Execution Plan Research Articles

APEX: affordance-based plan executor for indoor robotic navigation

ABSTRACT The concept of affordance is commonly described as the set of possibilities an environment offers an animal to select and execute actions. In the context of autonomous robot navigation, determining which affordances are available to a mobile agent provides crucial information to perform navigation tasks such as executing navigation plans or exploring new environments. In this work, we provide a robot with the capability of detecting changes in the set of navigation affordances that it has available as it moves through indoor spaces. Specifically, given a navigation plan represented as a sequence of high-level behaviors such as ‘turn left’ or ‘follow a corridor’, we propose the Affordance-Based Plan Executor (APEX) as a new learning-based method to execute this plan based on the identification of navigation affordances. As a relevant fact, the proposed method does not require a map of the environment at execution time. To the best of our knowledge, our work is one of the first to explicitly consider the identification of navigation affordances as a central element to implement the execution of a behavior-based navigation plan in an indoor environment. Our experiments using the Gibson simulator and environments from the Stanford 2D-3D-S dataset suggest that our approach performs well in previously seen environments in comparison to baselines, exceeding alternative approaches' success rate by up to 43%. Additionally, our approach shows promise at generalizing to previously unseen environments, exceeding the success rate of alternative approaches by up to 26.3%. Finally, our experiments confirm that explicit reasoning about affordances is key to APEX's performance.

Custom Triflange Acetabular Implants for Complex Hip Revisions: A Case Series.

Revision total hip arthroplasty (THA) presents a formidable challenge when addressing extensive acetabular defects, particularly in severe cases classified under Paprosky types 3A and 3B and American Academy of Orthopaedic Surgeons types 3 and 4. Traditional methods often fall short, prompting the potential use of custom triflange acetabular components or patient-specific acetabular implants (PSAIs). These implants are specifically designed to conform to an individual's anatomy, aiming to enhance defect reconstruction and pelvic stabilization. This case series describes the utilization of advanced 3-dimensional printing and rapid prototyping technologies to construct customized acetabular components, which can be instrumental in enabling precise preoperative planning and surgical execution for these difficult acetabular cases and potentially leading to improved surgical outcomes.

Manajemen Marketing Madrasah Melalui Teknologi Informasi Dan Komunikasi di MA Hidayatul Mubtadiin Jati Agung Lampung Selatan

The point of this examination is to decide and break down the preparation, execution and assessment of madrasa showcasing the executives through data and correspondence innovation at Madrasah Aliyah Hidayatul Mubtadiin Jati Agung South Lampung. This sort of exploration is subjective examination, the technique utilized in this exploration utilizes perception, meetings and documentation. The information sources in this examination are essential and optional exploration sources. The information investigation procedure utilized is an intuitive model and information triangulation to really look at the legitimacy of the information. The exploration results show that 1) Mama Hidayatul Mubtadiin's new understudy confirmations advertising arranging (PPDB) is the most vital phase in the understudy affirmations process. The initial step is vital, on the grounds that the initial step is important for the interaction that will prompt the eventual outcome. Figuring out a promoting program execution plan zeros in additional on tips, strategies, procedures or methodologies that are successful, effective and adaptable to carry out. Execution arranging should think about time distribution, accessibility of assets, HR, offices, etc. 2) Execution of Mama Hidayatul Muntadiin's showcasing through data and correspondence innovation by carrying out a blend, in particular item, value, spot and advancement. In the interim, the media utilized for madrasa advertising are handouts and the web like sites, WA, Instagram, Facebook, TV and papers. 3) Assess the advertising system or execution associated with showcasing, by taking a gander at the degree of promoting exercises that have been carried out, by proceeding with exercises that have been generally answered by the general population.

Assessment of residual prestress in existing concrete bridges: The Kalix bridge

The direct socio-economic consequences of the deterioration of aging infrastructure systems have triggered a continuous process of revising and updating current design standards and guidelines for critical network components. Specifically, long-term degradation processes demand the analysis and evaluation of vital structural assets such as prestressed concrete bridges. It is crucial to develop theoretically consistent, user-friendly, and non-destructive methodologies that engineering professionals can employ to prevent and mitigate potential catastrophic outcomes during the service life of these bridges. This study provides a thorough review of the available testing methods employed over the years for prestressed concrete bridges and introduces a comprehensive framework for evaluating existing methods for residual prestress force assessment. Through a multi-criteria selection process, the three most feasible tests were designed and carried out on an existing 66-year-old balanced cantilever box girder bridge exposed to freezing temperatures that affected the instrumentation plan and test execution. Finally, predictive models compliant with standard codes were calibrated based on the experimental results and the life cycle loss of prestress forces was evaluated to assess relevant bounding intervals. Findings reveal limited on-site testing and discrepancies between calculated residual forces and predictions by standard codes. The saw cut method showed a 18% difference from the initial applied prestress according to the prestress protocol, suggesting the use of a cover meter and concrete modulus evaluation for improved accuracy. The strand cutting method resulted in a 14% difference, emphasizing the need for stress redistribution assessment. The second-order deflection method showed a 6% difference, indicating a focus on enhanced boundary conditions and thorough sensitivity analysis for future investigations.

Cloud service models, business continuity and disaster recovery plans, and responsibilities

Purpose The purpose of this article is to identify the role of cloud computing services in business continuity and disaster recovery plans and delineate responsibilities for their execution. In recent times, there has been a huge upsurge in the usage of cloud service models such as infrastructure-as-a-service, platform-as-a-service, software-as-a-service and disaster recovery-as-a-service. However, in case of an emergency event or during contract negotiations, a question might arise as to who should be accountable and responsible for the content and execution of recovery plans. The main stakeholders in this scenario are cloud service providers and cloud consumers. Design/methodology/approach After a review of academic articles, standards, guidelines and vendor documentation, a proposal for assigning accountability and responsibility for business continuity and disaster recovery plans is presented, based on the RACI (responsible, accountable, consulted and informed) matrix. In this regard, a critical information infrastructure protection plan, a disaster recovery plan, an information systems contingency plan and a business continuity plan have been elaborated on in the article. Findings RACI matrices are presented for three general cloud service models and for three DRaaS models (managed, assisted and self-service). Accountability and responsibilities depend on the deployed cloud service model and the roles of cloud service providers and cloud consumers. Originality/value The proposed model for accountability and responsibility assignment provides a guideline for the allocation of responsibilities to roles not only during recovery but also during contract negotiations between cloud service providers and cloud consumers. By delving into business continuity and disaster recovery processes and activities, similar yet nuanced RACI matrices should be developed, as presented in this paper. They need to be customised for the specific context.

Linking executive pay to ESG goals: the role of board gender diversity

PurposeIn recent years, US firms have increasingly integrated ESG performance goals into their executive remuneration packages. This study examines the relationship between board gender diversity and the tendency of firms to incorporate ESG metrics in performance-based compensation using data from US firms. The key questions this study addresses are: Are firms with more females on the board more likely to link executive compensation metrics? What components and types of ESG metrics are more likely to be adopted by firms with more females on the board?.Design/methodology/approachThis study employs OLS regression, logistic regression, as well as instrumental variable, propensity score matching, and entropy balance methods to establish causality.FindingsThis study finds that firms with gender-diverse boards are more likely to shape their executive remuneration plans to be more ESG-oriented. The most significant positive relationship is observed with environmental and social sub-categories. The results also demonstrate that female directors are more likely to encourage firms to evaluate managers based on absolute and short-term ESG goals.Originality/valueThis study is one of the early studies that examine the adoption of ESG performance goals into executive compensation plans. It contributes to the existing literature by exploring the relationship between board gender diversity and the probability of firms incorporating ESG performance goals into executive compensation packages using a sample of US firms.

Mixed Reality Biopsy Navigation System Utilizing Markerless Needle Tracking and Imaging Data Superimposition.

Exact biopsy planning and careful execution of needle injection is crucial to ensure successful procedure completion as initially intended while minimizing the risk of complications. This study introduces a solution aimed at helping the operator navigate to precisely position the needle in a previously planned trajectory utilizing a mixed reality headset. A markerless needle tracking method was developed by integrating deep learning and deterministic computer vision techniques. The system is based on superimposing imaging data onto the patient's body in order to directly perceive the anatomy and determine a path from the selected injection site to the target location. Four types of tests were conducted to assess the system's performance: measuring the accuracy of needle pose estimation, determining the distance between injection sites and designated targets, evaluating the efficiency of material collection, and comparing procedure time and number of punctures required with and without the system. These tests, involving both phantoms and physician participation in the latter two, demonstrated the accuracy and usability of the proposed solution. The results showcased a significant improvement, with a reduction in number of punctures needed to reach the target location. The test was successfully completed on the first attempt in 70% of cases, as opposed to only 20% without the system. Additionally, there was a 53% reduction in procedure time, validating the effectiveness of the system.

Planning for complex decommissioning projects in Australia – Gippsland Basin case study

Over more than 50 years, safe and successful installation projects have enabled progressive development and expansion of the Gippsland Basin Joint Venture off the coast of Victoria, Australia. This has resulted in a highly integrated network of 19 offshore platforms which are now starting to progressively reach the end of their productive life and detailed planning for the first phase of decommissioning projects has increased in intensity. Decommissioning of these assets is planned to take place in a number of campaigns. The Campaign 1 Decommissioning Project includes the removal of up to 13 platforms and is likely to be the largest single project of its kind in the World. Experience of similar decommissioning projects in Australia is very limited, resulting in unprecedented challenges across many aspects of this project. This requires creative, innovative and adaptable solutions to be developed to enable an efficient execution methodology. This paper will explore the strategies, challenges and successes involved with the early planning and development phase of the Gippsland Basin Joint Venture, Campaign 1 Decommissioning Project. Key insights, from contracting, to execution planning and stakeholder engagement will be discussed, promoting sharing across the industry and improving efficiency for future decommissioning projects in Australia.

Use of computed tomography for shoulder arthroplasty: A systematic review

IntroductionThe prevalence of total shoulder arthroplasties is on the rise annually. Improvements in implant quality, construct stability, and surgical techniques have notably enhanced post-operative results, prompting an expansion of indications for shoulder arthroplasty. Despite its high success rate, opportunities for enhancement remain, especially in preoperative planning and intraoperative execution. Advanced imaging technologies offer significant potential in optimizing implant placement, thus improving the longevity of the procedure. To our knowledge, a comprehensive review examining the impact of advanced imaging on shoulder arthroplasty has yet to be conducted. This systematic review aims to investigate the benefits of advanced imaging technologies in this context, focusing on their application in preoperative planning, osteoarthritis assessment, intraoperative adjustments, patient-specific instrumentation, and navigational aids. MethodsThis review utilized a comprehensive search of PubMed to identify relevant studies published from 2000 to 2024, focusing on the application of various imaging techniques in shoulder arthroplasty. The search was conducted by two authors and centered on plain radiography, CT scans, and MRI. The selection criteria included availability of full-text articles, English language, direct comparison of imaging techniques, and a focus on patient outcomes, including discussions on broader applications such as intraoperative navigation and patient-specific instrumentation development. ResultsEnhanced imaging techniques, particularly CT scans and MRIs, have been shown to significantly improve outcomes in shoulder arthroplasty. While plain radiographs remain standard, CT scans provide superior bony detail, crucial for evaluating glenoid wear and determining augmentation needs. Preoperative CT imaging has been demonstrated to enhance implant placement accuracy. Moreover, intraoperative technologies based on CT imaging, such as patient-specific instrumentation and navigation systems, contribute to better surgical results. ConclusionThe benefits of CT imaging in shoulder arthroplasty significantly outweigh the associated costs. Current literature strongly supports the adoption of CT imaging in these procedures, particularly when used alongside modern operative technologies.

Collaborative online international learning in physiology: a case study.

Internationalization in higher education is essential, and although active learning methodologies are increasing and allow students to develop transversal skills, most still have a very local scope. In this context, the Collaborative Online International Learning (COIL) methodology is an interesting approach to benefit the students' development. It consists of an online program that involves creating multicultural teams to develop a specific learning project. Although this methodology is expanding, its use in physiology is still scarce. This paper aims to show an example of applying COIL methodology in physiology topics to enhance higher-education students' innovation and business skills. Our example project developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master students. Over 7 weeks, these teams, mentored by professors and researchers, engaged in workshops covering COIL methodology, business model design, executive summary planning, economic analyses, and communication techniques. Key outcomes included learning new concepts, developing soft skills, building confidence in innovative solution proposals, and experiencing diverse cultures. Challenges faced were language barriers, scheduling, task complexity, and logistical issues. This experience confirms the effectiveness of incorporating programs using COIL methodology into educational curriculums. Doing so exposes physiology students to innovation, entrepreneurship, and business creation while strengthening their professional connections and opening up postgraduation opportunities.NEW & NOTEWORTHY Although the Collaborative Online International Learning (COIL) methodology is expanding, its use in physiology is still scarce. Our example COIL project of 7 weeks developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master's students. Students perceived extracurricular activities in this format as beneficial. Coaches also expressed positive views about such initiatives, noting benefits for students and their development.

Learning complex predicates for cardinality estimation using recursive neural networks

Cardinality estimation is one of the most vital components in the query optimizer, which has been extensively studied recently. On one hand, traditional cardinality estimators, such as histograms and sampling methods, struggle to capture the correlations between multiple tables. On the other hand, current learning-based methods still suffer from the feature extraction of complex predicates and join relations, which will lead to inaccurate cost estimation, eventually a sub-optimal execution plan. To address these challenges, we present a novel end-to-end architecture leveraging deep learning to provide high-quality cardinality estimation. We exploit an effective feature extraction technique, which can fully make use of the structure of tables, join conditions and predicates. Besides, we use sampling-based technique to construct sample bitmaps for the tables and join conditions respectively. We also utilize the characteristics of predicate tree combined with recursive neural network to extract deep-level features of complex predicates. Finally, we embed these feature vectors into the model, which consists of three components: a recursive neural network, a graph convolutional neural network (GCN) and a multi-set convolutional neural network, to obtain the estimated cardinality. Extensive results conducted on real-world workloads demonstrate that our approach can achieve significant improvement in accuracy and be extended to queries with complex semantics.

Vision detection and path planning of mobile robots for rebar binding

AbstractFocused on the problems of cumbersome operation, low efficiency, and high cost in the traditional manual rebar binding process, we propose a mobile robot vision detection and path‐planning method for rebar binding to realize automated rebar binding by combining deep learning and path‐planning technology. A MobileNetV3‐SSD rebar binding crosspoints recognition model is built based on TensorFlow deep learning framework, and a crosspoints localization method combining control factor α and feature projection curve is introduced to achieve the localization of unbound crosspoints. In addition, A back‐and‐forth path‐planning algorithm with priority constraints combined with dead zone escape algorithm based on improved A* is proposed to achieve complete coverage path planning of the working area and path transfer of the dead zone. In the field test of the robot prototype, the classification accuracy and localization accuracy reached 94.40% and 90.49%, and the robot was able to reach complete coverage path planning successfully. The experimental results show that the visual detection method can achieve fast, noncontact and intelligent recognition of rebar binding crosspoints, which has good robustness and application value. At the same time, the proposed path‐planning method has higher efficiency in the execution of robot complete coverage path planning, and meets the basic requirements of path planning for rebar binding process.

Treatment of Medial Patellar Instability With Bipolar Patellofemoral Cartilage Lesions: Staged De-rotational Distal Femoral Osteotomy Followed by Bipolar Osteochondral Allograft Transplantation and Tibial-Tubercle Osteotomy

Background: Patellar instability with symptomatic cartilage lesions in young patients is a challenging problem to treat. The use of osteotomies to correct malalignment and fresh osteochondral allograft transplantation (OCA) to address cartilage lesions and patellofemoral dysplasia is a viable treatment option for carefully selected patients. Indications: The patient is a 22-year-old woman with medial patellar instability caused by iatrogenic distal femoral external rotation and uncontained grade IV patellofemoral lesions. The patient was indicated for OCA because the lesions were too large for an osteochondral autograft transfer system (OATS) and were uncontained and not amenable to autologous chondrocyte implantation. Bipolar OCA also addresses the patient’s patellofemoral dysplasia by restoring a more morphologically normal patellofemoral joint. The external rotation and mild varus deformity are corrected with a biplanar distal femoral osteotomy. Correction of malalignment is necessary prior to OCA transplantation to avoid abnormal graft loading and thereby decrease the risk of graft failure. Technique Description: (1) Diagnostic arthroscopy and fluoroscopic examination under anesthesia. (2) Lateral closing wedge de-rotational distal femoral osteotomy. (3) Bipolar OCA with tibial tubercle osteotomy and removal of hardware. Results: In this case, the patient had significant improvement in her symptoms and had full knee range of motion with a normal gait at 3 months after surgery. Depending on a patient’s preoperative function and the specific pathology, full recovery can take considerably longer. A successful outcome is considered return to activities of daily living without significant pain. Return to higher level athletic activities is significantly more unpredictable. Graft survival of bipolar patellofemoral OCA is variable, and the literature is limited by the small number of procedures performed, but published series range from 60% to 85% at 5 years. Discussion/Conclusion: A successful outcome in these unique, complex cases depends on good patient selection, preoperative planning, and surgical execution. Patellar instability can be reliably treated when the predisposing anatomical factors are appropriately corrected. Bipolar OCA can provide significant improvement in pain and function, but continues to have the highest rate of graft failure compared with other sites within the knee, and should be considered a salvage operation for patients with significant limitations in activities of daily living. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

CONSTRUCTION SITE INFORMATION MODELLING APPLIED TO INFRABIM

Construction industry lags in digitalization due to various factors, not least the complexity of implementing the BIM method in all production stages of the supply chain. This research focuses on CoSIM (Construction Site Information Modelling) design applied to the construction of new infrastructure and particularly addresses the issue of the Level-of-Information-Need structure based on the "model use" approach introduced by ISO 19650-1:2018 and the resulting IDS (Information Delivery Specification). To acquire useful information for the research aim, many site visits were conducted for over a year at a highway construction site in Italy to retrace the design process backward and highlight the available ergo-technical information assets and their shortcomings. As a result of the on-site monitoring, a database structure of ergo-technical information was graphically displayed through tabs. Specifically, the IDS made it possible to operationalize the structure theorized in the database through the Level-of-Information-Need in a machine-user dialogue. The IDS system was then interpreted as a combination of the IFC format, favoring the design process in an openBIM environment. This allowed the definition of specific infrastructure ergo-technics PropertySets and their related properties. The correct acquisition of ergo-technical information related to the project procedure is extremely useful regarding time, costs, and workers' Health & Safety planning. Therefore, the study aims to serve as a starting point for defining the contents of complex documents such as the EIR (Exchange Information Requirements) and/or the BEP (BIM Execution Plan) related to the activities of an infrastructure construction site, developed for the so-called "infraBIM" world.

CONSTRUCTION SITE INFORMATION MODELLING APPLIED TO INFRABIM

Construction industry lags in digitalization due to various factors, not least the complexity of implementing the BIM method in all production stages of the supply chain. This research focuses on CoSIM (Construction Site Information Modelling) design applied to the construction of new infrastructure and particularly addresses the issue of the Level-of-Information-Need structure based on the "model use" approach introduced by ISO 19650-1:2018 and the resulting IDS (Information Delivery Specification). To acquire useful information for the research aim, many site visits were conducted for over a year at a highway construction site in Italy to retrace the design process backward and highlight the available ergo-technical information assets and their shortcomings. As a result of the on-site monitoring, a database structure of ergo-technical information was graphically displayed through tabs. Specifically, the IDS made it possible to operationalize the structure theorized in the database through the Level-of-Information-Need in a machine-user dialogue. The IDS system was then interpreted as a combination of the IFC format, favoring the design process in an openBIM environment. This allowed the definition of specific infrastructure ergo-technics PropertySets and their related properties. The correct acquisition of ergo-technical information related to the project procedure is extremely useful regarding time, costs, and workers' Health & Safety planning. Therefore, the study aims to serve as a starting point for defining the contents of complex documents such as the EIR (Exchange Information Requirements) and/or the BEP (BIM Execution Plan) related to the activities of an infrastructure construction site, developed for the so-called "infraBIM" world.

Strategic Communications in the Digital Age: Crafting Effective Project Communication Plans to Enhance Enterprise Efficiency

In the era of rapid digital transformation, the creation and execution of a project communication plan have emerged as critical components in managing the flow of information within organizations. This white paper explores the structure and significance of a project communication plan, highlighting its role in aligning stakeholders, facilitating efficient information exchange, and ensuring projects remain on track. Through the lens of situational analysis, audience personas, and the strategic selection of communication channels, we delve into how a meticulously crafted communication plan can mitigate the pervasive challenge of information overload. The findings underscore the importance of adaptability, relevance, and targeted messaging in enhancing organizational communication. By addressing the detrimental effects of excessive and irrelevant information, this document presents a compelling case for the strategic implementation of communication plans as a remedy for improving productivity, strategic alignment, and decision-making efficacy within modern enterprises.

SPOC 双线融合教学设计与实践

Online teaching platforms and technologies have become important means of offline teaching. The two teaching scenarios should be fully integrated and collaborate to complete teaching tasks. Following the concept of collaborative teaching and the integration of teaching elements by Josh Bersin, this paper reconstructs and designs course teaching content through four stages: learner demand feature recognition, learning plan formulation, learning resource development, and learning plan execution. Three integration methods, including flipping, flexibility, and complementary classrooms, are introduced to complete teaching practice. The assessment results of final close-book paper test and the satisfaction evaluation of integrated teaching give affirmation to the teaching effectiveness. Therefore, it can be considered that teachers should choose different dual line integrated teaching models based on the differences in course content to drive learning pace and improve classroom teaching efficiency.

A 3D-Printed Model for High Sacrectomy of a Marjolin’s Ulcer–Associated Sacral Tumor: A Case Report and Literature Review

Marjolin’s ulcer is a rare but aggressive form of skin cancer that often presents significant surgical challenges due to the complex anatomy of the pelvis and the necessity for wide excision to avoid recurrence. This case report highlights the innovative use of a 3-dimensional (3D)–printed model for the precise planning and successful execution of a high partial sacrectomy in a 48-year-old male patient with quadriplegia. This patient, who had sustained a cervical spine injury in 1996, developed a sacral pressure sore that progressed into a Marjolin's ulcer. Utilizing high-resolution 3D computed tomography scans, we created a detailed 3D-printed model of the patient's sacrum, which facilitated a thorough understanding of the tumor's anatomy and its spatial relationships with critical structures. This approach significantly aided the surgical team in executing a challenging excision while minimizing risk to the adjacent organs. This case underscores the potential of 3D printing technology to enhance surgical planning and outcomes in complex oncological resections, particularly in anatomically challenging regions.

A learned cost model for big data query processing

The efficiency of query processing in the Spark SQL big data processing engine is significantly affected by execution plans and allocated resources. However, existing cost models for Spark SQL rely on hand-crafted rules. While learning-based cost models have been proposed for relational databases, they do not consider available resources. To address this issue, we propose a resource-aware deep learning model capable of automatically predicting query plan execution times based on historical data. To train our model, we embed query execution plans within a query plan tree and extracted features from allocated resources. An adaptive attention mechanism is integrated into the deep learning model to enhance prediction accuracy. Additionally, we extract sufficient features to represent data information and learn the effect of the data on query execution. This approach reduces the need for model retraining owing to data changes. The experimental results demonstrate that our deep cost model outperforms traditional rule-based methods and relational database learning-based optimizers in predicting query plan execution times.

P058 A service evaluation of rheumatologist-led ultrasound clinics at a tertiary care centre

Abstract Background/Aims Rheumatologist-led ultrasound (USG) clinics were established at UCLH over 10 years ago with an intention to improve speed of diagnosis and/or execution of treatment plan with the benefit of clinical assessment and diagnostic imaging in one appointment. The benefits for patients may include reduced time taken from work and reduced anxiety. This project aimed to evaluate reasons for referral to this clinic, the outcome of a patient review and the impact of this service. Methods Retrospective Health-record data were collected from EPIC using Google forms for patients who had USG of their hands in the specialist clinics for 3 months (Jan - March 2022). Data included patient demographics, clinical data, USG findings, intended change or initiation of treatment, and outcome of the review. Results 54 patients had been reviewed in the three months. More than half (61%) were referred to help answer a treatment-related question and the remaining were to confirm diagnosis (39%). Most patients referred for diagnosis had their diagnosis confirmed (86%). Majority (62%) also had appropriate follow up and two were discharged; a further six had potential to be discharged at this time. Out of the 33 referred for treatment questions, there were 23(70%) patients who needed no change to their treatment; 15(65%) of these would have potentially been initiated on biologics otherwise. This resulted in potential savings of between £76,497-£107,601 per 6-month (trial of DMARD) period due to drug cost. Table 1 lists potential indirect savings. Conclusion This service evaluation found considerable direct and indirect savings that emphasises the need for such specialist service in the cost-strapped NHS. The direct cost savings relate to the drugs that were not required to be initiated, with the majority attributed to the avoidance of biologics. In addition to the indirect cost savings to the NHS , the reduction of risk to the patient of unnecessary immunosuppression remains undefined. As a result of this service evaluation, to enhance potential discharges from this clinic, referring clinicians manage patient expectations at referral and communicatepotential for discharge at referral to the scanning clinician. Disclosure A. Zmuda: None. J. Manson: None. M. Castelino: None.