Integrated electronic prescribing and robotic dispensing: a case study

INTRODUCTION: To quantify the benefits of electronic prescribing directly linked to a robotic dispensing machine. CASE DESCRIPTION: Quantitative case study analysis is used on a single case. Hospital A (1,000 beds) has used an integrated electronic prescribing system for 10 years, and in 2009 linked two robotic dispensing machines to the system. The impact on dispensing error rates (quality) and efficiency (costs) were assessed. EVALUATION AND DISCUSSION: The implementation delivered staff efficiencies above expectation. For the out-patient department, this was 16% more than the business case had suggested. For the in-patients dispensary, four staff were released for re-deployment. Additionally, £500,000 in stockholding efficiency above that suggested by the business case was identified. Overall dispensing error rates were not adversely affected and products dispensed by the electronic prescribing - robot system produced zero dispensing errors. The speed of dispensing increased also, as the electronic prescribing - robot combination permitted almost instantaneous dispensing from the point of a doctor entering a prescription. CONCLUSION: It was significant that the combination of electronic prescribing and a robot eliminated dispensing errors. Any errors that did occur were not as a result of the electronic prescribing - robotic system (i.e. the product was not stocked within the robot). The direct linking of electronic prescribing and robots as a dispensing system together produces efficiencies and improves the quality of the dispensing process

An investigation into the behaviour of air rifle pellets in ballistic gel and their interaction with bone

Although air weapons are considerably lower in power than other firearms, there is increasing concern that serious injuries can result from their misuse. The present study was therefore carried out to improve understanding of the terminal ballistic behaviour of air rifle pellets. Pellets were fired into ballistic gel under a variety of conditions. The pellets penetrated further than anticipated from their low cross-sectional density, and Bloom number was not necessarily a good guide to gel behaviour. Pellet penetration into the gel decreased with increasing gel concentration, and appeared to be linear at higher concentrations. Pointed pellets penetrated up to 50% further than rounded pellets. Power and range affect penetration, but other factors are also important, and power alone is not a simple guide to potential penetration. Test firings were also carried out firing pellets into ballistic gel that contained sections of animal bone. Computed tomography (CT) and visual observation were employed to record the interactions. CT scanning showed potential as a tool for examining pellet damage. The bone appeared to be undamaged, but the pellets were severely deformed on impact. If the pellet strikes the bone at an angle, less energy is absorbed by the impact and the pellet fragments may ricochet and cause further damage in the gel. A tentative model is proposed for estimating the energy absorbed by the impact

Inherent-Structure Dynamics and Diffusion in Liquids

The self-diffusion constant D is expressed in terms of transitions among the local minima of the potential (inherent structure, IS) and their correlations. The formulae are evaluated and tested against simulation in the supercooled, unit-density Lennard-Jones liquid. The approximation of uncorrelated IS-transition (IST) vectors, D_{0}, greatly exceeds D in the upper temperature range, but merges with simulation at reduced T ~ 0.50. Since uncorrelated IST are associated with a hopping mechanism, the condition D ~ D_{0} provides a new way to identify the crossover to hopping. The results suggest that theories of diffusion in deeply supercooled liquids may be based on weakly correlated IST.Comment: submitted to PR

The Role of Viperin in the Innate Antiviral Response

AbstractViral infection of the cell is able to initiate a signaling cascade of events that ultimately attempts to limit viral replication and prevent escalating infection through expression of host antiviral proteins. Recent work has highlighted the importance of the host antiviral protein viperin in this process, with its ability to limit a large variety of viral infections as well as play a role in the production of type I interferon and the modulation of a number of transcription factor binding sites. Viperin appears to have the ability to modulate varying conditions within the cell and to interfere with proviral host proteins in its attempts to create an unfavorable environment for viral replication. The study of the mechanistic actions of viperin has come a long way in recent years, describing important functional domains of the protein for its antiviral and immune modulator actions as well as demonstrating its role as a member of the radical SAM enzyme family. However, despite the rapid expansion of knowledge regarding the functions of this highly conserved and ancient antiviral protein, there still remains large gaps in our understanding of the precise mechanisms at play for viperin to exert such a wide variety of roles within the cell

Electromagnetic properties of material coated surfaces

The electromagnetic properties of material coated conducting surfaces were investigated. The coating geometries consist of uniform layers over a planar surface, irregularly shaped formations near edges and randomly positioned, electrically small, irregularly shaped formations over a surface. Techniques to measure the scattered field and constitutive parameters from these geometries were studied. The significance of the scattered field from these geometries warrants further study

Green's Functions from Quantum Cluster Algorithms

We show that cluster algorithms for quantum models have a meaning independent of the basis chosen to construct them. Using this idea, we propose a new method for measuring with little effort a whole class of Green's functions, once a cluster algorithm for the partition function has been constructed. To explain the idea, we consider the quantum XY model and compute its two point Green's function in various ways, showing that all of them are equivalent. We also provide numerical evidence confirming the analytic arguments. Similar techniques are applicable to other models. In particular, in the recently constructed quantum link models, the new technique allows us to construct improved estimators for Wilson loops and may lead to a very precise determination of the glueball spectrum.Comment: 15 pages, LaTeX, with four figures. Added preprint numbe

Muon spin rotation studies of niobium for superconducting RF applications

In this work we investigate superconducting properties of niobium samples via application of the muon spin rotation/relaxation (muSR) technique. We employ for the first time the muSR technique to study samples that are cutout from large and small grain 1.5 GHz radio frequency (RF) single cell niobium cavities. The RF test of these cavities was accompanied by full temperature mapping to characterize the RF losses in each of the samples. Results of the muSR measurements show that standard cavity surface treatments like mild baking and buffered chemical polishing (BCP) performed on the studied samples affect their surface pinning strength. We find an interesting correlation between high field RF losses and field dependence of the sample magnetic volume fraction measured via muSR. The muSR line width observed in ZF-muSR measurements matches the behavior of Nb samples doped with minute amounts of Ta or N impurities. An upper bound for the upper critical field Hc2 of these cutouts is found.Comment: 20 pages, 14 figure

Protocol for the United Kingdom Rotator Cuff Study (UKUFF) : a randomised controlled trial of open and arthroscopic rotator cuff repair

This project was funded by the NIHR Health Technology Assessment programme (project number 05/47/02). J. L. Rees has received a grant from Oxford University which is related to this paper. J. Dawson reports that Oxford University has received a grant from HTA which is related to this paper, as well as a study grant.Peer reviewedPublisher PD

Association between electronic cigarette use and changes in quit attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of stop smoking services in England: time series analysis of population trends

Objectives To estimate how far changes in the prevalence of electronic cigarette (e-cigarette) use in England have been associated with changes in quit success, quit attempts, and use of licensed medication and behavioural support in quit attempts. Design Time series analysis of population trends. Participants Participants came from the Smoking Toolkit Study, which involves repeated, cross sectional household surveys of individuals aged 16 years and older in England. Data were aggregated on about 1200 smokers quarterly between 2006 and 2015. Monitoring data were also used from the national behavioural support programme; during the study, 8 029 012 quit dates were set with this programme. Setting England. Main outcome measures Prevalence of e-cigarette use in current smokers and during a quit attempt were used to predict quit success. Prevalence of e-cigarette use in current smokers was used to predict rate of quit attempts. Percentage of quit attempts involving e-cigarette use was also used to predict quit attempts involving use of prescription treatments, nicotine replacement therapy (NRT) on prescription and bought over the counter, and use of behavioural support. Analyses involved adjustment for a range of potential confounders. Results The success rate of quit attempts increased by 0.098% (95% confidence interval 0.064 to 0.132; P<0.001) and 0.058% (0.038 to 0.078; P<0.001) for every 1% increase in the prevalence of e-cigarette use by smokers and e-cigarette use during a recent quit attempt, respectively. There was no clear evidence for an association between e-cigarette use and rate of quit attempts (β 0.025; 95% confidence interval −0.035 to 0.085; P=0.41), use of NRT bought over the counter (β 0.006; −0.088 to 0.077; P=0.89), use of prescription treatment (β −0.070; −0.152 to 0.013; P=0.10), or use of behavioural support (β −0.013; −0.102 to 0.077; P=0.78). A negative association was found between e-cigarette use during a recent quit attempt and use of NRT obtained on prescription (β −0.098; −0.189 to −0.007; P=0.04). Conclusion Changes in prevalence of e-cigarette use in England have been positively associated with the success rates of quit attempts. No clear association has been found between e-cigarette use and the rate of quit attempts or the use of other quitting aids, except for NRT obtained on prescription, where the association has been negative. Study registration The analysis plan was preregistered (https://osf.io/fbgj2/)