How to (actually) save time while working remotely

Background:Helicopter emergency medical services (HEMS) and ground EMS (GEMS) are both integral parts of out-of-hospital transport systems for patients with ST-elevation myocardial infarction (STEMI) undergoing emergency transport for primary percutaneous coronary intervention (PPCI). There are firm data linking time savings for PPCI transports with improved outcome. A previous pilot analysis generated preliminary estimates for potential HEMS-associated time savings for PPCI transports.Methods:This non-interventional multicenter study conducted over the period 2012–2014 at six centers in the USA and in the State of Qatar assessed a consecutive series of HEMS transports for PPCI; at one center consecutive GEMS transports of at least 15 miles were also assessed if they came from sites that also used HEMS (dual-mode referring hospitals). The study assessed time from ground or air EMS dispatch to transport a patient to a cardiac center, through to the time of patient arrival at the receiving cardiac unit, to determine proportions of patients arriving within accepted 90- and 120-minute time windows for PPCI. Actual times were compared to “route-mapping” GEMS times generated using geographical information software. HEMS' potential time savings were calculated using program-specific aircraft characteristics, and the potential time savings for HEMS was translated into estimated mortality benefit.Results:The study included 257 HEMS and 27 GEMS cases. HEMS cases had a high rate of overall transport time (from dispatch to receiving cardiac unit arrival) that fell within the predefined windows of 90 minutes (67.7% of HEMS cases) and 120 minutes (91.1% of HEMS cases). As compared to the calculated GEMS times, HEMS was estimated to accrue a median time saving of 32 minutes (interquartile range, 17–46). The number needed to transport for HEMS to get one additional case to PPCI within 90 minutes was 3. In the varied contexts of this multicenter study, the number of lives saved by HEMS, solely through time savings, was calculated as 1.34 per 100 HEMS PPCI transports.Conclusions:In this multicenter study, HEMS PPCI transport was found to be appropriate as defined by meeting predefined time windows. The overall estimate for lives saved through time savings alone was consistent with previous pilot data and was also generally consistent with favorable cost-effectiveness. Further research is necessary to confirm these findings, but judicious HEMS deployment for PPCI transports is justified by these data.

Perceptions of Transvaginal Ultrasound by Patients Being Evaluated in the Emergency Department for Complications of First Trimester Pregnancy

Objectives: We retrospectively assess the potential impact of a novel, investigational Augmented Reality (AR) software application, Radiology with Holographic Augmentation (RadHA), on pediatric orthopedic surgeon's confidence in surgical planning, hardware selection, hardware fit, and estimated potential intraoperative time savings in the setting of complex adolescent elbow fractures.Methods: After study selection, 12 individual cases of complex elbow fractures in adolescent pediatric patients were identified for review. AR models were generated for each case derived from the patient's CT. Five fellowship-trained pediatric orthopedic surgeons reviewed each case for a total of 60 separate observations. Surgeons reviewed clinical data, radiologic imaging, and AR models and then answered Likert Scale questions on measures of confidence in presurgical planning and projected potential time savings. These data were reviewed and analyzed using various statistical tools.Results: Surgeons reported high confidence in the quality of the AR models created. Additionally, surgeons reported increased confidence in their surgical plan, increased confidence in hardware selection, and increased confidence in hardware fit. Within the sub-analysis of complex (comminuted) fractures, surgeons reported greater expected increases in confidence of their surgical plan and hardware fit. Overall, surgeons estimated potential intraoperative time savings, averaging 17.3 min for all fracture types and 17.6 min for complex fractures.Conclusions: Preoperative planning using AR-based models can increase surgeon confidence in preoperative planning, hardware selection, and confidence in hardware fit.

Ridesourcing services play a crucial role in metropolitan transportation systems and aggravate urban traffic congestion and air pollution. Ridesplitting is one possible way to reduce these adverse effects and improve transport efficiency. This paper aims to explore the potential of ridesplitting in peak hours using empirical ridesourcing data of Chengdu, China provided by DiDi Chuxing. A ridesplitting trip identification algorithm based on a shareability network is developed to quantify the potential of ridesplitting. Then, we evaluate the gap between the potential and actual scales of ridesplitting, which the literature has not yet reported. We compare the potential of ridesplitting under three different objectives. The results show that the objective of minimizing the total travel cost produces better performance than the objectives of maximizing shared trips and time savings. Under the objective of maximizing cost savings, the percentage of potential cost savings is 18.47% with an average delay of 4.76 minutes, whereas the actual percentage is 1.22% with an average delay of 9.86 minutes. The potential percentage of shared trips is 90.69%, while the actual percentage is 7.85%. Furthermore, the potential time savings can reach 25.75%, while the actual time savings are 2.38% in the real world. The findings of this study can help transportation management agencies and ridesourcing companies develop sensible policies to improve ridesplitting services.

Praxiserfahrungen mit Overviews of Reviews – wertvolle Entscheidungsunterstützung oder wissenschaftliche Fingerübung?

This study evaluates the diagnostic accuracy of a multimodal large language model (LLM), ChatGPT-4, in recognizing glaucoma using color fundus photographs (CFPs) with a benchmark dataset and without prior training or fine tuning. The publicly accessible Retinal Fundus Glaucoma Challenge "REFUGE" dataset was utilized for analyses. The input data consisted of the entire 400 image testing set. The task involved classifying fundus images into either 'Likely Glaucomatous' or 'Likely Non-Glaucomatous'. We constructed a confusion matrix to visualize the results of predictions from ChatGPT-4, focusing on accuracy of binary classifications (glaucoma vs non-glaucoma). ChatGPT-4 demonstrated an accuracy of 90% with a 95% confidence interval (CI) of 87.06%-92.94%. The sensitivity was found to be 50% (95% CI: 34.51%-65.49%), while the specificity was 94.44% (95% CI: 92.08%-96.81%). The precision was recorded at 50% (95% CI: 34.51%-65.49%), and the F1 Score was 0.50. ChatGPT-4 achieved relatively high diagnostic accuracy without prior fine tuning on CFPs. Considering the scarcity of data in specialized medical fields, including ophthalmology, the use of advanced AI techniques, such as LLMs, might require less data for training compared to other forms of AI with potential savings in time and financial resources. It may also pave the way for the development of innovative tools to support specialized medical care, particularly those dependent on multimodal data for diagnosis and follow-up, irrespective of resource constraints.

Chapter 1 - Introduction to Multishooting: Challenges and Rewards

The clinician-administered version of the Liebowitz Social Anxiety Scale (LSAS-CA) is a commonly used assessment device for the evaluation of social anxiety disorder and has been shown to have strong psychometric characteristics. Because of its apparently straightforward rating format and potential savings in time and effort, interest in the use of the LSAS as a self-report (LSAS-SR) measure has increased, and the LSAS-SR has been used in a number of studies. However, the psychometric properties of the LSAS-SR have not been well established. This study examined the psychometric properties of the LSAS-SR in comparison to the LSAS-CA in a sample of 99 individuals with a primary diagnosis of social anxiety disorder and 53 individuals with no current psychiatric disorder. There was little difference between the two versions of the LSAS on any scale or subscale score. Both forms were internally consistent and the subscale intercorrelations for the two forms were essentially identical. Correlations of each LSAS-SR index with its LSAS-CA counterpart were all highly significant. Finally, the convergent and discriminant validity of the two forms of the LSAS was shown to be strong. Results of this study suggest that the self-report version of the LSAS compares well to the clinician-administered version and may be validly employed in the assessment of social anxiety disorder.

Synthesis of nanocrystalline barium titanate: Effect of microwave power on phase evolution

The National Institute of Standards and Technology (NIST) has developed conceptual designs, laboratory scale models, and computer simulations/animation of several configurations of remotely operated cranes to assemble highway bridges. NIST’s designs have been patented and trademarked as “RoboCrane.” Major opportunities exist to develop fullscale cranes and demonstrate construction of temporary bridges, causeways across wetlands, and overpasses for traffic management over repair sites. Remotely operated, mobile, lightweight cranes can put modular bridge sections in place and provide better control of loads. This could result in faster assembly and less environmental disturbance. RoboCrane configurations that are well suited for bridge assembly and their potential savings in time and cost are discussed.

The relationship between gentamicin pharmacokinetics and measures of bioelectrical impedance (BI) in elderly patients was investigated with the aim of developing a potential noninvasive means of individualising gentamicin dosage. Linear regression analyses identified height/resistance2 as a statistically significant predictor of gentamicin distribution volume, V, [adjusted (adj)r2 = 0.53, coefficient of variation (CV) = 15.2%], and resistance/reactance and creatinine clearance (CLcr) as predictors of total systemic clearance, CL, adj r2 = 0.52, CV = 20.1%. Individualisation of gentamicin dosage regimens based on these relationships to achieve steady-state (SS), peak gentamicin concentrations, Css,max, and SS trough concentrations, Css,min, of 7.0 and 1.0 micrograms/ml, respectively, in an independent group of elderly patients resulted in serum gentamicin levels of 5.9 +/- 0.7 and 0.8 +/- 0.4 micrograms/ml. Mean absolute prediction errors averaged 0.7 +/- 0.5 micrograms/ml for Css,max and 0.5 +/- 0.3 micrograms/ml for Css,min. Measures of BI provided the best predictions of Css,max, whereas models based on CLcr alone were the best predictors of Css,min. This technique provides a means of complementing routine pharmacokinetic monitoring of gentamicin pharmacotherapy in the elderly hospitalised patient with reductions in patient discomfort and potential savings in time and cost.

Time Savings With Rituximab Subcutaneous (SC) Injection Vs Rituximab Intravenous (IV) Infusion: Final Analysis From a Time-and-Motion Study In 8 Countries

Exploring Innovative Strategies and Services in a Pandemic Era Ellysa Stern Cahoy (bio) and Maribeth Slebodnik (bio) The COVID-19 pandemic was an unprecedented crisis for academic libraries. In March 2020, libraries were confronted with the immediate challenge of maintaining access for their users while moving to a fully remote environment. As classes migrated rapidly online, libraries were slower to close.1 A monthlong spiral of reducing services and hours ended for most in a complete closure of the physical facilities. By March 29, most academic libraries had shut their doors.2 Librarians had to reenvision how they would provide specialized services, instruction, research support, and collections in the remote environment. As 2020 progressed, collective trauma continued. The murder of George Floyd in Minneapolis, Minnesota, triggered demonstrations against police violence and racism across the United States. At the same time, protests erupted worldwide against racial inequities and economic hardships due to the pandemic. The world would never be the same, and many people got their first extended exposure to ongoing and multilayered hardship and global crisis. These events required academic libraries to do a hard reset. They had to reconsider once set-in-stone processes and procedures because it simply was no longer possible to do things the way they had always been done. Responses to the pandemic and antiracism reshaped many library practices by fall 2020. Remote and on-site work, online learning, electronic collections, and more became different in the aftermath. The culture of physically working together in an academic library radically shifted. No longer colocated, academic library faculty and staff invented new ways of gathering remotely, building community, and caring for one another. An even more urgent and always necessary focus on diversity, equity, and inclusion in our organizations confronted and profoundly changed institutional positions and past practices. In summer 2020, portal Editor Marianne Ryan suggested developing a special issue centered on these current crises—the pandemic, racial inequities, and economic challenges—engulfing our world. These upheavals offered librarians a chance to question their traditional practices and perspectives and adapt to what was possible—and what worked in the moment—within individual institutions and the profession. With that in [End Page 1] mind, this issue of portal: Libraries and the Academy explores and accentuates positive possibilities—the unique opportunities, creative strategies, and innovative responses—that emerged in academic libraries because of or in spite of these challenges. This double special issue is the sixth in portal’s 20-year history. Our fall 2020 call for proposals yielded a landslide of unique and thoughtful abstracts—nearly 80 submissions from academic librarians at a wide range of institutions, including large universities, private colleges, and community colleges across the United States. Novice authors, as well as those sharing diverse perspectives, were encouraged to suggest ideas. From these proposals, we began to see themes emerge around teaching and learning, inventive access to collections, and diversity, equity, inclusion, and accessibility initiatives. The articles featured in this special issue encapsulate areas of focused innovation that developed throughout academic libraries in the United States. Every article acknowledges the existence of twin pandemics—COVID-19 and the plague of racial violence and social inequity. These combined crises mandated a thoughtful focus on how our institutions could continue to teach and provide resources to our core populations while increasing efforts to offer equitable access and a culture of compassionate care. Inventive Provision of Services] New services emerged as a result of pandemic-specific needs. In “Bridging the Digital Divide: WiFi Hot Spots as a Means of Digital Equity,” Meghan Salsbury and Mary Anne Hansen detail the development of a project to provide wireless access to their rural students. Confronting the digital divide inherent in sparsely populated Montana, the authors obtained a grant to purchase and lend wireless hot spots to students and faculty members as long-term circulating items. The article shares a theme that recurred through many in our issue: libraries and librarians understanding and meeting critical basic needs on campus. Similarly, Sarah Fancher and Sarah Mabee confronted an emerging challenge for their students at Ozarks Technical Community College in Missouri. They realized that students would benefit from facilitated access to resources on specific...

This paper aims to showcase the benefits of incorporating repositionable isolation plug technology in perforation and stimulation operations in multi-layered wells. It will highlight how this technology can effectively reduce time and costs when conducting perforation and stimulation across multiple zones in wells with extensive horizontal sections and challenging sour conditions. Due to the limits imposed by high contrasts in reservoir properties, acid stimulation and perforation gun lengths, the perforation and stimulation zones must be isolated using isolation plugs. This new approach allows the well operator to efficiently reposition the plug and isolate all the zones without having to retrieve the BottomHole Assembly (BHA) to surface. The innovative approach of doing the perforation and stimulation has already been tested and proven over several years by a prominent operator in the Middle East. This paper outlines the steps of how the perforation and stimulation operations are performed, as well as the benefits of utilizing cutting-edge repositionable isolation plug technology to enhance efficiency. The paper delves into the technology that has made it possible to enhance the operations, showcasing significant time- and cost-savings. Additionally, it emphasizes the potential time savings as the wells become longer, deeper, and more complex with an increasing number of zones. By employing a single plug to isolate all zones, operators can eliminate the need for multiple isolation runs, potentially saving several days per well during the completion phase. The innovative approach to zone isolation enhances operational efficiency during well completion operations, resulting in increased productivity and profitability for the well operators. By minimizing the number of well entries and exits, operational risks are reduced, ultimately fostering a safer work environment.

Brick-and-mortar retailers are facing increased pressure to innovate to remain competitive against online retailers. In recent years, brick-and-mortar retailers have implemented the addition of curbside service, which allows customers to order ahead and pick up their items without leaving their cars (“click and collect”). While curbside pick-up service has surged 208% during the COVID-19 pandemic (Thomas 2020), it is unclear whether the service will persist in a post-pandemic world. Little empirical research has examined curbside pick-up antecedents or customer behaviors, despite investigations into curbside pick-up being an important issue for marketers (Grewal et al. 2021). This research explores the interplay between customer perceptions of curbside pick-up, time saved by customers, and downstream financial consequences for firms that provide curbside pick-up. Drawing upon the planning fallacy (Kahneman & Tversky 1977), which explains how people underestimate the length of time a task will take to complete, two studies test outcomes at both the firm and customer level. Study 1, an experimental design, examines the impact of itemized versus grouping time saving perceptions for consumers. This study shows that when firms “unpack” the amount of time saved by curbside service, then the perceived value is differentially higher than when time savings are grouped together. Study 2 uses data from a large retailer in the Midwest area of the United States. In Study 2, the authors show that the introduction of curbside service increases the repurchase time for consumers initially, but over time these effects diminish. Overall, the results of these studies show that offering curbside pick-up increases repurchase time for customers, that customers cannot accurately judge how valuable curbside pick-up will be to them, and that firms can convey the value of curbside pick-up via "unpacking" (i.e., itemizing) potential time savings.