Shedding Light on the Off-Hours Coverage Gap in Radiology: Improving Turnaround Times and Critical Results Reporting

Objective: Devise a plan to optimize off-hours faculty and trainee staffing within the Department of Radiology Measure the magnitude of patient safety gains in terms of report turnaround times (TAT) and critical results communication times (CRC)https://jdc.jefferson.edu/patientsafetyposters/1044/thumbnail.jp

Increasing Ultrasound-Guided Thyroid Biopsy Yield

Objectives: Conduct Plan-Do-Study-Act (PDSA) performance improvement project to improve thyroid biopsy yield Short Term\u3ereduce unsuccessful biopsies by 50% Long-Term\u3eeliminate unsuccessful biopsieshttps://jdc.jefferson.edu/patientsafetyposters/1064/thumbnail.jp

Reading Room Assistance Pilot: Improving Radiologist Workflow

Aims for Improvement Our aim for improvement was to find ways to decrease distractions and phone calls in the body radiology reading room and to convert unpredictable and “immediate-response distractions” to “managed distractions” that can be addressed without aborting patient care/case interpretation immediately and unnecessarily. The goal was to decrease interruptions which would allow more time to be spent on reading cases, learning, and teaching. One metric that we identified was the number of phone calls to the reading room, which we intend to decrease by 50% within the first quarter. Another metric was the radiology attending and resident attitudes toward workflow and efficiency in the reading room. We intend to assess radiologist perception of the workflow environment and a decrease in distractions as measured by a survey administered before and after implementation. Additionally, we expect to improve efficiency and will compare productivity in terms of care delivered/cases reviewed

The Leeway of Shipping Containers at Different Immersion Levels

The leeway of 20-foot containers in typical distress conditions is established through field experiments in a Norwegian fjord and in open-ocean conditions off the coast of France with wind speed ranging from calm to 14 m/s. The experimental setup is described in detail and certain recommendations given for experiments on objects of this size. The results are compared with the leeway of a scaled-down container before the full set of measured leeway characteristics are compared with a semi-analytical model of immersed containers. Our results are broadly consistent with the semi-analytical model, but the model is found to be sensitive to choice of drag coefficient and makes no estimate of the cross-wind leeway of containers. We extend the results from the semi-analytical immersion model by extrapolating the observed leeway divergence and estimates of the experimental uncertainty to various realistic immersion levels. The sensitivity of these leeway estimates at different immersion levels are tested using a stochastic trajectory model. Search areas are found to be sensitive to the exact immersion levels, the choice of drag coefficient and somewhat less sensitive to the inclusion of leeway divergence. We further compare the search areas thus found with a range of trajectories estimated using the semi-analytical model with only perturbations to the immersion level. We find that the search areas calculated without estimates of crosswind leeway and its uncertainty will grossly underestimate the rate of expansion of the search areas. We recommend that stochastic trajectory models of container drift should account for these uncertainties by generating search areas for different immersion levels and with the uncertainties in crosswind and downwind leeway reported from our field experiments.Comment: 25 pages, 11 figures and 5 tables; Ocean Dynamics, Special Issue on Advances in Search and Rescue at Sea (2012

A Novel Ultrasonic Method for Accurate Characterization of Microstructural Gradients in Monolithic and Composite Tubular Structures

Prior studies have shown that ultrasonic velocity/time-of-flight imaging that uses back surface echo reflections to gauge volumetric material quality is well suited (perhaps more so than is the commonlyused peak amplitude c-scanning) for quantitative characterization of microstructural gradients. Such gradients include those due to pore fraction, density, fiber fraction, and chemical composition variations [11–15]. Variations in these microstructural factors can affect the uniformity of physical performance (including mechanical [stiffness, strength], thermal [conductivity], and electrical [conductivity, superconducting transition temperature], etc. performance) of monolithic and composite [1,3,6,12]. A weakness of conventional ultrasonic velocity/time-of-flight imaging (as well as to a lesser extent ultrasonic peak amplitude c-scanning where back surface echoes are gated [17] is that the image shows the effects of thickness as well as microstructural variations unless the part is uniformly thick. This limits this type of imaging’s usefulness in practical applications. The effect of thickness is easily observed from the equation for pulse-echo waveform time-of-flight (2τ) between the first front surface echo (FS) and the first back surface echo (B1), or between two successive back surface echoes where: 2τ=(2d)V (1) where d is the sample thickness and V is the velocity of ultrasound in the material. Interpretation of the time-of-flight image is difficult as thickness variation effects can mask or overemphasize the true microstructural variation portrayed in the image of a part containing thickness variations. Thickness effects on time-of-flight can also be interpreted by rearranging equation (1) to calculate velocity: V=(2d)2τ (2) such that velocity is inversely proportional to time-of-flight. Velocity and time-of-flight maps will be affected similarly (although inversely in terms of magnitude) by thickness variations, and velocity maps are used in this investigation to indicate time-of-flight variations.</p

Probabilistic Clustering of Time-Evolving Distance Data

We present a novel probabilistic clustering model for objects that are represented via pairwise distances and observed at different time points. The proposed method utilizes the information given by adjacent time points to find the underlying cluster structure and obtain a smooth cluster evolution. This approach allows the number of objects and clusters to differ at every time point, and no identification on the identities of the objects is needed. Further, the model does not require the number of clusters being specified in advance -- they are instead determined automatically using a Dirichlet process prior. We validate our model on synthetic data showing that the proposed method is more accurate than state-of-the-art clustering methods. Finally, we use our dynamic clustering model to analyze and illustrate the evolution of brain cancer patients over time

A retrospective observational study to determine baseline characteristics and early prescribing patterns for patients receiving Alirocumab in UK clinical practice

Background Alirocumab is a fully human monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9) and has been previously shown, in the phase III ODYSSEY clinical trial program, to provide significant lowering of lowdensity lipoprotein cholesterol (LDL-C) and reduction in risk of major adverse cardiovascular events. However, real-world evidence to date is limited. Objective The primary objective was to describe baseline characteristics, clinical history, and prior lipid-lowering therapy (LLT) use of patients initiated on alirocumab in UK clinical practice following publication of health technology appraisal (HTA) body recommendations. Secondary objectives included description of alirocumab use and lipid parameter outcomes over a 4-month follow-up period. Methods In this retrospective, single-arm, observational, multicenter study, data were collected for 150 patients initiated on alirocumab. Results Mean (standard deviation; SD) age of patients was 61.4 (10.5) years and baseline median (interquartile range; IQR) LDL-C level was 4.8 (4.2–5.8) mmol/l. Alirocumab use occurred predominantly in patients with heterozygous familial hypercholesterolemia (HeFH) (n = 100/150, 66%) and those with statin intolerance (n = 123/150, 82%). Most patients started on alirocumab 75 mg (n = 108/150 [72%]) and 35 (23.3%) were up-titrated to 150 mg. Clinically significant reductions in atherogenic lipid parameters were observed with alirocumab, including LDL-C (median [IQR] change from baseline, − 53.6% [− 62.9 to − 34.9], P < 0.001). Conclusion This study highlights the unmet need for additional LLT in patients with uncontrolled hyperlipidemia and demonstrates the clinical utility of alirocumab in early real-world practice, where dosing flexibility is an important attribute of this therapeutic option

Alcohol Use and Periodic Limb Movements of Sleep

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65771/1/j.1530-0277.1993.tb00747.x.pd

The SNAPSHOT study protocol : SNAcking, Physical activity, Self-regulation, and Heart rate Over Time

Peer reviewedPublisher PD