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

Crocodiles as dinosaurs: Behavioural thermoregulation in very large ectotherms leads to high and stable body temperatures

Empirical field data describing daily and seasonal cycles in body temperature (Tb) of free-ranging Crocodylus porosus (32-1010 kg) can be predicted by a mathematical analysis. The analysis provides a mechanistic explanation for the decreased amplitude of daily cycles in Tb and the increase in 'average' Tb with increasing mass. Assessments of 'average' daily Tb were made by dividing the integral of the difference between measured values of Tb and minimum operative temperature by the period of integration, to yield a thermal index expressing relative 'warmth' of crocodiles. The average daily Tb of a 1010 kg crocodile was 3.7 degrees C warmer than that of a 42 kg individual in summer and 1.9 degreesC warmer than that of a 32 kg individual in winter. The success of this mathematical approach confirms that crocodiles are simple ectotherms and that there is unlikely to be a significant contribution to their thermal biology from physiological mechanisms. Behaviour, however, is very important even in large individuals. Crocodiles in the field typically move daily between land and water in cycles that vary seasonally. We predicted Tb for the reverse of these behavioural cycles, which more than doubled seasonal fluctuations in Tb compared with the observed fluctuations. We were also able to predict the Tb of very large, dinosaur-sized crocodiles in a similar climate to that at our study site. A 10 000 kg 'crocodile', for example, would be expected to have a Tb of 31 degreesC in winter, varying by less than 0.1 degrees C during a day when operative temperatures varied by nearly 20 degrees C, from 20 to 38 degrees C. The study confirms that, in low latitudes at least, large dinosaurs must have had an essentially high and stable value of Tb, without any need for endothermy. Also, access to shade or water must have been crucial for the survival of large dinosaurs at low latitudes. Furthermore, the finding of increasing 'average' Tb as ectotherms grow larger may have implications for the metabolic rates of very large reptiles, because the Q10 effect could counteract the downscaling of metabolic rate with mass, an effect that seems not to have been recognised previously

Laser retroreflector experiment on NAVSTAR 35 and 36

In GPS one of the primary errors contributing to positioning inaccuracy is the performance of the on-board atomic clock. To determine and predict the performance of this atomic clock has been a problem due to the ambiguity of the orbital position error and clock uncertainty in the Radio Frequency (RF) tracking of the navigation signals. The Laser Retroreflector Experiment (LRE) on-board NAVSTAR 35 and 36 provides a means of separating these ambiguous errors by enabling highly precise and accurate satellite positions to be determined independently of the RF signals. The results of examining onboard clock behavior after removing the orbital position signatures will be discussed. GPS RF tracking data from various DOD and other sites are used to reconstruct the onboard clock data and examine the clock behavior. From these data, the effects of clock performance on GPS positioning performance can examined

Application of an Ultralight Aircraft to Aerial Surveys of Kangaroos on Grazing Properties

A Drifter ultralight aircraft was used as a platform for line-transect aerial surveys of three species of kangaroo in the sheep rangelands south-east of Blackall and north of Longreach in central-western Queensland in winter 1993 and 1994. Favourable comparisons between the results of ultralight surveys and those made from a helicopter flying the same transects and foot surveys along another set of transects, all within a few days of the ultralight survey, confirmed the expectation we had that an ultralight would be a satisfactory and much cheaper vehicle for conducting aerial surveys of kangaroos. The comparisons are even more favourable when data for the three species surveyed are combined, pointing to a problem in species identification and underlining the importance of using only experienced observers for aerial survey of kangaroos, whatever the platform. The use of an ultralight aircraft could have particular value where a comparatively small area, such as an individual sheep or cattle property, is under consideration. In this paper, we present the numerical comparisons, along with an evaluation of the practicability of using this type of aircraft. We also describe a possible future scenario in which an accreditation process could see approved kangaroo surveyors undertaking property assessments by ultralight, under contract to graziers or other interested parties

Molecular Identification of Eimeria Species in Broiler Chickens in Trinidad, West Indies

Coccidiosis is an intestinal disease of chickens of major economic importance to broiler industries worldwide. Species of coccidia found in chickens include Eimeria acervulina, Eimeria brunetti, Eimeria maxima, Eimeria mitis, Eimeria necatrix, Eimeria praecox, and Eimeria tenella. In recent years, polymerase chain reaction (PCR) has been developed to provide accurate and rapid identification of the seven known Eimeria species of chickens. The aim of this study was to use species-specific real-time PCR (qPCR) to identify which of the seven Eimeria species are present in Trinidad poultry. Seventeen pooled fecal samples were collected from 6 broiler farms (2–5 pens per farm) across Trinidad. Feces were also collected from birds showing clinical signs of coccidiosis in two live bird markets (pluck shops). qPCR revealed the presence of five species of Eimeria (E. acervulina, E. maxima, E. mitis, E. necatrix, and E. tenella), but not E. brunetti or E. praecox. Mixed infections were detected on all broiler farms, and DNA of two highly pathogenic Eimeria species (E. tenella and E. necatrix) was detected in feces taken from clinically sick birds sampled from the two pluck shops

Temporal Foraging Patterns of Nonnative Frogs (Eleutherodactylus Coqui) in Hawaii

The Puerto Rican Coqui Frog (Eleutherodactylus coqui) is a nocturnal, invasive species that was introduced into Hawaii in the 1980s. Because they reach extremely high densities (up to 90,000 frogs/ha), they have the potential to affect invertebrate prey communities. Previously, researchers used frogs collected only at night to characterize their prey. Because Coquis use retreat sites near the forest floor during the day and understory perch sites at night, frogs collected at night might show different amounts and types of prey than would frogs collected in the morning. We analyzed stomach contents of 435 frogs collected in the morning (0300–0600 h) and at night (1900–2200 h) from five sites on the island of Hawaii. Frogs collected in the morning had 1.7 times more prey items and 2.1 times greater prey volume than those collected at night; however, prey composition did not differ between morning- and evening-collected frogs. Across sites, Formicidae (ants) and Amphipoda (amphipods) were the dominant prey, and at least 61.6% of their prey items were nonnative species. Across sites, morning- and evening-collected stomach contents were not different from environmental samples of leaflitter invertebrates but were different from environmental samples of foliage and flying invertebrates, suggesting that Coquis forage primarily in the leaf litter throughout the night. Previous research that investigated stomach contents of frogs collected only at night greatly underestimated the number and volume of prey items that Coquis consume during the entire foraging period but accurately described their primary prey: nonnative, leaf-litter invertebrates

Air Conditions Close to the Ground and the Effect on Airplane Landings

This report presents the results of an investigation undertaken to determine the feasibility of making glide landings in gusty air. Wind velocities were measured at several stations between the ground and a height of 51 feet, and flight tests were made to determine the actual influence of gusts on an airplane gliding close to the ground

Factors influencing prognosis in adults with acute myelogenous leukaemia.

A study of the thymidine labelling index (TLI) of bone marrow blast cells in 58 untreated patients with acute myelogenous leukemia showed no correlation with remission rate but there was a strong correlation between labelling index and remission length in the 21 patients who achieved remission. The median remission length of the patients was 33 weeks. Of the 12 patients with initial labelling indices greater than 10%, only 2 had remissions longer than 33 weeks whereas 8 of the 9 patients with labelling indices less than 10% had remissions longer than 33 weeks. No correlation could be found between the degree of cytological differentiation and remission induction, remission length or survival. No correlation was found between the TLI and the degree of cytological differentiation. Age and initial platelet count were confirmed to be important factors influencing complete remission rate, but these factors did not correlate with remission length. Sixteen patients had their pretreatment sera assayed for mouse marrow colony stimulating activity and inhibitor levels but there was no correlation with subsequent response to treatment, although the number of patients examined was clearly too small for any definite conclusions to be drawn