Abstract Background: The benefit of MR-only workflow compared to current CT-based workflow for prostate radiotherapy is reduction of systematic errors in the radiotherapy chain by 2–3 mm. Nowadays, MRI is used for target delineation while CT is needed for position verification. In MR-only workflows, MRI based synthetic CT (sCT) replaces CT. Intraprostatic fiducial markers (FMs) are used as a surrogate for the position of the prostate improving targeting. However, FMs are not visible on sCT. Therefore, a semi-automatic method for burning-in FMs on sCT was developed. Accuracy of MR-only workflow using semi-automatically burned-in FMs was assessed and compared to CT/MR workflow. Methods: Thirty-one prostate cancer patients receiving radiotherapy, underwent an additional MR sequence (mDIXON) to create an sCT for MR-only workflow simulation. Three sources of accuracy in the CT/MR- and MR-only workflow were investigated. To compare image registrations for target delineation, the inter-observer error (IOE) of FM-based CT-to-MR image registrations and soft-tissue-based MR-to-MR image registrations were determined on twenty patients. Secondly, the inter-observer variation of the resulting FM positions was determined on twenty patients. Thirdly, on 26 patients CBCTs were retrospectively registered on sCT with burned-in FMs and compared to CT-CBCT registrations. Results: Image registration for target delineation shows a three times smaller IOE for MR-only workflow compared to CT/MR workflow. All observers agreed in correctly identifying all FMs for 18 out of 20 patients (90%). The IOE in CC direction of the center of mass (COM) position of the markers was within the CT slice thickness (2.5 mm), the IOE in AP and RL direction were below 1.0 mm and 1.5 mm, respectively. Registrations for IGRT position verification in MR-only workflow compared to CT/MR workflow were equivalent in RL-, CC- and AP-direction, except for a significant difference for random error in rotation. Conclusions: MR-only workflow using sCT with burned-in FMs is an improvement compared to the current CT/ MR workflow, with a three times smaller inter observer error in CT-MR registration and comparable CBCT registration results between CT and sCT reference scans. Trial registry Medical Research Involving Human Subjects Act (WMO) does apply to this study and was approved by the Medical Ethics review Committee of the Academic Medical Center. Registration number: NL65414.018.18. Date of registration: 21–08-2018.
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This paper presents work aimed at improved organization and performance of production in housing renovation projects. The purpose is to explore and demonstrate the potential of lean work organization and industrialized product technology to improve workflow and productive time. The research included selected case studies that have been found to implement lean work organization and industrialized product technology in an experimental setting. Adjustments to the work organization and construction technology have been implemented on site. The effects of the adjustments have been measured and were reviewed with operatives and managers. The data have been collected and analyzed, in comparison to traditional settings. Two projects were studied. The first case implied am application of lean work organization in which labor was reorganized redistributing and balancing operations among operatives of different trades. In the second case industrialized solution for prefabricated installation of prefabricated roofs. In both cases the labor productivity increased substantially compared to traditional situations. Although the limited number of cases, both situations appeared to be representative for other housing projects. This has led to conclusions extrapolated from both cases applicable to other projects, and contribution to the knowledge to improve production in construction. Vrijhoef, R. (2016). “Effects of Lean Work Organization and Industrialization on Workflow and Productive Time in Housing Renovation Projects.” In: Proc. 24 th Ann. Conf. of the Int’l. Group for Lean Construction, Boston, MA, USA, sect.2 pp. 63–72. Available at: .
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The Circular Wood 4.0 Workflow API is a comprehensive and automated “file-to-factory” system that bridges the gap between design using waste wood resources and production processes aligned with Smart Industry principles. This software serves as the core IT infrastructure for an end-to-end automated workflow, enabling seamless data flow from material availability to final production. Key features include full traceability, real-time process monitoring, and integration of design and manufacturing stages. The API is composed of several interconnected components that manage the entire workflow, from intelligent resource matching and design generation to production preparation and execution; facilitating efficient, sustainable, and transparent fabrication processes.
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Clinical Decision Support Systems (CDSS) are increasingly developed for hospital nursing practice, yet their impact on decision-making, workflow efficiency, and patient outcomes remains complex. This rapid review synthesizes findings from 21 studies, highlighting both the benefits and challenges of CDSS implementation focused on three key areas. CDSS can enhance nursing decision-making by reducing variability and improving standardization, but there are concerns about system usability and the tendency to override recommendations. While CDSS improve workflow efficiency by prioritizing tasks, issues such as alert fatigue and poor interoperability with hospital systems hinder their potential. Patient outcomes benefit from CDSS-driven medication safety and risk prevention, yet adherence to recommendations varies among nurses. These findings underscore the need for user-centered CDSS that align with nursing values. Future research should explore long-term effectiveness, implementation strategies and best practices for integrating CDSS into nursing workflows.
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Do individual characteristics influence how the quality of work is related to the use of a workflow management system (WFM) in a Dutch social insurance organisation? This key question is addressed in this paper. Building upon DeLone and McLean’s model, we investigated the effects of gender, age, education, system experience and computer skills on the relationship between the level of user satisfaction with a WFM system and the perceived quality of work. The expected effects of individual characteristics were tested using survey data collected from 143 end users of a large Dutch social insurance organisation that recently deployed a WFM system. The results of the regression analysis show that: 1 user satisfaction has a positive relationship with quality of work 2 age has a significant moderating influence on the perceived quality of work 3 gender and system experience have no moderating effects 4 education and system computer skills (as individual characteristics) had a degree of moderating effects. These results imply that it is valuable to focus on older employees when deploying information technology as WFM systems, i.e., by improving their computer skills in particular.
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Emergent social software platforms zijn anders dan de traditionele bedrijfsapplicaties. Het gebruik ervan is vrijwillig. Ze kennen geen workflow of autorisaties. Het gebruik staat los van titel of positie. ESSP's snijden dus dwars door de organisatiehiërarchie heen.
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Rapport van de pilot SMART Sensordata Infrastructuur (SSI). Deze pilot is uitgevoerd door docenten en studenten van de opleiding AGIS van de HAS green academy in de periode van juni t/m december 2022 in samenwerking met en met financiële steun van het DCC voor Praktijkgericht onderzoek van SURF. Dit rapport bevat de volgende op te leveren resultaten:1. Ontwerp en praktische beschrijving van algemeen toepasbare datadriven-workflow voor sensordata2. Ontwerp en praktische beschrijving van metadata-model van sensor-data, gericht op datadefinitie en datakwaliteit
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Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
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Although systematic reviews are considered as central components in evidence-based practice, they currently face an important challenge to keep up with the exponential publication rate of clinical trials. After initial publication, only a minority of the systematic reviews are updated, and it often takes multiple years before these results become accessible. Consequently, many systematic reviews are not up to date, thereby increasing the time-gap between research findings and clinical practice. A potential solution is offered by a living systematic reviews approach. These types of studies are characterized by a workflow of continuous updates which decreases the time it takes to disseminate new findings. Although living systematic reviews are specifically designed to continuously synthesize new evidence in rapidly emerging topics, they have also considerable potential in slower developing domains, such as rehabilitation science. In this commentary, we outline the rationale and required steps to transition a regular systematic review into a living systematic review. We also propose a workflow that is designed for rehabilitation science.
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Purpose In this systematic literature review, the effects of the application of a checklist during in hospital resuscitation of trauma patients on adherence to the ATLS guidelines, trauma team performance, and patient-related outcomes were integrated. Methods A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Metaanalyses checklist. The search was performed in Pubmed, Embase, CINAHL, and Cochrane inception till January 2019. Randomized controlled- or controlled before-and-after study design were included. All other forms of observational study designs, reviews, case series or case reports, animal studies, and simulation studies were excluded. The Effective Public Health Practice Project Quality Assessment Tool was applied to assess the methodological quality of the included studies. Results Three of the 625 identified articles were included, which all used a before-and-after study design. Two studies showed that Advanced Trauma Life Support (ATLS)-related tasks are significantly more frequently performed when a checklist was applied during resuscitation. [14 of 30 tasks (p < 0.05), respectively, 18 of 19 tasks (p < 0.05)]. One study showed that time to task completion (− 9 s, 95% CI = − 13.8 to − 4.8 s) and workflow improved, which was analyzed as model fitness (0.90 vs 0.96; p < 0.001); conformance frequency (26.1% vs 77.6%; p < 0.001); and frequency of unique workflow traces (31.7% vs 19.1%; p = 0.005). One study showed that the incidence of pneumonia was higher in the group where a checklist was applied [adjusted odds ratio (aOR) 1.69, 95% Confidence Interval (CI 1.03–2.80)]. No difference was found for nine other assessed complications or missed injuries. Reduced mortality rates were found in the most severely injured patient group (Injury Severity score > 25, aOR 0.51, 95% CI 0.30–0.89). Conclusions The application of a checklist may improve ATLS adherence and workflow during trauma resuscitation. Current literature is insufficient to truly define the effect of the application of a checklist during trauma resuscitation on patientrelated outcomes, although one study showed promising results as an improved chance of survival for the most severely injured patients was found.
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