Choosing the Right Test (Influenza) Versus Respiratory Viral Panel With Faster Turnaround Time and Cost Savings

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S142-S143
Author(s):  
Bo Lin ◽  
Manan Christian ◽  
Margarita Kogan ◽  
Alejandro Zuretti
Keyword(s):  
Respiratory Infections ◽  
Medical Center ◽  
Low Cost ◽  
Cost Savings ◽  
Turnaround Time ◽  
Viral Pathogens ◽  
Highly Sensitive ◽  
Hospital Patients ◽  
Syncytial Virus ◽  
The Right

Abstract Introduction Respiratory infections are very common in hospital patients. Viral pathogens including influenza (Flu) and respiratory syncytial virus (RSV) are frequent causes. Respiratory viral panels (RVPs) have been routinely ordered in our institution with a turnaround time (TAT) of 48 hours at a cost of approximately $170/test. Meanwhile, Flu and RSV PCR are offered in house with a TAT of only 40 minutes and much lower cost ($40/test) than RVP. Here, we examined the optimization of use of these tests in our medical center. Methods Results of the specimens sent for RVP testing as well as their results from Flu/RSV PCR and the negative result rate were reviewed. The TAT and costs were compared between RVP and Flu/RSV PCR. Results We reviewed 69 specimens from MICU sent for RVP during 10/1/2018 to 1/31/2019. Total negative specimen rate was 74%. The specimens identified positive for Flu or RSV by RVP were also positive for in-house Flu/RSV PCR. Therefore, we have recommended clinicians to order in-house highly sensitive and specific Flu/RSV PCR first for faster TAT and cost saving. Since the recommendation, the number of RVP orders has dropped from 660 (January 2018) to 131 (January 2019), with savings of more than $80,000 in 1 month. Conclusion In-house Flu/RSV PCR test is highly sensitive and specific for identifying the common viral pathogens in patients with respiratory infection. It is fast and relatively low cost compared to RVP and should be considered as an effective first-line test.

scholarly journals Respiratory Viral Pathogens in Children Evaluated at Military Treatment Facilities in Oahu, Hawaii From 2014 to 2018: Seasonality and Climatic Factors

2020 ◽  
Author(s):  
Agnes S Montgomery ◽  
Michael B Lustik ◽  
Milissa U Jones ◽  
Timothy S Horseman
Keyword(s):  
Respiratory Syncytial Virus ◽  
Influenza A ◽  
Climatic Factors ◽  
Medical Center ◽  
Respiratory Viruses ◽  
Preventive Strategies ◽  
Viral Pathogens ◽  
Treatment Facilities ◽  
Syncytial Virus ◽  
Military Treatment Facilities

Abstract Five-year retrospective analysis of respiratory viruses in children less than 18 years old at Tripler Army Medical Center and outlying clinics in Oahu. Respiratory syncytial virus and influenza A showed pronounced seasonality with peaks from September to December and December to March, respectively. Results provide a better understanding of the timing of viral preventive strategies in Oahu.

Low-Cost Adhesives for Temporary Substrate Support

2012 ◽  
Vol 2012 (DPC) ◽  
pp. 1-60
Author(s):  
John Moore ◽  
Jared Pettit
Keyword(s):  
Current Practice ◽  
Low Cost ◽  
Cost Savings ◽  
Specific Design ◽  
Substrate Support ◽  
Wide Range ◽  
Rapid Removal ◽  
Green Factory ◽  
The Right ◽  
Simple Materials

Temporary adhesives are a key part to 3DIC integration. Choosing the right adhesive is critical as it defines your process, tooling needs, and by virtue of its chemistry, will control throughput and yield. Although several products and tooling exist in the market, few offer a clear path to achieve HVM at an affordable cost. [1] A wide range in materials and processes are available, most which can be tailored to a specific design or tooling objective. Multiple options in adhesives allow grinding and polishing to <20um, protection during backside processing (e.g. TSVs), thermal resistance to >400C, [2] CVD acceptance (Fig. 1), and rapid removal with cleans on a film frame (Fig. 2). Using batch processing, throughput is increased by a factor of 5 while cost is reduced by 50%, suggesting a COO that is 10% relative to current practice. Instituting simple materials and processes matched to a customer's design will provide benefits beyond cost savings, including “green factory” certification. This presentation reviews several current practices in the market and contrasts these options with alternative low-cost adhesives and processes that are tuned to a customer's product design and tooling. Examples include excerpts from handling thin substrates in semiconductor, solar, and TFT/LCD fabrication lines.

scholarly journals Supplier evaluation in industrial power services: a case study in gas-turbine maintenance, repair, and overhaul

2020 ◽  
Vol 202 ◽  
pp. 13002
Author(s):  
Yordian Fachrie ◽  
Arviansyah
Keyword(s):  
Gas Turbine ◽  
Low Cost ◽  
Skill Training ◽  
Operating Cost ◽  
Turnaround Time ◽  
Turbine Engine ◽  
Quick Turnaround ◽  
The Right ◽  
Industrial Gas Turbine ◽  
Quick Turnaround Time

The maintenance is one of the highest costs in a gas-turbine engine, after operating cost with approximately about 14-19 % of the total cost. Some of the operators do not have spare engines, and it will lead to operation shutdown. With the current market, most MRO challenged to provide their costumer to achieve quick turnaround time (TAT) at a low cost without affecting the quality of the product. Since MRO is selling the skill services, it took applied technology, skill training, and experience to deliver quality, which needs high cost. Therefore, MRO needs to collaborate with other parties (original manufacturer or others) to increase its capacity and capability. MRO should concern more for evaluating the vendors to align with the strategies to get quick turnaround time with the right quality product. Supplier selection is the objective of this research by analyzing the selection criteria at Industrial Gas-Turbine maintenance. The highest priority is the vendor effectiveness followed by the quality, cost, risk management. The highest weight is based on the priority of the supplier.

scholarly journals Role of Upper Respiratory Microbiota and Virome in Childhood Rhinitis and Wheeze: Collegium Internationale Allergologicum Update 2021

2021 ◽  
pp. 1-12
Author(s):  
Carina Jing Xuan Tay ◽  
Le Duc Huy Ta ◽  
Yu Xiang Ow Yeong ◽  
Gaik Chin Yap ◽  
Justin Jang Hann Chu ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Current Knowledge ◽  
Respiratory Health ◽  
Viral Pathogens ◽  
Respiratory Disorders ◽  
Immunological Responses ◽  
Commensal Microbiota ◽  
Syncytial Virus ◽  
Future Work ◽  
Respiratory Microbiota

There is emerging evidence that the respiratory microbiota influences airway health, and there has been intense research interest in its role in respiratory infections and allergic airway disorders. This review aims to summarize current knowledge of nasal microbiome and virome and their associations with childhood rhinitis and wheeze. The healthy infant nasal microbiome is dominated by <i>Corynebacteriaceae</i> and <i>Staphylococcaceae</i>. In contrast, infants who subsequently develop respiratory disorders are depleted of these microbes and are instead enriched with <i>Proteobacteria spp.</i> Although human rhinovirus and human respiratory syncytial virus are well-documented major viral pathogens that trigger rhinitis and wheezing disorders in infants, recent limited data indicate that bacteriophages may have a role in respiratory health. Future work investigating the interplay between commensal microbiota, virome, and host immunological responses is an important step toward understanding the dynamics of the nasal community in order to develop a strategical approach to combat these common childhood respiratory disorders.

scholarly journals Abnormal liver tests in admitted patients with SARS-Cov-2 or other respiratory viruses- prognostic similarities and temporal disparities

2020 ◽  
Author(s):  
Noa Shafran ◽  
Assaf Issachar ◽  
Tzippy Shochat ◽  
Inbal Haya Shafran ◽  
Michael Bursztyn ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Time Course ◽  
Respiratory Infections ◽  
Infection Type ◽  
Medical Center ◽  
Severe Disease ◽  
Respiratory Viruses ◽  
Severe Liver ◽  
Syncytial Virus ◽  
Liver Tests

AbstractBackground and AimsAbnormal liver tests are common in patients with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, but their association with short-term outcomes is controversial. We aimed to compare the pattern of abnormal liver tests in SARS-CoV-2 patients with those of patients infected with influenza or respiratory syncytial virus (RSV), two non-hepatotropic respiratory viruses, and their association with in-hospital mechanical ventilation or death.MethodsA retrospective cohort study of 1271 hospitalized patients (872 influenza, 218 RSV, and 181 SARS-Cov-2) in a tertiary medical center. We defined abnormal liver tests as GPT, GOT or GGT≥40IU/ML at any time-point during hospitalization.ResultsAbnormal liver tests were mild-moderate in the majority of patients regardless of infection type but the majority of patients with influenza or RSV had a transaminases peak earlier during hospitalization compared to patients with SARS-Cov-2. Abnormal liver tests correlated with markers of severe disease across all types of infections, and were associated with mechanical ventilation or death, occurring mainly in patients with severe liver tests abnormalities (>200IU/L) (27.2%, 39.4% and 55.6% of patients with influenza, RSV or SARS-Cov-2). In multivariate analysis, controlling for age, gender, lymphopenia and CRP, liver tests abnormalities remained significantly associated with mechanical ventilation or death for influenza (OR= 3.047, 95% CI 1.518-6.117) and RSV (OR= 3.402, 95% CI 1.032-11.220) but not for SARS-Cov-2 (OR= 0.995, 95% CI 0.198-4.989). These results were confirmed upon propensity score matching.ConclusionsAbnormal liver tests during hospitalization with different viral respiratory infections are common, may differ in their time-course and reflect disease severity. They are associated with worse outcomes, mainly in patients with severe liver test abnormalities, regardless of infection type.

scholarly journals Acute respiratory viral infections in children in Rio de Janeiro and Teresópolis, Brazil

2012 ◽  
Vol 54 (5) ◽  
pp. 249-255 ◽  
Author(s):  
Maria Carolina M. Albuquerque ◽  
Rafael B. Varella ◽  
Norma Santos
Keyword(s):  
Rio De Janeiro ◽  
Influenza A ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Respiratory Viruses ◽  
Respiratory Pathogens ◽  
Viral Pathogens ◽  
Nasal Swabs ◽  
Syncytial Virus ◽  
Viral Respiratory Infections

The frequency of viral pathogens causing respiratory infections in children in the cities of Rio de Janeiro and Teresópolis was investigated. Nasal swabs from children with acute respiratory illnesses were collected between March 2006 and October 2007. Specimens were tested for viral detection by conventional (RT)-PCR and/or real time PCR. Of the 205 nasal swabs tested, 64 (31.2%) were positive for at least one of the viral pathogens. Single infections were detected in 56 samples, 50 of those were caused by RNA viruses: 33 samples tested positive for rhinovirus, five for influenza A, five for metapneumovirus, four for coronavirus and, three for respiratory syncytial virus. For the DNA viruses, five samples were positive for bocavirus and one for adenovirus. Co-infections with these viruses were detected in eight samples. Our data demonstrate a high frequency of viral respiratory infections, emphasizing the need for a more accurate diagnosis particularly for the emerging respiratory viruses. The fact that the emerging respiratory viruses were present in 9.2% of the tested samples suggests that these viruses could be important respiratory pathogens in the country.

scholarly journals Optimized Skip-Stop Metro Line Operation Using Smart Card Data

2017 ◽  
Vol 2017 ◽  
pp. 1-17 ◽  
Author(s):  
Peitong Zhang ◽  
Zhanbo Sun ◽  
Xiaobo Liu
Keyword(s):  
Travel Time ◽  
Smart Card ◽  
Low Cost ◽  
Optimal Solution ◽  
Cost Savings ◽  
Passenger Demand ◽  
Passenger Travel ◽  
Smart Card Data ◽  
Transit Agencies ◽  
The Right

Skip-stop operation is a low cost approach to improving the efficiency of metro operation and passenger travel experience. This paper proposes a novel method to optimize the skip-stop scheme for bidirectional metro lines so that the average passenger travel time can be minimized. Different from the conventional “A/B” scheme, the proposed Flexible Skip-Stop Scheme (FSSS) can better accommodate spatially and temporally varied passenger demand. A genetic algorithm (GA) based approach is then developed to efficiently search for the optimal solution. A case study is conducted based on a real world bidirectional metro line in Shenzhen, China, using the time-dependent passenger demand extracted from smart card data. It is found that the optimized skip-stop operation is able to reduce the average passenger travel time and transit agencies may benefit from this scheme due to energy and operational cost savings. Analyses are made to evaluate the effects of that fact that certain number of passengers fail to board the right train (due to skip operation). Results show that FSSS always outperforms the all-stop scheme even when most passengers of the skipped OD pairs are confused and cannot get on the right train.

Impact of embedded medication assistance program specialists on medication access in outpatient oncology clinics

2020 ◽  
pp. 107815522097026
Author(s):  
Seyram S Fudzie ◽  
Brandon Luong ◽  
Stephanie J Jean ◽  
Suzanne J Francart
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Cost Savings ◽  
Retrospective Chart Review ◽  
Turnaround Time ◽  
Primary Objective ◽  
Financial Assistance ◽  
Assistance Program ◽  
Assistance Programs ◽  
The Impact

Introduction Medication prior authorizations (PA) required by insurance payers can be time-consuming to complete and may lead to delays in treatment for cancer patients. The primary objective of this study is to assess the impact of Medication Assistance Program (MAP) specialists embedded in adult hematology and oncology clinics on the PA and financial assistance process. Methods This was a retrospective chart review study performed at a large academic medical center that examined medication referrals completed by MAP specialists in four hematology and oncology clinics. The primary outcome was the median PA turnaround time, defined as time from initial referral creation to final referral completion. Secondary outcomes assessed median turnaround time for financial assistance programs and total patient savings. Results A total of 176 prior authorization, 92 manufacturer patient assistance program (PAP), and 37 copay assistance referrals were completed. The median turnaround times were 24, 154, and 19 hours for PA, manufacturer PAP, and copay assistance program referrals, respectively. Total cost savings amounted to over $1.8 million for patients approved to receive medications through manufacturer PAPs. Conclusions Embedding MAP specialists in adult hematology/oncology clinics supports an efficient and timely process for PA approvals while also providing patient cost-savings.

Bacteria and Viral Profile of Severe Acute Respiratory Infections of Children Attending Yangon Children’s Hospital and Yankin Children’s Hospital

2019 ◽  
Vol 31 (1) ◽  
pp. 44-51
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Antibiotic Sensitivity ◽  
Parainfluenza Virus ◽  
Sensitivity Testing ◽  
E Coli ◽  
Children's Hospital ◽  
Severe Acute Respiratory Infection ◽  
Children’S Hospital ◽  
Syncytial Virus

Objectives of study are (1) to reinforce the national capacity for diagnosis and antibiogram of some infectious diseases causing severe acute respiratory infection (SARI) and (2) to build a network between hospital and laboratory for the diagnosis and surveillance of SARI in Yangon. This study is a crosssectional hospital- and laboratory-based descriptive study. A total of 825 samples including respiratory samples and blood samples from 511 children attending Yangon Children’s Hospital and Yankin Children’s Hospital from December 2014 to April 2016 for treatment of SARI were included. Identification and antibiotic sensitivity testing were done using Vitek 2. Out of 129 gram-negative bacilli (GNB), K. pneumoniae 32%, P. aeruginosa 18%, A. baumannii 13%, E. coli 9% were mostly isolated. Among 35 gram-positive cocci (GPC), S. aureus 42% and S. pneumoniae 6% were mostly isolated. Multidrug resistance rates were E. coli 100%, K. pneumoniae 95%, A. baumanii 82% and P. aeruginosa 17%. Extended-spectrum beta-latamase (ESBL)-producing K. pneumoniae and E. coli was 6 out of 10 tested organisms. Carbarpenemase-producing GNB and methicillin-resistant Staphylococcus aureus (MRSA) were 21% and 33%, respectively. Virology section tested 529 samples of 490 patients using the FTD33 Multiplex PCR method which can detect 33 pathogens including 20 viruses, 12 bacteria and 1 fungus. Out of 490 patients, 374 were PCR positive. Different types of samples including nasopharyngeal, throat, endotracheal and laryngeal swab, tracheal secretion and bronchoalveolar lavage, were tested. Out of 566 viruses, respiratory syncytial virus (RSV) (19.3%), rhinovirus (17.0%), parechovirus (14.3%), bocavirus (11.1%), adenovirus (10.2%), metapneumo-virus A and B (10.2%), parainfluenza virus (5.7%), enterovirus (3.0%), influenza A virus (2.8%), coronavirus (4%), parainfluenza virus (0.9%) and influenza C virus (0.4%) were detected. This study highlighted the etiological agents of bacteria, viruses and drug-resistant bacterial pathogens in SARI.

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