry Time is 5 days for each remaining 3-digit ZIP Code origin-destination...

Mobile Healthcare System for Health Checkups and Telemedicine in Post-Disaster Situations.

PubMed

Hu, Min; Sugimoto, Megumi; Hargrave, Andrew Rebeiro; Nohara, Yasunobu; Moriyama, Michiko; Ahmed, Ashir; Shimizu, Shuji; Nakashima, Naoki

2015-01-01

Portable Healthcare Clinic (PHC) is a mobile healthcare system comprising of medical sensors and health assessment criteria. It has been applied in Bangladesh for the last two years as a pilot program to identify non-communicable diseases. In this study, we adapted PHC to fit post-disaster conditions. The PHC health assessment criteria are redesigned to deal with emergency cases and healthcare worker insufficiency. A new algorithm makes an initial assessment of age, symptoms, and whether the person is seeing a doctor. These changes will make the turn-around time shorter and will enable reaching the most affected patients better. We tested the operability and turn-around time of the adapted system at the debris flow disaster shelters in Hiroshima, Japan. Changing the PHC health assessment criteria and other solutions such as a list of medicine preparation makes the PHC system switch into an emergency mode more smoothly following a natural disaster.

Performance evaluation of a particle-enhanced turbidimetric cystatin C assay on the Abbott ci8200 analyzer.

PubMed

Flodin, Mats; Larsson, Anders

2009-06-01

Glomerular filtration rate (GFR) is widely accepted as the best overall measure of kidney function. Cystatin C is a novel endogenous GFR marker that has been shown to be superior to creatinine for estimation of GFR in several studies. There is a need for cystatin C assays adapted to routine chemistry instrument to minimize turnaround times and allowing 24 h/day availability. We have evaluated a new cystatin C assay developed for Architect cSystem (Abbott Laboratories, Abbott Park, IL, USA). The cystatin C assay showed good agreement with the corresponding assay from Dade Behring (Deerfield, IL, USA). The assay has a very low total imprecision and a good linearity. The new cystatin C assay is an interesting alternative to current cystatin C assays. On an Architect cSystem the assay can be performed with the same turnaround times and availability as creatinine.

National Combustion Code: Parallel Implementation and Performance

NASA Technical Reports Server (NTRS)

Quealy, A.; Ryder, R.; Norris, A.; Liu, N.-S.

2000-01-01

The National Combustion Code (NCC) is being developed by an industry-government team for the design and analysis of combustion systems. CORSAIR-CCD is the current baseline reacting flow solver for NCC. This is a parallel, unstructured grid code which uses a distributed memory, message passing model for its parallel implementation. The focus of the present effort has been to improve the performance of the NCC flow solver to meet combustor designer requirements for model accuracy and analysis turnaround time. Improving the performance of this code contributes significantly to the overall reduction in time and cost of the combustor design cycle. This paper describes the parallel implementation of the NCC flow solver and summarizes its current parallel performance on an SGI Origin 2000. Earlier parallel performance results on an IBM SP-2 are also included. The performance improvements which have enabled a turnaround of less than 15 hours for a 1.3 million element fully reacting combustion simulation are described.

Collaborative School Turnaround: A Study of the Impact of School Federations on Student Outcomes

ERIC Educational Resources Information Center

Chapman, Christopher; Muijs, Daniel

2013-01-01

School federations are groups of two or more schools operating under a single governance structure. The study reported in this article compared federations designed to raise performance in low-attaining schools against a matched sample of their non-federated counterparts. The findings are based on quantitative analysis of data collected in…

Investing in Development: Six High-Performing, High-Poverty Schools Implement the Massachusetts Teacher Evaluation Policy

ERIC Educational Resources Information Center

Reinhorn, Stefanie K.; Johnson, Susan Moore; Simon, Nicole S.

2017-01-01

We studied how six high-performing, high-poverty schools in one large Massachusetts city implemented the state's new teacher evaluation policy. The sample includes traditional, turnaround, restart, and charter schools, each of which had received the state's highest accountability rating. We sought to learn how these successful schools approached…

Off the Clock: What More Time Can (and Can't) Do for School Turnarounds. Education Sector Reports

ERIC Educational Resources Information Center

Silva, Elena

2012-01-01

If less time in the classroom is a cause of poor student performance, can adding more time be the cure? This strategy underlies a major effort to fix the nation's worst public schools. Billions of federal stimulus dollars are being spent to expand learning time on behalf of disadvantaged children. And extended learning time (ELT) is being proposed…

Effect of ADAMTS13 activity turnaround time on plasma utilization for suspected thrombotic thrombocytopenic purpura.

PubMed

Connell, Nathan T; Cheves, Tracey; Sweeney, Joseph D

2016-02-01

Thrombotic thrombocytopenic purpura (TTP) due to deficiency of the von Willebrand-cleaving protease ADAMTS13 is a hematologic emergency that requires prompt initiation of therapeutic plasma exchange (TPE). Long turnaround times (TATs) have precluded the use of pre-TPE measurement of ADAMTS13 activity for the initial diagnosis in most institutions. An in-house rapid TAT (r-TAT) assay for ADAMTS13 activity was implemented after 18 months of validation. In a quasi-experimental design using interrupted time series analysis, patterns of plasma utilization in patients with suspected TTP were assessed after implementation of this assay for ADAMTS13 activity and compared to utilization patterns for patients who received plasma exchange before r-TAT assay implementation designated the standard TAT period. In the 18 months after implementation of the r-TAT ADAMTS13 assay, there was a significant reduction in plasma utilization per patient suspected of having TTP (mean, 144.5 units vs. 63.3 units of plasma per patients suspected of having TTP; p = 0.002). The mean number of exchanges per patient and mean number of exchanges after achieving a platelet count of at least 150 × 10(9) /L were lower in the r-TAT cohort (p < 0.001 for both). There was no significant difference in 30-day mortality. Implementation of a rapid turnaround assay for ADAMTS13 resulted in a significant reduction in plasma utilization for patients with suspected TTP, without an increase in mortality. This study demonstrates that these data, provided in a timely fashion, can avoid unnecessary plasma exchange in patients who do not have TTP. © 2015 AABB.

Rectal swab sampling followed by an enrichment culture-based real-time PCR assay to detect Salmonella enterocolitis in children.

PubMed

Lin, L-H; Tsai, C-Y; Hung, M-H; Fang, Y-T; Ling, Q-D

2011-09-01

Although routine bacterial culture is the traditional reference standard method for the detection of Salmonella infection in children with diarrhoea, it is a time-consuming procedure that usually only gives results after 3-4 days. Some molecular detection methods can improve the turn-around time to within 24 h, but these methods are not applied directly from stool or rectal swab specimens as routine diagnostic methods for the detection of gastrointestinal pathogens. In this study, we tested the feasibility of a bacterial enrichment culture-based real-time PCR assay method for detecting and screening for diarrhoea in children caused by Salmonella. Our results showed that the minimum real-time PCR assay time required to detect enriched bacterial culture from a swab was 3 h. In all children with suspected Salmonella diarrhoea, the enrichment culture-based real-time PCR achieved 85.4% sensitivity and 98.1% specificity, as compared with the 53.7% sensitivity and 100% specificity of detection with the routine bacterial culture method. We suggest that rectal swab sampling followed by enrichment culture-based real-time PCR is suitable as a rapid method for detecting and screening for Salmonella in paediatric patients. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Nuclear Magnetic Resonance Spectroscopy-Based Identification of Yeast.

PubMed

Himmelreich, Uwe; Sorrell, Tania C; Daniel, Heide-Marie

2017-01-01

Rapid and robust high-throughput identification of environmental, industrial, or clinical yeast isolates is important whenever relatively large numbers of samples need to be processed in a cost-efficient way. Nuclear magnetic resonance (NMR) spectroscopy generates complex data based on metabolite profiles, chemical composition and possibly on medium consumption, which can not only be used for the assessment of metabolic pathways but also for accurate identification of yeast down to the subspecies level. Initial results on NMR based yeast identification where comparable with conventional and DNA-based identification. Potential advantages of NMR spectroscopy in mycological laboratories include not only accurate identification but also the potential of automated sample delivery, automated analysis using computer-based methods, rapid turnaround time, high throughput, and low running costs.We describe here the sample preparation, data acquisition and analysis for NMR-based yeast identification. In addition, a roadmap for the development of classification strategies is given that will result in the acquisition of a database and analysis algorithms for yeast identification in different environments.

Physician Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 81 Institutions.

PubMed

McCall, Shannon J; Souers, Rhona J; Blond, Barbara; Massie, Larry

2016-10-01

-Assessment of customer satisfaction is a vital component of the laboratory quality improvement program. -To survey the level of physician satisfaction with hospital clinical laboratory services. -Participating institutions provided demographic information and survey results of physician satisfaction, with specific features of clinical laboratory services individually rated on a scale of 5 (excellent) to 1 (poor). -Eighty-one institutions submitted 2425 surveys. The median overall satisfaction score was 4.2 (10th percentile, 3.6; 90th percentile, 4.6). Of the 16 surveyed areas receiving the highest percentage of excellent/good ratings (combined scores of 4 and 5), quality of results was highest along with test menu adequacy, staff courtesy, and overall satisfaction. Of the 4 categories receiving the lowest percentage values of excellent/good ratings, 3 were related to turnaround time for inpatient "STAT" (tests performed immediately), outpatient STAT, and esoteric tests. The fourth was a new category presented in this survey: ease of electronic order entry. Here, 11.4% (241 of 2121) of physicians assigned below-average (2) or poor (1) scores. The 5 categories deemed most important to physicians included quality of results, turnaround times for inpatient STAT, routine, and outpatient STAT tests, and clinical report format. Overall satisfaction as measured by physician willingness to recommend their laboratory to another physician remains high at 94.5% (2160 of 2286 respondents). -There is a continued trend of high physician satisfaction and loyalty with clinical laboratory services. Physician dissatisfaction with ease of electronic order entry represents a new challenge. Test turnaround times are persistent areas of dissatisfaction, representing areas for improvement.

Implementation and optimization of automated dispensing cabinet technology.

PubMed

McCarthy, Bryan C; Ferker, Michael

2016-10-01

A multifaceted automated dispensing cabinet (ADC) optimization initiative at a large hospital is described. The ADC optimization project, which was launched approximately six weeks after activation of ADCs in 30 patient care unit medication rooms of a newly established adult hospital, included (1) adjustment of par inventory levels (desired on-hand quantities of medications) and par reorder quantities to reduce the risk of ADC supply exhaustion and improve restocking efficiency, (2) expansion of ADC "common stock" (medications assigned to ADC inventories) to increase medication availability at the point of care, and (3) removal of some infrequently prescribed medications from ADCs to reduce the likelihood of product expiration. The purpose of the project was to address organizational concerns regarding widespread ADC medication stockouts, growing reliance on cart-fill medication delivery systems, and suboptimal medication order turnaround times. Leveraging of the ADC technology platform's reporting functionalities for enhanced inventory control yielded a number of benefits, including cost savings resulting from reduced pharmacy technician labor requirements (estimated at $2,728 annually), a substantial reduction in the overall weekly stockout percentage (from 3.2% before optimization to 0.5% eight months after optimization), an improvement in the average medication turnaround time, and estimated cost avoidance of $19,660 attributed to the reduced potential for product expiration. Efforts to optimize ADCs through par level optimization, expansion of common stock, and removal of infrequently used medications reduced pharmacy technician labor, decreased stockout percentages, generated opportunities for cost avoidance, and improved medication turnaround times. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Preanalytical influence of pneumatic tube delivery system on results of routine biochemistry and haematology analysis.

PubMed

Petit, Morgane; Mine, Louis; Pascreau, Tiffany; Brouzes, Chantal; Majoux, Sandrine; Borgel, Delphine; Beaudeux, Jean-Louis; Lasne, Dominique; Hennequin, Carole

2017-12-01

Pneumatic tube delivery system (PTS) enables to reduce considerably turnaround times. The aim of the study was to assess the influence of the PTS on the quality of routine biochemical and hematological tests in our laboratory. Blood samples from 6 hospitalized patients and 8 healthy volunteers were analyzed. Blood samples were delivered to the laboratory by a PTS and by a human courier. We performed the following analysis: ionized calcium, sodium, potassium, lactate deshydrogenase (LDH), aspartate aminotransferase (ASAT), arterial blood gas, complete blood count and coagulation test as prothrombin time, activated partial thromboplastin time, factors V and VIII. Results were compared between the both method of transport according to the recommendation of the Société française de biologie clinique and the French committee for accreditation (SH-GTA01, norme NF ISO 5275-6). The hemolysis index of plasma was similar between the groups and no morphological differences were found on blood cells. For three samples, when delivered by PTS, LDH levels (two samples) and neutrophil polynuclear count (one sample) were above the recommended guidelines compared to those delivered by courier. Conversely, LDH levels and FVIII were below in two samples delivered by PTS. LDH levels, PNN count or factor VIII can be affected by PTS without the clinical interpretation being modified. We concluded that the PTS can be used to transport blood samples for routine biochemical and hematological analysis in our hospital.

WINCADRE (COMPUTER-AIDED DATA REVIEW AND EVALUATION)

EPA Science Inventory

WinCADRE (Computer-Aided Data Review and Evaluation) is a Windows -based program designed for computer-assisted data validation. WinCADRE is a powerful tool which significantly decreases data validation turnaround time. The electronic-data-deliverable format has been designed ...

How do hospital professionals involved in a randomised controlled trial perceive the value of genotyping vs. PCR-ribotyping for control of hospital acquired C. difficile infections?

PubMed Central

2014-01-01

Background Despite scientific advances in typing of C. difficile strains very little is known about how hospital staff use typing results during periods of increased incidence (PIIs). This qualitative study, undertaken alongside a randomised controlled trial (RCT), explored this issue. The trial compared ribotyping versus more rapid genotyping (MLVA or multilocus variable repeat analysis) and found no significant difference in post 48 hour cases (C difficile transmissions). Methods In-depth qualitative interviews with senior staff in 11/16 hospital trusts in the trial (5 MLVA and 6 Ribotyping). Semi-structured interviews were conducted at end of the trial period. Transcripts were content analysed using framework analysis supported by NVivo-8 software. Common sub-themes were extracted by two researchers independently. These were compared and organised into over-arching categories or ‘super-ordinate themes’. Results The trial recorded that 45% of typing tests had some impact on infection control (IC) activities. Interviews indicated that tests had little impact on initial IC decisions. These were driven by hospital protocols and automatically triggered when a PII was identified. To influence decision-making, a laboratory turnaround time < 3 days (ideally 24 hours) was suggested; MLVA turnaround time was 5.3 days. Typing results were predominantly used to modify initiated IC activities such as ward cleaning, audits of practice or staff training; major decisions (e.g. ward closure) were unaffected. Organisational factors could limit utilisation of MLVA results. Results were twice as likely to be reported as ‘aiding management’ (indirect benefit) than impacting on IC activities (direct effect). Some interviewees considered test results provided reassurance about earlier IC decisions; others identified secondary benefits on organisational culture. An underlying benefit of improved discrimination provided by MLVA typing was the ability to explore epidemiology associated with CDI cases in a hospital more thoroughly. Conclusions Ribotyping and MLVA are both valued by users. MLVA had little additional direct impact on initial infection control decisions. This would require reduced turnaround time. The major impact is adjustments to earlier IC measures and retrospective reassurance. For this, turnaround time is less important than discriminatory power. The potential remains for wider use of genotyping to examine transmission routes. PMID:24656142

Development and application of two independent real-time PCR assays to detect clinically relevant Mucorales species.

PubMed

Springer, Jan; Goldenberger, Daniel; Schmidt, Friderike; Weisser, Maja; Wehrle-Wieland, Elisabeth; Einsele, Hermann; Frei, Reno; Löffler, Jürgen

2016-03-01

PCR-based detection of Mucorales species could improve diagnosis of suspected invasive fungal infection, leading to a better patient outcome. This study describes two independent probe-based real-time PCR tests for detection of clinically relevant Mucorales, targeting specific fragments of the 18S and the 28S rRNA genes. Both assays have a short turnaround time, allow fast, specific and very sensitive detection of clinically relevant Mucorales and have the potential to be used as quantitative tests. They were validated on various clinical samples (fresh and formalin-fixed paraffin-embedded specimens, mainly biopsies, n = 17). The assays should be used as add-on tools to complement standard techniques; a combined approach of both real-time PCR assays has 100 % sensitivity. Genus identification by subsequent sequencing is possible for amplicons of the 18S PCR assay. In conclusion, combination of the two independent Mucorales assays described in this study, 18S and 28S, detected all clinical samples associated with proven Mucorales infection (n = 10). Reliable and specific identification of Mucorales is a prerequisite for successful antifungal therapy as these fungi show intrinsic resistance to voriconazole and caspofungin.

A Software Engineering Paradigm for Quick-turnaround Earth Science Data Projects

NASA Astrophysics Data System (ADS)

Moore, K.

2016-12-01

As is generally the case with applied sciences professional and educational programs, the participants of such programs can come from a variety of technical backgrounds. In the NASA DEVELOP National Program, the participants constitute an interdisciplinary set of backgrounds, with varying levels of experience with computer programming. DEVELOP makes use of geographically explicit data sets, and it is necessary to use geographic information systems and geospatial image processing environments. As data sets cover longer time spans and include more complex sets of parameters, automation is becoming an increasingly prevalent feature. Though platforms such as ArcGIS, ERDAS Imagine, and ENVI facilitate the batch-processing of geospatial imagery, these environments are naturally constricting to the user in that they limit him or her to the tools that are available. Users must then turn to "homemade" scripting in more traditional programming languages such as Python, JavaScript, or R, to automate workflows. However, in the context of quick-turnaround projects like those in DEVELOP, the programming learning curve may be prohibitively steep. In this work, we consider how to best design a software development paradigm that addresses two major constants: an arbitrarily experienced programmer and quick-turnaround project timelines.

Kuss Middle School: Expanding Time to Accelerate School Improvement

ERIC Educational Resources Information Center

Massachusetts 2020, 2012

2012-01-01

In 2004, Kuss Middle School became the first school declared "Chronically Underperforming" by the state of Massachusetts. But by 2010, Kuss had transformed itself into a model for schools around the country seeking a comprehensive turnaround strategy. Kuss is using increased learning time as the primary catalyst to accelerate learning,…

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day zero Critical Entry Time... origin before the day zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... intra-Network Distribution Center (NDC) Standard Mail pieces accepted at origin before the day-zero...

39 CFR 121.3 - Standard Mail.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Facility (SCF) turnaround Standard Mail® pieces accepted at origin before the day zero Critical Entry Time... origin before the day zero Critical Entry Time is 4 days when the OPD&C/F and the ADC are the same... intra-Network Distribution Center (NDC) Standard Mail pieces accepted at origin before the day-zero...

Comparison of a real-time PCR method with a culture method for the detection of Salmonella enterica serotype enteritidis in naturally contaminated environmental samples from integrated poultry houses.

PubMed

Lungu, Bwalya; Waltman, W Douglas; Berghaus, Roy D; Hofacre, Charles L

2012-04-01

Conventional culture methods have traditionally been considered the "gold standard" for the isolation and identification of foodborne bacterial pathogens. However, culture methods are labor-intensive and time-consuming. A Salmonella enterica serotype Enteritidis-specific real-time PCR assay that recently received interim approval by the National Poultry Improvement Plan for the detection of Salmonella Enteritidis was evaluated against a culture method that had also received interim National Poultry Improvement Plan approval for the analysis of environmental samples from integrated poultry houses. The method was validated with 422 field samples collected by either the boot sock or drag swab method. The samples were cultured by selective enrichment in tetrathionate broth followed by transfer onto a modified semisolid Rappaport-Vassiliadis medium and then plating onto brilliant green with novobiocin and xylose lysine brilliant Tergitol 4 plates. One-milliliter aliquots of the selective enrichment broths from each sample were collected for DNA extraction by the commercial PrepSEQ nucleic acid extraction assay and analysis by the Salmonella Enteritidis-specific real-time PCR assay. The real-time PCR assay detected no significant differences between the boot sock and drag swab samples. In contrast, the culture method detected a significantly higher number of positive samples from boot socks. The diagnostic sensitivity of the real-time PCR assay for the field samples was significantly higher than that of the culture method. The kappa value obtained was 0.46, indicating moderate agreement between the real-time PCR assay and the culture method. In addition, the real-time PCR method had a turnaround time of 2 days compared with 4 to 8 days for the culture method. The higher sensitivity as well as the reduction in time and labor makes this real-time PCR assay an excellent alternative to conventional culture methods for diagnostic purposes, surveillance, and research studies to improve food safety.

Quantitation of Staphylococcus aureus in Seawater Using CHROMagar™ SA

PubMed Central

Pombo, David; Hui, Jennifer; Kurano, Michelle; Bankowski, Matthew J; Seifried, Steven E

2010-01-01

A microbiological algorithm has been developed to analyze beach water samples for the determination of viable colony forming units (CFU) of Staphylococcus aureus (S. aureus). Membrane filtration enumeration of S. aureus from recreational beach waters using the chromogenic media CHROMagar™SA alone yields a positive predictive value (PPV) of 70%. Presumptive CHROMagar™SA colonies were confirmed as S. aureus by 24-hour tube coagulase test. Combined, these two tests yield a PPV of 100%. This algorithm enables accurate quantitation of S. aureus in seawater in 72 hours and could support risk-prediction processes for recreational waters. A more rapid protocol, utilizing a 4-hour tube coagulase confirmatory test, enables a 48-hour turnaround time with a modest false negative rate of less than 10%. PMID:20222490

Case Studies of Schools Receiving School Improvement Grants. Final Report. NCEE 2016-4002

ERIC Educational Resources Information Center

Le Floch, Kerstin Carlson; O'Day, Jennifer; Birman, Beatrice; Hurlburt, Steven; Nayfack, Michelle; Halloran, Clare; Boyle, Andrea; Brown, Seth; Mercado-Garcia, Diana; Goff, Rose; Rosenberg, Linda; Hulsey, Lara

2016-01-01

The Study of School Turnaround (SST) examines the change process in a diverse, purposive sample of schools receiving federal School Improvement Grants (SIG) from 2010-11 to 2012-13. With the passage of the American Recovery and Reinvestment Act of 2009 (ARRA), the SIG program underwent three major shifts. First, ARRA boosted total SIG funding in…

A rapid single-tube protocol for HAV detection by nested real-time PCR.

PubMed

Hu, Yuan; Arsov, Ivica

2014-09-01

Infections by food-borne viruses such as hepatitis A virus (HAV) and norovirus are significant public health concerns worldwide. Since food-borne viruses are rarely confirmed through direct isolation from contaminated samples, highly sensitive molecular techniques remain the methods of choice for the detection of viral genetic material. Our group has previously developed a specific nested real-time PCR (NRT-PCR) assay for HAV detection that improved overall sensitivity. Furthermore in this study, we have developed a single-tube NRT-PCR approach for HAV detection in food samples that reduces the likelihood of cross contamination between tubes during sample manipulation. HAV RNA was isolated from HAV-spiked food samples and HAV-infected cell cultures. All reactions following HAV RNA isolation, including conventional reverse transcriptase PCR, nested-PCR, and RT-PCR were performed in a single tube. Our results demonstrated that all the samples tested positive by RT-PCR and nested-PCR were also positive by a single-tube NRT-PCR. The detection limits observed for HAV-infected cell cultures and HAV-spiked green onions were 0.1 and 1 PFU, respectively. This novel method retained the specificity and robustness of the original NRT-PCR method, while greatly reducing sample manipulation, turnaround time, and the risk of carry-over contamination. Single-tube NRT-PCR thus represents a promising new tool that can potentially facilitate the detection of HAV in foods thereby improving food safety and public health.

EURADOS intercomparison on emergency radiobioassay.

PubMed

Li, Chunsheng; Battisti, Paolo; Berard, Philippe; Cazoulat, Alain; Cuellar, Antonio; Cruz-Suarez, Rodolfo; Dai, Xiongxin; Giardina, Isabella; Hammond, Derek; Hernandez, Carolina; Kiser, Stephen; Ko, Raymond; Kramer-Tremblay, Sheila; Lecompte, Yannick; Navarro, Eva; Navas, Cristina; Sadi, Baki; Sierra, Inmaculada; Verrezen, Freddy; Lopez, Maria A

2015-12-01

Nine laboratories participated in an intercomparison exercise organised by the European Radiation Dosimetry Group (EURADOS) for emergency radiobioassay involving four high-risk radionuclides ((239)Pu, (241)Am, (90)Sr and (226)Ra). Diverse methods of analysis were used by the participating laboratories for the in vitro determination of each of the four radionuclides in urine samples. Almost all the methods used are sensitive enough to meet the requirements for emergency radiobioassay derived for this project in reference to the Clinical Decision Guide introduced by the NCRP. Results from most of the methods meet the requirements of ISO 28218 on accuracy in terms of relative bias and relative precision. However, some technical gaps have been identified. For example, some laboratories do not have the ability to assay samples containing (226)Ra, and sample turnaround time would be expected to be much shorter than that reported by many laboratories, as timely results for internal contamination and early decisions on medical intervention are highly desired. Participating laboratories are expected to learn from each other on the methods used to improve the interoperability among these laboratories. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Anatomy of a public health agency turnaround: the case of the general health district in Mahoning County.

PubMed

Honoré, Peggy A; Stefanak, Matthew; Dessens, Scott

2012-01-01

A turnaround describes an organization's ability to recover from successive periods of decline. Current and projected declines in US economic conditions continue to place local public health departments at risk of fiscal exigency. This examination focused on turnaround methodologies used by a local public health department to reverse successive periods of operational and financial declines. Illustrations are provided on the value added by implementing financial ratio and trend analysis in addition to using evidence-based private sector turnaround strategies of retrenchment, repositioning, and reorganization. Evidence has shown how the financial analysis and strategies aided in identifying operational weakness and set in motion corrective measures. The Public Health Uniform Data System is introduced along with a list of standards offered for mainstreaming these and other routine stewardship practices to diagnose, predict, and prevent agency declines.

Temperature-Modulated Array High-Performance Liquid Chromatography

PubMed Central

Premstaller, Andreas; Xiao, Wenzhong; Oberacher, Herbert; O'Keefe, Matthew; Stern, David; Willis, Thomas; Huber, Christian G.; Oefner, Peter J.

2001-01-01

Using novel monolithic poly(styrene-divinylbenzene) capillary columns with an internal diameter of 0.2 mm, we demonstrate for the first time the feasibility of constructing high-performance liquid chromatography arrays for the detection of mutations by heteroduplex analysis under partially denaturing conditions. In one embodiment, such an array can be used to analyze one sample simultaneously at different temperatures to maximize the detection of mutations in DNA fragments containing multiple discrete melting domains. Alternatively, one may inject different samples onto columns kept at the same effective temperature. Further improvements in throughput can be obtained by means of laser-induced fluorescence detection and the differential labeling of samples with up to four different fluorophores. Major advantages of monolithic capillary high-performance liquid chromatographic arrays over their capillary electrophoretic analogs are the chemical inertness of the poly(styrene-divinylbenzene) stationary phase, the physical robustness of the column bed due to its covalent linkage to the inner surface of the fused silica capillary, and the feasibility to modify the stationary phase thereby allowing the separation of compounds not only on the principle of size exclusion, but also adsorption, distribution, and ion exchange. Analyses times are on the order of a few minutes and turnaround time is extremely short as there is no need for the replenishment of the separation matrix between runs. PMID:11691859

Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi.

PubMed

Palchaudhuri, Sonali; Tweya, Hannock; Hosseinipour, Mina

2014-06-01

The 2011 Malawi HIV guidelines promote CD4 monitoring for pre-ART assessment and considering HIVRNA monitoring for ART response assessment, while some clinics used CD4 for both. We assessed clinical ordering practices as compared to guidelines, and determined whether the samples were successfully and promptly processed. We conducted a retrospective review of all patients seen in from August 2010 through July 2011,, in two urban HIV-care clinics that utilized 6-monthly CD4 monitoring regardless of ART status. We calculated the percentage of patients on whom clinicians ordered CD4 or HIVRNA analysis. For all samples sent, we determined rates of successful lab-processing, and mean time to returned results. Of 20581 patients seen, 8029 (39%) had at least one blood draw for CD4 count. Among pre-ART patients, 2668/2844 (93.8%) had CD4 counts performed for eligibility. Of all CD4 samples sent, 8082/9207 (89%) samples were successfully processed. Of those, mean time to processing was 1.6 days (s.d 1.5) but mean time to results being available to clinician was 9.3 days (s.d. 3.7). Regarding HIVRNA, 172 patients of 17737 on ART had a blood draw and only 118/213 (55%) samples were successfully processed. Mean processing time was 39.5 days (s.d. 21.7); mean time to results being available to clinician was 43.1 days (s.d. 25.1). During the one-year evaluated, there were multiple lapses in processing HIVRNA samples for up to 2 months. Clinicians underutilize CD4 and HIVRNA as monitoring tools in HIV care. Laboratory processing failures and turnaround times are unacceptably high for viral load analysis. Alternative strategies need to be considered in order to meet laboratory monitoring needs.

Rapid identification of bacteria from positive blood culture bottles by use of matrix-assisted laser desorption-ionization time of flight mass spectrometry fingerprinting.

PubMed

Christner, Martin; Rohde, Holger; Wolters, Manuel; Sobottka, Ingo; Wegscheider, Karl; Aepfelbacher, Martin

2010-05-01

Early and adequate antimicrobial therapy has been shown to improve the clinical outcome in bloodstream infections (BSI). To provide rapid pathogen identification for targeted treatment, we applied matrix-assisted laser desorption-ionization time of flight (MALDI-TOF) mass spectrometry fingerprinting to bacteria directly recovered from blood culture bottles. A total of 304 aerobic and anaerobic blood cultures, reported positive by a Bactec 9240 system, were subjected in parallel to differential centrifugation with subsequent mass spectrometry fingerprinting and reference identification using established microbiological methods. A representative spectrum of bloodstream pathogens was recovered from 277 samples that grew a single bacterial isolate. Species identification by direct mass spectrometry fingerprinting matched reference identification in 95% of these samples and worked equally well for aerobic and anaerobic culture bottles. Application of commonly used score cutoffs to classify the fingerprinting results led to an identification rate of 87%. Mismatching mostly resulted from insufficient bacterial numbers and preferentially occurred with Gram-positive samples. The respective spectra showed low concordance to database references and were effectively rejected by score thresholds. Spiking experiments and examination of the respective study samples even suggested applicability of the method to mixed cultures. With turnaround times around 100 min, the approach allowed for reliable pathogen identification at the day of blood culture positivity, providing treatment-relevant information within the critical phase of septic illness.

Transforming Schools through Expanded Learning Time: Orchard Gardens K-8 Pilot School. Update 2013

ERIC Educational Resources Information Center

Chan, Roy

2013-01-01

For years, Orchard Gardens K-8 Pilot School was plagued by low student achievement and high staff turnover. Then, in 2010, with an expanded school schedule made possible through federal funding, Orchard Gardens began a remarkable turnaround. Today, the school is demonstrating how increased learning time, combined with other key turnaround…

WINCADRE INORGANIC (WINDOWS COMPUTER-AIDED DATA REVIEW AND EVALUATION)

EPA Science Inventory

WinCADRE (Computer-Aided Data Review and Evaluation) is a Windows -based program designed for computer-assisted data validation. WinCADRE is a powerful tool which significantly decreases data validation turnaround time. The electronic-data-deliverable format has been designed in...

Overset Grid Methods Applied to Nonlinear Potential Flows

NASA Technical Reports Server (NTRS)

Holst, Terry; Kwak, Dochan (Technical Monitor)

2000-01-01

The objectives of this viewgraph presentation are to develop Chimera-based potential methodology which is compatible with overflow and overflow infrastructure, creating options for an advanced problem solving environment and to significantly reduce turnaround time for aerodynamic analysis and design (primarily cruise conditions).

Geo-referenced digital data acquisition and processing system using LiDAR technology.

DOT National Transportation Integrated Search

2006-02-01

LiDAR technology, introduced in the late 90s, has received wide acceptance in airborne surveying as a leading : tool for obtaining high-quality surface data at decimeter-level vertical accuracy in an unprecedentedly short : turnaround time. State-of-...

The use of vouchers in HIV prevention, referral treatment, and care for young MSM and young transgender people in Dhaka, Bangladesh: experience from ‘HIM’ initiative

PubMed Central

Oyewale, Tajudeen O.; Ahmed, Shale; Ahmed, Farid; Tazreen, Mona; Uddin, Ziya; Rahman, Anisur; Oyediran, Kola A.

2016-01-01

Introduction The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15–24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%. Methods Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services. Results and discussion A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections. Conclusion The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services. PMID:26945145

The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes.

PubMed

Petrides, Athena K; Bixho, Ida; Goonan, Ellen M; Bates, David W; Shaykevich, Shimon; Lipsitz, Stuart R; Landman, Adam B; Tanasijevic, Milenko J; Melanson, Stacy E F

2017-03-01

- A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). - To determine the impact of an interfaced EHR-LIS on laboratory processes. - We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. - The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. - An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

Performance evaluation of the Abbott RealTime HCV Genotype II for hepatitis C virus genotyping.

PubMed

Sohn, Yong-Hak; Ko, Sun-Young; Kim, Myeong Hee; Oh, Heung-Bum

2010-04-01

The Abbott RealTime hepatitis C virus (HCV) Genotype II (Abbott Molecular Inc.) for HCV genotyping, which uses real-time PCR technology, has recently been developed. Accuracy and sensitivity of detection were assessed using the HCV RNA PHW202 performance panel (SeraCare Life Sciences). Consistency with restriction fragment mass polymorphism (RFMP) data, cross-reactivity with other viruses, and the ability to detect minor strains in mixtures of genotypes 1 and 2 were evaluated using clinical samples. All performance panel viruses were correctly genotyped at levels of >500 IU/mL. Results were 100% concordant with RFMP genotypic data (66/66). However, 5% (3/66) of the samples examined displayed probable genotypic cross reactivity. No cross reactivity with other viruses was evident. Minor strains in the mixtures were not effectively distinguished, even at quantities higher than the detection limit. The Abbott RealTime HCV Genotype II assay was very accurate and yielded results consistent with RFMP data. Although the assay has the advantages of automation and short turnaround time, we suggest that further improvements are necessary before it is used routinely in clinical practice. Efforts are needed to decrease cross reactivity among genotypes and to improve the ability to detect minor genotypes in mixed infections.

A new multiplex real-time PCR test for HSV1/2 and syphilis: an evaluation of its impact in the laboratory and clinical setting.

PubMed

Scott, Laura Jane; Gunson, Rory N; Carman, William F; Winter, Andrew J

2010-12-01

To develop, evaluate and implement a new multiplex real-time PCR test for the detection of herpes simplex virus (HSV)1, HSV2 and syphilis in a single sample using a single test. A multiplex real-time PCR test detecting HSV1, HSV2 and Treponema pallidum was designed, validated and evaluated for a period of 6 months on patients attending the Sandyford Initiative (a series of genitourinary medicine clinics in and around Glasgow). A total of 692 samples were tested, and T pallidum PCR positives were confirmed by a second PCR at the Scottish Reference Laboratory (SBSTIRL). All PCR results were aligned with dark ground microscopy findings and serological results where available and compared. The laboratory validation of the multiplex assay showed the test to be sensitive, specific and robust. Of the 692 samples, 139 were positive for HSV1, 136 for HSV2, 15 for syphilis, one for both syphilis and HSV1, and 401 were negative; the reference laboratory confirmed all T pallidum PCR-positive samples. The PCR test was more sensitive than both dark ground microscopy and serological testing for the diagnosis of primary syphilis. The introduction of this new test has led to a better turnaround time for the diagnosis of genital ulcer disease, better detection of primary syphilis infection, and the detection of unexpected cases of syphilis where the aetiological agent suspected was HSV.

Evaluation of Ion Torrent sequencing technology for rapid clinical human leucocyte antigen typing.

PubMed

Guerra, Sandra G; Chong, Winnie; Brown, Colin J; Navarrete, Cristina V

2018-06-05

The development of techniques to define the human leucocyte antigen (HLA) region has proven to be challenging due to its high level of polymorphism. Within a clinical laboratory, a technique for high-resolution HLA typing, which is rapid and cost effective is essential. NGS has provided a rapid, high-resolution HLA typing solution, which has reduced the number of HLA ambiguities seen with other typing methods. In this study, the One Lambda NXType NGS kit was tested on the Ion Torrent PGM platform. A total of 362 registry donors from four ethnic populations (Europeans, South Asians, Africans and Chinese) were NGS HLA typed across 9-loci (HLA-A, -B, -C, -DRB1,-DRB345 -DQB1 and -DPB1). Concordance rates of 91%-98% were obtained (for HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1) when compared to historical PCR-SSO HLA types, and the identification of uncommon alleles such as A*24:07:01 and C*04:82 were observed. A turnaround time of four days was achieved for typing 44 samples. However, some limitations were observed; primer locations did not allow all ambiguities to be resolved for HLA Class II where Exon I and IV amplification are needed (HLA-DRB1*04:07:01/04:92, HLA-DRB1*09:01:02/*09:21 and HLA-DRB1*12:01:01/*12:10). This study has demonstrated high-resolution typing by NGS can be achieved in an acceptable turnaround time for a clinical laboratory; however, the Ion Torrent workflow has some technical limitations that should be addressed. © 2018 John Wiley & Sons Ltd.

The effects of total laboratory automation on the management of a clinical chemistry laboratory. Retrospective analysis of 36 years.

PubMed

Sarkozi, Laszlo; Simson, Elkin; Ramanathan, Lakshmi

2003-03-01

Thirty-six years of data and history of laboratory practice at our institution has enabled us to follow the effects of analytical automation, then recently pre-analytical and post-analytical automation on productivity, cost reduction and enhanced quality of service. In 1998, we began the operation of a pre- and post-analytical automation system (robotics), together with an advanced laboratory information system to process specimens prior to analysis, deliver them to various automated analytical instruments, specimen outlet racks and finally to refrigerated stockyards. By the end of 3 years of continuous operation, we compared the chemistry part of the system with the prior 33 years and quantitated the financial impact of the various stages of automation. Between 1965 and 2000, the Consumer Price Index increased by a factor of 5.5 in the United States. During the same 36 years, at our institution's Chemistry Department the productivity (indicated as the number of reported test results/employee/year) increased from 10,600 to 104,558 (9.3-fold). When expressed in constant 1965 dollars, the total cost per test decreased from 0.79 dollars to 0.15 dollars. Turnaround time for availability of results on patient units decreased to the extent that Stat specimens requiring a turnaround time of <1 h do not need to be separately prepared or prioritized on the system. Our experience shows that the introduction of a robotics system for perianalytical automation has brought a large improvement in productivity together with decreased operational cost. It enabled us to significantly increase our workload together with a reduction of personnel. In addition, stats are handled easily and there are benefits such as safer working conditions and improved sample identification, which are difficult to quantify at this stage.

Case Studies of Schools Receiving School Improvement Grants: Findings after the First Year of Implementation. NCEE 2014-4015

ERIC Educational Resources Information Center

Le Floch, Kerstin Carlson; Birman, Beatrice; O'Day, Jennifer; Hurlburt, Steven; Mercado-Garcia, Diana; Goff, Rose; Manship, Karen; Brown, Seth; Therriault, Susan Bowles; Rosenberg, Linda; Angus, Megan Hague; Hulsey, Lara

2014-01-01

The Study of School Turnaround examines the improvement process in a purposive sample of 35 case study schools receiving federal School Improvement Grants (SIG) over a three-year period (2010-11 to 2012-13 school years). Using site visit, teacher survey, and fiscal data, the case studies describe the school contexts, the principals' leadership…

Computer Networking with the Victorian Correspondence School.

ERIC Educational Resources Information Center

Conboy, Ian

During 1985 the Education Department installed two-way radios in 44 remote secondary schools in Victoria, Australia, to improve turn-around time for correspondence assignments. Subsequently, teacher supervisors at Melbourne's Correspondence School sought ways to further augument audio interactivity with computer networking. Computer equipment was…

Reengineering the laboratory: strategic process and systems innovation to improve performance. Recreating our role on the health-care team.

PubMed

Johnson, E

1995-01-01

The author describes reengineering efforts in the laboratory of a 550-bed hospital. Key benefits include reduced costs, improved turnaround time, and redirection of staff into new roles in information management and outreach.

Novel molecular diagnostic tools for malaria elimination: a review of options from the point of view of high-throughput and applicability in resource limited settings.

PubMed

Britton, Sumudu; Cheng, Qin; McCarthy, James S

2016-02-16

As malaria transmission continues to decrease, an increasing number of countries will enter pre-elimination and elimination. To interrupt transmission, changes in control strategies are likely to require more accurate identification of all carriers of Plasmodium parasites, both symptomatic and asymptomatic, using diagnostic tools that are highly sensitive, high throughput and with fast turnaround times preferably performed in local health service settings. Currently available immunochromatographic lateral flow rapid diagnostic tests and field microscopy are unlikely to consistently detect infections at parasite densities less than 100 parasites/µL making them insufficiently sensitive for detecting all carriers. Molecular diagnostic platforms, such as PCR and LAMP, are currently available in reference laboratories, but at a cost both financially and in turnaround time. This review describes the recent progress in developing molecular diagnostic tools in terms of their capacity for high throughput and potential for performance in non-reference laboratories for malaria elimination.

Accurate Detection of Streptococcus pyogenes at the Point of Care Using the cobas Liat Strep A Nucleic Acid Test.

PubMed

Wang, Fangnian; Tian, Yu; Chen, Lingjun; Luo, Robert; Sickler, Joanna; Liesenfeld, Oliver; Chen, Shuqi

2017-10-01

The performance of a polymerase chain reaction-based point-of-care assay, the cobas Strep A Nucleic Acid Test for use on the cobas Liat System (cobas Liat Strep A assay), for the detection of group A Streptococcus bacteria was evaluated in primary care settings. Throat swab specimens from 427 patients were tested with the cobas Liat Strep A assay and a rapid antigen detection test (RADT) by existing medical staff at 5 primary care clinics, and results were compared with bacterial culture. The cobas Liat Strep A assay demonstrated equivalent sensitivity (97.7%) and specificity (93.3%) to reference culture with a 15-minute turnaround time. In comparison to RADTs, the cobas Liat Strep A assay showed improved sensitivity (97.7% Liat vs 84.5% RADT). The Clinical Laboratory Improvement Amendments-waived cobas Liat Strep A assay demonstrated the ease of use and improved turnaround time of RADTs along with the sensitivity of culture.

Development of a new protocol for rapid bacterial identification and susceptibility testing directly from urine samples.

PubMed

Zboromyrska, Y; Rubio, E; Alejo, I; Vergara, A; Mons, A; Campo, I; Bosch, J; Marco, F; Vila, J

2016-06-01

The current gold standard method for the diagnosis of urinary tract infections (UTI) is urine culture that requires 18-48 h for the identification of the causative microorganisms and an additional 24 h until the results of antimicrobial susceptibility testing (AST) are available. The aim of this study was to shorten the time of urine sample processing by a combination of flow cytometry for screening and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for bacterial identification followed by AST directly from urine. The study was divided into two parts. During the first part, 675 urine samples were processed by a flow cytometry device and a cut-off value of bacterial count was determined to select samples for direct identification by MALDI-TOF-MS at ≥5 × 10(6) bacteria/mL. During the second part, 163 of 1029 processed samples reached the cut-off value. The sample preparation protocol for direct identification included two centrifugation and two washing steps. Direct AST was performed by the disc diffusion method if a reliable direct identification was obtained. Direct MALDI-TOF-MS identification was performed in 140 urine samples; 125 of the samples were positive by urine culture, 12 were contaminated and 3 were negative. Reliable direct identification was obtained in 108 (86.4%) of the 125 positive samples. AST was performed in 102 identified samples, and the results were fully concordant with the routine method among 83 monomicrobial infections. In conclusion, the turnaround time of the protocol described to diagnose UTI was about 1 h for microbial identification and 18-24 h for AST. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Digital Baseband Architecture For Transponder

NASA Technical Reports Server (NTRS)

Nguyen, Tien M.; Yeh, Hen-Geul

1995-01-01

Proposed advanced transponder for long-distance radio communication system with turnaround ranging contains carrier-signal-tracking loop including baseband digital "front end." For reduced cost, transponder includes analog intermediate-frequency (IF) section and analog automatic gain control (AGC) loop at first of two IF mixers. However, second IF mixer redesigned to ease digitization of baseband functions. To conserve power and provide for simpler and smaller transponder hardware, baseband digital signal-processing circuits designed to implement undersampling scheme. Furthermore, sampling scheme and sampling frequency chosen so redesign involves minimum modification of command-detector unit (CDU).

KRAS detection in colonic tumors by DNA extraction from FTA paper: the molecular touch-prep.

PubMed

Petras, Melissa L; Lefferts, Joel A; Ward, Brian P; Suriawinata, Arief A; Tsongalis, Gregory J

2011-12-01

DNA isolated from formalin-fixed paraffin-embedded (FFPE) tissue is usually more degraded and contains more polymerase chain reaction (PCR) inhibitors than DNA isolated from nonfixed tissue. In addition, the tumor size and cellular heterogeneity found in tissue sections can often impact testing for molecular biomarkers. As a potential remedy to this situation, we evaluated the use of Whatman FTA paper cards for collection of colorectal tumor samples before tissue fixation and for isolation of DNA for use in a real-time PCR-based KRAS mutation assay. Eleven colon tumor samples were collected by making a cut into the fresh tumor and applying the Whatman FTA paper to the cut surface. Matched FFPE tissue blocks from these tumors were also collected for comparison. KRAS mutation analysis was carried out using the Applied Biosystems 7500 Fast Real-time PCR System using 7 independent custom TaqMan PCR assays. Of the 11 colon tumors sampled, 6 were positive for KRAS mutations in both the Whatman FTA paper preparations and corresponding FFPE samples. Whatman FTA paper cards for collection of colorectal tumor samples before tissue fixation and for isolation of DNA have many advantages including ease of use, intrinsic antimicrobial properties, long storage potential (stability of DNA over time), and a faster turnaround time for results. Extracted DNA should be suitable for most molecular diagnostic assays that use PCR techniques. This novel means of DNA preservation from surgical specimens would benefit from additional study and validation as a dependable and practical technique to preserve specimens for molecular testing.

DB4US: A Decision Support System for Laboratory Information Management.

PubMed

Carmona-Cejudo, José M; Hortas, Maria Luisa; Baena-García, Manuel; Lana-Linati, Jorge; González, Carlos; Redondo, Maximino; Morales-Bueno, Rafael

2012-11-14

Until recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. To develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. We propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. DB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. The proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources.

34. BOILER HOUSE, COAL CONVEYOR AND TURNAROUND TRACK FOR COAL ...

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

34. BOILER HOUSE, COAL CONVEYOR AND TURN-AROUND TRACK FOR COAL CARS (NOTE: COAL CAR No. 6 IN FAR BACK GROUND) - Delaware County Electric Company, Chester Station, Delaware River at South end of Ward Street, Chester, Delaware County, PA

Prenatal diagnosis of i(18q) and dup(18q) cases by quantitative fluorescent PCR

PubMed Central

Castro-Volio, Isabel; Ortíz-Morales, Fernando; Valle-Bourrouet, Luisa; Malespín-Bendaña, Wendy

2013-01-01

Particular sonographic fetal malformations are common in chromosome 18 aberrations, requiring invasive prenatal tests to confirm the diagnosis. Karyotyping is the gold standard assay in these cases, although it is a high complexity, expensive and approximately 2 weeks turnaround time test. On the contrary, quantitative fluorescent PCR is considered an accurate, simple, low cost and rapid assay, particularly useful for the diagnosis of aneuploidies of chromosomes 13, 18 and 21 and for the detection of maternal cell contamination of the sample. Clinical presentation of two cases of rare chromosome 18 defects, diagnosed using both techniques. One case was an isochromosome and the other was a partial duplication. Quantitative fluorescent PCR was an invaluable tool for the cytogenetics laboratory PMID:24045756

Microsatellite Imputation for parental verification from SNP across multiple Bos taurus and indicus breeds

USDA-ARS?s Scientific Manuscript database

Microsatellite markers (MS) have traditionally been used for parental verification and are still the international standard in spite of their higher cost, error rate, and turnaround time compared with Single Nucleotide Polymorphisms (SNP)-based assays. Despite domestic and international demands fro...

Implementation of Peer-Reviewed Homework Assignments

ERIC Educational Resources Information Center

Zare, Richard N.; Cox, Charles T., Jr.; Murphy, Katherine; Bayas, Camille

2017-01-01

In large, introductory courses, instructors and teaching assistants often struggle to provide detailed feedback on student homework in a timely manner. Here we describe a peer-reviewed homework system that provides quick turnaround while offering flexibility in the construction of homework problems. Homework is administered through a cycle, which…

Real-time PCR assay in differentiating Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii infections in Orang Asli settlements in Malaysia.

PubMed

Lau, Yee Ling; Anthony, Claudia; Fakhrurrazi, Siti Aminah; Ibrahim, Jamaiah; Ithoi, Init; Mahmud, Rohela

2013-08-28

Amebiasis caused by Entamoeba histolytica is the third leading cause of death worldwide. This pathogenic amoeba is morphologically indistinguishable from E. dispar and E. moshkovskii, the non-pathogenic species. Polymerase chain reaction is the current method of choice approved by World Health Organization. Real-time PCR is another attractive molecular method for diagnosis of infectious diseases as post-PCR analyses are eliminated and turnaround times are shorter. The present work aimed to compare the results of Entamoeba species identification using the real-time assay against the established nested PCR method. In this study, a total of 334 human faecal samples were collected from different Orang Asli settlements. Faecal samples were processed by direct wet smear and formalin ethyl acetate concentration methods followed by iodine staining and was microscopically examined for Entamoeba species and other intestinal parasites. Microscopically positive samples were then subject to nested PCR and real-time PCR. The overall prevalence of Entamoeba infection was 19.5% (65/334). SK Posh Piah recorded highest Entamoeba prevalence (63.3%) while Kampung Kemensah had the lowest prevalence (3.7%) of Entamoeba. Microscopically positive samples were then tested by real-time PCR and nested PCR for the presence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii infection. Real-time PCR showed higher Entamoeba detection (86.2%) compared to nested PCR (80%), although the McNemar test value showed no significant difference between the two methods (p = 0.221). This study is the first in Malaysia to report the use of real-time PCR in identifying and differentiating the three Entamoeba infections. It is also proven to be more effective compared to the conventional nested PCR molecular method.

Real-time PCR assay in differentiating Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii infections in Orang Asli settlements in Malaysia

PubMed Central

2013-01-01

Background Amebiasis caused by Entamoeba histolytica is the third leading cause of death worldwide. This pathogenic amoeba is morphologically indistinguishable from E. dispar and E. moshkovskii, the non-pathogenic species. Polymerase chain reaction is the current method of choice approved by World Health Organization. Real-time PCR is another attractive molecular method for diagnosis of infectious diseases as post-PCR analyses are eliminated and turnaround times are shorter. The present work aimed to compare the results of Entamoeba species identification using the real-time assay against the established nested PCR method. Methods In this study, a total of 334 human faecal samples were collected from different Orang Asli settlements. Faecal samples were processed by direct wet smear and formalin ethyl acetate concentration methods followed by iodine staining and was microscopically examined for Entamoeba species and other intestinal parasites. Microscopically positive samples were then subject to nested PCR and real-time PCR. Results The overall prevalence of Entamoeba infection was 19.5% (65/334). SK Posh Piah recorded highest Entamoeba prevalence (63.3%) while Kampung Kemensah had the lowest prevalence (3.7%) of Entamoeba. Microscopically positive samples were then tested by real-time PCR and nested PCR for the presence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii infection. Real-time PCR showed higher Entamoeba detection (86.2%) compared to nested PCR (80%), although the McNemar test value showed no significant difference between the two methods (p = 0.221). Conclusions This study is the first in Malaysia to report the use of real-time PCR in identifying and differentiating the three Entamoeba infections. It is also proven to be more effective compared to the conventional nested PCR molecular method. PMID:23985047

Utilization of stat test priority in the clinical laboratory: a College of American Pathologists q-probes study of 52 institutions.

PubMed

Volmar, Keith E; Wilkinson, David S; Wagar, Elizabeth A; Lehman, Christopher M

2013-02-01

Utilization of stat testing priority is a balance between safe, efficient patient management and resource expenditure. To determine the rate of stat testing, compare rates among institutions, and determine the distribution of turnaround time expectations for different turnaround time priorities. During a 7-day period, participants prospectively determined the total number of chemistry, hematology, and coagulation billable tests from inpatients and emergency department patients. Among these, the total numbers of billable tests performed stat were identified. Laboratories also reported the levels of test priority they offered and turnaround expectations for each level of test priority. Fifty institutions submitted data for the study, with 2 additional participants submitting partial results. Participants identified 639 589 chemistry, hematology, and coagulation billable tests, with 229 896 (35.9%) performed stat. The stat rate varied from 21.3% at the 10th percentile to 55.4% at the 90th percentile, with a median of 37.0% of participants' tests performed stat. Laboratories include a mean of 206 tests in chemistry, hematology, and coagulation test menus, with 67% of these tests offered stat. The fraction of the test menu offered stat varied from 29.0% at the 10th percentile to 97.8% at the 90th percentile, with a median of 73.3% of tests on the menu offered stat. The most common number of testing priorities offered by participating laboratories was 3 (44.2%). Among the 52 participating laboratories, the median stat testing rate was 37.0% and a median 73.3% of the test menu was offered stat.

Response rate, response time, and economic costs of survey research: A randomized trial of practicing pharmacists.

PubMed

Hardigan, Patrick C; Popovici, Ioana; Carvajal, Manuel J

2016-01-01

There is a gap between increasing demands from pharmacy journals, publishers, and reviewers for high survey response rates and the actual responses often obtained in the field by survey researchers. Presumably demands have been set high because response rates, times, and costs affect the validity and reliability of survey results. Explore the extent to which survey response rates, average response times, and economic costs are affected by conditions under which pharmacist workforce surveys are administered. A random sample of 7200 U.S. practicing pharmacists was selected. The sample was stratified by delivery method, questionnaire length, item placement, and gender of respondent for a total of 300 observations within each subgroup. A job satisfaction survey was administered during March-April 2012. Delivery method was the only classification showing significant differences in response rates and average response times. The postal mail procedure accounted for the highest response rates of completed surveys, but the email method exhibited the quickest turnaround. A hybrid approach, consisting of a combination of postal and electronic means, showed the least favorable results. Postal mail was 2.9 times more cost effective than the email approach and 4.6 times more cost effective than the hybrid approach. Researchers seeking to increase practicing pharmacists' survey participation and reduce response time and related costs can benefit from the analytical procedures tested here. Copyright © 2016 Elsevier Inc. All rights reserved.

A rapid, highly sensitive and culture-free detection of pathogens from blood by positive enrichment.

PubMed

Vutukuru, Manjula Ramya; Sharma, Divya Khandige; Ragavendar, M S; Schmolke, Susanne; Huang, Yiwei; Gumbrecht, Walter; Mitra, Nivedita

2016-12-01

Molecular diagnostics is a promising alternative to culture based methods for the detection of bloodstream infections, notably due to its overall lower turnaround time when starting directly from patient samples. Whole blood is usually the starting diagnostic sample in suspected bloodstream infections. The detection of low concentrations of pathogens in blood using a molecular assay necessitates a fairly high starting volume of blood sample in the range of 5-10mL. This large volume of blood sample has a substantial accompanying human genomic content that interferes with pathogen detection. In this study, we have established a workflow using magnetic beads coated with Apolipoprotein H that makes it possible to concentrate pathogens from a 5.0mL whole blood sample, thereby enriching pathogens from whole blood background and also reducing the sample volume to ~200μL or less. We have also demonstrated that this method of enrichment allows detection of 1CFU/mL of Escherichia coli, Enterococcus gallinarum and Candida tropicalis from 5mL blood using quantitative PCR; a detection limit that is not possible in unenriched samples. The enrichment method demonstrated here took 30min to complete and can be easily integrated with various downstream molecular and microbiological techniques. Copyright © 2016 Elsevier B.V. All rights reserved.

Specimen Collection and Submission Manual

DTIC Science & Technology

2016-06-01

immunoassays Specimen: tissue or bone marrow (100 mg); Whole EDTA blood or serum (0.5 ml) Nasopharyngeal or throat swab, dry or in transport medium; Sputum... Syndrome Coronavirus (MERS-CoV) – detection in clinical samples Methodology: molecular Specimen: If possible collect 3 specimen types (lower...guidelines-clinical-specimens.html) Shipping: ship cold on wet ice or ice packs. For delays exceeding 72 hours, ship frozen on dry ice. Turnaround: 1-2

Building Teacher Capacity to Support English Language Learners in Schools Receiving School Improvement Grants. NCEE Evaluation Brief. NCEE 2015-4004

ERIC Educational Resources Information Center

Boyle, Andrea; Golden, Laura; Le Floch, Kerstin Carlson; O'Day, Jennifer; Harris, Barbara; Wissel, Sarah

2014-01-01

The Study of School Turnaround examines the improvement process in a purposive sample of 35 case study schools receiving federal funds through the School Improvement Grants (SIG) program over a three-year period (2010-11 to 2012-13 school years). This brief focuses on 11 of these SIG schools with high proportions of English Language Learner (ELL)…

A Focused Look at Schools Receiving School Improvement Grants That Have Percentages of English Language Learner Students. NCEE Evaluation Brief. NCEE 2014-4014

ERIC Educational Resources Information Center

Golden, Laura; Harris, Barbara; Mercado-Garcia, Diana; Boyle, Andrea; Le Floch, Kerstin Carlson; O'Day, Jennifer

2014-01-01

The Study of School Turnaround examines the improvement process in a purposive sample of 35 case study schools receiving federal funds through the School Improvement Grants (SIG) program over a three-year period (2010-11 to 2012-13 school years). This evaluation brief focuses on 11 of these SIG schools with high proportions of English Language…

A Focused Look at Rural Schools Receiving School Improvement Grants. NCEE Evaluation Brief. NCEE 2014-4013

ERIC Educational Resources Information Center

Rosenberg, Linda; Christianson, Megan Davis; Angus, Megan Hague; Rosenthal, Emily

2014-01-01

The Study of School Turnaround is a set of case studies of the school improvement process in a purposive sample of 35 schools receiving federal funds through the School Improvement Grants (SIG) program over a three-year period (school years 2010-11 to 2012-13). This evaluation brief focuses on the nine SIG schools that were in rural areas and how…

76 FR 13136 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... design; (3) analyze the impact of receipt of RTT funds on student outcomes using an interrupted time series design; and (4) investigate the relationship between STM turnaround models (and strategies within...-performing schools. The evaluation is designed to (1) study the implementation of RTT and SIG; (2) analyze...

75 FR 78230 - Notice of Proposed Information Collection Requests

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... discontinuity design; (3) analyze the impact of receipt of RTT funds on student outcomes using an interrupted time series design; and (4) investigate the relationship between STM turnaround models (and strategies... (STMs) in the lowest-performing schools. The evaluation is designed to (1) study the implementation of...

How to get parts out of prison (without paperwork).

PubMed

Brown, K

1998-11-01

This article describes the business relationship between a manufacturing company and a vendor that is a minimum-security correctional facility. In particular, it describes a set of revisions in the purchasing and delivery process that reduced the amount of paperwork substantially and also reduced the turnaround time.

75 FR 74024 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... purpose of the Study of School Turnaround is to document over time the intervention models, approaches... with school principals, district administrators and state officials; site visits to case study schools... study team will conduct in-depth case studies over three years, and two sets of 10 ``special topics...

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

39 CFR 121.4 - Package Services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

Turning Schools around

ERIC Educational Resources Information Center

Johnson, Sabrina

2011-01-01

Schools across the country are seeking creative ways to meet the high demands of school accountability. For example, in Montgomery (AL) Public Schools, "turnaround specialists" work at the direction of the local system's board of education. The district decided to treat turnaround specialists as partners who work with school principals…

Mixing Metaphors: Building Infrastructure for Large Scale School Turnaround

ERIC Educational Resources Information Center

Peurach, Donald J.; Neumerski, Christine M.

2015-01-01

The purpose of this analysis is to increase understanding of the possibilities and challenges of building educational infrastructure--the basic, foundational structures, systems, and resources--to support large-scale school turnaround. Building educational infrastructure often exceeds the capacity of schools, districts, and state education…

Process configuration of Liquid-nitrogen Energy Storage System (LESS) for maximum turnaround efficiency

NASA Astrophysics Data System (ADS)

Dutta, Rohan; Ghosh, Parthasarathi; Chowdhury, Kanchan

2017-12-01

Diverse power generation sector requires energy storage due to penetration of variable renewable energy sources and use of CO2 capture plants with fossil fuel based power plants. Cryogenic energy storage being large-scale, decoupled system with capability of producing large power in the range of MWs is one of the options. The drawback of these systems is low turnaround efficiencies due to liquefaction processes being highly energy intensive. In this paper, the scopes of improving the turnaround efficiency of such a plant based on liquid Nitrogen were identified and some of them were addressed. A method using multiple stages of reheat and expansion was proposed for improved turnaround efficiency from 22% to 47% using four such stages in the cycle. The novelty here is the application of reheating in a cryogenic system and utilization of waste heat for that purpose. Based on the study, process conditions for a laboratory-scale setup were determined and presented here.

A comparison between the efficiency of the Xpert MTB/RIF assay and nested PCR in identifying Mycobacterium tuberculosis during routine clinical practice.

PubMed

Kim, Cheol-Hong; Woo, Heungjeong; Hyun, In Gyu; Kim, Changhwan; Choi, Jeong-Hee; Jang, Seung-Hun; Park, Sang Myeon; Kim, Dong-Gyu; Lee, Myung Goo; Jung, Ki-Suck; Hyun, Jeongwon; Kim, Hyun Soo

2014-06-01

Polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis (MTB) is more sensitive, specific, and rapid than the conventional methods of acid-fast bacilli (AFB) smear and culture. The aim of this study was to determine if the Xpert MTB/rifampicin (RIF) assay had additional advantages over nested PCR for the detection of MTB in a geographical area with intermediate tuberculosis (TB) incidence. Between February and December 2013, the Xpert MTB/RIF assay and MTB nested PCR, as well as AFB smear and culture, were simultaneously performed on 198 clinical samples (160 pulmonary and 38 non-pulmonary specimens) collected from 171 patients hospitalized at Hallym University Medical Center for possible TB. The accuracy of the diagnosis of MTB culture-positive TB and the turnaround time of reporting laboratory results were calculated and compared. Rifampin resistance by the Xpert MTB/RIF assay was reviewed with that of conventional drug susceptibility testing (DST). The sensitivity, specificity, and positive and negative predictive values of the Xpert MTB/RIF assay and MTB nested PCR for diagnosis of MTB culture-positive pulmonary TB were 86.1% vs. 69.4% (P=0.1563), 97.8% vs. 94.1% (P=0.2173), 91.2% vs. 75.8% (P=0.1695), and 96.4% vs. 92.0% (P=0.2032), respectively. The median turnaround times of the Xpert MTB/RIF assay and MTB nested PCR were 0 [0-4] days and 4 [1-11] days, respectively (P<0.001). Two cases of rifampin resistance, as determined by the Xpert MTB/RIF assay, were found to be multi-drug resistant (MDR) pulmonary TB by DST. The Xpert MTB/RIF assay seemed to be sensitive, specific, and comparable to nested PCR for identifying MTB among clinically suspected TB patients, and the assay can be valuable in giving a timely identification of resistance to rifampin.

Nonpreemptive run-time scheduling issues on a multitasked, multiprogrammed multiprocessor with dependencies, bidimensional tasks, folding and dynamic graphs

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

Miller, Allan Ray

1987-05-01

Increases in high speed hardware have mandated studies in software techniques to exploit the parallel capabilities. This thesis examines the effects a run-time scheduler has on a multiprocessor. The model consists of directed, acyclic graphs, generated from serial FORTRAN benchmark programs by the parallel compiler Parafrase. A multitasked, multiprogrammed environment is created. Dependencies are generated by the compiler. Tasks are bidimensional, i.e., they may specify both time and processor requests. Processor requests may be folded into execution time by the scheduler. The graphs may arrive at arbitrary time intervals. The general case is NP-hard, thus, a variety of heuristics aremore » examined by a simulator. Multiprogramming demonstrates a greater need for a run-time scheduler than does monoprogramming for a variety of reasons, e.g., greater stress on the processors, a larger number of independent control paths, more variety in the task parameters, etc. The dynamic critical path series of algorithms perform well. Dynamic critical volume did not add much. Unfortunately, dynamic critical path maximizes turnaround time as well as throughput. Two schedulers are presented which balance throughput and turnaround time. The first requires classification of jobs by type; the second requires selection of a ratio value which is dependent upon system parameters. 45 refs., 19 figs., 20 tabs.« less

Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

PubMed

Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

2012-11-01

To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Single-pair fluorescence resonance energy transfer analysis of mRNA transcripts for highly sensitive gene expression profiling in near real time.

PubMed

Peng, Zhiyong; Young, Brandon; Baird, Alison E; Soper, Steven A

2013-08-20

Expression analysis of mRNAs transcribed from certain genes can be used as important sources of biomarkers for in vitro diagnostics. While the use of reverse transcription quantitative PCR (RT-qPCR) can provide excellent analytical sensitivity for monitoring transcript numbers, more sensitive approaches for expression analysis that can report results in near real-time are needed for many critical applications. We report a novel assay that can provide exquisite limits-of-quantitation and consists of reverse transcription (RT) followed by a ligase detection reaction (LDR) with single-pair fluorescence resonance energy transfer (spFRET) to provide digital readout through molecular counting. For this assay, no PCR was employed, which enabled short assay turnaround times. To facilitate implementation of the assay, a cyclic olefin copolymer (COC) microchip, which was fabricated using hot embossing, was employed to carry out the LDR in a continuous flow format with online single-molecule detection following the LDR. As demonstrators of the assay's utility, MMP-7 mRNA was expression profiled from several colorectal cancer cell lines. It was found that the RT-LDR/spFRET assay produced highly linear calibration plots even in the low copy number regime. Comparison to RT-qPCR indicated a better linearity over the low copy number range investigated (10-10,000 copies) with an R(2) = 0.9995 for RT-LDR/spFRET and R(2) = 0.98 for RT-qPCR. In addition, differentiating between copy numbers of 10 and 50 could be performed with higher confidence using RT-LDR/spFRET. To demonstrate the short assay turnaround times obtainable using the RT-LDR/spFRET assay, a two thermal cycle LDR was carried out on amphiphysin gene transcripts that can serve as important diagnostic markers for ischemic stroke. The ability to supply diagnostic information on possible stroke events in short turnaround times using RT-LDR/spFRET will enable clinicians to treat patients effectively with appropriate time-sensitive therapeutics.

Single-Pair Fret Analysis of mRNA Transcripts for Highly Sensitive Gene Expression Profiling in Near Real Time

PubMed Central

Peng, Zhiyong; Young, Brandon; Baird, Alison E.; Soper, Steven A.

2013-01-01

Expression analysis of mRNAs transcribed from certain genes can be used as important sources of biomarkers for in vitro diagnostics. While the use of reverse transcription quantitative PCR (RT-qPCR) can provide excellent analytical sensitivity for monitoring transcript numbers, more sensitive approaches for expression analysis that can report results in near real-time are needed for many critical applications. We report a novel assay that can provide exquisite limits-of-quantitation and consists of reverse transcription (RT) followed by a ligase detection reaction (LDR) with single-pair fluorescence resonance energy transfer (spFRET) to provide digital readout through molecular counting. For this assay, no PCR was employed, which enabled short assay turnaround times. To facilitate implementation of the assay, a cyclic olefin copolymer (COC) microchip, which was fabricated using hot embossing, was employed to carry out the LDR in a continuous flow format with on-line single-molecule detection following the LDR. As demonstrators of the assay's utility, MMP-7 mRNA was expression profiled from several colorectal cancer cell lines. It was found that the RT-LDR/spFRET assay produced highly linear calibration plots even in the low copy number regime. Comparison to RT-qPCR indicated a better linearity over the low copy number range investigated (10 − 10,000 copies) with an R2 = 0.9995 for RT-LDR/spFRET and R2 = 0.98 for RT-qPCR. In addition, differentiating between copy numbers of 10 and 50 could be performed with higher confidence using RT-LDR/spFRET. To demonstrate the short assay turnaround times obtainable using the RT-LDR/spFRET assay, a 2 thermal cycle LDR was carried out on amphiphysin gene transcripts that can serve as important diagnostic markers for ischemic stroke. The ability to supply diagnostic information on possible stroke events in short turnaround times using RT-LDR/spFRET will enable clinicians to treat patients effectively with appropriate time-sensitive therapeutics. PMID:23869556

Manned geosynchronous mission requirements and systems analysis study extension

NASA Technical Reports Server (NTRS)

1981-01-01

Turnaround requirements for the manned orbital transfer vehicle (MOTV) baseline and alternate concepts with and without a space operations center (SOC) are defined. Manned orbital transfer vehicle maintenance, refurbishment, resupply, and refueling are considered as well as the most effective combination of ground based and space based turnaround activities. Ground and flight operations requirements for abort are identified as well as low cost approaches to space and ground operations through maintenance and missions sensitivity studies. The recommended turnaround mix shows that space basing MOTV at SOC with periodic return to ground for overhaul results in minimum recurring costs. A pressurized hangar at SOC reduces labor costs by approximately 50%.

Chemistry and haematology sample rejection and clinical impact in a tertiary laboratory in Cape Town.

PubMed

Jacobsz, Lourens A; Zemlin, Annalise E; Roos, Mark J; Erasmus, Rajiv T

2011-10-14

Recent publications report that up to 70% of total laboratory errors occur in the pre-analytical phase. Identification of specific problems highlights pre-analytic processes susceptible to errors. The rejection of unsuitable samples can lead to delayed turnaround time and affect patient care. A retrospective audit was conducted investigating the rejection rate of routine blood specimens received at chemistry and haematology laboratories over a 2-week period. The reasons for rejection and potential clinical impact of these rejections were investigated. Thirty patient files were randomly selected and examined to assess the impact of these rejections on clinical care. A total of 32,910 specimens were received during the study period, of which 481 were rejected, giving a rejection rate of 1.46%. The main reasons for rejection were inappropriate clotting (30%) and inadequate sample volume (22%). Only 51.7% of rejected samples were repeated and the average time for a repeat sample to reach the laboratory was about 5 days (121 h). Of the repeated samples, 5.1% had results within critical values. Examination of patient folders showed that in 40% of cases the rejection of samples had an impact on patient care. The evaluation of pre-analytical processes in the laboratory, with regard to sample rejection, allowed one to identify problem areas where improvement is necessary. Rejected samples due to factors out of the laboratory's control had a definite impact on patient care and can thus affect customer satisfaction. Clinicians should be aware of these factors to prevent such rejections.

Rapid multiplexed genotyping for hereditary thrombophilia by SELDI-TOF mass spectrometry.

PubMed

Yang, Shangbin; Xu, Lihui; Wu, Haifeng M

2010-03-01

Approximately 50% of patients with venous thromboembolism also present with hereditary predisposition. The most common genetic factors are single nucleotide polymorphisms (SNPs) of factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T. Genotyping these SNPs helps clinicians to correctly diagnose the disease and properly manage patients. In this study, we report a novel method using surface-enhanced laser desorption and ionization time of flight mass spectrometry to rapidly genotype, in a multiplex fashion, 3 SNPs that predispose patients to thrombosis. First, patient DNA samples were subjected to polymerase chain reaction to amplify and extend the DNA products with masses corresponding to specific genotypes. Polymerase chain reaction products were then applied to Q10 anionic protein chips, undergoing on-chip sample enrichment and clean-up. Finally, the genotypes of the SNPs were determined by surface-enhanced laser desorption and ionization time of flight mass spectrometry. This method offers a rapid turnaround time of less than 5 hours from sample collection to result reporting. The analytical accuracy of each SNP genotyping result has been confirmed by DNA sequencing. In addition, the genotype results produced by this method were validated by comparing them with results obtained by the approved method in the clinical reference laboratory. This novel method is fast, accurate, and reproducible, and thus provides an excellent platform to promote personalized medicine in the management of clotting disorders.

Use of mobile phones and text messaging to decrease the turnaround time for early infant HIV diagnosis and notification in rural Zambia: an observational study.

PubMed

Sutcliffe, Catherine G; Thuma, Philip E; van Dijk, Janneke H; Sinywimaanzi, Kathy; Mweetwa, Sydney; Hamahuwa, Mutinta; Moss, William J

2017-03-08

Early infant diagnosis of HIV infection is challenging in rural sub-Saharan Africa as blood samples are sent to central laboratories for HIV DNA testing, leading to delays in diagnosis and treatment initiation. Simple technologies to rapidly deliver results to clinics and notify mothers of test results would decrease many of these delays. The feasibility of using mobile phones to contact mothers was evaluated. In addition, the first two years of implementation of a national short message service (SMS) reporting system to deliver test results from the laboratory to the clinic were evaluated. The study was conducted in Macha, Zambia from 2013 to 2015 among mothers of HIV-exposed infants. Mothers were interviewed about mobile phone use and willingness to be contacted directly or through their rural health center. Mothers were contacted according to their preferred method of communication when test results were available. Mothers of positive infants were asked to return to the clinic as soon as possible. Dates of sample collection, delivery of test results to the clinic and notification of mothers were documented in addition to test results. Four hundred nineteen mothers and infants were enrolled. Only 30% of mothers had ever used a mobile phone. 96% of mobile phone owners were reached by study staff and 98% of mothers without mobile phones were contacted through their rural health center. Turnaround times for mothers of positive infants were approximately 2 weeks shorter than for mothers of negative infants. Delivery of test results by the national SMS system improved from 2013 to 2014, with increases in the availability of texted results (38 vs. 91%) and arrival of the texted result prior to the hardcopy report (27 vs. 83%). Texted results arriving at the clinic before the hardcopy were received a median of 19 days earlier. Four discrepancies between texted and hardcopy results were identified out of 340 tests. Mobile phone and text messaging technology has the potential to improve early infant diagnosis but challenges to widespread implementation need to be addressed, including low mobile phone ownership, use and coverage in rural areas.

Review of "What's Trust Got to Do with It?"

ERIC Educational Resources Information Center

Mathis, William J.

2012-01-01

This report offers recommendations for building community support for federal school turnaround approaches, particularly in communities that oppose these approaches. Parents, the report concludes, want improvement but cherish their local schools and distrust the turnaround options mandated from above by higher levels of government. Thus,…

Making Sense of School Turnarounds

ERIC Educational Resources Information Center

Hess, Frederick M.

2012-01-01

Today, in a sector flooded with $3.5 billion in School Improvement Grant funds and the resulting improvement plans, there's great faith that "turnaround" strategies are a promising way to tackle stubborn problems with persistently low-performing schools. Unlike traditional reform efforts, with their emphasis on incremental improvement, turnarounds…

Improving Emergency Department radiology transportation time: a successful implementation of lean methodology.

PubMed

Hitti, Eveline A; El-Eid, Ghada R; Tamim, Hani; Saleh, Rana; Saliba, Miriam; Naffaa, Lena

2017-09-05

Emergency Department overcrowding has become a global problem and a growing safety and quality concern. Radiology and laboratory turnaround time, ED boarding and increased ED visits are some of the factors that contribute to ED overcrowding. Lean methods have been used in the ED to address multiple flow challenges from improving door-to-doctor time to reducing length of stay. The objective of this study is to determine the effectiveness of using Lean management methods on improving Emergency Department transportation times for plain radiography. We performed a before and after study at an academic urban Emergency Department with 49,000 annual visits after implementing a Lean driven intervention. The primary outcome was mean radiology transportation turnaround time (TAT). Secondary outcomes included overall study turnaround time from order processing to preliminary report time as well as ED length of stay. All ED patients undergoing plain radiography 6 months pre-intervention were compared to all ED patients undergoing plain radiography 6 months post-intervention after a 1 month washout period. Post intervention there was a statistically significant decrease in the mean transportation TAT (mean ± SD: 9.87 min ± 15.05 versus 22.89 min ± 22.05, respectively, p-value <0.0001). In addition, it was found that 71.6% of patients in the post-intervention had transportation TAT ≤ 10 min, as compared to 32.3% in the pre-intervention period, p-value <0.0001, with narrower interquartile ranges in the post-intervention period. Similarly, the "study processing to preliminary report time" and the length of stay were lower in the post-intervention as compared to the pre-intervention, (52.50 min ± 35.43 versus 54.04 min ± 34.72, p-value = 0.02 and 3.65 h ± 5.17 versus 4.57 h ± 10.43, p < 0.0001, respectively), in spite of an increase in the time it took to elease a preliminary report in the post-intervention period. Using Lean change management techniques can be effective in reducing transportation time to plain radiography in the Emergency Department as well as improving process reliability.

Pre-K as School Turnaround Strategy

ERIC Educational Resources Information Center

Buenafe, Anthony Q.

2011-01-01

Both state and local school systems, recognizing the strong and growing evidence of pre-kindergarten's effectiveness in closing achievement gaps, are implementing early learning programs as part of their education reform efforts. In low-performing districts, pre-k has emerged as a promising turnaround strategy, reaching children before they become…

Retirees Turn Around Low-Performing Schools

ERIC Educational Resources Information Center

Stover, Del

2007-01-01

In the last few years, a number of states, education associations, and universities have launched new programs to build up the cadre of school turnaround specialists. These programs are often modeled on the experiences of consultants in the corporate world. This article discusses the advantages of using turnaround specialists and describes the…

78 FR 68096 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Quick...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

... Training Administration (ETA) sponsored information collection request (ICR) titled, ``Quick Turnaround... Information and Regulatory Affairs, Attn: OMB Desk Officer for DOL- ETA, Office of Management and Budget, Room... authority for the ETA to conduct quick turnaround surveys on Workforce Investment Act (WIA) related issues...

School Turnaround Leaders: Competencies for Success. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

Evidence collected over the last 30 years suggests that effective school leaders significantly influence student learning and other aspects of school performance. Documented experience also indicates that individual leaders in failing organizations in various sectors, including education, can effect rapid, dramatic improvements. School turnaround…

Key Decisions of a First-Year "Turnaround" Principal

ERIC Educational Resources Information Center

Duke, Daniel; Salmonowicz, Michael

2010-01-01

This article examines the decisions made by one principal in her first year as a school turnaround specialist in a low-performing urban elementary school. Researchers focused on decisions related to the principal's three high-priority concerns: (1) elimination of an ineffective instructional program; (2) creation of a culture of teacher…

Policy Perspective: School Turnaround in England. Utilizing the Private Sector

ERIC Educational Resources Information Center

Corbett, Julie

2014-01-01

This paper, written by strategic partner of the Center on School Turnaround (CST), Julie Corbett, provides research and examples on England's approach to turning around its lowest performing schools. The English education system utilizes private vendors to support chronically low-performing schools and districts. The introduction is followed by…

Turnaround: Leading Stressed Colleges and Universities to Excellence

ERIC Educational Resources Information Center

Martin, James; Samels, James E.

2008-01-01

Nearly one thousand colleges and universities in the United States face major challenges--from catastrophic hurricanes to loss of accreditation to sagging enrollment. What can leaders of such at-risk institutions do to improve their situation? "Turnaround" gives college and university leaders the tools they need to put their fragile institutions…

CAD/CAM, Creativity, and Discipline Lead to Turnaround School Success

ERIC Educational Resources Information Center

Gorman, Lynn

2012-01-01

Miami Central High School technology teacher Frank Houghtaling thinks the connection between theory and application is one reason his students perform better on the Florida Comprehensive Assessment Test (FCAT). The impressive turnaround school drew local and national attention last spring when one of Houghtaling's students, Dagoberto Cruz, won…

Turnarounds to Transfer: Design beyond the Modes

ERIC Educational Resources Information Center

Eddy, Jennifer

2014-01-01

In "Turnarounds to Transfer," teachers design a collection of tasks toward the summative performance goal but go beyond the Communicative mode criteria: they must assess for transfer. Transfer design criteria must include a complexity or variation that make learners engage critical thinking skills and call upon a repertoire of knowledge…

Importing Leaders for School Turnarounds: Lessons and Opportunities

ERIC Educational Resources Information Center

Kowal, Julie; Hassel, Emily Ayscue

2011-01-01

One of the biggest challenges in education today is identifying talented candidates to successfully lead turnarounds of persistently low-achieving schools. Evidence suggests that the traditional principal pool is already stretched to capacity and cannot supply enough leaders to fix failing schools. But potentially thousands of leaders capable of…

Turnaround, Transformational, or Transactional Leadership: An Ethical Dilemma in School Reform

ERIC Educational Resources Information Center

Mette, Ian M.; Scribner, Jay P.

2014-01-01

This case was written for school leaders, specifically building-level principals and central office administrators attempting to implement school turnaround reform efforts. Often, leaders who embark on this type of organizational change work in intense environments that produce high levels of pressure to demonstrate improvement in student…

Turnaround Momentum Still Fragile

ERIC Educational Resources Information Center

Klein, Alyson

2012-01-01

The federal program providing billions of dollars to help states and districts close or remake some of their worst-performing schools remains a work in progress after two years, with more than 1,200 turnaround efforts under way but still no definitive verdict on its effectiveness. The School Improvement Grant (SIG) program, supercharged by a…

Turning around Schools: A View from Teachers as Policy Implementers

ERIC Educational Resources Information Center

Chisum, Jamie B.

2014-01-01

This single case study examines how stakeholders of a local education agency (LEA) understand and implement state turnaround policy for its chronically underperforming schools. While there is ample research on how to improve chronically underperforming schools, that research becomes limited when looking at turnaround implementation actions that…

Chronically Low-Performing Schools and Turnaround: Evidence from Three States

ERIC Educational Resources Information Center

Hansen, Michael; Choi, Kilchan

2012-01-01

The criteria for determining the student outcomes that define a school as having "turned around" are not well defined, and the definition of turnaround performance varies across studies. Although current policy initiatives offer guidelines for identifying CLP schools, there is no standard definition or methodology in common usage. This…

Turning around Schools: A View from School Leaders as Policy Implementers

ERIC Educational Resources Information Center

Geiser, Jill S.

2014-01-01

This single case study examines how stakeholders of a local education agency (LEA) understand and implement state turnaround policy for its chronically underperforming schools. While there is ample research on how to improve chronically underperforming schools, that research becomes limited when looking at turnaround implementation actions that…

Mission Operations of the Mars Exploration Rovers

NASA Technical Reports Server (NTRS)

Bass, Deborah; Lauback, Sharon; Mishkin, Andrew; Limonadi, Daniel

2007-01-01

A document describes a system of processes involved in planning, commanding, and monitoring operations of the rovers Spirit and Opportunity of the Mars Exploration Rover mission. The system is designed to minimize command turnaround time, given that inherent uncertainties in terrain conditions and in successful completion of planned landed spacecraft motions preclude planning of some spacecraft activities until the results of prior activities are known by the ground-based operations team. The processes are partitioned into those (designated as tactical) that must be tied to the Martian clock and those (designated strategic) that can, without loss, be completed in a more leisurely fashion. The tactical processes include assessment of downlinked data, refinement and validation of activity plans, sequencing of commands, and integration and validation of sequences. Strategic processes include communications planning and generation of long-term activity plans. The primary benefit of this partition is to enable the tactical portion of the team to focus solely on tasks that contribute directly to meeting the deadlines for commanding the rover s each sol (1 sol = 1 Martian day) - achieving a turnaround time of 18 hours or less, while facilitating strategic team interactions with other organizations that do not work on a Mars time schedule.

Flow cytometry shows added value in diagnosing lymphoma in brain biopsies.

PubMed

van der Meulen, Matthijs; Bromberg, Jacoline E C; Lam, King H; Dammers, Ruben; Langerak, Anton W; Doorduijn, Jeanette K; Kros, Johan M; van den Bent, Martin J; van der Velden, Vincent H J

2018-05-10

To assess the sensitivity, specificity and turnaround time of flow cytometric analysis on brain biopsies compared to histology plus immunohistochemistry analysis in tumors with clinical suspicion of lymphoma. All brain biopsies performed between 2010 and 2015 at our institution and analyzed by both immunohistochemistry and flow cytometry were included in this retrospective study. Immunohistochemistry was considered the gold standard. In a total of 77 biopsies from 71 patients, 49 lymphomas were diagnosed by immunohistochemistry, flow cytometry results were concordant in 71 biopsies (92,2%). We found a specificity and sensitivity of flow cytometry of 100% and 87,8%, respectively. The time between the biopsy and reporting the result (turnaround time) was significantly shorter for flow cytometry, compared to immunohistochemistry (median: 1 versus 5 days). Flow cytometry has a high specificity and can confirm the diagnosis of a lymphoma significantly faster than immunohistochemistry. This allows for rapid initiation of treatment in this highly aggressive tumor. However, since its sensitivity is less than 100%, we recommend to perform histology plus immunohistochemistry in parallel to flow cytometry. This article is protected by copyright. All rights reserved. © 2018 International Clinical Cytometry Society.

Immunosuppressant therapeutic drug monitoring by LC-MS/MS: workflow optimization through automated processing of whole blood samples.

PubMed

Marinova, Mariela; Artusi, Carlo; Brugnolo, Laura; Antonelli, Giorgia; Zaninotto, Martina; Plebani, Mario

2013-11-01

Although, due to its high specificity and sensitivity, LC-MS/MS is an efficient technique for the routine determination of immunosuppressants in whole blood, it involves time-consuming manual sample preparation. The aim of the present study was therefore to develop an automated sample-preparation protocol for the quantification of sirolimus, everolimus and tacrolimus by LC-MS/MS using a liquid handling platform. Six-level commercially available blood calibrators were used for assay development, while four quality control materials and three blood samples from patients under immunosuppressant treatment were employed for the evaluation of imprecision. Barcode reading, sample re-suspension, transfer of whole blood samples into 96-well plates, addition of internal standard solution, mixing, and protein precipitation were performed with a liquid handling platform. After plate filtration, the deproteinised supernatants were submitted for SPE on-line. The only manual steps in the entire process were de-capping of the tubes, and transfer of the well plates to the HPLC autosampler. Calibration curves were linear throughout the selected ranges. The imprecision and accuracy data for all analytes were highly satisfactory. The agreement between the results obtained with manual and those obtained with automated sample preparation was optimal (n=390, r=0.96). In daily routine (100 patient samples) the typical overall total turnaround time was less than 6h. Our findings indicate that the proposed analytical system is suitable for routine analysis, since it is straightforward and precise. Furthermore, it incurs less manual workload and less risk of error in the quantification of whole blood immunosuppressant concentrations than conventional methods. © 2013.

The cobas p 630 instrument: a dedicated pre-analytic solution to optimize COBAS® AmpliPrep/COBAS® TaqMan® system workflow and turn-around-time.

PubMed

Vallefuoco, L; Sorrentino, R; Spalletti Cernia, D; Colucci, G; Portella, G

2012-12-01

The cobas p 630, a fully automated pre-analytical instrument for primary tube handling recently introduced to complete the Cobas(®) TaqMan systems portfolio, was evaluated in conjunction with: the COBAS(®) AmpliPrep/COBAS(®) TaqMan HBV Test, v2.0, COBAS(®) AmpliPrep/COBAS(®) TaqMan HCV Test, v1.0 and COBAS(®) AmpliPrep/COBAS(®) TaqMan HIV Test, v2.0. The instrument performance in transferring samples from primary to secondary tubes, its impact in improving COBAS(®) AmpliPrep/COBAS(®) TaqMan workflow and hands-on reduction and the risk of possible cross-contamination were assessed. Samples from 42 HBsAg positive, 42 HCV and 42 HIV antibody (Ab) positive patients as well as 21 healthy blood donors were processed with or without automated primary tubes. HIV, HCV and HBsAg positive samples showed a correlation index of 0.999, 0.987 and of 0.994, respectively. To assess for cross-contamination, high titer HBV DNA positive samples, HCV RNA and HIV RNA positive samples were distributed in the cobas p 630 in alternate tube positions, adjacent to negative control samples within the same rack. None of the healthy donor samples showed any reactivity. Based on these results, the cobas p 630 can improve workflow and sample tracing in laboratories performing molecular tests, and reduce turnaround time, errors, and risks. Copyright © 2012 Elsevier B.V. All rights reserved.

Culture Morph

ERIC Educational Resources Information Center

Heid, Susan D.

2007-01-01

Historically, it's been an unavoidable truth: IT people and library people have not been inclined to come to the concept of service with the same view. For IT, it's been all about keeping the servers and systems up, the websites going, and the help desk calls and their turnaround times to a minimum. For library professionals, service has meant…

24 CFR 901.10 - Indicator #1, vacancy rate and unit turnaround time.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Indicator #1, vacancy rate and unit... HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING MANAGEMENT ASSESSMENT PROGRAM § 901.10 Indicator #1, vacancy... computation: (1) Units approved for non-dwelling use. (2) Employee occupied units. (3) Vacant units approved...

Building Turnaround Capacity for Urban School Improvement: The Role of Adaptive Leadership and Defined Autonomy

ERIC Educational Resources Information Center

Conrad, Jill K.

2013-01-01

This dissertation examines the levels of and relationships between technical leadership, adaptive leadership, and defined autonomy among Denver school leaders along with their combined effects on school growth gains over time. Thirty principals provided complete responses to an online survey that included existing scales for technical leadership,…

Northern Network Committee Interlibrary Loan Survey Report.

ERIC Educational Resources Information Center

California State Univ. and Colleges, Los Angeles. Northern Library Regional Cooperation Board.

All libraries of the 19 campuses in the California State University system were surveyed about their interlibrary loan operations. Information concerning the turnaround time was sought in three specific areas: (1) from date of patron request to date of patron receipt; (2) from date of library request to date of patron notification; and (3) from…

The Students in Front of Us: Reform for the Current Generation of Urban High School Students

ERIC Educational Resources Information Center

Burks, Joe; Hochbein, Craig

2015-01-01

The implementation of education policies requiring the turnaround of persistently low-achieving schools has demanded reforms that will not only improve achievement, but also deliver results in a short period of time. To meet such demands, Jefferson County Public Schools educators implemented Project Proficiency (PP). Results from…

Imputation of microsatellite alleles from dense SNP genotypes for parentage verification across multiple Bos taurus and Bos indicus breeds

USDA-ARS?s Scientific Manuscript database

Microsatellite markers (MS) have traditionally been used for parental verification and are still the international standard in spite of their higher cost, error rate, and turnaround time compared with Single Nucleotide Polymorphisms (SNP) -based assays. Despite domestic and international demands fr...

Learning Walks: Build Hearty Appetites for Professional Development

ERIC Educational Resources Information Center

Steiny, Julia

2009-01-01

Mike Carbone has been the principal of Kickemuit Middle School in Warren, Rhode Island, since 1990. He's seen some bad times there before a dramatic turnaround. When asked what finally got his school's engine revved and moving the school forward, he said without hesitation: "Learning walks." In this article, the author describes how…

Preparing Turnaround Leaders for High Needs Urban Schools

ERIC Educational Resources Information Center

Lochmiller, Chad R.; Chesnut, Colleen E.

2017-01-01

Purpose: The purpose of this paper is to describe the program structure and design considerations of a 25-day, full-time apprenticeship in a university-based principal preparation program. Design/Methodology/ Approach: The study used a qualitative case study design that drew upon interviews and focus groups with program participants as well as…

Tough Questions for Tough Times

ERIC Educational Resources Information Center

Parrett, William; Budge, Kathleen

2009-01-01

Six high-performing/high-poverty schools provide insights into what it takes to make a dramatic turnaround. School leaders had to make tough calls--and many of those decisions were about how to use resources. The budget in a high-performing, high-poverty school is a moral document, reflective of the school's beliefs about the conditions necessary…

Navy Maintenance: The P-3 Aircraft Overhaul Program Can Be Improved.

DTIC Science & Technology

1987-06-01

Air Sys- tems Command’s Naval Aviation Logistics Center, we obtained data on aircraft turnaround times, mobilization requirements, and aircraft over...480 561 637 P-3 Workload as a Percent of 23 22 25 27 Total FINDING Z: Aplicability of Procedural Changes To Other Aircraft. The GAO observed that the

The Psychological Record: Reaffirming the Past and Embracing the Future

ERIC Educational Resources Information Center

Rehfeldt, Ruth Anne

2007-01-01

In providing an outlet for manuscripts from all areas of scientific psychology, it was the founders' intentions that authors would experience a more rapid turn-around from submission to publication than was the case with other general psychology journals at the time. Despite difficulties created by World War II, "The Psychological Record" remained…

Automation, consolidation, and integration in autoimmune diagnostics.

PubMed

Tozzoli, Renato; D'Aurizio, Federica; Villalta, Danilo; Bizzaro, Nicola

2015-08-01

Over the past two decades, we have witnessed an extraordinary change in autoimmune diagnostics, characterized by the progressive evolution of analytical technologies, the availability of new tests, and the explosive growth of molecular biology and proteomics. Aside from these huge improvements, organizational changes have also occurred which brought about a more modern vision of the autoimmune laboratory. The introduction of automation (for harmonization of testing, reduction of human error, reduction of handling steps, increase of productivity, decrease of turnaround time, improvement of safety), consolidation (combining different analytical technologies or strategies on one instrument or on one group of connected instruments) and integration (linking analytical instruments or group of instruments with pre- and post-analytical devices) opened a new era in immunodiagnostics. In this article, we review the most important changes that have occurred in autoimmune diagnostics and present some models related to the introduction of automation in the autoimmunology laboratory, such as automated indirect immunofluorescence and changes in the two-step strategy for detection of autoantibodies; automated monoplex immunoassays and reduction of turnaround time; and automated multiplex immunoassays for autoantibody profiling.

Application of the Toyota Production System improves core laboratory operations.

PubMed

Rutledge, Joe; Xu, Min; Simpson, Joanne

2010-01-01

To meet the increased clinical demands of our hospital expansion, improve quality, and reduce costs, our tertiary care, pediatric core laboratory used the Toyota Production System lean processing to reorganize our 24-hour, 7 d/wk core laboratory. A 4-month, consultant-driven process removed waste, led to a physical reset of the space to match the work flow, and developed a work cell for our random access analyzers. In addition, visual controls, single piece flow, standard work, and "5S" were instituted. The new design met our goals as reflected by achieving and maintaining improved turnaround time (TAT; mean for creatinine reduced from 54 to 23 minutes) with increased testing volume (20%), monetary savings (4 full-time equivalents), decreased variability in TAT, and better space utilization (25% gain). The project had the unanticipated consequence of eliminating STAT testing because our in-laboratory TAT for routine testing was less than our prior STAT turnaround goal. The viability of this approach is demonstrated by sustained gains and further PDCA (Plan, Do, Check, Act) improvements during the 4 years after completion of the project.

Implementation of a 'lean' cytopathology service: towards routine same-day reporting.

PubMed

Hewer, Ekkehard; Hammer, Caroline; Fricke-Vetsch, Daniela; Baumann, Cinzia; Perren, Aurel; Schmitt, Anja M

2018-05-01

To systematically assess the effects of a Lean management intervention in an academic cytopathology service. We monitored outcomes including specimen turnaround times during stepwise implementation of a lean cytopathology workflow for gynaecological and non-gynaecological cytology. The intervention resulted in a major reduction of turnaround times for both gynaecological (3rd quartile 4.1 vs 2.3 working days) and non-gynaecological cytology (3rd quartile 1.9 vs. 1.2 working days). Introduction of fully electronic reporting had additional effect over continuous staining of slides alone. The rate of non-gynaecological specimens reported the same day increased from 4.5% to 56.5% of specimens received before noon. Lean management principles provide a useful framework for organization of a cytopathology workflow. Stepwise implementation beginning with a simplified gynaecological cytology workflow allowed involved staff to monitor the effects of individual changes and allowed for a smooth transition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reevaluation of Stratospheric Ozone Trends From SAGE II Data Using a Simultaneous Temporal and Spatial Analysis

NASA Technical Reports Server (NTRS)

Damadeo, R. P.; Zawodny, J. M.; Thomason, L. W.

2014-01-01

This paper details a new method of regression for sparsely sampled data sets for use with time-series analysis, in particular the Stratospheric Aerosol and Gas Experiment (SAGE) II ozone data set. Non-uniform spatial, temporal, and diurnal sampling present in the data set result in biased values for the long-term trend if not accounted for. This new method is performed close to the native resolution of measurements and is a simultaneous temporal and spatial analysis that accounts for potential diurnal ozone variation. Results show biases, introduced by the way data is prepared for use with traditional methods, can be as high as 10%. Derived long-term changes show declines in ozone similar to other studies but very different trends in the presumed recovery period, with differences up to 2% per decade. The regression model allows for a variable turnaround time and reveals a hemispheric asymmetry in derived trends in the middle to upper stratosphere. Similar methodology is also applied to SAGE II aerosol optical depth data to create a new volcanic proxy that covers the SAGE II mission period. Ultimately this technique may be extensible towards the inclusion of multiple data sets without the need for homogenization.

Optimization of subculture and DNA extraction steps within the whole genome sequencing workflow for source tracking of Salmonella enterica and Listeria monocytogenes.

PubMed

Gimonet, Johan; Portmann, Anne-Catherine; Fournier, Coralie; Baert, Leen

2018-06-16

This work shows that an incubation time reduced to 4-5 h to prepare a culture for DNA extraction followed by an automated DNA extraction can shorten the hands-on time, the turnaround time by 30% and increase the throughput while maintaining the WGS quality assessed by high quality Single Nucleotide Polymorphism analysis. Copyright © 2018. Published by Elsevier B.V.

An evaluation of superminicomputers for thermal analysis

NASA Technical Reports Server (NTRS)

Storaasli, O. O.; Vidal, J. B.; Jones, G. K.

1982-01-01

The use of superminicomputers for solving a series of increasingly complex thermal analysis problems is investigated. The approach involved (1) installation and verification of the SPAR thermal analyzer software on superminicomputers at Langley Research Center and Goddard Space Flight Center, (2) solution of six increasingly complex thermal problems on this equipment, and (3) comparison of solution (accuracy, CPU time, turnaround time, and cost) with solutions on large mainframe computers.

Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients

PubMed Central

Schuetz, Audrey N.; Jenkins, Stephen G.; Calfee, David P.; Walsh, Thomas J.; Wells, Martin T.; Hollenberg, James P.; Glesby, Marshall J.

2016-01-01

Rapid and definitive diagnosis of viral respiratory infections is imperative in patient triage and management. We compared the outcomes for adult patients with positive tests for respiratory viruses at a tertiary care center across two consecutive influenza seasons (winters of 2010-2011 and 2012). Infections were diagnosed by conventional methods in the first season and by multiplex PCR (FilmArray) in the second season. FilmArray decreased the time to diagnosis of influenza compared to conventional methods (median turnaround times of 1.7 h versus 7.7 h, respectively; P = 0.015); FilmArray also decreased the time to diagnosis of non-influenza viruses (1.5 h versus 13.5 h, respectively; P < 0.0001). Multivariate logistic regression found that a diagnosis of influenza by FilmArray was associated with significantly lower odds ratios (ORs) for admission (P = 0.046), length of stay (P = 0.040), duration of antimicrobial use (P = 0.032), and number of chest radiographs (P = 0.005), when controlling for potential confounders. We conclude that the rapid turnaround time, multiplex nature of the test (allowing simultaneous detection of an array of viruses), and superior sensitivity of FilmArray may improve the evaluation and management of patients suspected of having respiratory virus infections. PMID:27225406

Can States Take Over and Turn Around School Districts? Evidence from Lawrence, Massachusetts

ERIC Educational Resources Information Center

Schueler, Beth E.; Goodman, Joshua S.; Deming, David J.

2017-01-01

The Every Student Succeeds Act (ESSA) requires states to identify and turn around struggling schools, with federal school improvement money required to fund evidence-based policies. Most research on turnarounds has focused on individual schools, whereas studies of district-wide turnarounds have come from relatively exceptional settings and…

Choosing a School Turnaround Provider. Lessons Learned. Volume 1, Issue 3

ERIC Educational Resources Information Center

Lockwood, Anne Turnbaugh; Fleischman, Steve

2010-01-01

Droves of school turnaround providers are chasing the massive federal infusion of funds flowing into failing schools. They arrive armed with glossy materials, impressive sounding claims, and, often, citing their prior relationships or experiences with one's school to support their promises of great service and impressive outcomes. But, are their…

California Turnaround Schools: An Analysis of School Improvement Grant Effectiveness

ERIC Educational Resources Information Center

Graham, Khalil N.

2013-01-01

The purpose of this study was to evaluate the effectiveness of School Improvement Grants (SIGs) in the state of California (CA) in increasing student achievement using the turnaround implementation model. The American Recovery and Reinvestment Act of 2009 (ARRA) included educational priorities focused on fixing America's lowest achieving schools.…

Straight A's: Public Education Policy and Progress. Volume 10, Number 11

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

"Straight A's: Public Education Policy and Progress" is a biweekly newsletter that focuses on education news and events both in Washington, DC and around the country. The following articles are included in this issue: (1) Turnaround or Full Speed Ahead?: House Committee Raises Concerns with School Turnaround Models Included in Obama…

Fiery Passion and Relentless Commitment: The Lived Experiences of African American Women Principals in Turnaround Model Schools

ERIC Educational Resources Information Center

Aldaco, Adrienne L. Gratten

2016-01-01

Chronically low performing schools in the United States have required targeted support and interventions to increase student achievement. In recent years, the school turnaround model has emerged as a swift, dramatic, comprehensive approach to implementing interventions in the lowest performing schools (Calkins, Guenther, Belfiore, & Lash,…

Turning around Maple Shade Middle School: A Principal's Initial Reform Efforts

ERIC Educational Resources Information Center

Salmonowicz, Michael J.; Levy, Melissa K.

2009-01-01

This case was written for use in courses dealing with school administration, specifically those related to organizational change, school improvement/turnaround, and the principalship. It explores a veteran principal's first year as a "turnaround specialist" in a low-performing middle school, where she works with a sense of urgency to achieve an…

Portrait of a Turnaround Leader in a High Needs District

ERIC Educational Resources Information Center

Hewitt, Kimberly Kappler; Reitzug, Ulrich

2015-01-01

Using portraiture methodology involving interview, observation, and artifact data, this study portrays a turnaround leader, Dr. Susan Gray, in a high needs, rural district in the Southeast. In three years, Gray led Lincoln Elementary from nearly being reconstituted to being an award-winning school. Gray has subsequently been assigned other…

Turning around Failing Organizations: Insights for Educational Leaders

ERIC Educational Resources Information Center

Murphy, Joseph

2010-01-01

Purpose: In this article, we review the literature from the organizational sciences to develop a grounded narrative of turnaround in education. Approach: The approach is a review of literature. We employ an integrated process to unpack and make sense of the turnaround literature from the organizational sciences. We rely on strategies appropriate…

Democratic School Turnarounds: Pursuing Equity and Learning from Evidence

ERIC Educational Resources Information Center

Trujillo, Tina; Renée, Michelle

2013-01-01

the report "Democratic School Turnarounds" considers the democratic tensions inherent in the federal School Improvement Grant (SIG) policy's market-based school reforms and critiques the research base that many of these reforms are based on. It concludes with a set of recommendations that re-center the purposes of public education…

Turnaround Arts Initiative: Final Evaluatiion Report

ERIC Educational Resources Information Center

Stoelinga, Sara Ray; Silk, Yael; Reddy, Prateek; Rahman, Nadiv

2015-01-01

The President's Committee on the Arts and the Humanities (PCAH) released the results of an independent study that shows substantial gains in student achievement at schools participating in its Turnaround Arts initiative. The eight schools' in the pilot phase of the initiative, showing increases in reading and math scores, as well as an increase in…

School Turnaround Teachers: Competencies for Success. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

Individual teachers have the largest single school effect on student performance. Documented experience also indicates that individual teachers in high-poverty schools can effect rapid, dramatic student learning improvements within their own classrooms. Organization-wide change of a similar magnitude takes a broader effort with daring leadership…

Transforming Turnaround Schools in China: Strategies, Achievements, and Challenges

ERIC Educational Resources Information Center

Liu, Peng

2016-01-01

The existence of turnaround schools has been a problem in the Chinese education system. There are diverse causes including the education system itself, the financial system, and other issues. However, there has been a lack of research to help us fully understand this phenomenon. This article provides a holistic perspective on the strategies the…

Duplex quantitative real-time PCR assay for the detection and discrimination of the eggs of Toxocara canis and Toxocara cati (Nematoda, Ascaridoidea) in soil and fecal samples.

PubMed

Durant, Jean-Francois; Irenge, Leonid M; Fogt-Wyrwas, Renata; Dumont, Catherine; Doucet, Jean-Pierre; Mignon, Bernard; Losson, Bertrand; Gala, Jean-Luc

2012-12-07

Toxocarosis is a zoonotic disease caused by Toxocara canis (T. canis) and/or Toxocara cati (T. cati), two worldwide distributed roundworms which are parasites of canids and felids, respectively. Infections of humans occur through ingestion of embryonated eggs of T. canis or T. cati, when playing with soils contaminated with dogs or cats feces. Accordingly, the assessment of potential contamination of these areas with these roundworms eggs is paramount. A duplex quantitative real-time PCR (2qPCR) targeting the ribosomal RNA gene internal transcribed spacer (ITS2) has been developed and used for rapid and specific identification of T. canis and T. cati eggs in fecal and soil samples. The assay was set up on DNA samples extracted from 53 adult worms including T. canis, T. cati, T. leonina, Ascaris suum (A. suum) and Parascaris equorum (P. equorum). The assay was used to assess the presence of T. cati eggs in several samples, including 12 clean soil samples spiked with eggs of either T. cati or A. suum, 10 actual soil samples randomly collected from playgrounds in Brussels, and fecal samples from cats, dogs, and other animals. 2qPCR results on dogs and cats fecal samples were compared with results from microscopic examination. 2qPCR assay allowed specific detection of T. canis and T. cati, whether adult worms, eggs spiked in soil or fecal samples. The 2qPCR limit of detection (LOD) in spiked soil samples was 2 eggs per g of soil for a turnaround time of 3 hours. A perfect concordance was observed between 2qPCR assay and microscopic examination on dogs and cats feces. The newly developed 2qPCR assay can be useful for high throughput prospective or retrospective detection of T.canis and/or T. cati eggs in fecal samples as well as in soil samples from playgrounds, parks and sandpits.

DB4US: A Decision Support System for Laboratory Information Management

PubMed Central

Hortas, Maria Luisa; Baena-García, Manuel; Lana-Linati, Jorge; González, Carlos; Redondo, Maximino; Morales-Bueno, Rafael

2012-01-01

Background Until recently, laboratory automation has focused primarily on improving hardware. Future advances are concentrated on intelligent software since laboratories performing clinical diagnostic testing require improved information systems to address their data processing needs. In this paper, we propose DB4US, an application that automates information related to laboratory quality indicators information. Currently, there is a lack of ready-to-use management quality measures. This application addresses this deficiency through the extraction, consolidation, statistical analysis, and visualization of data related to the use of demographics, reagents, and turn-around times. The design and implementation issues, as well as the technologies used for the implementation of this system, are discussed in this paper. Objective To develop a general methodology that integrates the computation of ready-to-use management quality measures and a dashboard to easily analyze the overall performance of a laboratory, as well as automatically detect anomalies or errors. The novelty of our approach lies in the application of integrated web-based dashboards as an information management system in hospital laboratories. Methods We propose a new methodology for laboratory information management based on the extraction, consolidation, statistical analysis, and visualization of data related to demographics, reagents, and turn-around times, offering a dashboard-like user web interface to the laboratory manager. The methodology comprises a unified data warehouse that stores and consolidates multidimensional data from different data sources. The methodology is illustrated through the implementation and validation of DB4US, a novel web application based on this methodology that constructs an interface to obtain ready-to-use indicators, and offers the possibility to drill down from high-level metrics to more detailed summaries. The offered indicators are calculated beforehand so that they are ready to use when the user needs them. The design is based on a set of different parallel processes to precalculate indicators. The application displays information related to tests, requests, samples, and turn-around times. The dashboard is designed to show the set of indicators on a single screen. Results DB4US was deployed for the first time in the Hospital Costa del Sol in 2008. In our evaluation we show the positive impact of this methodology for laboratory professionals, since the use of our application has reduced the time needed for the elaboration of the different statistical indicators and has also provided information that has been used to optimize the usage of laboratory resources by the discovery of anomalies in the indicators. DB4US users benefit from Internet-based communication of results, since this information is available from any computer without having to install any additional software. Conclusions The proposed methodology and the accompanying web application, DB4US, automates the processing of information related to laboratory quality indicators and offers a novel approach for managing laboratory-related information, benefiting from an Internet-based communication mechanism. The application of this methodology has been shown to improve the usage of time, as well as other laboratory resources. PMID:23608745

Assays for therapeutic drug monitoring of β-lactam antibiotics: A structured review.

PubMed

Carlier, Mieke; Stove, Veronique; Wallis, Steven C; De Waele, Jan J; Verstraete, Alain G; Lipman, Jeffrey; Roberts, Jason A

2015-10-01

In some patient groups, including critically ill patients, the pharmacokinetics of β-lactam antibiotics may be profoundly disturbed due to pathophysiological changes in distribution and elimination. Therapeutic drug monitoring (TDM) is a strategy that may help to optimise dosing. The aim of this review was to identify and analyse the published literature on the methods used for β-lactam quantification in TDM programmes. Sixteen reports described methods for the simultaneous determination of three or more β-lactam antibiotics in plasma/serum. Measurement of these antibiotics, due to low frequency of usage relative to some other tests, is generally limited to in-house chromatographic methods coupled to ultraviolet or mass spectrometric detection. Although many published methods state they are fit for TDM, they are inconvenient because of intensive sample preparation and/or long run times. Ideally, methods used for routine TDM should have a short turnaround time (fast run-time and fast sample preparation), a low limit of quantification and a sufficiently high upper limit of quantification. The published assays included a median of 6 analytes [interquartile range (IQR) 4-10], with meropenem and piperacillin being the most frequently measured β-lactam antibiotics. The median run time was 8 min (IQR 5.9-21.3 min). There is also a growing number of methods measuring free concentrations. An assay that measures antibiotics without any sample preparation would be the next step towards real-time monitoring; no such method is currently available. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs.

PubMed

Wagner, Anjuli; Slyker, Jennifer; Langat, Agnes; Inwani, Irene; Adhiambo, Judith; Benki-Nugent, Sarah; Tapia, Ken; Njuguna, Irene; Wamalwa, Dalton; John-Stewart, Grace

2015-02-15

Despite expanded programs for prevention of mother-to-child HIV transmission (PMTCT), HIV-infected infants may not be diagnosed until they are ill. Comparing HIV prevalence and outcomes in infants diagnosed in PMTCT programs to those in hospital settings may improve pediatric HIV diagnosis strategies. HIV-exposed infants <12 months old were recruited from 9 PMTCT sites in public maternal child health (MCH) clinics or from an inpatient setting in Nairobi, Kenya and tested for HIV using HIV DNA assays. A subset of HIV-infected infants <4.5 months of age was enrolled in a research study and followed for 2 years. HIV prevalence, number needed to test, infant age at testing, and turnaround time for tests were compared between PMTCT programs and hospital sites. Among the enrolled cohort, baseline characteristics, survival, and timing of antiretroviral therapy (ART) initiation were compared between infants diagnosed in PMTCT programs versus hospital. Among 1,923 HIV-exposed infants, HIV prevalence was higher among infants tested in hospital than PMTCT early infant diagnosis (EID) sites (41% vs. 11%, p < 0.001); the number of HIV-exposed infants needed to test to diagnose one infection was 2.4 in the hospital vs. 9.1 in PMTCT. Receipt of HIV test results was faster among hospitalized infants (7 vs. 25 days, p < 0.001). Infants diagnosed in hospital were older at the time of testing than PMTCT diagnosed infants (5.0 vs. 1.6 months, respectively, p < 0.001). In the subset of 99 HIV-infected infants <4.5 months old followed longitudinally, hospital-diagnosed infants did not differ from PMTCT-diagnosed infants in time to ART initiation; however, hospital-diagnosed infants were >3 times as likely to die (HR = 3.1, 95% CI = 1.3-7.6). Among HIV-exposed infants, hospital-based testing was more likely to detect an HIV-infected infant than PMTCT testing. Because young symptomatic infants diagnosed with HIV during hospitalization have very high mortality, every effort should be made to diagnose HIV infections before symptom onset. Systems to expedite turnaround time at PMTCT EID sites and to routinize inpatient pediatric HIV testing are necessary to improve pediatric HIV outcomes.

Textiles, Tariffs, and Turnarounds: Profits Improved.

ERIC Educational Resources Information Center

Aronoff, Craig

1986-01-01

The U.S. textile industry may serve as a classic study on regeneration through market forces. The industry has recently made a turnaround in profits after having been recognized as an industry that was losing most of its profits to overseas producers. The reasons for the emerging strength of the industry is that it began to innovate after a…

A Case Study of Change Strategies Implemented in a Turnaround Elementary School

ERIC Educational Resources Information Center

Colson, Jo Ann

2012-01-01

This case study examined the change strategies in a turnaround school at the elementary level to understand and describe how change occurred and was sustained at this campus. This study examined the factors which contributed to the change in academic success of students, examined beliefs about change that led to the change process, identified the…

Investigating the Role of Human Resources in School Turnaround: Evidence from Two States

ERIC Educational Resources Information Center

Hansen, Michael

2012-01-01

Teachers are generally recognized as the schooling factor accounting for the highest proportion of student learning outcomes (Aaronson et al., 2007; Hanushek, 1986). This implies the quick and dramatic improvement in school performance observed in turnaround (TA) schools was associated with a major change in the performance of its teachers. This…

Developing Arizona Turnaround Leaders to Build High-Capacity Schools in the Midst of Accountability Pressures and Changing Demographics

ERIC Educational Resources Information Center

Ylimaki, Rose M.; Brunderman, Lynnette; Bennett, Jeffrey V.; Dugan, Thad

2014-01-01

Today's accountability policies and changing demographics have created conditions in which leaders must rapidly build school capacity and improve outcomes in culturally diverse schools. This article presents findings from a mixed-methods evaluation of an Arizona Turnaround Leadership Development Project. The project drew on studies of turnaround…

The Effects of School Turnaround in Tennessee's Achievement School District and Innovation Zones

ERIC Educational Resources Information Center

Zimmer, Ron; Henry, Gary T.; Kho, Adam

2017-01-01

In recent years, the federal government has invested billions of dollars to reform chronically low-performing schools. To fulfill their federal Race to the Top grant agreement, Tennessee implemented three turnaround strategies that adhered to the federal restart and transformation models: (a) placed schools under the auspices of the Achievement…

The Turnaround Mindset: Aligning Leadership for Student Success

ERIC Educational Resources Information Center

Fairchild, Tierney Temple; DeMary, Jo Lynne

2011-01-01

This book provides a valuable balance between what one must know and what one must do to turn around low-performing schools. The 3-E framework simplifies this complex process by focusing resources on the environment, the executive, and the execution of the turnaround plan. Central to each of these components is a spotlight on the values supporting…

Turning Around Failing Schools: Policy Insights from the Corporate, Government, and Nonprofit Sectors

ERIC Educational Resources Information Center

Murphy, Joseph

2009-01-01

In this article, the author reviews research from the organizational sciences to develop turnaround policy guidelines that may prove useful for policy makers and educators. The approach is an integrative review of the literature. The author employs a comprehensive process to unpack and make sense of the turnaround literature from the…

Tinkering and Turnarounds: Understanding the Contemporary Campaign to Improve Low-Performing Schools

ERIC Educational Resources Information Center

Duke, Daniel L.

2012-01-01

An unprecedented amount of attention in recent years has been focused on turning around low-performing schools. Drawing on insights from Tyack and Cuban's (1995) "Tinkering Toward Utopia," the article analyzes the forces behind the school turnaround phenomenon and how they have evolved since passage of the No Child Left Behind Act. The…

The Reading Turn-Around: A Five Part Framework for Differentiated Instruction. Practitioners Bookshelf, Language & Literacy Series

ERIC Educational Resources Information Center

Jones, Stephanie; Clarke, Lane; Enriquez, Grace

2009-01-01

This book demonstrates a five-part framework for teachers, reading specialists, and literacy coaches who want to help their least engaged students become powerful readers. Merging theory and practice, the guide offers successful strategies to reach your "struggling" learners. The authors show how you can "turn-around" your instructional practice,…

The Project L.I.F.T. Story: Early Lessons from a Public-Private Education Turnaround Initiative

ERIC Educational Resources Information Center

Kim, Juli; Ellison, Shonaka

2015-01-01

Leading Charlotte foundations formed a funding collaborative to support a five-year district turnaround initiative to dramatically improve educational outcomes for students in the West Charlotte High School corridor, one of the city's lowest-performing feeder zones. The "Project L.I.F.T." initiative involves four areas of education…

The Rural Turnaround in Ohio: Some Evidence Related to Implications.

ERIC Educational Resources Information Center

Thomas, Donald W.; Bachtel, Douglas C.

Limited to residents of small towns, villages and the rural open country, the study assessed the implications of the rural turnaround in the southern Ohio counties of Athens, Gallia, Jackson, Meigs, and Vinton. All five counties experienced outmigration in the 1950s, and all but Athens County lost population through outmigration in the 1960s. In…

The Double Bind for Women: Exploring the Gendered Nature of Turnaround Leadership in a Principal Preparation Program

ERIC Educational Resources Information Center

Weiner, Jennie Miles; Burton, Laura J.

2016-01-01

In this study of nine participants in a turnaround principal preparation program, Jennie Miles Weiner and Laura J. Burton explore how gender role identity shaped participants' views of effective principal leadership and their place within it. The authors find that although female and male participants initially framed effective leadership…

Turnaround Principals: An Unmistakable Conclusion--Site-Level Success Stems from Superintendent Support

ERIC Educational Resources Information Center

Burbach, Harold J.; Butler, Alfred R., IV

2005-01-01

The authors of this article were recently privileged to spend five days with a group of 10 talented principals who have been charged with turning around academically low-performing schools in their respective districts. These principals were selected as participants in a Turnaround Specialist Program initiated by Gov. Mark R. Warner of Virginia…

Participatory Democracy and Struggling Schools: Making Space for Youth in School Turnarounds

ERIC Educational Resources Information Center

Kirshner, Ben; Jefferson, Anton

2015-01-01

Background/Context:Federal policy, as codified in Race to the Top (RTT) funding guidelines, outlines four types of intervention: turnaround, restart, closure, and transformation. RTT has embraced a technocratic paradigm for school reform that frames choice less as the opportunity for the public to deliberate about what it wants from its schools…

17 CFR 240.17Ad-2 - Turnaround, processing, and forwarding of items.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Turnaround, processing, and forwarding of items. 240.17Ad-2 Section 240.17Ad-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE... be filed with the Comptroller of the Currency shall be filed with the Office of the Comptroller of...

17 CFR 240.17Ad-2 - Turnaround, processing, and forwarding of items.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Turnaround, processing, and forwarding of items. 240.17Ad-2 Section 240.17Ad-2 Commodity and Securities Exchanges SECURITIES AND EXCHANGE... be filed with the Comptroller of the Currency shall be filed with the Office of the Comptroller of...

Under soggy skies on a Sunday morning, the Space Shuttle Endeavour is encased in the Mate-DeMate gantry during turnaround processing at NASA DFRC

NASA Image and Video Library

2008-12-07

Under soggy skies on a Sunday morning, the Space Shuttle Endeavour is encased in the Mate-DeMate gantry during turnaround processing at NASA's Dryden Flight Research Center following its STS-126 landing at Edwards Air Force Base a week earlier.

Portfolio District Reform Meets School Turnaround: Early Implementation Findings from the Los Angeles Public School Choice Initiative

ERIC Educational Resources Information Center

Marsh, Julie A.; Strunk, Katharine O.; Bush, Susan

2013-01-01

Purpose: Despite the popularity of school "turnaround" and "portfolio district" management as solutions to low performance, there has been limited research on these strategies. The purpose of this paper is to address this gap by exploring the strategic case of Los Angeles Unified School District's Public School Choice…

Turnaround High School Principals: Recruit, Prepare and Empower Leaders of Change.

ERIC Educational Resources Information Center

Schmidt-Davis, Jon; Bottoms, Gene

2012-01-01

Recent studies make one reality clear: While multiple factors can cause a low-performing high school to be in a turnaround situation, every high school that makes dramatic academic improvement has strong, effective school leadership. Turning a school around is no work for novices. It takes a skilled, visionary and proactive principal to pull apart…

Incorporating Early Learning Strategies in the School Improvement Grants (SIG) Program

ERIC Educational Resources Information Center

Connors-Tadros, Lori; Dunn, Lenay; Martella, Jana; McCauley, Carlas

2015-01-01

The Center on Enhancing Early Learning Outcomes (CEELO) and the Center on School Turnaround (CST) collaborated to develop case studies of three selected schools receiving SIG funds that have, with the support of their districts, promoted the use of early childhood programming (PK-3) as a key strategy in their schools' turnaround models. The goal…

School Turnaround Leaders: Selection Toolkit. Part of the School Turnaround Collection from Public Impact

ERIC Educational Resources Information Center

Public Impact, 2008

2008-01-01

This toolkit includes the following separate sections: (1) Selection Preparation Guide; (2) Day-of-Interview Tools; (3) Candidate Rating Tools; and (4) Candidate Comparison and Decision Tools. Each of the sections is designed to be used at different stages of the selection process. The first section provides a list of competencies that would…

Gamed by the System: Adequate Yearly Progress as an Indicator of Persistently Low-Achieving School Performance

ERIC Educational Resources Information Center

Hochbein, Craig; Mitchell, Amanda M.; Pollio, Martin

2013-01-01

The recent policy focus on the turnaround of persistently low-achieving schools has generated considerable debate about the reforms needed to dramatically and quickly increase school performance. The purpose of this article is not to focus on specific turnaround interventions, but rather on the identification of schools slated to receive these…

Turnaround Policy and Practice: A Case Study of Turning around a Failing School with English-Language-Learners

ERIC Educational Resources Information Center

Reyes, Augustina; Garcia, Andres

2014-01-01

In an era of school reform and high stakes accountability, the major challenge in education is to turnaround the nation's lowest-performing schools. National policy provides abundant resources with often restrictive prerequisites. Research indicates that quality principals and teachers are the most important factors for turning around the lowest…

How to Know when Dramatic Change Is on Track: Leading Indicators of School Turnarounds

ERIC Educational Resources Information Center

Kowal, Julie; Ableidinger, Joe

2011-01-01

In recent years, national policymakers have placed new emphasis on "school turnarounds" as a strategy for rapid, dramatic improvement in chronically failing schools, calling on education leaders to turn around performance in the 5,000 lowest-achieving schools nationwide. This goal may seem daunting, given the dismal success rates of…

Hospital turnaround strategies.

PubMed

Langabeer, James

2008-01-01

Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

Automation of checkout for the shuttle operations era

NASA Technical Reports Server (NTRS)

Anderson, J. A.; Hendrickson, K. O.

1985-01-01

The Space Shuttle checkout is different from its Apollo predecessor. The complexity of the hardware, the shortened turnaround time, and the software that performs ground checkout are outlined. Generating new techniques and standards for software development and the management structure to control it are implemented. The utilization of computer systems for vehicle testing is high lighted.

The Learning Principal[R]. Volume 4, Number 7

ERIC Educational Resources Information Center

von Frank, Valerie, Ed.

2009-01-01

"The Learning Principal" is an eight-page newsletter published eight times a year. It focuses on the important and unique work of school principals. This issue includes: (1) A Learning Community Is Built on Trust (Valerie von Frank); (2) School Leadership: Q & A: Turnaround Doesn't Have to Take Years, Just Solid Leadership (Valerie von Frank); (3)…

Development of a 5'-nuclease real-time PCR assay targeting fliP for the rapid identification of Burkholderia mallei in clinical samples.

PubMed

Tomaso, Herbert; Scholz, Holger C; Al Dahouk, Sascha; Eickhoff, Meike; Treu, Thomas M; Wernery, Renate; Wernery, Ulrich; Neubauer, Heinrich

2006-02-01

Burkholderia mallei is a potential biological agent that causes glanders or farcy in solipeds, a disease notifiable to the Office International des Epizooties (OIE). The number of reported outbreaks has increased steadily during the last decade, but diagnosis is hampered by the low bacterial load in infected tissues and excretions. We developed a B. mallei-specific 5'-nuclease real-time PCR assay that targets the fliP gene of B. mallei and includes an internal amplification control. Specificity was assessed with 19 B. mallei strains, 27 Burkholderia pseudomallei strains, other Burkholderia strains of 29 species, and clinically relevant non-Burkholderia organisms. Amplification products were observed in all B. mallei strains but in no other bacteria. The linear range of the B. mallei real-time PCR covered concentrations from 240 pg to 70 fg of bacterial DNA/reaction. The detection limit was 60 fg of B. mallei DNA. The clinical applicability of the assay was demonstrated by use of organ samples from diseased horses of a recent outbreak that was reported to the OIE by the United Arab Emirates in 2004. Compared with conventional PCR, our rapid 5'-nuclease real-time PCR assay for the specific identification of B. mallei has a lower risk of carryover contamination and eliminates the need for post-PCR manipulations. This real-time PCR assay also shortens the turnaround time for results and has the potential for automation.

Rapid Molecular Microbiologic Diagnosis of Prosthetic Joint Infection

PubMed Central

Cazanave, Charles; Greenwood-Quaintance, Kerryl E.; Hanssen, Arlen D.; Karau, Melissa J.; Schmidt, Suzannah M.; Gomez Urena, Eric O.; Mandrekar, Jayawant N.; Osmon, Douglas R.; Lough, Lindsay E.; Pritt, Bobbi S.; Steckelberg, James M.

2013-01-01

We previously showed that culture of samples obtained by prosthesis vortexing and sonication was more sensitive than tissue culture for prosthetic joint infection (PJI) diagnosis. Despite improved sensitivity, culture-negative cases remained; furthermore, culture has a long turnaround time. We designed a genus-/group-specific rapid PCR assay panel targeting PJI bacteria and applied it to samples obtained by vortexing and sonicating explanted hip and knee prostheses, and we compared the results to those with sonicate fluid and periprosthetic tissue culture obtained at revision or resection arthroplasty. We studied 434 subjects with knee (n = 272) or hip (n = 162) prostheses; using a standardized definition, 144 had PJI. Sensitivities of tissue culture, of sonicate fluid culture, and of PCR were 70.1, 72.9, and 77.1%, respectively. Specificities were 97.9, 98.3, and 97.9%, respectively. Sonicate fluid PCR was more sensitive than tissue culture (P = 0.04). PCR of prosthesis sonication samples is more sensitive than tissue culture for the microbiologic diagnosis of prosthetic hip and knee infection and provides same-day PJI diagnosis with definition of microbiology. The high assay specificity suggests that typical PJI bacteria may not cause aseptic implant failure. PMID:23658273

Integrated shotgun sequencing and bioinformatics pipeline allows ultra-fast mitogenome recovery and confirms substantial gene rearrangements in Australian freshwater crayfishes

PubMed Central

2014-01-01

Background Although it is possible to recover the complete mitogenome directly from shotgun sequencing data, currently reported methods and pipelines are still relatively time consuming and costly. Using a sample of the Australian freshwater crayfish Engaeus lengana, we demonstrate that it is possible to achieve three-day turnaround time (four hours hands-on time) from tissue sample to NCBI-ready submission file through the integration of MiSeq sequencing platform, Nextera sample preparation protocol, MITObim assembly algorithm and MITOS annotation pipeline. Results The complete mitochondrial genome of the parastacid freshwater crayfish, Engaeus lengana, was recovered by modest shotgun sequencing (1.2 giga bases) using the Illumina MiSeq benchtop sequencing platform. Genome assembly using the MITObim mitogenome assembler recovered the mitochondrial genome as a single contig with a 97-fold mean coverage (min. = 17; max. = 138). The mitogenome consists of 15,934 base pairs and contains the typical 37 mitochondrial genes and a non-coding AT-rich region. The genome arrangement is similar to the only other published parastacid mitogenome from the Australian genus Cherax. Conclusions We infer that the gene order arrangement found in Cherax destructor is common to Australian crayfish and may be a derived feature of the southern hemisphere family Parastacidae. Further, we report to our knowledge, the simplest and fastest protocol for the recovery and assembly of complete mitochondrial genomes using the MiSeq benchtop sequencer. PMID:24484414

Detection of Foodborne Pathogenic Bacteria using Bacteriophage Tail Spike Proteins

NASA Astrophysics Data System (ADS)

Poshtiban, Somayyeh

Foodborne infections are worldwide health problem with tremendous social and financial impacts. Efforts are focused on developing accurate and reliable technologies for detection of food contaminations in early stages preferably on-site. This thesis focuses on interfacing engineering and biology by combining phage receptor binding proteins (RBPs) with engineered platforms including microresonator-based biosensors, magnetic particles and polymerase chain reaction (PCR) to develop bacterial detection sensors. We used phage RBPs as target specific bioreceptors to develop an enhanced microresonator array for bacterial detection. These resonator beams are optimized to feature a high natural frequency while offer large surface area for capture of bacteria. Theoretical analysis indicates a high mass sensitivity with a threshold for the detection of a single bacterial cell. We used phage RBPs as target specific bioreceptors, and successfully demonstrated the application of these phage RBB-immobilized arrays for specific detection of C. jejuni cells. We also developed a RBP-derivatized magnetic pre-enrichment method as an upstream sample preparation method to improve sensitivity and specificity of PCR for detection of bacterial cells in various food samples. The combination of RBP-based magnetic separation and real-time PCR allowed the detection of small number of bacteria in artificially contaminated food samples without any need for time consuming pre-enrichment step through culturing. We also looked into integration of the RBP-based magnetic separation with PCR onto a single microfluidic lab-on-a-chip to reduce the overall turnaround time.

Turning Around along the Cosmic Web

NASA Astrophysics Data System (ADS)

Lee, Jounghun; Yepes, Gustavo

2016-12-01

A bound violation designates a case in which the turnaround radius of a bound object exceeds the upper limit imposed by the spherical collapse model based on the standard ΛCDM paradigm. Given that the turnaround radius of a bound object is a stochastic quantity and that the spherical model overly simplifies the true gravitational collapse, which actually proceeds anisotropically along the cosmic web, the rarity of the occurrence of a bound violation may depend on the web environment. Assuming a Planck cosmology, we numerically construct the bound-zone peculiar velocity profiles along the cosmic web (filaments and sheets) around the isolated groups with virial mass {M}{{v}}≥slant 3× {10}13 {h}-1 {M}⊙ identified in the Small MultiDark Planck simulations and determine the radial distances at which their peculiar velocities equal the Hubble expansion speed as the turnaround radii of the groups. It is found that although the average turnaround radii of the isolated groups are well below the spherical bound limit on all mass scales, the bound violations are not forbidden for individual groups, and the cosmic web has an effect of reducing the rarity of the occurrence of a bound violation. Explaining that the spherical bound limit on the turnaround radius in fact represents the threshold distance up to which the intervention of the external gravitational field in the bound-zone peculiar velocity profiles around the nonisolated groups stays negligible, we discuss the possibility of using the threshold distance scale to constrain locally the equation of state of dark energy.

A Rural School/Community: A Case Study of a Dramatic Turnaround & Its Implications for School Improvement.

ERIC Educational Resources Information Center

Carlson, Robert V.

This paper presents a case study of a rural community exhibiting a dramatic turnaround in community support for a new school bond issue. Demographic change was partly responsible for the change in community attitudes, with two waves of immigration altering the long-term conservative orientation of this community. After a series of failed…

State Capacity to Support School Turnaround. NCEE Evaluation Brief. NCEE 2015-4012

ERIC Educational Resources Information Center

Tanenbaum, Courtney; Boyle, Andrea; Graczewski, Cheryl; James-Burdumy, Susanne; Dragoset, Lisa; Hallgren, Kristin

2015-01-01

One objective of the U.S. Department of Education's (ED) School Improvement Grants (SIG) and Race to the Top (RTT) program is to help states enhance their capacity to support the turnaround of low-performing schools. This capacity may be important, given how difficult it is to produce substantial and sustained achievement gains in low-performing…

Beyond Turnaround: A Synthesis of Relevant Frameworks for Leaders of Sustained Improvement in Previously Low-Performing Schools

ERIC Educational Resources Information Center

Hitt, Dallas Hambrick; Meyers, Coby V.

2018-01-01

We understand very little about what is special that leaders do to facilitate improvement that is both transformational and lasting in previously persistently failing schools in the United States. Relatively little is understood about change not just during the initial turnaround stage, but that "endures" on the larger journey as the…

The "City of Firsts" Charts a New Path on Turnaround. Linking State and Local School Improvement

ERIC Educational Resources Information Center

Jochim, Ashley; Opalka, Alice

2017-01-01

In 2014, the Springfield Public School district in Massachusetts had tried just about every strategy in the turnaround playbook to improve a set of struggling middle schools, but these efforts failed to generate the desired improvement. In 2015, drawing inspiration from national efforts to infuse schools with enhanced autonomy and accountability,…

A Case Study of a Turnaround High School: An Examination of the Maryland State Department of Education Breakthrough Center Intervention

ERIC Educational Resources Information Center

Galindo, Claudia; Stein, Kathleen; Schaffer, Eugene

2016-01-01

This study examined the Maryland State Department of Education Breakthrough Center (BTC) engagement in a Baltimore City turnaround high school. Utilizing a case-study design and mixed-methods research, data were collected through interviews, informal observations, and review of administrative and achievement documents. Beginning in the 2011-2012…

Investing for Sustainable Turnaround. Sustaining School Turnaround at Scale. Brief 2

ERIC Educational Resources Information Center

Education Resource Strategies, 2012

2012-01-01

The Federal government has brought the issue of low-performing schools to the forefront of public conversation by committing $3.5 billion over three years to turn around these schools. As of March 2011, over 1200 schools across the country had been awarded School Improvement Grants (SIG). Given the magnitude of this short-term investment and the…

Operational Authority, Support, and Monitoring of School Turnaround. NCEE Evaluation Brief. NCEE 2014-4008

ERIC Educational Resources Information Center

Herman, Rebecca; Graczewski, Cheryl; James-Burdumy, Susanne; Murray, Matthew; Perez-Johnson, Irma; Tanenbaum, Courtney

2013-01-01

The federal School Improvement Grants (SIG) program, to which $3 billion were allocated under the American Recovery and Reinvestment Act of 2009 (ARRA), supports schools attempting to turn around a history of low performance. School turnaround also is a focus of Race to the Top (RTT), another ARRA-supported initiative, which involved a roughly $4…

Are Bad Schools Immortal? The Scarcity of Turnarounds and Shutdowns in Both Charter and District Sectors

ERIC Educational Resources Information Center

Stuit, David A.

2010-01-01

This study investigates the successes of the charter and district sectors in eliminating bad schools via dramatic turnarounds in performance and/or shutdowns. It identified 2,025 low-performing charter and district schools across ten states, each of which is home to a sizable number of charter schools. These particular schools were tracked from…

A Case Study of Essential Components of School Success in a Turnaround School

ERIC Educational Resources Information Center

Cronin, Jodi Lynn

2016-01-01

School reform and turnaround efforts have been in the public eye since the signing of the Elementary and Secondary Act (ESEA) into law by President Lyndon Baines Johnson in 1965. Research has been focused on the School Improvement Grant, as well as the essential components that improve performance of schools. This qualitative case examines one…

Turnaround Schools: Practices Used by Nationally Recognized Principals to Improve Student Achievement in High Poverty Schools

ERIC Educational Resources Information Center

Brown, Angela Antuanette

2012-01-01

The specific purpose of this study was to identify the practices used by leaders of National Blue Ribbon Awarded Schools to successfully turnaround a school or to maintain proficient achievement scores within the school. The school principals answered a four part questionnaire for this study. Part 1 of the questionnaire asked about the extent to…

Where the world stands still: turnaround as a strong test of ΛCDM cosmology

NASA Astrophysics Data System (ADS)

Pavlidou, V.; Tomaras, T. N.

2014-09-01

Our intuitive understanding of cosmic structure formation works best in scales small enough so that isolated, bound, relaxed gravitating systems are no longer adjusting their radius; and large enough so that space and matter follow the average expansion of the Universe. Yet one of the most robust predictions of ΛCDM cosmology concerns the scale that separates these limits: the turnaround radius, which is the non-expanding shell furthest away from the center of a bound structure. We show that the maximum possible value of the turnaround radius within the framework of the ΛCDM model is, for a given mass M, equal to (3GM/Λ c2)1/3, with G Newton's constant and c the speed of light, independently of cosmic epoch, exact nature of dark matter, or baryonic effects. We discuss the possible use of this prediction as an observational test for ΛCDM cosmology. Current data appear to favor ΛCDM over alternatives with local inhomogeneities and no Λ. However there exist several local-universe structures that have, within errors, reached their limiting size. With improved determinations of their turnaround radii and the enclosed mass, these objects may challenge the limit and ΛCDM cosmology.

Rapid review programs to support health care and policy decision making: a descriptive analysis of processes and methods.

PubMed

Polisena, Julie; Garritty, Chantelle; Kamel, Chris; Stevens, Adrienne; Abou-Setta, Ahmed M

2015-03-14

Health care decision makers often need to make decisions in limited timeframes and cannot await the completion of a full evidence review. Rapid reviews (RRs), utilizing streamlined systematic review methods, are increasingly being used to synthesize the evidence with a shorter turnaround time. Our primary objective was to describe the processes and methods used internationally to produce RRs. In addition, we sought to understand the underlying themes associated with these programs. We contacted representatives of international RR programs from a broad realm in health care to gather information about the methods and processes used to produce RRs. The responses were summarized narratively to understand the characteristics associated with their processes and methods. The summaries were compared and contrasted to highlight potential themes and trends related to the different RR programs. Twenty-nine international RR programs were included in our sample with a broad organizational representation from academia, government, research institutions, and non-for-profit organizations. Responses revealed that the main objectives for RRs were to inform decision making with regards to funding health care technologies, services and policy, and program development. Central themes that influenced the methods used by RR programs, and report type and dissemination were the imposed turnaround time to complete a report, resources available, the complexity and sensitivity of the research topics, and permission from the requestor. Our study confirmed that there is no standard approach to conduct RRs. Differences in processes and methods across programs may be the result of the novelty of RR methods versus other types of evidence syntheses, customization of RRs for various decision makers, and definition of 'rapid' by organizations, since it impacts both the timelines and the evidence synthesis methods. Future research should investigate the impact of current RR methods and reporting to support informed health care decision making, the effects of potential biases that may be introduced with streamlined methods, and the effectiveness of RR reporting guidelines on transparency.

A cloud-compatible bioinformatics pipeline for ultrarapid pathogen identification from next-generation sequencing of clinical samples

PubMed Central

Naccache, Samia N.; Federman, Scot; Veeraraghavan, Narayanan; Zaharia, Matei; Lee, Deanna; Samayoa, Erik; Bouquet, Jerome; Greninger, Alexander L.; Luk, Ka-Cheung; Enge, Barryett; Wadford, Debra A.; Messenger, Sharon L.; Genrich, Gillian L.; Pellegrino, Kristen; Grard, Gilda; Leroy, Eric; Schneider, Bradley S.; Fair, Joseph N.; Martínez, Miguel A.; Isa, Pavel; Crump, John A.; DeRisi, Joseph L.; Sittler, Taylor; Hackett, John; Miller, Steve; Chiu, Charles Y.

2014-01-01

Unbiased next-generation sequencing (NGS) approaches enable comprehensive pathogen detection in the clinical microbiology laboratory and have numerous applications for public health surveillance, outbreak investigation, and the diagnosis of infectious diseases. However, practical deployment of the technology is hindered by the bioinformatics challenge of analyzing results accurately and in a clinically relevant timeframe. Here we describe SURPI (“sequence-based ultrarapid pathogen identification”), a computational pipeline for pathogen identification from complex metagenomic NGS data generated from clinical samples, and demonstrate use of the pipeline in the analysis of 237 clinical samples comprising more than 1.1 billion sequences. Deployable on both cloud-based and standalone servers, SURPI leverages two state-of-the-art aligners for accelerated analyses, SNAP and RAPSearch, which are as accurate as existing bioinformatics tools but orders of magnitude faster in performance. In fast mode, SURPI detects viruses and bacteria by scanning data sets of 7–500 million reads in 11 min to 5 h, while in comprehensive mode, all known microorganisms are identified, followed by de novo assembly and protein homology searches for divergent viruses in 50 min to 16 h. SURPI has also directly contributed to real-time microbial diagnosis in acutely ill patients, underscoring its potential key role in the development of unbiased NGS-based clinical assays in infectious diseases that demand rapid turnaround times. PMID:24899342

Validation of a rapid DNA process with the RapidHIT® ID system using GlobalFiler® Express chemistry, a platform optimized for decentralized testing environments.

PubMed

Salceda, Susana; Barican, Arnaldo; Buscaino, Jacklyn; Goldman, Bruce; Klevenberg, Jim; Kuhn, Melissa; Lehto, Dennis; Lin, Frank; Nguyen, Phong; Park, Charles; Pearson, Francesca; Pittaro, Rick; Salodkar, Sayali; Schueren, Robert; Smith, Corey; Troup, Charles; Tsou, Dean; Vangbo, Mattias; Wunderle, Justus; King, David

2017-05-01

The RapidHIT ® ID is a fully automated sample-to-answer system for short tandem repeat (STR)-based human identification. The RapidHIT ID has been optimized for use in decentralized environments and processes presumed single source DNA samples, generating Combined DNA Index System (CODIS)-compatible DNA profiles in less than 90min. The system is easy to use, requiring less than one minute of hands-on time. Profiles are reviewed using centralized linking software, RapidLINK™ (IntegenX, Pleasanton, CA), a software tool designed to collate DNA profiles from single or multiple RapidHIT ID systems at different geographic locations. The RapidHIT ID has been designed to employ GlobalFiler ® Express and AmpFLSTR ® NGMSElect™, Thermo Fisher Scientific (Waltham, MA) STR chemistries. The Developmental Validation studies were performed using GlobalFiler ® Express with single source reference samples according to Scientific Working Group for DNA Analysis Methods guidelines. These results show that multiple RapidHIT ID systems networked with RapidLINK software form a highly reliable system for wide-scale deployment in locations such as police booking stations and border crossings enabling real-time testing of arrestees, potential human trafficking victims, and other instances where rapid turnaround is essential. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Requirements for radiation emergency urine bioassay techniques for the public and first responders.

PubMed

Li, Chunsheng; Vlahovich, Slavica; Dai, Xiongxin; Richardson, Richard B; Daka, Joseph N; Kramer, Gary H

2010-11-01

Following a radiation emergency, the affected public and the first responders may need to be quickly assessed for internal contamination by the radionuclides involved. Urine bioassay is one of the most commonly used methods for assessing radionuclide intake and radiation dose. This paper attempts to derive the sensitivity requirements (from inhalation exposure) for the urine bioassay techniques for the top 10 high-risk radionuclides that might be used in a terrorist attack. The requirements are based on a proposed reference dose to adults of 0.1 Sv (CED, committed effective dose). In addition, requirements related to sample turnaround time and field deployability of the assay techniques are also discussed. A review of currently available assay techniques summarized in this paper reveals that method development for ²⁴¹Am, ²²⁶Ra, ²³⁸Pu, and ⁹⁰Sr urine bioassay is needed.

GEMPAK: An arbitrary aircraft geometry generator

NASA Technical Reports Server (NTRS)

Stack, S. H.; Edwards, C. L. W.; Small, W. J.

1977-01-01

A computer program, GEMPAK, has been developed to aid in the generation of detailed configuration geometry. The program was written to allow the user as much flexibility as possible in his choices of configurations and the detail of description desired and at the same time keep input requirements and program turnaround and cost to a minimum. The program consists of routines that generate fuselage and planar-surface (winglike) geometry and a routine that will determine the true intersection of all components with the fuselage. This paper describes the methods by which the various geometries are generated and provides input description with sample input and output. Also included are descriptions of the primary program variables and functions performed by the various routines. The FORTRAN program GEMPAK has been used extensively in conjunction with interfaces to several aerodynamic and plotting computer programs and has proven to be an effective aid in the preliminary design phase of aircraft configurations.

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

Bhattacharya, Sourav; Dialektopoulos, Konstantinos F.; Romano, Antonio Enea

The maximum size of a cosmic structure is given by the maximum turnaround radius—the scale where the attraction due to its mass is balanced by the repulsion due to dark energy. We derive generic formulae for the estimation of the maximum turnaround radius in any theory of gravity obeying the Einstein equivalence principle, in two situations: on a spherically symmetric spacetime and on a perturbed Friedman-Robertson-Walker spacetime. We show that the two formulae agree. As an application of our formula, we calculate the maximum turnaround radius in the case of the Brans-Dicke theory of gravity. We find that for thismore » theory, such maximum sizes always lie above the ΛCDM value, by a factor 1 + 1/3ω, where ω>> 1 is the Brans-Dicke parameter, implying consistency of the theory with current data.« less

Searching for Constraints on Starobinsky's Model with a Disappearing Cosmological Constant on Galaxy Cluster Scales

NASA Astrophysics Data System (ADS)

Alexeyev, S. O.; Latosh, B. N.; Echeistov, V. A.

2017-12-01

Predictions of the f( R)-gravity model with a disappearing cosmological constant (Starobinsky's model) on scales characteristic of galaxies and their clusters are considered. The absence of a difference in the mass dependence of the turnaround radius between Starobinsky's model and General Relativity accessible to observation at the current accuracy of measurements has been established. This is true both for small masses (from 109 M Sun) corresponding to an individual galaxy and for masses corresponding to large galaxy clusters (up to 1015 M Sun). The turnaround radius increases with parameter n for all masses. Despite the fact that some models give a considerably smaller turnaround radius than does General Relativity, none of the models goes beyond the bounds specified by the observational data.

Stability of plasma electrolytes in Barricor and PST II tubes under different storage conditions.

PubMed

Balbás, Luis Alfredo Bautista; Amaro, Marta Segovia; Rioja, Rubén Gómez; Martín, María José Alcaide; Soto, Antonio Buńo

2017-02-15

Sample stability can be influenced by many different factors; evaporation and leakage from residual cells are the most relevant factors for electrolytes. During the analytical phase, samples are usually kept uncapped at room temperature. Once samples are processed, they are usually stored sealed and refrigerated. Long turnaround time and the possibility of "add-on test" need consideration for electrolyte stability. The aim of our study is to examine short-term electrolyte stability in this two-common laboratory working conditions in two different lithium heparin plasma tubes (Barricor and PST II, Becton Dickinson). In 39 plasma samples from voluntary subjects we measured sodium (Na + ), potassium (K + ) and chloride (Cl - ) at 6 time points since centrifugation (0h, 3h, 6h, 9h, 12h and 15h). Maximum allowable bias (clinically significant change) was based in SEQC (Sociedad Espańola de Química Clínica) recommendations; 1% for Cl - , 0.6% for Na + and 4% for K + . In open room temperature tubes, clinically significant changes appeared in Na + and Cl - after 3 hours and in K + after 9 hours in both types of tubes. In refrigerated sealed tubes, all the analytes were clinically stable up to 12 hours in both kinds of plasma tubes. We observed a statistically significant progressive increase in K + levels, which was less pronounced in Barricor tubes. Stability of electrolytes is compromised after 3 hours in open tubes and after 12 hours in sealed tubes.

An Overview on Prenatal Screening for Chromosomal Aberrations.

PubMed

Hixson, Lucas; Goel, Srishti; Schuber, Paul; Faltas, Vanessa; Lee, Jessica; Narayakkadan, Anjali; Leung, Ho; Osborne, Jim

2015-10-01

This article is a review of current and emerging methods used for prenatal detection of chromosomal aneuploidies. Chromosomal anomalies in the developing fetus can occur in any pregnancy and lead to death prior to or shortly after birth or to costly lifelong disabilities. Early detection of fetal chromosomal aneuploidies, an atypical number of certain chromosomes, can help parents evaluate their pregnancy options. Current diagnostic methods include maternal serum sampling or nuchal translucency testing, which are minimally invasive diagnostics, but lack sensitivity and specificity. The gold standard, karyotyping, requires amniocentesis or chorionic villus sampling, which are highly invasive and can cause abortions. In addition, many of these methods have long turnaround times, which can cause anxiety in mothers. Next-generation sequencing of fetal DNA in maternal blood enables minimally invasive, sensitive, and reasonably rapid analysis of fetal chromosomal anomalies and can be of clinical utility to parents. This review covers traditional methods and next-generation sequencing techniques for diagnosing aneuploidies in terms of clinical utility, technological characteristics, and market potential. © 2015 Society for Laboratory Automation and Screening.

Novel method for on-road emission factor measurements using a plume capture trailer.

PubMed

Morawska, L; Ristovski, Z D; Johnson, G R; Jayaratne, E R; Mengersen, K

2007-01-15

The method outlined provides for emission factor measurements to be made for unmodified vehicles driving under real world conditions at minimal cost. The method consists of a plume capture trailer towed behind a test vehicle. The trailer collects a sample of the naturally diluted plume in a 200 L conductive bag and this is delivered immediately to a mobile laboratory for subsequent analysis of particulate and gaseous emissions. The method offers low test turnaround times with the potential to complete much larger numbers of emission factor measurements than have been possible using dynamometer testing. Samples can be collected at distances up to 3 m from the exhaust pipe allowing investigation of early dilution processes. Particle size distribution measurements, as well as particle number and mass emission factor measurements, based on naturally diluted plumes are presented. A dilution profile relating the plume dilution ratio to distance from the vehicle tail pipe for a diesel passenger vehicle is also presented. Such profiles are an essential input for new mechanistic roadway air quality models.

Computational Methodology for Absolute Calibration Curves for Microfluidic Optical Analyses

PubMed Central

Chang, Chia-Pin; Nagel, David J.; Zaghloul, Mona E.

2010-01-01

Optical fluorescence and absorption are two of the primary techniques used for analytical microfluidics. We provide a thorough yet tractable method for computing the performance of diverse optical micro-analytical systems. Sample sizes range from nano- to many micro-liters and concentrations from nano- to milli-molar. Equations are provided to trace quantitatively the flow of the fundamental entities, namely photons and electrons, and the conversion of energy from the source, through optical components, samples and spectral-selective components, to the detectors and beyond. The equations permit facile computations of calibration curves that relate the concentrations or numbers of molecules measured to the absolute signals from the system. This methodology provides the basis for both detailed understanding and improved design of microfluidic optical analytical systems. It saves prototype turn-around time, and is much simpler and faster to use than ray tracing programs. Over two thousand spreadsheet computations were performed during this study. We found that some design variations produce higher signal levels and, for constant noise levels, lower minimum detection limits. Improvements of more than a factor of 1,000 were realized. PMID:22163573

Progressive sampling-based Bayesian optimization for efficient and automatic machine learning model selection.

PubMed

Zeng, Xueqiang; Luo, Gang

2017-12-01

Machine learning is broadly used for clinical data analysis. Before training a model, a machine learning algorithm must be selected. Also, the values of one or more model parameters termed hyper-parameters must be set. Selecting algorithms and hyper-parameter values requires advanced machine learning knowledge and many labor-intensive manual iterations. To lower the bar to machine learning, miscellaneous automatic selection methods for algorithms and/or hyper-parameter values have been proposed. Existing automatic selection methods are inefficient on large data sets. This poses a challenge for using machine learning in the clinical big data era. To address the challenge, this paper presents progressive sampling-based Bayesian optimization, an efficient and automatic selection method for both algorithms and hyper-parameter values. We report an implementation of the method. We show that compared to a state of the art automatic selection method, our method can significantly reduce search time, classification error rate, and standard deviation of error rate due to randomization. This is major progress towards enabling fast turnaround in identifying high-quality solutions required by many machine learning-based clinical data analysis tasks.

MOD: An Organic Detector for the Future Exploration of Mars

NASA Technical Reports Server (NTRS)

Kminek, G.; Bada, J. L.; Botta, O.; Grunthaner, F.; Glavin, D. P.

1999-01-01

The Mars Organic Detector (MOD) is designed to assess whether organic compounds, possibly associated with life, are present in Martian rock and soil samples. MOD has a detection limit that is at least two orders of magnitude more sensitive than the Viking GCMS. MOD is focused on detecting amino acids, amines and PAH (polycyclic aromatic hydrocarbons). Amino acids play an essential role in biochemistry on Earth and PAH are widespread throughout the universe and can provide an indication of the delivery of meteoritic organic material to Mars. The advantage of MOD is the absence of wet chemistry and its simple and robust design. The sample will be extracted from the mineral matrix (0.1 - 1 g of rock-powder) using sublimation and analyzed with a fluorescence detector. The isolation method is based on the fact that amino acids and PAH are volatile at temperatures greater than 150C. The fluorescence detection scheme is based on UV excitation with LED's, optical filters, PrN diode photon detector and a sample calibration reservoir. Fluorescamine is used as a fluorescing reagent for amino acids and amines, while PAH are naturally fluorescent. There is no sample preparation required and the turnaround time for a single analysis is on the order of minutes.

Rapid identification of microorganisms from positive blood cultures by testing early growth on solid media using matrix-assisted laser desorption ionization-time of flight mass spectrometry.

PubMed

Gonzalez, Mark D; Weber, Carol J; Burnham, Carey-Ann D

2016-06-01

We performed a retrospective analysis of a simple modification to MALDI-TOF MS for microorganism identification to accurately improve the turnaround time (TAT) for identification of Enterobacteriaceae recovered in blood cultures. Relative to standard MALDI-TOF MS procedures, we reduced TAT from 28.3 (n=90) to 21.2h (n=107). Copyright © 2016 Elsevier Inc. All rights reserved.

Development of a thyroid function strategy for general practice.

PubMed Central

Ramachandran, S; Milles, J J; Wells, M B; Hall, R A

1998-01-01

A study was carried out to investigate a thyroid stimulating hormone (TSH) frontline strategy that could potentially result in a more straightforward interpretation of thyroid function tests, a reduction in the number of inappropriate referrals to medical outpatients, an improvement in the 'turnaround time' of results, and a reduction in the number of unnecessary tests carried out, thereby reducing costs. PMID:10071403

National Combustion Code: Parallel Performance

NASA Technical Reports Server (NTRS)

Babrauckas, Theresa

2001-01-01

This report discusses the National Combustion Code (NCC). The NCC is an integrated system of codes for the design and analysis of combustion systems. The advanced features of the NCC meet designers' requirements for model accuracy and turn-around time. The fundamental features at the inception of the NCC were parallel processing and unstructured mesh. The design and performance of the NCC are discussed.

Adoption of Lean Principles in a High-Volume Molecular Diagnostic Microbiology Laboratory

PubMed Central

Mitchell, P. Shawn; Mandrekar, Jayawant N.

2014-01-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. PMID:24829247

New methods and materials for molding and casting ice formations

NASA Technical Reports Server (NTRS)

Reehorst, Andrew L.; Richter, G. Paul

1987-01-01

This study was designed to find improved materials and techniques for molding and casting natural or simulated ice shapes that could replace the wax and plaster method. By utilizing modern molding and casting materials and techniques, a new methodology was developed that provides excellent reproduction, low-temperature capability, and reasonable turnaround time. The resulting casts are accurate and tough.

Aqua-Aura QuickDAM (QDAM) 2.0 Ops Concept

NASA Technical Reports Server (NTRS)

Nidhiry, John

2015-01-01

The presentation describes the Quick Debris Avoidance Maneuver (QDAM) 2.0 process used the Aqua and Aura flight teams to (a) reduce the work load and dependency on staff and systems; (b) reduce turn-around time and provide emergency last minute capabilities; and (c) increase burn parameter flexibility. The presentation also compares the QDAM 2.0 process to previous approaches.

Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program

ERIC Educational Resources Information Center

Roelandt, James P.

2012-01-01

Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

Developing a lean culture in the laboratory.

PubMed

Napoles, Leyda; Quintana, Maria

2006-07-25

The Director of Pathology at Jackson Memorial Hospital was interested in improving the operational efficiencies of the department in order to enhance the department's level of service in conjunction with the expansion of the overall health system. The decision was made to implement proven Lean practices in the laboratory under the direction of a major consulting firm. This article details the scope of the initial project as well as the operating principles of Lean manufacturing practices as applied to the clinical laboratory. The goals of the project were to improve turnaround times of laboratory results, reduce inventory and supply costs, improve staff productivity, maximize workflow, and eliminate waste. Extensive data gathering and analysis guided the work process by highlighting the areas of highest opportunity. This systematic approach resulted in recommendations for the workflow and physical layout of the laboratory. It also included the introduction of "standard workflow" and "visual controls" as critical items that streamlined operational efficiencies. The authors provide actual photographs and schematics of the reorganization and improvements to the physical layout of the laboratory. In conclusion, this project resulted in decreased turnaround times and increased productivity, as well as significant savings in the overall laboratory operations.

School Improvement and Urban Renewal: The Impact of a Turnaround School's Performance on Real Property Values in Its Surrounding Community

ERIC Educational Resources Information Center

Jacobson, Stephen L.; Szczesek, Jill

2013-01-01

This study investigates the economic impact of a "turnaround" school on real property values in its surrounding community as related to the argument introduced by Tiebout in 1956 correlating local public goods, in this case school success, to housing-location decision making. Using single-family home sales found on the Multiple Listing System and…

Evaluation of Massachusetts Office of District and School Turnaround Assistance to Commissioner's Districts and Schools: Impact of School Redesign Grants

ERIC Educational Resources Information Center

LiCalsi, Christina; Citkowicz, Martyna; Friedman, Lawrence B.; Brown, Megan

2015-01-01

The Massachusetts Office of District and School Turnaround (ODST) assists the Commissioner's Districts (the 10 largest districts in the state) and schools within those districts. The assistance focuses on turning around the lowest performing schools in the district while building district capacity to support improvement in other district schools.…

District Support Systems for the Alignment of Curriculum, Instruction, and Assessment: Can We Predict Student Achievement in Reading and Writing for School Turnaround?

ERIC Educational Resources Information Center

Abbott, Laura Lynn Tanner

2014-01-01

The purpose of this quantitative non-experimental predictive study was to determine if CIA alignment factors and related district support systems are associated with student achievement to enable the turnaround of schools in crisis. This study aimed to utilize the District Snapshot Tool to determine if the district systems that support CIA…

Distributed computer system enhances productivity for SRB joint optimization

NASA Technical Reports Server (NTRS)

Rogers, James L., Jr.; Young, Katherine C.; Barthelemy, Jean-Francois M.

1987-01-01

Initial calculations of a redesign of the solid rocket booster joint that failed during the shuttle tragedy showed that the design had a weight penalty associated with it. Optimization techniques were to be applied to determine if there was any way to reduce the weight while keeping the joint opening closed and limiting the stresses. To allow engineers to examine as many alternatives as possible, a system was developed consisting of existing software that coupled structural analysis with optimization which would execute on a network of computer workstations. To increase turnaround, this system took advantage of the parallelism offered by the finite difference technique of computing gradients to allow several workstations to contribute to the solution of the problem simultaneously. The resulting system reduced the amount of time to complete one optimization cycle from two hours to one-half hour with a potential of reducing it to 15 minutes. The current distributed system, which contains numerous extensions, requires one hour turnaround per optimization cycle. This would take four hours for the sequential system.

[Increasing Number of Road Traffic Fatalities in Germany - Turnaround or Snap-Shot].

PubMed

Brand, S; Schmucker, U; Lob, G; Haasper, C; Juhra, C; Hell, W; Rieth, P; Matthes, G

2017-04-01

Introduction: For the first time since 20 years, the number of road accident fatalities in 2011 increased on German roads compared to earlier periods. Methods and Results: The presented paper submitted by the expert group for accident prevention investigates and discusses possible reasons for the observed increase in road traffic fatalities. Results: Climate changes as well as changes in economic environment, and technological progress in car and passenger safety are identified as possible reasons for the observed increase. Discussion: Mentioning the "Decade of Action for Road Safety" initiated by the UNO and coordinated by the WHO, the overall goal is a worldwide reduction of accident related road fatalities. But prognostic calculations predict an asymptotic approximation to a limit of road fatalities. To achieve a reduction by half until 2020 intense collaboration and disproportional expenditure are necessary. Conclusion: From the authors' point of view the current increase of traffic fatalities in Germany is rated as a snapshot rather than a turnaround. Georg Thieme Verlag KG Stuttgart · New York.

Surface term effects on mass estimators

NASA Astrophysics Data System (ADS)

Membrado, M.; Pacheco, A. F.

2016-05-01

Context. We propose a way of estimating the mass contained in the volume occupied by a sample of galaxies in a virialized system. Aims: We analyze the influence of surface effects and the contribution of the cosmological constant terms on our mass estimations of galaxy systems. Methods: We propose two equations that contain surface terms to estimate galaxy sample masses. When the surface terms are neglected, these equations provide the so-called virial and projected masses. Both equations lead to a single equation that allows sample masses to be estimated without the need for calculating surface terms. Sample masses for some nearest galaxy groups are estimated and compared with virialized masses determined from turn-around radii and results of a spherical infall model. Results: Surface effects have a considerable effect on the mass estimations of the studied galaxy groups. According to our results, they lead sample masses of some groups to being less than half the virial mass estimations and even less than 10% of projected mass estimations. However, the contributions of cosmological constant terms to mass estimations are smaller than 2% for the majority of the virialized groups studied. Our estimations are in agreement with virialized masses calculated from turn-around radii. Virialized masses for complexes were found to be: (8.9 ± 2.8) × 1011 M⊙ for the Milky Way - M 31; (12.5 ± 2.5) × 1011 M⊙ for M 81 - NGC 2403; (21.5 ± 7.7) × 1011 M⊙. for Cantaurs A - M 83; and (7.9 ± 2.6) × 1011 M⊙. for IC 324 - Maffei. Conclusions: The nearest galaxy groups located inside a sphere of 5 Mpc have been addressed to explore the performance of our mass estimator. We have seen that surface effects make mass estimations of galaxy groups rather smaller than both virial and projected masses. In mass calculations, cosmological constant terms can be neglected; nevertheless, the collapse of cold dark matter leading to virialized structures is strongly affected by the cosmological constant. We have also seen that, if mass density were proportional to luminosity density on different scales in the Universe, the 5 Mpc sphere would have a mean density close to that of the sphere region containing galaxies and systems of galaxies; thus, the rest of the sphere could contain regions of low-mass dark halos with similar mass density. This mass density would be about 4.5 times greater than that of the matter background of the Universe at present.

Development and Validation of a Rotor-Gene Real-Time PCR Assay for Detection, Identification, and Quantification of Chlamydia trachomatis in a Single Reaction

PubMed Central

Jalal, Hamid; Stephen, Hannah; Curran, Martin D.; Burton, Janet; Bradley, Michelle; Carne, Christopher

2006-01-01

A multitarget real-time PCR (MRT-PCR) for detection of Chlamydia trachomatis DNA was developed and validated. There were three targets for amplification in a single reaction: the cryptic plasmid (CP), the major outer membrane protein (MOMP) gene, and an internal control. The assay had the following characteristics: (i) detection and confirmation of the presence of C. trachomatis DNA in a single reaction, (ii) detection of all genovars of C. trachomatis without any cross-reactivity with pathogenic bacteria or commensal organisms of the oropharynx and genital tract, (iii) a 95% probability of detection with three copies of MOMP and one copy of CP per reaction mixture, (iv) identification of the inhibition of amplification, (v) a quantitative dynamic range of 25 to 250,000 genome copies per reaction mixture, (vi) high intra- and interassay reproducibilities, and (vii) correct identification of all samples in the validation panel. There were 146 COBAS Amplicor PCR (Amplicor PCR)-positive samples and 122 Amplicor PCR-negative samples in the panel. MRT-PCR detected CP DNA alone in 6 (4%) Amplicor PCR-positive samples and both CP and MOMP DNAs in 140 (96%) of 146 Amplicor PCR-positive samples. The quantity of MOMP DNA in 95 (68%) of 140 samples was within the dynamic range of the assay. The median C. trachomatis load in these samples was 321 genome copies per reaction mixture (range, 26 to 40,137 genome copies per reaction mixture). Due to the inclusion of two different C. trachomatis-specific targets, the assay confirmed 259 (97%) of 268 results in a single reaction. This assay could be used in the qualitative format for the routine detection of C. trachomatis and in the quantitative format for study of the pathogenesis of C. trachomatis-associated diseases. The assay demonstrated the potential to eliminate the need for confirmatory testing in almost all samples, thus reducing the turnaround time and the workload. PMID:16390971

Total laboratory automation: Do stat tests still matter?

PubMed

Dolci, Alberto; Giavarina, Davide; Pasqualetti, Sara; Szőke, Dominika; Panteghini, Mauro

2017-07-01

During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions. In this laboratory department model, the short TAT for all first-line tests performed by TLA in the core laboratory represents the key paradigm, where no more stat testing is required because all samples are handled in real-time and (auto)validated results dispatched in a time that fulfills clinical needs. To optimally reach this goal, laboratories should be actively involved in managing all the steps covering the total examination process, speeding up also extra-laboratory phases, such sample delivery. Furthermore, to warrant effectiveness and not only efficiency, all the processes, e.g. specimen integrity check, should be managed by middleware through a predefined set of rules defined in light of the clinical governance. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Applications of ISES for the atmospheric sciences

NASA Technical Reports Server (NTRS)

Hoell, James M., Jr.

1990-01-01

The proposed Information Sciences Experiment System (ISES) will offer the opportunity for real-time access to measurements acquired aboard the Earth Observation System (Eos) satellite. These measurements can then be transmitted to remotely located ground based stations. The application of such measurements to issues related to atmospheric science which was presented to a workshop convened to review possible application of the ISES in earth sciences is summarized. The proposed protocol for Eos instruments requires that measurement results be available in a central data archive within 72 hours of acquiring data. Such a turnaround of raw satellite data to the final product will clearly enhance the timeliness of the results. Compared to the time that results from many current satellite programs, the 72 hour turnaround may be considered real time. Examples are discussed showing how real-time measurements from one or more of the proposed Eos instruments could have been applied to the study of certain issues important to global atmospheric chemistry. Each of the examples discussed is based upon a field mission conducted during the past five years. Each of these examples will emphasize how real-time data could have been used to alter the course of a field experiment, thereby enhancing the scientific output. For the examples, brief overviews of the scientific rationale and objectives, the region of operation, the measurements aboard the aircraft, and finally how one or more of the proposed Eos instruments could have provided data to enhance the productivity of the mission are discussed.

Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center.

PubMed

Mehr, Chelsea R; Obstfeld, Amrom E; Barrett, Amanda C; Montone, Kathleen T; Schwartz, Lauren E

2017-01-01

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

PubMed Central

2010-01-01

Background Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell. Methods We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell. Results Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement). Conclusions Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT. PMID:20181123

Turnaround in an aged persons' mental health service in crisis: a case study of organisational renewal.

PubMed

Stafrace, Simon; Lilly, Alan

2008-08-01

This case study demonstrates how leadership was harnessed to turn around a decline in the performance of an aged persons' mental health service - the Namarra Nursing Home at Caulfield General Medical Centre in Melbourne, Australia. In 2000 the nursing home faced a crisis of public confidence due to failings in the management of quality, clinical risk and human resources within the service. These problems reflected structural and operational shortcomings in the clinical directorate and wider organisation. In this article, we detail the process of turnaround from the perspective of senior executive managers with professional and operational responsibility for the service. This turnaround required attention to local clinical accountability and transformation of the mental health program from a collocated but operationally isolated service to one integrated within the governance structures of the auspicing organisation.

Point -of -care testing (POCT) in molecular diagnostics: Performance evaluation of GeneXpert HCV RNA test in diagnosing and monitoring of HCV infection.

PubMed

Gupta, Ekta; Agarwala, Pragya; Kumar, Guresh; Maiwall, Rakhi; Sarin, Shiv Kumar

2017-03-01

Molecular testing at the point-of-care may turn out to be game changer for HCV diagnosis and treatment monitoring, through increased sensitivity, reduced turnaround time, and ease of performance. One such assay GeneXpert ® has recently been released. Comparative analysis between performances of GeneXpert ® and Abbott HCV-RNA was done. 174 HCV infected patients were recruited and, one time plasma samples from 154 patients and repeated samples from 20 patients, obtained at specific treatment time-points (0, 4, 12 and 24) weeks were serially re-tested on Xpert ® . Genotype 3 was the commonest, seen in 80 (66%) of the cases, genotype 1 in 34 (28.3%), genotype 4 in 4 (3.3%) and genotypes 2 and 5 in 1 (0.8%) each. Median HCV RNA load was 4.69 log 10 (range: 0-6.98log 10 ) IU/ml. Overall a very good correlation was seen between the two assays (R 2 =0.985), concordance of the results between the assays was seen in 138 samples (89.6%). High and low positive standards were tested ten times on Xpert ® to evaluate the precision and the coefficient of variation was 0.01 for HPC and 0.07 for the LPC. Monitoring of patients on two different regimes of treatment, pegylated interferon plus ribavirin and sofosbuvir plus ribavirin was done by both the systems at baseline, 4, 12 and 24 weeks. Perfect correlation between the assays in the course of therapy at different treatment time- point in genotypes 3 and 1 was seen. The study demonstrates excellent performance of the Xpert ® HCV assay in viral load assessment and in treatment course monitoring consistency. Copyright © 2017 Elsevier B.V. All rights reserved.

Massive metrology using fast e-beam technology improves OPC model accuracy by >2x at faster turnaround time

NASA Astrophysics Data System (ADS)

Zhao, Qian; Wang, Lei; Wang, Jazer; Wang, ChangAn; Shi, Hong-Fei; Guerrero, James; Feng, Mu; Zhang, Qiang; Liang, Jiao; Guo, Yunbo; Zhang, Chen; Wallow, Tom; Rio, David; Wang, Lester; Wang, Alvin; Wang, Jen-Shiang; Gronlund, Keith; Lang, Jun; Koh, Kar Kit; Zhang, Dong Qing; Zhang, Hongxin; Krishnamurthy, Subramanian; Fei, Ray; Lin, Chiawen; Fang, Wei; Wang, Fei

2018-03-01

Classical SEM metrology, CD-SEM, uses low data rate and extensive frame-averaging technique to achieve high-quality SEM imaging for high-precision metrology. The drawbacks include prolonged data collection time and larger photoresist shrinkage due to excess electron dosage. This paper will introduce a novel e-beam metrology system based on a high data rate, large probe current, and ultra-low noise electron optics design. At the same level of metrology precision, this high speed e-beam metrology system could significantly shorten data collection time and reduce electron dosage. In this work, the data collection speed is higher than 7,000 images per hr. Moreover, a novel large field of view (LFOV) capability at high resolution was enabled by an advanced electron deflection system design. The area coverage by LFOV is >100x larger than classical SEM. Superior metrology precision throughout the whole image has been achieved, and high quality metrology data could be extracted from full field. This new capability on metrology will further improve metrology data collection speed to support the need for large volume of metrology data from OPC model calibration of next generation technology. The shrinking EPE (Edge Placement Error) budget places more stringent requirement on OPC model accuracy, which is increasingly limited by metrology errors. In the current practice of metrology data collection and data processing to model calibration flow, CD-SEM throughput becomes a bottleneck that limits the amount of metrology measurements available for OPC model calibration, impacting pattern coverage and model accuracy especially for 2D pattern prediction. To address the trade-off in metrology sampling and model accuracy constrained by the cycle time requirement, this paper employs the high speed e-beam metrology system and a new computational software solution to take full advantage of the large volume data and significantly reduce both systematic and random metrology errors. The new computational software enables users to generate large quantity of highly accurate EP (Edge Placement) gauges and significantly improve design pattern coverage with up to 5X gain in model prediction accuracy on complex 2D patterns. Overall, this work showed >2x improvement in OPC model accuracy at a faster model turn-around time.

Using lean methodology to improve productivity in a hospital oncology pharmacy.

PubMed

Sullivan, Peter; Soefje, Scott; Reinhart, David; McGeary, Catherine; Cabie, Eric D

2014-09-01

Quality improvements achieved by a hospital pharmacy through the use of lean methodology to guide i.v. compounding workflow changes are described. The outpatient oncology pharmacy of Yale-New Haven Hospital conducted a quality-improvement initiative to identify and implement workflow changes to support a major expansion of chemotherapy services. Applying concepts of lean methodology (i.e., elimination of non-value-added steps and waste in the production process), the pharmacy team performed a failure mode and effects analysis, workflow mapping, and impact analysis; staff pharmacists and pharmacy technicians identified 38 opportunities to decrease waste and increase efficiency. Three workflow processes (order verification, compounding, and delivery) accounted for 24 of 38 recommendations and were targeted for lean process improvements. The workflow was decreased to 14 steps, eliminating 6 non-value-added steps, and pharmacy staff resources and schedules were realigned with the streamlined workflow. The time required for pharmacist verification of patient-specific oncology orders was decreased by 33%; the time required for product verification was decreased by 52%. The average medication delivery time was decreased by 47%. The results of baseline and postimplementation time trials indicated a decrease in overall turnaround time to about 70 minutes, compared with a baseline time of about 90 minutes. The use of lean methodology to identify non-value-added steps in oncology order processing and the implementation of staff-recommended workflow changes resulted in an overall reduction in the turnaround time per dose. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Efficiency improvements of offline metrology job creation

NASA Astrophysics Data System (ADS)

Zuniga, Victor J.; Carlson, Alan; Podlesny, John C.; Knutrud, Paul C.

1999-06-01

Progress of the first lot of a new design through the production line is watched very closely. All performance metrics, cycle-time, in-line measurement results and final electrical performance are critical. Rapid movement of this lot through the line has serious time-to-market implications. Having this material waiting at a metrology operation for an engineer to create a measurement job plan wastes valuable turnaround time. Further, efficient use of a metrology system is compromised by the time required to create and maintain these measurement job plans. Thus, having a method to develop metrology job plans prior to the actual running of the material through the manufacture area can significantly improve both cycle time and overall equipment efficiency. Motorola and Schlumberger have worked together to develop and test such a system. The Remote Job Generator (RJG) created job plans for new device sin a manufacturing process from an NT host or workstation, offline. This increases available system tim effort making production measurements, decreases turnaround time on job plan creation and editing, and improves consistency across job plans. Most importantly this allows job plans for new devices to be available before the first wafers of the device arrive at the tool for measurement. The software also includes a database manager which allows updates of existing job plans to incorporate measurement changes required by process changes or measurement optimization. This paper will review the result of productivity enhancements through the increased metrology utilization and decreased cycle time associated with the use of RJG. Finally, improvements in process control through better control of Job Plans across different devices and layers will be discussed.

Comparison of BD GeneOhm Methicillin-Resistant Staphylococcus aureus (MRSA) PCR versus the CHROMagar MRSA Assay for Screening Patients for the Presence of MRSA Strains▿

PubMed Central

Boyce, John M.; Havill, Nancy L.

2008-01-01

We compared the BD GeneOhm methicillin-resistant Staphylococcus aureus (MRSA) real-time PCR assay with the CHROMagar MRSA assay for the detection of MRSA in 286 nasal surveillance specimens. Compared with the CHROMagar MRSA assay, PCR had sensitivity, specificity, positive predictive value, and negative predictive values of 100%, 98.6%, 95.8%, and 100%, respectively. The mean PCR turnaround time was 14.5 h. PMID:18032616

Space shuttle solid rocket booster cost-per-flight analysis technique

NASA Technical Reports Server (NTRS)

Forney, J. A.

1979-01-01

A cost per flight computer model is described which considers: traffic model, component attrition, hardware useful life, turnaround time for refurbishment, manufacturing rates, learning curves on the time to perform tasks, cost improvement curves on quantity hardware buys, inflation, spares philosophy, long lead, hardware funding requirements, and other logistics and scheduling constraints. Additional uses of the model include assessing the cost per flight impact of changing major space shuttle program parameters and searching for opportunities to make cost effective management decisions.

The Launch Processing System for Space Shuttle.

NASA Technical Reports Server (NTRS)

Springer, D. A.

1973-01-01

In order to reduce costs and accelerate vehicle turnaround, a single automated system will be developed to support shuttle launch site operations, replacing a multiplicity of systems used in previous programs. The Launch Processing System will provide real-time control, data analysis, and information display for the checkout, servicing, launch, landing, and refurbishment of the launch vehicles, payloads, and all ground support systems. It will also provide real-time and historical data retrieval for management and sustaining engineering (test records and procedures, logistics, configuration control, scheduling, etc.).

Rapid-cycle testing cuts bed turnaround by 85%.

PubMed

2004-11-01

You can use rapid-cycle testing to try out new approaches to overcrowding much more frequently than with more traditional process improvement strategies. Improving bed turnaround notification can yield dramatic improvements. Telling staff they have to try a new process only for three days makes it easier to gain buy-in. Look for old policies that are no longer needed, yet continue to keep your staff bogged down.

Definition of technology development missions for early space stations orbit transfer vehicle serving. Phase 2, task 1: Space station support of operational OTV servicing

NASA Technical Reports Server (NTRS)

1983-01-01

Representative space based orbital transfer vehicles (OTV), ground based vehicle turnaround assessment, functional operational requirements and facilities, mission turnaround operations, a comparison of ground based versus space based tasks, activation of servicing facilities prior to IOC, fleet operations requirements, maintenance facilities, OTV servicing facilities, space station support requirements, and packaging for delivery are discussed.

Where the world stands still: turnaround as a strong test of ΛCDM cosmology

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

Pavlidou, V.; Tomaras, T.N., E-mail: pavlidou@physics.uoc.gr, E-mail: tomaras@physics.uoc.gr

Our intuitive understanding of cosmic structure formation works best in scales small enough so that isolated, bound, relaxed gravitating systems are no longer adjusting their radius; and large enough so that space and matter follow the average expansion of the Universe. Yet one of the most robust predictions of ΛCDM cosmology concerns the scale that separates these limits: the turnaround radius, which is the non-expanding shell furthest away from the center of a bound structure. We show that the maximum possible value of the turnaround radius within the framework of the ΛCDM model is, for a given mass M, equalmore » to (3GM/Λ c{sup 2}){sup 1/3}, with G Newton's constant and c the speed of light, independently of cosmic epoch, exact nature of dark matter, or baryonic effects. We discuss the possible use of this prediction as an observational test for ΛCDM cosmology. Current data appear to favor ΛCDM over alternatives with local inhomogeneities and no Λ. However there exist several local-universe structures that have, within errors, reached their limiting size. With improved determinations of their turnaround radii and the enclosed mass, these objects may challenge the limit and ΛCDM cosmology.« less

Providing critical laboratory results on time, every time to help reduce emergency department length of stay: how our laboratory achieved a Six Sigma level of performance.

PubMed

Blick, Kenneth E

2013-08-01

To develop a fully automated core laboratory, handling samples on a "first in, first out" real-time basis with Lean/Six Sigma management tools. Our primary goal was to provide services to critical care areas, eliminating turnaround time outlier percentage (TAT-OP) as a factor in patient length of stay (LOS). A secondary goal was to achieve a better laboratory return on investment. In 2011, we reached our primary goal when we calculated the TAT-OP distribution and found we had achieved a Six Sigma level of performance, ensuring that our laboratory service can be essentially eliminated as a factor in emergency department patient LOS. We also measured return on investment, showing a productivity improvement of 35%, keeping pace with our increased testing volume. As a result of our Lean process improvements and Six Sigma initiatives, in part through (1) strategic deployment of point-of-care testing and (2) core laboratory total automation with robotics, middleware, and expert system technology, physicians and nurses at the Oklahoma University Medical Center can more effectively deliver lifesaving health care using evidence-based protocols that depend heavily on "on time, every time" laboratory services.

A comparison of time-shared vs. batch development of space software

NASA Technical Reports Server (NTRS)

Forthofer, M.

1977-01-01

In connection with a study regarding the ground support software development for the Space Shuttle, an investigation was conducted concerning the most suitable software development techniques to be employed. A time-sharing 'trial period' was used to determine whether or not time-sharing would be a cost-effective software development technique for the Ground Based Shuttle system. It was found that time-sharing substantially improved job turnaround and programmer access to the computer for the representative group of ground support programmers. Moreover, this improvement resulted in an estimated saving of over fifty programmer days during the trial period.

Outsourcing Library Technical Services. A How-To-Do-It Manual for Librarians. How-To-Do-It Manuals for Librarians, Number 69.

ERIC Educational Resources Information Center

Hirshon, Arnold; Winters, Barbara

In the effort to reduce costs, improve productivity, enhance quality of services, and improve turnaround time for ordering, receiving, and cataloging new materials, libraries are increasingly turning to outsourcing as a strategic management tool to help them maximize use of their fiscal and human resources. This guide covers all aspects of…

Delta Clipper vehicle design for supportability

NASA Astrophysics Data System (ADS)

Smiljanic, Ray R.; Klevatt, Paul L.; Steinmeyer, Donald A.

1993-02-01

The paper describes the Single Stage Rocket Technology (SSRT) Delta Clipper vehicle design. As a means of reducing vehicle processing and turnaround times, the SSRT Delta Clipper design, contrary to past practices, incorporates support ability engineering features into its initial set of design requirements. The engineering process used to 'design-in' supportability into the Delta Clipper vehicle is described in detail and is illustrated using diagrams.

Using corporate finance to engineer an organizational turnaround.

PubMed

Sussman, Jason H; Dziesinski, Ray R

2002-11-01

Georgia's Southern Regional Medical Center used a proven corporate finance approach to dramatically improve its financial position and integrate its strategic and financial planning. Managers throughout the organization were educated about principles of corporate finance. Reliable cash-flow projections were used to create a multiyear glide path to financial stability. Initiatives were tied to specific time frames and quantifiable financial goals and underwent a standardized review process.

INM Integrated Noise Model Version 2. Programmer’s Guide

DTIC Science & Technology

1979-09-01

cost, turnaround time, and system-dependent limitations. 3.2 CONVERSION PROBLEMS Item Item Item No. Desciption Category 1 BLOCK DATA Initialization IBM ...Restricted 2 Boolean Operations Differences Call Statement Parameters Extensions 4 Data Initialization IBM Restricted 5 ENTRY Differences 6 EQUIVALENCE...Machine Dependent 7 Format: A CDC Extension 8 Hollerith Strings IBM Restricted 9 Hollerith Variables IBM Restricted 10 Identifier Names CDC Extension

Application of computer graphics in the design of custom orthopedic implants.

PubMed

Bechtold, J E

1986-10-01

Implementation of newly developed computer modelling techniques and computer graphics displays and software have greatly aided the orthopedic design engineer and physician in creating a custom implant with good anatomic conformity in a short turnaround time. Further advances in computerized design and manufacturing will continue to simplify the development of custom prostheses and enlarge their niche in the joint replacement market.

An Analysis of Unplanned Requirements and Their Impact on the Naval Electronic Systems Command

DTIC Science & Technology

1976-06-01

Evaluation Repair Turnaround Time Ship Alteration Management Information System Shipbuilding and Conversion, Navy Standard Hardware Program Ships Parts...pending assigment of a NSN. Such equipments would have little opportunity to accumulate any demand history. Secondly, the relatively low percentage of...mentioned above. Unfortunately, sufficient historical information was not available to fully accomplish this goal. In the case of assets acquired from

No Turning Back: A Case Study Analysis of Leadership Practices of Organizational Turnaround at A North Carolina Historically Black High School

ERIC Educational Resources Information Center

Chavis, William M.

2016-01-01

Despite the seeming progressiveness in moving from "Plessy v. Ferguson" to "Brown v. Board of Education," and from the Jim Crow era to the Civil Rights Movement, schools continue to exist that are racially homogenous and segregated at the core. Many of these schools were created in times of harsh legislation that mandated a…

Clinical effectiveness of rapid tests for methicillin resistant Staphylococcus aureus (MRSA) in hospitalized patients: a systematic review

PubMed Central

2011-01-01

Background Methicillin resistant Staphylococcus aureus (MRSA) are often resistant to multiple classes of antibiotics. The research objectives of this systematic review were to evaluate the clinical effectiveness of polymerase chain reaction (PCR) versus chromogenic agar for MRSA screening, and PCR versus no screening for several clinical outcomes, including MRSA colonization and infection rates. Methods An electronic literature search was conducted on studies evaluating polymerase chain reaction techniques and methicillin (also spelled meticillin) resistant Staphylococcus aureus that were published from 1993 onwards using Medline, Medline In-Process & Other Non-Indexed Citations, BIOSIS Previews, and EMBASE. Due to the presence of heterogeneity in the selected studies, the clinical findings of individual studies were described. Results Nine studies that compared screening for MRSA using PCR versus screening using chromogenic agar in a hospital setting, and two studies that compared screening using PCR with no or targeted screening were identified. Some studies found lower MRSA colonization and acquisition, infection, and transmission rates in screening with PCR versus screening with chromogenic agar, and the turnaround time for screening test results was lower for PCR. One study reported a lower number of unnecessary isolation days with screening using PCR versus screening with chromogenic agar, but the proportion of patients isolated was similar between both groups. The turnaround time for test results and number of isolation days were lower for PCR versus chromogenic agar for MRSA screening. Conclusions The use of PCR for MRSA screening demonstrated a lower turnaround time and number of isolation days compared with chromogenic agar. Given the mixed quality and number of studies (11 studies), gaps remain in the published literature and the evidence remains insufficient. In addition to screening, factors such as the number of contacts between healthcare workers and patients, number of patients attended by one healthcare worker per day, probability of colonization among healthcare workers, and MRSA status of hospital shared equipment and hospital environment must be considered to control the transmission of MRSA in a hospital setting. PMID:22151575

Warfarin genotyping in a single PCR reaction for microchip electrophoresis.

PubMed

Poe, Brian L; Haverstick, Doris M; Landers, James P

2012-04-01

Warfarin is the most commonly prescribed oral anticoagulant medication but also is the second leading cause of emergency room visits for adverse drug reactions. Genetic testing for warfarin sensitivity may reduce hospitalization rates, but prospective genotyping is impeded in part by the turnaround time and costs of genotyping. Microfluidics-based assays can reduce reagent consumption and analysis time; however, no current assay has integrated multiplexed allele-specific PCR for warfarin genotyping with electrophoretic microfluidics hardware. Ideally, such an assay would use a single PCR reaction and, without further processing, a single microchip electrophoresis (ME) run to determine the 3 single-nucleotide polymorphisms (SNPs) affecting warfarin sensitivity [i.e., CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) *2, CYP2C9 *3, and the VKORC1 (vitamin K epoxide reductase complex 1) A/B haplotype]. We designed and optimized primers for a fully multiplexed assay to examine 3 biallelic SNPs with the tetraprimer amplification refractory mutation system (T-ARMS). The assay was developed with conventional PCR equipment and demonstrated for microfluidic infrared-mediated PCR. Genotypes were determined by ME on the basis of the pattern of PCR products. Thirty-five samples of human genomic DNA were analyzed with this multiplex T-ARMS assay, and 100% of the genotype determinations agreed with the results obtained by other validated methods. The sample population included several genotypes conferring warfarin sensitivity, with both homozygous and heterozygous genotypes for each SNP. Total analysis times for the PCR and ME were approximately 75 min (1-sample run) and 90 min (12-sample run). This multiplexed T-ARMS assay coupled with microfluidics hardware constitutes a promising avenue for an inexpensive and rapid platform for warfarin genotyping.

Comparison of the Sanofi Diagnostics Pasteur Chlamydia Microplate EIA shortened assay with the original standard assay and cell culture.

PubMed

Chan, E L; Brandt, K; Stoneham, H; Horsman, G

1997-08-01

The new Sanofi Diagnostics Pasteur Chlamydia Microplate EIA shortened assay was evaluated by comparison with the original standard assay and cell culture. A total of 853 paired male and female genital tract specimens was tested with both Sanofi Chlamydia Microplate EIA shortened and standard assays and the results were compared with those of cell culture. For confirmation, a blocking assay run in the shortened format was used. Discrepancies between the three methods were resolved by a direct fluorescent antibody (DFA) test on the EIA samples or the culture retentate, or both. After resolution of discrepant results, the standard assay had a sensitivity, specificity, positive predictive value and negative predictive value of 98.5%, 100%, 100% and 99.9%, respectively. The shortened assay results were 100%, 100%, 100% and 100%, respectively. The shortened assay takes approximately 1.5 h less time than the standard assay and this study demonstrated that they have equivalent sensitivity and specificity. The improvement in turnaround time enables results to be reported on the same day.

Pharmacist involvement in a multidisciplinary initiative to reduce sepsis-related mortality.

PubMed

Beardsley, James R; Jones, Catherine M; Williamson, John; Chou, Jason; Currie-Coyoy, Margaret; Jackson, Teresa

2016-02-01

Pharmacy department contributions to a medical center's broad initiative to improve sepsis care outcomes are described. Timely and appropriate antimicrobial therapy is a key factor in optimizing treatment outcomes in patients with severe sepsis or septic shock. The inpatient pharmacy at Wake Forest Baptist Health implemented standardized processes to reduce order turnaround time and facilitate prompt antibiotic administration as part of the hospital's multidisciplinary "Code Sepsis" initiative. The program includes (1) nurse-conducted screening for sepsis using a standard assessment instrument, (2) pager alerts notifying rapid-response, pharmacy, and other personnel of cases of suspected sepsis, (3) activation of an electronic order set including guideline-based antibiotic therapy recommendations based on local pathogen patterns, and (4) a protocol allowing pharmacists to select an antibiotic regimen if providers are busy with other patient care duties. Assessments conducted during and after implementation of the Code Sepsis initiative showed improvements in key program metrics. The mean ± S.D. time from receipt of a Code Sepsis page to antibiotic delivery was reduced to 14.1 ± 13.7 minutes, the mean time from identification of suspected sepsis to antibiotic administration was reduced to 31 minutes in the hospital's intensive care units and to 51 minutes in non-critical care units, and the institution's performance on a widely used measure of sepsis-related mortality improved dramatically. Implementation of the Code Sepsis initiative was associated with reductions in order turnaround time, time to antibiotic administration, and sepsis-related mortality. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Turnaround Insights from the Organizational Sciences: A Review of the Empirical Evidence and the Development of a Staged Model of Recovery with Potential Implications for the PK-12 Education Sector

ERIC Educational Resources Information Center

Murphy, Joseph

2008-01-01

In this article, we review research from the organizational sciences to develop lessons for educators and policy makers. The approach is an integrative review of the literature. We employ a comprehensive process to unpack and make sense of the turnaround literature from the organizational sciences. We rely on strategies appropriate for document…

Turnarounds require team building and rebuilding. Interview by Donald E. L. Johnson.

PubMed

Knoble, J K

1989-11-01

James K. Knoble, president of the 369-bed JFK Medical Center, Atlantis, Fla., and former president of Methodist Medical Center of Illinois, Peoria, is in the midst of his third turnaround situation since he became a hospital CEO in 1965. Knoble is known as a CEO who keeps close track of the business environment, works closely with his board and medical staff and is effective at building a staff and delegating significant operating responsibilities. At JFK, whose previous administrator stole large sums of money and left it with serious financial and operating problems, Knoble is back in the operating mode. He is again a hands-on hospital operator, working closely with department heads as well as with the board and medical staff. In this interview with Health Care Strategic Management's editor and publisher, Donald E.L. Johnson, Knoble discusses his team building and turnaround strategy and JFK's progress during the last 18 months.

Comparison of DNA extraction methods used to detect bacterial and yeast DNA from spiked whole blood by real-time PCR.

PubMed

Dalla-Costa, Libera M; Morello, Luis G; Conte, Danieli; Pereira, Luciane A; Palmeiro, Jussara K; Ambrosio, Altair; Cardozo, Dayane; Krieger, Marco A; Raboni, Sonia M

2017-09-01

Sepsis is the leading cause of death in intensive care units (ICUs) worldwide and its diagnosis remains a challenge. Blood culturing is the gold standard technique for blood stream infection (BSI) identification. Molecular tests to detect pathogens in whole blood enable early use of antimicrobials and affect clinical outcomes. Here, using real-time PCR, we evaluated DNA extraction using seven manual and three automated commercially available systems with whole blood samples artificially contaminated with Escherichia coli, Staphylococcus aureus, and Candida albicans, microorganisms commonly associated with BSI. Overall, the commercial kits evaluated presented several technical limitations including long turnaround time and low DNA yield and purity. The performance of the kits was comparable for detection of high microorganism loads (10 6 CFU/mL). However, the detection of lower concentrations was variable, despite the addition of pre-processing treatment to kits without such steps. Of the evaluated kits, the UMD-Universal CE IVD kit generated a higher quantity of DNA with greater nucleic acid purity and afforded the detection of the lowest microbial load in the samples. The inclusion of pre-processing steps with the kit seems to be critical for the detection of microorganism DNA directly from whole blood. In conclusion, future application of molecular techniques will require overcoming major challenges such as the detection of low levels of microorganism nucleic acids amidst the large quantity of human DNA present in samples or differences in the cellular structures of etiological agents that can also prevent high-quality DNA yields. Copyright © 2017 Elsevier B.V. All rights reserved.

Pharmacogenetics of clopidogrel: comparison between a standard and a rapid genetic testing.

PubMed

Saracini, Claudia; Vestrini, Anna; Galora, Silvia; Armillis, Alessandra; Abbate, Rosanna; Giusti, Betti

2012-06-01

CYP2C19 variant alleles are independent predictors of clopidogrel response variability and occurrence of major adverse cardiovascular events in high-risk vascular patients on clopidogrel therapy. Increasing evidence suggests a combination of platelet function testing with CYP2C19 genetic testing may be more effective in identifying high-risk individuals for alternative antiplatelet therapeutic strategies. A crucial point in evaluating the use of these polymorphisms in clinical practice, besides test accuracy, is the cost of the genetic test and rapid availability of the results. One hundred acute coronary syndrome patients were genotyped for CYP2C19*2,*3,*4,*5, and *17 polymorphisms with two platforms: Verigene(®) and the TaqMan(®) system. Genotyping results obtained by the classical TaqMan approach and the rapid Verigene approach showed a 100% concordance for all the five polymorphisms investigated. The Verigene system had shorter turnaround time with respect to TaqMan. The cost of reagents for TaqMan genotyping was lower than that for the Verigene system, but the effective manual staff involvement and the relative cost resulted in higher cost for TaqMan than for Verigene. The Verigene system demonstrated good performance in terms of turnaround time and cost for the evaluation of the clopidogrel poor metabolizer status, giving genetic information in suitable time (206 min) for a therapeutic strategy decision.

Improving medical imaging report turnaround times: the role of technolgy.

PubMed

Marquez, Luis O; Stewart, Howard

2005-01-01

At Southern Ohio Medical Center (SOMC), the medical imaging department and the radiologists expressed a strong desire to improve workflow. The improved workflow was a major motivating factor toward implementing a new RIS and speech recognition technology. The need to monitor workflow in a real-time fashion and to evaluate productivity and resources necessitated that a new solution be found. A decision was made to roll out both the new RIS product and speech recognition to maximize the resources to interface and implement the new solution. Prior to implementation of the new RIS, the medical imaging department operated in a conventional electronic-order-entry to paper request manner. The paper request followed the study through exam completion to the radiologist. SOMC entered into a contract with its PACS vendor to participate in beta testing and clinical trials for a new RIS product for the US market. Backup plans were created in the event the product failed to function as planned--either during the beta testing period or during clinical trails. The last piece of the technology puzzle to improve report turnaround time was voice recognition technology. Speech recognition enhanced the RIS technology as soon as it was implemented. The results show that the project has been a success. The new RIS, combined with speech recognition and the PACS, makes for a very effective solution to patient, exam, and results management in the medical imaging department.

Efficiency of an automated reception and turnaround time management system for the phlebotomy room.

PubMed

Yun, Soon Gyu; Shin, Jeong Won; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.

Text processing for technical reports (direct computer-assisted origination, editing, and output of text)

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

De Volpi, A.; Fenrick, M. R.; Stanford, G. S.

1980-10-01

Documentation often is a primary residual of research and development. Because of this important role and because of the large amount of time consumed in generating technical reports, particularly those containing formulas and graphics, an existing data-processing computer system has been adapted so as to provide text-processing of technical documents. Emphasis has been on accuracy, turnaround time, and time savings for staff and secretaries, for the types of reports normally produced in the reactor development program. The computer-assisted text-processing system, called TXT, has been implemented to benefit primarily the originator of technical reports. The system is of particular value tomore » professional staff, such as scientists and engineers, who have responsibility for generating much correspondence or lengthy, complex reports or manuscripts - especially if prompt turnaround and high accuracy are required. It can produce text that contains special Greek or mathematical symbols. Written in FORTRAN and MACRO, the program TXT operates on a PDP-11 minicomputer under the RSX-11M multitask multiuser monitor. Peripheral hardware includes videoterminals, electrostatic printers, and magnetic disks. Either data- or word-processing tasks may be performed at the terminals. The repertoire of operations has been restricted so as to minimize user training and memory burden. Spectarial staff may be readily trained to make corrections from annotated copy. Some examples of camera-ready copy are provided.« less

Efficiency of an Automated Reception and Turnaround Time Management System for the Phlebotomy Room

PubMed Central

Yun, Soon Gyu; Park, Eun Su; Bang, Hae In; Kang, Jung Gu

2016-01-01

Background Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. Methods The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. Results Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. Conclusions The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room. PMID:26522759

Evaluation of Simplexa Group A Strep Direct Kit Compared to Hologic Group A Streptococcal Direct Assay for Detection of Group A Streptococcus in Throat Swabs.

PubMed

Church, Deirdre L; Lloyd, Tracie; Larios, Oscar; Gregson, Daniel B

2018-03-01

Diagnosis of bacterial pharyngitis is confirmed by detection of group A Streptococcus (GAS) in patient throat samples. Testing of throat samples has historically relied on culture, but new molecular methods allow much faster test turnaround time (i.e., same day versus 48 to 72 h for culture). Our laboratory uses the Hologic GAS Direct (GASD) assay for screening more than 125,000 throat samples per year. Simplexa GAS Direct is a new real-time quantitative PCR (qPCR) assay that does not require initial DNA extraction. Performance of Simplexa qPCR was compared to GASD. A total of 289 throat swabs were collected from patients attending ambulatory clinics in Calgary, Alberta, Canada. A total of 60 (20.8%) of the samples were initially GAS positive by either method: 54 by both methods, 4 by Simplex qPCR alone, and 2 by GASD alone. An in-house PCR using a unique GAS primer set was used to resolve the 6 discrepant results. Overall, GASD compared to Simplexa qPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 93.1% versus 100%, 100% versus 100%, 100% versus 100%, and 98.31% versus 100%, respectively. Implementation of Simplexa qPCR in our laboratory setting would cost more but allow the high sample volume to be reported in half the time and save 0.62 medical laboratory technician (MLT) full-time equivalent (FTE). In comparison to culture, the implementation of Simplexa qPCR would save 2.79 medical laboratory assistant (MLA) FTE plus 0.94 MLT FTE. Simplexa qPCR has improved performance and diagnostic efficiency in a high-volume laboratory compared to GASD for GAS detection in throat swabs. Copyright © 2018 American Society for Microbiology.

Duplex quantitative real-time PCR assay for the detection and discrimination of the eggs of Toxocara canis and Toxocara cati (Nematoda, Ascaridoidea) in soil and fecal samples

PubMed Central

2012-01-01

Background Toxocarosis is a zoonotic disease caused by Toxocara canis (T. canis) and/or Toxocara cati (T. cati), two worldwide distributed roundworms which are parasites of canids and felids, respectively. Infections of humans occur through ingestion of embryonated eggs of T. canis or T. cati, when playing with soils contaminated with dogs or cats feces. Accordingly, the assessment of potential contamination of these areas with these roundworms eggs is paramount. Methods A duplex quantitative real-time PCR (2qPCR) targeting the ribosomal RNA gene internal transcribed spacer (ITS2) has been developed and used for rapid and specific identification of T. canis and T. cati eggs in fecal and soil samples. The assay was set up on DNA samples extracted from 53 adult worms including T. canis, T. cati, T. leonina, Ascaris suum (A. suum) and Parascaris equorum (P. equorum). The assay was used to assess the presence of T. cati eggs in several samples, including 12 clean soil samples spiked with eggs of either T. cati or A. suum, 10 actual soil samples randomly collected from playgrounds in Brussels, and fecal samples from cats, dogs, and other animals. 2qPCR results on dogs and cats fecal samples were compared with results from microscopic examination. Results 2qPCR assay allowed specific detection of T. canis and T. cati, whether adult worms, eggs spiked in soil or fecal samples. The 2qPCR limit of detection (LOD) in spiked soil samples was 2 eggs per g of soil for a turnaround time of 3 hours. A perfect concordance was observed between 2qPCR assay and microscopic examination on dogs and cats feces. Conclusion The newly developed 2qPCR assay can be useful for high throughput prospective or retrospective detection of T.canis and/or T. cati eggs in fecal samples as well as in soil samples from playgrounds, parks and sandpits. PMID:23216873

Impact of reference change value (RCV) based autoverification on turnaround time and physician satisfaction

PubMed Central

Fernández-Grande, Esther; Valera-Rodriguez, Carolina; Sáenz-Mateos, Luis; Sastre-Gómez, Amparo; García-Chico, Pilar; Palomino-Muñoz, Teodoro J.

2017-01-01

Background For a quicker delivery of laboratory test results to the hospital emergency department (ED), we implemented an autoverification system based on the reference change value (RCV). The aim of this study was to assess how the RCV based autoverification reflected on turnaround time (TAT) and on physician satisfaction. Materials and methods The laboratory information system (LIS) was programmed to autoverify the results as long as they were within the range settled by RCV, so that the autoverified results were reported to the physician as soon as the tests were carried out, without any further intervention. We analyzed the same three-month periods’ TAT and verification time (VFT) from the years prior to and following the implementation of RCV autoverification. The change in physicians’ satisfaction levels was assessed using the hospital’s Annual Physician Satisfaction Survey (APSS). Over sixty percent of physicians completed the questionnaire, and the amount of daily ED test requests (nearly three hundred) did not vary throughout the duration of this study. Results Mann-Whitney U test showed that the VFT was significantly reduced in all the test but troponin I. There were substantial reductions in TAT medians (haemogram, 75%; fibrinogen, 41%; prothrombin time, 40%; sodium, 27%). The percentage of physicians satisfied with the haematological and biochemical tests´ TAT increased from 84% to 93% and from 86% to 91% respectively. Conclusions Our results reveal that VFT and TAT were severely reduced in most emergency tests, greatly improving physicians’ satisfaction with TAT. PMID:28694725

Comparative evaluation of three commercial systems for nucleic acid extraction from urine specimens.

PubMed

Tang, Yi-Wei; Sefers, Susan E; Li, Haijing; Kohn, Debra J; Procop, Gary W

2005-09-01

A nucleic acid extraction system that can handle small numbers of specimens with a short test turnaround time and short hands-on time is desirable for emergent testing. We performed a comparative validation on three systems: the MagNA Pure compact system (Compact), the NucliSens miniMAG extraction instrument (miniMAG), and the BioRobot EZ1 system (EZ1). A total of 75 urine specimens submitted for polyomavirus BK virus detection were used. The human beta-actin gene was detected on 75 (100%), 75 (100%), and 72 (96%) nucleic acid extracts prepared by the miniMAG, EZ1, and Compact, respectively. The miniMAG produced the highest quantity of nucleic acids and the best precision among the three systems. The agreement rate was 100% for BKV detection on nucleic acid extracts prepared by the three extraction systems. When a full panel of specimens was run, the hands-on time and test turnaround time were 105.7 and 121.1 min for miniMAG, 6.1 and 22.6 min for EZ1, and 7.4 and 33.7 min for Compact, respectively. The EZ1 and Compact systems processed automatic nucleic acid extraction properly, providing a good solution to the need for sporadic but emergent specimen detection. The miniMAG yielded the highest quantity of nucleic acids, suggesting that this system would be the best for specimens containing a low number of microorganisms of interest.

Disposable collection kit for rapid and reliable collection of saliva.

PubMed

Yamaguchi, Masaki; Tezuka, Yuki; Takeda, Kazunori; Shetty, Vivek

2015-01-01

To describe and evaluate disposable saliva collection kit for rapid, reliable, and reproducible collection of saliva samples. The saliva collection kit comprised of a saliva absorbent swab and an extractor unit was used to retrieve whole saliva samples from 10 subjects. The accuracy and precision of the extracted volumes (3, 10, and 30 μl) were compared to similar volumes drawn from control samples obtained by passive drool. Additionally, the impact of kit collection method on subsequent immunoassay results was verified by assessing salivary cortisol levels in the samples and comparing them to controls. The recovered volumes for the whole saliva samples were 3.85 ± 0.28, 10.79 ± 0.95, and 31.18 ± 1.72 μl, respectively (CV = 8.76%) and 2.91 ± 0.19, 9.75 ± 0.43, and 29.64 ± 0.91 μl, respectively, (CV = 6.36%) for the controls. There was a close correspondence between the salivary cortisol levels from the saliva samples obtained by the collection kit and the controls (R(2)  > 0.96). The disposable saliva collection kit allows accurate and repeatable collection of fixed amounts of whole saliva and does not interfere with subsequent measurements of salivary cortisol. The simple collection process, lack of elaborate specimen recovery steps, and the short turnaround time (<3 min) should render the kit attractive to test subjects and researchers alike. © 2015 Wiley Periodicals, Inc.

Stability of plasma electrolytes in Barricor and PST II tubes under different storage conditions

PubMed Central

Balbás, Luis Alfredo Bautista; Amaro, Marta Segovia; Rioja, Rubén Gómez; Martín, María José Alcaide; Soto, Antonio Buńo

2017-01-01

Introduction Sample stability can be influenced by many different factors; evaporation and leakage from residual cells are the most relevant factors for electrolytes. During the analytical phase, samples are usually kept uncapped at room temperature. Once samples are processed, they are usually stored sealed and refrigerated. Long turnaround time and the possibility of “add-on test” need consideration for electrolyte stability. The aim of our study is to examine short-term electrolyte stability in this two-common laboratory working conditions in two different lithium heparin plasma tubes (Barricor and PST II, Becton Dickinson). Materials and methods In 39 plasma samples from voluntary subjects we measured sodium (Na+), potassium (K+) and chloride (Cl–) at 6 time points since centrifugation (0h, 3h, 6h, 9h, 12h and 15h). Maximum allowable bias (clinically significant change) was based in SEQC (Sociedad Espańola de Química Clínica) recommendations; 1% for Cl–, 0.6% for Na+ and 4% for K+. Results In open room temperature tubes, clinically significant changes appeared in Na+ and Cl– after 3 hours and in K+ after 9 hours in both types of tubes. In refrigerated sealed tubes, all the analytes were clinically stable up to 12 hours in both kinds of plasma tubes. We observed a statistically significant progressive increase in K+ levels, which was less pronounced in Barricor tubes. Conclusion Stability of electrolytes is compromised after 3 hours in open tubes and after 12 hours in sealed tubes. PMID:28392743

Validation of the Six Sigma Z-score for the quality assessment of clinical laboratory timeliness.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2018-03-28

The International Federation of Clinical Chemistry and Laboratory Medicine has introduced in recent times the turnaround time (TAT) as mandatory quality indicator for the postanalytical phase. Classic TAT indicators, namely, average, median, 90th percentile and proportion of acceptable test (PAT), are in use since almost 40 years and to date represent the mainstay for gauging the laboratory timeliness. In this study, we investigated the performance of the Six Sigma Z-score, which was previously introduced as a device for the quantitative assessment of timeliness. A numerical simulation was obtained modeling the actual TAT data set using the log-logistic probability density function. Five thousand replicates for each size of the artificial TAT random sample (n=20, 50, 250 and 1000) were generated, and different laboratory conditions were simulated manipulating the PDF in order to generate more or less variable data. The Z-score and the classic TAT indicators were assessed for precision (%CV), robustness toward right-tailing (precision at different sample variability), sensitivity and specificity. Z-score showed sensitivity and specificity comparable to PAT (≈80% with n≥250), but superior precision that ranged within 20% by moderately small sized samples (n≥50); furthermore, Z-score was less affected by the value of the cutoff used for setting the acceptable TAT, as well as by the sample variability that reflected into the magnitude of right-tailing. The Z-score was a valid indicator of laboratory timeliness and a suitable device to improve as well as to maintain the achieved quality level.

Implementing a laboratory automation system: experience of a large clinical laboratory.

PubMed

Lam, Choong Weng; Jacob, Edward

2012-02-01

Laboratories today face increasing pressure to automate their operations as they are challenged by a continuing increase in workload, need to reduce expenditure, and difficulties in recruitment of experienced technical staff. Was the implementation of a laboratory automation system (LAS) in the Clinical Biochemistry Laboratory at Singapore General Hospital successful? There is no simple answer, so the following topics comparing and contrasting pre- and post-LAS have been explored: turnaround time (TAT), laboratory errors, and staff satisfaction. The benefits and limitations of LAS from the laboratory experience were also reviewed. The mean TAT for both stat and routine samples decreased post-LAS (30% and 13.4%, respectively). In the 90th percentile TAT chart, a 29% reduction was seen in the processing of stat samples on the LAS. However, no significant difference in the 90th percentile TAT was observed with routine samples. It was surprising to note that laboratory errors increased post-LAS. Considerable effort was needed to overcome the initial difficulties associated with adjusting to a new system, new software, and new working procedures. Although some of the known advantages and limitations of LAS have been validated, the claimed benefits such as improvements in TAT, laboratory errors, and staff morale were not evident in the initial months.

A cloud-compatible bioinformatics pipeline for ultrarapid pathogen identification from next-generation sequencing of clinical samples.

PubMed

Naccache, Samia N; Federman, Scot; Veeraraghavan, Narayanan; Zaharia, Matei; Lee, Deanna; Samayoa, Erik; Bouquet, Jerome; Greninger, Alexander L; Luk, Ka-Cheung; Enge, Barryett; Wadford, Debra A; Messenger, Sharon L; Genrich, Gillian L; Pellegrino, Kristen; Grard, Gilda; Leroy, Eric; Schneider, Bradley S; Fair, Joseph N; Martínez, Miguel A; Isa, Pavel; Crump, John A; DeRisi, Joseph L; Sittler, Taylor; Hackett, John; Miller, Steve; Chiu, Charles Y

2014-07-01

Unbiased next-generation sequencing (NGS) approaches enable comprehensive pathogen detection in the clinical microbiology laboratory and have numerous applications for public health surveillance, outbreak investigation, and the diagnosis of infectious diseases. However, practical deployment of the technology is hindered by the bioinformatics challenge of analyzing results accurately and in a clinically relevant timeframe. Here we describe SURPI ("sequence-based ultrarapid pathogen identification"), a computational pipeline for pathogen identification from complex metagenomic NGS data generated from clinical samples, and demonstrate use of the pipeline in the analysis of 237 clinical samples comprising more than 1.1 billion sequences. Deployable on both cloud-based and standalone servers, SURPI leverages two state-of-the-art aligners for accelerated analyses, SNAP and RAPSearch, which are as accurate as existing bioinformatics tools but orders of magnitude faster in performance. In fast mode, SURPI detects viruses and bacteria by scanning data sets of 7-500 million reads in 11 min to 5 h, while in comprehensive mode, all known microorganisms are identified, followed by de novo assembly and protein homology searches for divergent viruses in 50 min to 16 h. SURPI has also directly contributed to real-time microbial diagnosis in acutely ill patients, underscoring its potential key role in the development of unbiased NGS-based clinical assays in infectious diseases that demand rapid turnaround times. © 2014 Naccache et al.; Published by Cold Spring Harbor Laboratory Press.

Analysis of the whole mitochondrial genome: translation of the Ion Torrent Personal Genome Machine system to the diagnostic bench?

PubMed

Seneca, Sara; Vancampenhout, Kim; Van Coster, Rudy; Smet, Joél; Lissens, Willy; Vanlander, Arnaud; De Paepe, Boel; Jonckheere, An; Stouffs, Katrien; De Meirleir, Linda

2015-01-01

Next-generation sequencing (NGS), an innovative sequencing technology that enables the successful analysis of numerous gene sequences in a massive parallel sequencing approach, has revolutionized the field of molecular biology. Although NGS was introduced in a rather recent past, the technology has already demonstrated its potential and effectiveness in many research projects, and is now on the verge of being introduced into the diagnostic setting of routine laboratories to delineate the molecular basis of genetic disease in undiagnosed patient samples. We tested a benchtop device on retrospective genomic DNA (gDNA) samples of controls and patients with a clinical suspicion of a mitochondrial DNA disorder. This Ion Torrent Personal Genome Machine platform is a high-throughput sequencer with a fast turnaround time and reasonable running costs. We challenged the chemistry and technology with the analysis and processing of a mutational spectrum composed of samples with single-nucleotide substitutions, indels (insertions and deletions) and large single or multiple deletions, occasionally in heteroplasmy. The output data were compared with previously obtained conventional dideoxy sequencing results and the mitochondrial revised Cambridge Reference Sequence (rCRS). We were able to identify the majority of all nucleotide alterations, but three false-negative results were also encountered in the data set. At the same time, the poor performance of the PGM instrument in regions associated with homopolymeric stretches generated many false-positive miscalls demanding additional manual curation of the data.

State Policies to Transform Struggling Schools: How Various State Policies Can Be Used to Enable School & District Turnaround. Meeting the Turnaround Challenge: Strategies, Resources & Tools to Transform a Framework into Practice

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2009

2009-01-01

State governments wield significant authority in the management of public schools. As a nexus for federal funding, state funding, and regulatory authority, states have both the legal and financial power to help drive school change. The "No Child Left Behind Act" has required each state to create a system of standards-based assessment and…

Lessons from Astrobiological Planetary Analogue Exploration in Iceland: Biomarker Assay Performance and Downselection

NASA Technical Reports Server (NTRS)

Gentry, D. M.; Amador, E. S.; Cable, M. L.; Cantrell, T.; Chaudry, N.; Cullen, T.; Duca, Z.; Kirby, J.; Jacobsen, M.; McCaig, H.;

Strategic Performance Management Evaluation for the Navy’s Splice Local Area Networks.

DTIC Science & Technology

1985-04-01

Communications Agency (DCA)/Federal Data Corporation (FDC) literature; an extensive survey of academic and professional book and article literature... interesting closing note on strategic planning characteristics is that the period during which collapse or disaster develops is of the same order as the...accepted set of standards. In computer performance, such things as paging rates , throughput, input/output channel usage, turnaround * 32 EM-. time

Increasing Open Source Software Integration on the Department of Defense Unclassified Desktop

DTIC Science & Technology

2008-06-01

free and legal access to the source code grants the user or operating agency considerable power and control . Commercial, off-the-shelf (COTS...COMMAND, CONTROL AND COMMUNICATIONS (C-3)) from the NAVAL POSTGRADUATE SCHOOL June 2008 Author: Steven A. Schearer Approved...Network. This fee also entitles users to unlimited web support with a two-business-day turnaround time. The retail price for a one year, basic

Making sense from space-time data in laboratory experiments on space plasma processes

NASA Technical Reports Server (NTRS)

Gekelman, Walter; Bamber, James; Leneman, David; Vincena, Steve; Maggs, James; Rosenberg, Steve

1995-01-01

A number of visualization techniques are discussed in a laboratory experiment designed to study phenomena that occur in space. Visualization tools are used to design the apparatus, collect data, and make one-, two-, and three-dimensional plots of the results. These tools are an indispensable part of the experiment because the data sets are hundreds of megabytes in size and rapid turnaround is required.

Combustor Simulation

NASA Technical Reports Server (NTRS)

Norris, Andrew

2003-01-01

The goal was to perform 3D simulation of GE90 combustor, as part of full turbofan engine simulation. Requirements of high fidelity as well as fast turn-around time require massively parallel code. National Combustion Code (NCC) was chosen for this task as supports up to 999 processors and includes state-of-the-art combustion models. Also required is ability to take inlet conditions from compressor code and give exit conditions to turbine code.

Adoption of lean principles in a high-volume molecular diagnostic microbiology laboratory.

PubMed

Mitchell, P Shawn; Mandrekar, Jayawant N; Yao, Joseph D C

2014-07-01

Clinical laboratories are constantly facing challenges to do more with less, enhance quality, improve test turnaround time, and reduce operational expenses. Experience with adopting and applying lean concepts and tools used extensively in the manufacturing industry is described for a high-volume clinical molecular microbiology laboratory, illustrating how operational success and benefits can be achieved. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

PubMed Central

Hoffman, Heather J.; Mokone, Majoalane; Tukei, Vincent J.; Nchephe, Matsepeli; Phalatse, Mamakhetha; Tiam, Appolinaire; Guay, Laura; Mofenson, Lynne

2017-01-01

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants' HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems. PMID:29410914

National Space Transportation System (NSTS) technology needs

NASA Technical Reports Server (NTRS)

Winterhalter, David L.; Ulrich, Kimberly K.

1990-01-01

The National Space Transportation System (NSTS) is one of the Nation's most valuable resources, providing manned transportation to and from space in support of payloads and scientific research. The NSTS program is currently faced with the problem of hardware obsolescence, which could result in unacceptable schedule and cost impacts to the flight program. Obsolescence problems occur because certain components are no longer being manufactured or repair turnaround time is excessive. In order to achieve a long-term, reliable transportation system that can support manned access to space through 2010 and beyond, NASA must develop a strategic plan for a phased implementation of enhancements which will satisfy this long-term goal. The NSTS program has initiated the Assured Shuttle Availability (ASA) project with the following objectives: eliminate hardware obsolescence in critical areas, increase reliability and safety of the vehicle, decrease operational costs and turnaround time, and improve operational capability. The strategy for ASA will be to first meet the mandatory needs - keep the Shuttle flying. Non-mandatory changes that will improve operational capability and enhance performance will then be considered if funding is adequate. Upgrade packages should be developed to install within designated inspection periods, grouped in a systematic approach to reduce cost and schedule impacts, and allow the capability to provide a Block 2 Shuttle (Phase 3).

A model for consolidation of clinical microbiology laboratory services within a multihospital health-care system.

PubMed

Carter, Elliot; Stubbs, James R; Bennett, Betsy

2004-01-01

To determine the cost-effectiveness of consolidating clinical microbiology services in a three-hospital health-care network while maintaining high-quality laboratory services, a retrospective review of the total costs of maintaining separate clinical microbiology laboratories within our health-care system was compared to the cost of providing these services after consolidation. Turnaround times before and after consolidation were compared to assess efficiency of the consolidated services. Input of clinicians was also solicited to ensure that quality of services and customer satisfaction remained high. The results of the consolidation project show that the net fiscal saving because of consolidation of clinical microbiology services within our health-care system will be approximately 100,000 dollars per fiscal year. This value includes increased courier charges as well as personnel savings. Although fiscal savings are an integral part of any laboratory consolidation plan, the financial considerations must be balanced by quality of service. The response to consolidation from clinicians was decidedly mixed before implementation of the plan because of fear of increased turnaround times and limited access to laboratory information. The consolidation process, however, was smooth with few physician complaints. The consolidation of our clinical microbiology services illustrates that significant financial savings can be achieved without compromise of efficiency or quality of service.

Milrinone therapeutic drug monitoring in a pediatric population: Development and validation of a quantitative liquid chromatography-tandem mass spectrometry method.

PubMed

Raizman, Joshua E; Taylor, Katherine; Parshuram, Christopher; Colantonio, David A

2017-05-01

Milrinone is a potent selective phosphodiesterase type III inhibitor which stimulates myocardial function and improves myocardial relaxation. Although therapeutic monitoring is crucial to maintain therapeutic outcome, little data is available. A proof-of-principle study has been initiated in our institution to evaluate the clinical impact of optimizing milrinone dosing through therapeutic drug monitoring (TDM) in children following cardiac surgery. We developed a robust LC-MS/MS method to quantify milrinone in serum from pediatric patients in real-time. A liquid-liquid extraction procedure was used to prepare samples for analysis prior to measurement by LC-MS/MS. Performance characteristics, such as linearity, limit of quantitation (LOQ) and precision, were assessed. Patient samples were acquired post-surgery and analyzed to determine the concentration-time profile of the drug as well as to track turn-around-times. Within day precision was <8.3% across 3 levels of QC. Between-day precision was <12%. The method was linear from 50 to 800μg/l; the lower limit of quantification was 22μg/l. Comparison with another LC-MS/MS method showed good agreement. Using this simplified method, turnaround times within 3-6h were achievable, and patient drug profiles demonstrated that some milrinone levels were either sub-therapeutic or in the toxic range, highlighting the importance for milrinone TDM. This simplified and quick method proved to be analytically robust and able to provide therapeutic monitoring of milrinone in real-time in patients post-cardiac surgery. Copyright © 2017. Published by Elsevier B.V.

Multi-Center Evaluation of the Automated Immunohematology Instrument, the ORTHO VISION Analyzer.

PubMed

Aysola, Agnes; Wheeler, Leslie; Brown, Richard; Denham, Rebecca; Colavecchia, Connie; Pavenski, Katerina; Krok, Elizabeth; Hayes, Chelsea; Klapper, Ellen

2017-02-01

ORTHO VISION Analyzer (Vision), is an immunohematology instrument using ID-MT gel card technology with digital image processing. It has a continuous, random sample access with STAT priority processing. The efficiency and ease of operation of Vision was evaluated at 5 medical centers. De-identified patient samples were tested on the ORTHO ProVue Analyzer (ProVue) and repeated on the Vision mimicking the daily workload pattern. Turnaround times (TAT) were collected and compared. Operators rated key features of the analyzer on a scale of 1 to 5. A total of 507 samples were tested on both instruments at the 5 trial sites. The mean TAT (SD) were 31.6 minutes (5.5) with Vision and 35.7 minutes (8.4) with ProVue, which renders a 12% reduction. Type and screens were performed on 381 samples; the mean TAT (SD) was 32.2 minutes (4.5) with Vision and 37.0 minutes (7.4) with ProVue. Antibody identification with eleven panel cells was performed on 134 samples on Vision; TAT (SD) was 43.2 minutes (8.3). The installation, training, configuration, maintenance and validation processes are all streamlined to provide a short implementation time. The average rating of main functions by the operators was 4.1 to 4.8. Opportunities for improvement, such as flexibility with editing QC results, maintenance schedule, and printing options were identified. The capabilities to perform serial dilutions, to accept pediatric tubes, and review results by e-Connectivity are enhancements over the ProVue. Vision provides shorter TAT compared to ProVue. Every site described a positive experience using Vision. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pre-analytical effects of pneumatic tube system transport on routine haematology and coagulation tests, global coagulation assays and platelet function assays.

PubMed

Le Quellec, Sandra; Paris, Mickaël; Nougier, Christophe; Sobas, Frédéric; Rugeri, Lucia; Girard, Sandrine; Bordet, Jean-Claude; Négrier, Claude; Dargaud, Yesim

2017-05-01

Pneumatic tube system (PTS) in hospitals is commonly used for the transport of blood samples to clinical laboratories, as it is rapid and cost-effective. The aim was to compare the effects on haematology samples of a newly acquired ~2km-long PTS that links 2 hospitals with usual transport (non-pneumatic tube system, NPTS). Complete blood cell count, routine coagulation assays, platelet function tests (PFT) with light-transmission aggregometry and global coagulation assays including ROTEM® and thrombin generation assay (TGA) were performed on blood samples from 30 healthy volunteers and 9 healthy volunteers who agreed to take aspirin prior to blood sampling. The turnaround time was reduced by 31% (p<0.001) with the use of PTS. No statistically significant difference was observed for most routine haematology assays including PFT, and ROTEM® analysis. A statistically significant, but not clinically relevant, shortening of the APTT after sample transport by PTS was found (mean±SD: 30s±1.8 vs. 29.5s±2.1 for NPTS). D-dimer levels were 7.4% higher after transport through PTS but were not discordant. A statistically significant increase of thrombin generation was found in both platelet poor- and platelet rich- plasma samples after PTS transport compared to NPTS transport. PTS is suitable for the transport of samples prior to routine haematology assays including PFT, but should not be used for samples intended for thrombin generation measurement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

PubMed

Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

2018-01-01

The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P < .0001, Fisher exact test), with a marked reduction in variability. Further, the time from autopsy to presentation at weekly clinicopathological rounds was also reduced (median: 73 days prior to lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

Quantifying stratospheric ozone trends: Complications due to stratospheric cooling

NASA Astrophysics Data System (ADS)

McLinden, C. A.; Fioletov, V.

2011-02-01

Recent studies suggest that ozone turnaround (the second stage of ozone recovery) is near. Determining precisely when this occurs, however, will be complicated by greenhouse gas-induced stratospheric cooling as ozone trends derived from profile data in different units and/or vertical co-ordinates will not agree. Stratospheric cooling leads to simultaneous trends in air density and layer thicknesses, confounding the interpretation of ozone trends. A simple model suggests that instruments measuring ozone in different units may differ as to the onset of turnaround by a decade, with some indicting a continued decline while others an increase. This concept was illustrated by examining the long-term (1979-2005) ozone trends in the SAGE (Stratospheric Aerosol and Gas Experiment) and SBUV (Solar Backscatter Ultraviolet) time series. Trends from SAGE, which measures number density as a function of altitude, and SBUV, which measures partial column as a function of pressure, are known to differ by 4-6%/decade in the upper stratosphere. It is shown that this long-standing difference can be reconciled to within 2%/decade when the trend in temperature is properly accounted for.

A novel technology to control proppant backproduction

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

Card, R.J.; Howard, P.R.; Feraud, J.P.

1995-11-01

A new technology has been developed to control proppant backproduction and to increase flexibility in well turnaround and production strategies. The technology has been used successfully on several hundred hydraulic fracturing treatments. In this technology, a mixture of fibers and proppant is pumped into the fracture to form a mixture of fibers and proppant is pumped into the fracture to form a pack that is resistant to proppant backproduction under typical oil/gas production conditions. The proppant/fiber mixture depends on a physical mechanism rather than chemical bonding to increase pack resistance to flowback. There are no minimum closure stress, temperature, ormore » shut-in time requirements associated with the use of this technology, which increases the flexibility available to the operator to optimize well turnaround and production strategy. This paper reviews the laboratory data relevant to the understanding and application of this technology. Studies include proppant pack resistance to flowback in one- and two-phase flow, the effect of cyclic loading, aging phenomena, permeability/conductivity studies, and fluid/breaker interactions. The benefits of the technology are illustrated with field studies.« less

HL-20 operations and support requirements for the Personnel Launch System mission

NASA Technical Reports Server (NTRS)

Morris, W. D.; White, Nancy H.; Caldwell, Ronald G.

1993-01-01

The processing, mission planning, and support requirements were defined for the HL-20 lifting-body configuration that can serve as a Personnel Launch System. These requirements were based on the assumption of an operating environment that incorporates aircraft and airline support methods and techniques that are applicable to operations. The study covered the complete turnaround process for the HL-20, including landing through launch, and mission operations, but did not address the support requirements of the launch vehicle except for the integrated activities. Support is defined in terms of manpower, staffing levels, facilities, ground support equipment, maintenance/sparing requirements, and turnaround processing time. Support results were drawn from two contracted studies, plus an in-house analysis used to define the maintenance manpower. The results of the contracted studies were used as the basis for a stochastic simulation of the support environment to determine the sufficiency of support and the effect of variance on vehicle processing. Results indicate the levels of support defined for the HL-20 through this process to be sufficient to achieve the desired flight rate of eight flights per year.

Developing a gate-array capability at a research and development laboratory

NASA Astrophysics Data System (ADS)

Balch, J. W.; Current, K. W.; Magnuson, W. G., Jr.; Pocha, M. D.

1983-03-01

Experiences in developing a gate array capability for low volume applications in a research and development (R and D) laboratory are described. By purchasing unfinished wafers and doing the customization steps in-house. Turnaround time was shortened to as little as one week and the direct costs reduced to as low as $5K per design. Designs generally require fast turnaround (a few weeks to a few months) and very low volumes (1 to 25). Design costs must be kept at a minimum. After reviewing available commercial gate array design and fabrication services, it was determined that objectives would best be met by using existing internal integrated circuit fabrication facilities, the COMPUTERVISION interactive graphics layout system, and extensive computational capabilities. The reasons and the approach taken for; selection for a particular gate array wafer, adapting a particular logic simulation program, and how layout aids were enhanced are discussed. Testing of the customized chips is described. The content, schedule, and results of the internal gate array course recently completed are discussed. Finally, problem areas and near term plans are presented.

Comparison of the Immulite and RIA assay methods for measuring peripheral blood progesterone levels in Greyhound bitches.

PubMed

Chapwanya, A; Clegg, T; Stanley, P; Vaughan, L

2008-09-15

Determination of optimal breeding time in bitches earmarked for single insemination only is based on measurement of peripheral blood serum or plasma progesterone concentration. In this paper a comparison is made between radioimmune assay (RIA) and chemoluminescent assay (Immulite) for determination of P4 concentrations in the bitch. The Immulite assay is shown to be an accurate and reliable method for serum or plasma P4 measurement. It compares favourably with other methods in terms of turn-around time, cost and accessibility for veterinarians in practice.

Sharing the skies: the Gemini Observatory international time allocation process

NASA Astrophysics Data System (ADS)

Margheim, Steven J.

2016-07-01

Gemini Observatory serves a diverse community of four partner countries (United States, Canada, Brazil, and Argentina), two hosts (Chile and University of Hawaii), and limited-term partnerships (currently Australia and the Republic of Korea). Observing time is available via multiple opportunities including Large and Long Pro- grams, Fast-turnaround programs, and regular semester queue programs. The slate of programs for observation each semester must be created by merging programs from these multiple, conflicting sources. This paper de- scribes the time allocation process used to schedule the overall science program for the semester, with emphasis on the International Time Allocation Committee and the software applications used.

Quasi-metagenomics and realtime sequencing aided detection and subtyping of Salmonella enterica from food samples.

PubMed

Hyeon, Ji-Yeon; Li, Shaoting; Mann, David A; Zhang, Shaokang; Li, Zhen; Chen, Yi; Deng, Xiangyu

2017-12-01

Metagenomics analysis of food samples promises isolation-independent detection and subtyping of foodborne bacterial pathogens in a single workflow. Selective concentration of Salmonella genomic DNA through immunomagnetic separation (IMS) and multiple displacement amplification (MDA) were shown to shorten culture enrichment of Salmonella -spiked raw chicken breast samples by over 12 hours while permitting serotyping and high-fidelity single nucleotide polymorphisms (SNP) typing of the pathogen using short shotgun sequencing reads. The herein termed quasi-metagenomics approach was evaluated on Salmonella -spiked lettuce and black peppercorn samples as well as retail chicken parts naturally contaminated with different serotypes of Salmonella. Between 8 and 24 h culture enrichment was required for detecting and subtyping naturally occurring Salmonella from unspiked chicken parts compared with 4 to 12 h culture enrichment when Salmonella -spiked food samples were analyzed, indicating the likely need for longer culture enrichment to revive low levels of stressed or injured Salmonella cells in food. Further acceleration of the workflow was achieved by real-time nanopore sequencing. After 1.5 hours of analysis on a potable sequencer, sufficient data were generated from sequencing IMS-MDA product of a cultured-enriched lettuce sample to allow serotyping and robust phylogenetic placement of the inoculated isolate. Importance Both culture enrichment and next-generation sequencing remain to be time-consuming processes for food testing where rapid methods for pathogen detection are widely available. Our study demonstrated substantial acceleration of the respective process through IMS-MDA and real-time nanopore sequencing. In one example, the combined use of the two methods delivered a less than 24 h turnaround time from a Salmonella -contaminated lettuce sample to phylogenetic identification of the pathogen. Improved efficiency like this is important for further expanding the use of whole genome and metagenomics sequencing in microbial analysis of food. Our results suggest the potential of the quasi-metagenomics approach in areas where rapid detection and subtyping of foodborne pathogens is important, such as foodborne outbreak response and precision tracking and monitoring of foodborne pathogens in production environments and supply chains. Copyright © 2017 American Society for Microbiology.