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

Simulating Dynamical Features of Escape Panic

One of the most disastrous forms of collective human behaviour is the kind of crowd stampede induced by panic, often leading to fatalities as people are crushed or trampled. Sometimes this behaviour is triggered in life-threatening situations such as fires in crowded buildings; at other times, stampedes can arise from the rush for seats or seemingly without causes. Tragic examples within recent months include the panics in Harare, Zimbabwe, and at the Roskilde rock concert in Denmark. Although engineers are finding ways to alleviate the scale of such disasters, their frequency seems to be increasing with the number and size of mass events. Yet, systematic studies of panic behaviour, and quantitative theories capable of predicting such crowd dynamics, are rare. Here we show that simulations based on a model of pedestrian behaviour can provide valuable insights into the mechanisms of and preconditions for panic and jamming by incoordination. Our results suggest practical ways of minimising the harmful consequences of such events and the existence of an optimal escape strategy, corresponding to a suitable mixture of individualistic and collective behaviour.Comment: For related information see http://angel.elte.hu/~panic, http://www.helbing.org, http://angel.elte.hu/~fij, and http://angel.elte.hu/~vicse

The genetics of reproductive isolation and the potential for gene exchange between Drosophila Pseudoobscura and D. Persimilis via backcross hybrid males

Hybrid male sterility, hybrid inviability, sexual isolation, and a hybrid male courtship dysfunction reproductively isolate Drosophila pseudoobscura and D. persimilis. Previous studies of the genetic bases of these isolating mechanisms have yielded only limited information about how much and what areas of the genome are susceptible to interspecies introgression. We have examined the genetic basis of these barriers to gene exchange in several thousand backcross hybrid male progeny of these species using 14 codominant molecular genetic markers spanning the five chromosomes of these species, focusing particularly on the autosomes. Hybrid male sterility, hybrid inviability, and the hybrid male courtship dysfunction were all associated with X-autosome interactions involving primarily the inverted regions on the left arm of the X-chromosome and the center of the second chromosome. Sexual isolation from D. pseudoobscura females was primarily associated with the left arm of the X-chromosome, although both the right arm and the center of the second chromosome also contributed to it. Sexual isolation from D. persimilis females was primarily associated with the second chromosome. The absence of isolating mechanisms being associated with many autosomal regions, including some large inverted regions that separate the strains, suggests that these phenotypes may not be caused by genes spread throughout the genome. We suggest that gene flow between these species via hybrid males may be possible at loci spread across much of the autosomes

Metabolic Changes Following a 1-Year Diet and Exercise Intervention in Patients With Type 2 Diabetes

Objective—To characterize the relationships among longterm improvements in peripheral insulin sensitivity (glucose disposal rate [GDR]), fasting glucose, and free fatty acids (FFAs) and concomitant changes in weight and adipose tissue mass and distribution induced by lifestyle intervention in obese individuals with type 2 diabetes. Research Design And Methods—We measured GDR, fasting glucose, and FFAs during a euglycemic clamp and adipose tissue mass and distribution, organ fat, and adipocyte size by dual-energy X-ray absorptiometry, CT scan, and adipose tissue biopsy in 26 men and 32 women in the Look-AHEAD trial before and after 1 year of diet and exercise aimed at weight loss. Results—Weight and fasting glucose decreased significantly (P _ 0.0001) and significantly more in men than in women (_12 vs. _8% and _16 vs. _7%, respectively; P _ 0.05), while FFAs during hyperinsulinemia decreased and GDR increased significantly (P _ 0.00001) and similarly in both sexes (_53 vs. _41% and 63 vs. 43%; P _ NS). Men achieved a more favorable fat distribution by losing more from upper compared with lower and from deeper compared with superficial adipose tissue depots (P _ 0.01). Decreases in weight and adipose tissue mass predicted improvements in GDR but not in fasting glucose or fasting FFAs; however, decreases in FFAs during hyperinsulinemia significantly determined GDR improvements. Hepatic fat was the only regional fat measure whose change contributed independently to changes in metabolic variables. Conclusions—Patients with type 2 diabetes undergoing a 1-year lifestyle intervention had significant improvements in GDR, fasting glucose, FFAs and adipose tissue distribution. However, changes in overall weight (adipose tissue mass) and hepatic fat were the most important determinants of metabolic improvements.Jeanine B. Albu, Leonie K. Heilbronn, David E. Kelley, Steven R. Smith, Koichiro Azuma, Evan S. Berk, F. Xavier Pi-Sunyer, Eric Ravussin, and the Look AHEAD Adipose Research Grou

Bupropion and Nicotine Patch as Smoking Cessation Aids in Alcoholics

This is a double blind placebo controlled study of sustained release bupropion as a smoking cessation aid in alcoholics undergoing treatment for their alcoholism. Participants (N=58) were enrolled within one week of entry into alcohol treatment from community and Veterans Affairs Substance Use Disorder programs. All participants received nicotine patch and were invited to attend a smoking cessation lecture and group. Cigarette smoking and alcohol outcomes were measured at six months. Bupropion when added to nicotine patch did not improve smoking outcomes. One-third of participants on bupropion reported discontinuing the drug during weeks 1-4. Participants reported cigarette outcomes with nicotine patch which are similar to those seen in the general population. All study participants significantly reduced cigarette use. Co-morbid affective disorder or antipersonality disorder did not affect outcomes. Alcohol outcomes were improved in those who discontinued cigarettes

Mineral Surface and Fluid Chemistry in Nakhlite Analog Water-Rock Reactions

We report on experiments with Mars analog materials under diagenetic conditions and find characteristic chemical surface changes in correspondence with the fluid conditions

New Constraints on Neutralino Dark Matter in the Supersymmetric Standard Model

We investigate the prospects for neutralino dark matter within the Supersymmetric Standard Model (SSM) including the constraints from universal soft supersymmetry breaking and radiative breaking of the electroweak symmetry. The latter is enforced by using the one-loop Higgs effective potential which automatically gives the one-loop corrected Higgs boson masses. We perform an exhaustive search of the allowed five-dimensional parameter space and find that the neutralino relic abundance $\Omega_\chi h^2_0$ depends most strongly on the ratio $\xi_0\equiv m_0/m_{1/2}$. For $\xi_0\gg1$ the relic abundance is almost always much too large, whereas for $\xi_0\ll1$ the opposite occurs. For $\xi_0\sim1$ there are wide ranges of the remaining parameters for which $\Omega_\chi\sim1$. We also determine that m_{\tilde q}\gsim250\GeV and m_{\tilde l}\gsim100\GeV are necessary in order to possibly achieve $\Omega_\chi\sim1$. These lower bounds are much weaker than the corresponding ones derived previously when radiative breaking was {\it not} enforced.Comment: 12 pages plus 6 figures (not included), CERN-TH.6584/92, CTP-TAMU-56/92, UAHEP921

Amazonian Hydrothermal Alteration Comparing Nakhlite Secondary Mineralogy to Water Rock Reaction Experiments

We report on results from experiments with Mars analog materials under diagenetic conditions. The mineralogical results of our experiments suggest that an important type of fluid alteration in the Amazonian may be short duration (e.g. less than 1 year) events from near neutral, dilute brines, that were able to exchange CO2 either directly, or via ice reservoirs, with the atmosphere