A Modified Delphi Methodology to Conduct an Failure Modes Effects Analysis: a Patient-centric Effort in a Clinical Medical Laboratory

This paper describes the use of an information gathering tool, the Delphi technique, to overcome issues encountered when conducting a Failure Modes Effects Analysis (FMEA) as part of a Define, Measure, Analyze, Implement, Control (DMAIC) study to improve the processes of a clinical medical laboratory. The study was conducted with the goals of reducing medical errors in the Total Testing Process (TTP) in order to improve patient safety, patient satisfaction, and improve the overall quality of the healthcare services provided by the subject hospital while meeting its Joint Commission (JC) accreditation requirements. The study found that the Delphi technique was very useful in overcoming four barriers encountered in conducting an FMEA in a hospital’s clinical medical laboratory and in achieving those goals

Community banking in the e-business era

This paper reviews how existing and potential uses of Internet technology can generate a competitive advantage for rural community banks. To do so, it offers a framework for analyzing Internet technology investment decisions. Organizations in this segment of the banking industry are often more removed from centers of technology and have traditionally been more conservative in their approaches to information technology (among other things). Banking Associations have developed in the U.S., such as the Independent Bankers Association, to try and help community banks coordinate marketing, legislative, and other issues that they have in common. The use of Internet technology can and will have a great strategic impact on the operations, management, and marketing for these banks and their associations. After a review of current technologies and their uses, the paper will identify specific opportunities for inter-, intra-, and extranet applications that could be used to enhance the internal and external competitive factors of these more isolated businesses and their associations. The paper will then present a framework for evaluating investment decisions in this new technology

RFID in Healthcare: A Six Sigma DMAIC and Simulation Case Study

Develop a business model to generate quantitative evidence of the benefits of implementing Radio Frequency Identification (RFID) technology limiting the scope to outpatient surgical processes in hospitals. Analysis showed significant estimated annual cost and time savings in carrying out patients’ surgical procedures with RFID technology implementation for the outpatient surgery processes in a hospital. This is largely due to elimination of both the non-value added activities of locating supplies and equipment and also the elimination of the “return” loop created by preventable post-operative infections. Several poka-yokes developed using RFID technology were identified to eliminate those two issues, as well as, for improving the safety of the patient and cost effectiveness of the operation to ensure the success of the outpatient surgical process. Several poka-yokes developed using RFID technology were identified for improving the safety of the patient and cost effectiveness of the operation to ensure the success of the outpatient surgical process

Bed-load Transport of Mixed-size Sediment: Fractional Transport Rates, Bed Forms, and the Development of a Coarse Bed-surface Layer

Fractional transport rates, bed surface texture, and bed configuration were measured after a mixed size sediment had reached an equilibrium transport state for seven different flow strengths in a recirculating laboratory flume. Fractional transport rates were also measured at the beginning of each run when the bed was well mixed and planar. The start-up observations allow us to describe the variation of fractional transport rates with bed shear stress for a constant bed surface texture and bed configuration. The start-up and equilibrium observations together allow, for the first time, an unambiguous description of the mutual adjustment among the transport, the bed configuration, and the bed surface, as the transport system moves toward equilibrium. We find that a substantial interaction exists among the transport, bed surface, and bed configuration. Bed forms and a coarse surface layer coexist over a range of bed shear stress. Under some flow conditions the size and shape of the bed forms are controlled by the presence of the coarse surface layer. At higher flows the coarse surface layer is eliminated by scour in the lee of the bed forms. If the bed surface is defined as that over which the bed forms move, a coherent relation between the bed surface texture and the transport grain size distribution may be defined. At equilibrium the transport rates of all fractions were not equally mobile, defined as identical transport and bed grain size distributions, although equal mobility was approached for runs in which the bed shear stress was more than twice that for initial motion of the mixture. Under some flow conditions the transport was observed to adjust away from equal mobility as the bed adjusted from a well-mixed start-up condition to an equilibrium state. Development of a partial static armor, wherein some individual grains become essentially immobile even though other grains in the same fraction remain in transport, is suggested to explain these adjustments between the transport and bed surface grain size distributions. Constraints on equilibrium mixed size sediment transport are defined. The special conditions for which equal mobility must hold and the relevance to natural conditions of flume results and the equal mobility concept are discussed

Identification of hip fracture patients from radiographs using Fourier analysis of the trabecular structure: a cross-sectional study

Peer reviewedPublisher PD

GUDMAP - An Online GenitoUrinary Resource

The GenitoUrinary Development Molecular Anatomy Project (GUDMAP) is a consortium of laboratories working to provide the scientific and medical community with gene expression data and tools to facilitate research (see "www.gudmap.org":http://www.gudmap.org). The data provided by GUDMAP includes large _in situ_ hybridization screens (wholemount and section) and expression microarray analysis of components of the developing mouse urogenital system (including laser-captured material and FACS-isolated cells from transgenic reporter mice). In addition, a high-resolution anatomy ontology has been developed by members of the GUDMAP consortium to describe the subcompartments of the developing murine genitourinary tract. 

The GUDMAP Database Development Team and Editorial Office - both based in Edinburgh - function to ensure submission, curation, storage and presentation of the data submitted by the GUDMAP consortium. Our collective aim is twofold: 1) to simplify the process of submission so that data is publically available as soon as it is produced; and 2) to organize this information in a database and ensure that the online interface is continuously available and easy to use. Thus far, we have developed a range of tools that help both the submitter and the end user. These include: an online annotation tool that simplifies _in situ_ data submission through an ontology-based graphical user interface; a database interface that allows users to browse and query expression data, and to filter data by organ system; a heat-map display of microarray data and analyses. Furthermore, the Edinburgh team has developed a GUDMAP Disease Database that queries associations between genes, genitourinary diseases, and renal/urinary and reproductive phenotypes. In collaboration with GUDMAP consortium members at the CCHMC (Cincinnati Children's Hospital Medical Center), the Disease Database is being extended to include mammalian phenotypes mapped to OMIM entries. 

By virtue of its impressive dataset and its ease of use we hope that the GUDMAP Website will continue to serve as a powerful resource for biologists, clinicians and bioinformaticians with an interest in the urogenital system

Experimental Study of Incipient Motion in Mixed-size Sediment

Transport rates of five sediments were measured in a laboratory flume. Three of these sediments had the same mean size, the same size distribution shape, and different values of grain size distribution standard deviation. The critical shear stress for incipient motion of the individual size fractions within these sediments was estimated as that shear stress that produced a small dimensionless transport rate. The sorting of the sediment mixture had little effect on the critical shear stress of individual fractions, once the median size (D50) of the mixture and a fraction\u27s relative size (Di/D50) are accounted for. Our data, combined with previously published data, show a remarkably consistent relation between the critical shear stress of individual fractions and the fraction\u27s relative grain size, despite a broad variation in the available data of mixture sorting, grain size distribution shape, mean grain size, and grain shape. All fractions in a size mixture begin moving at close to the same value of bed shear stress during steady state transport conditions. This result is apparently true for transport systems where the transport rates of individual fractions are determined solely by the flow and bed sediment (recirculating systems), as well as for systems where the fractional transport rates are imposed on the system (feed systems). This equivalence in initial-motion results is important because natural transporting systems often show attributes of both types of behavior in an unknown combination

Sox10 is required for Schwann cell identity and progression beyond the immature Schwann cell stage

The Sox10 transcription factor is required to maintain as well as specify glial identity, adding new causes for the neuropathies associated with SOX10 mutations

Evaluating Vendor-Managed Inventory (VMI) in Non Traditional Environments Using Simulation

This study provided empirical evidence that sufficient economic benefits could be achieved with the use of a technology-enabled vendor-managed inventory (VMI) system in a unique chain such that a firm could justify spending the money necessary to create the infrastructure to support it. The models, while based on a specific type of business, were still generic enough that the results could be generalized to many types of highly distributed, variable demand delivery systems. The study compared the costs of inventory systems used in practice by rural farm cooperatives to possible technology-enabled systems. Fuel delivery data from two agricultural cooperatives in Nebraska provided the basis for this study. The data were used to construct demand distribution for discrete event simulation models of conventional cooperative fuel delivery systems. The results generated from this base model were compared to the op¬erating costs of a technology-enabled system under a variety of VMI implementation alternatives. Performance was measured in inventory costs, delivery costs and stockouts. The study found that VMI alternatives outperformed traditional delivery methods and that the use of such technology could be economically justified in many logistics prob¬lems dealing with variable demand patterns through the cost savings created