Abstract Background Improving antibiotic stewardship whilst simultaneously optimizing patient safety is a perpetually vexing clinical conundrum, which has been compounded by the current COVID-19 pandemic. Procalcitonin (PCT) measurement has previously demonstrated utility in this regard, when combined with routine clinical investigation, in certain patient populations. Objectives To assess whether the inclusion of PCT measurement as part of routine clinical care, instituted during a quality improvement project (QIP), increases the appropriateness of antibiotic administration. Methods A retrospective analysis was performed on 6 month interim data obtained from May to October 2021 during a QIP, which assessed the effect of PCT measurement on antimicrobial stewardship. All patients included had a primary diagnosis of respiratory illness and were analysed both together and as COVID-19 and non-COVID-19 subgroups to assess how often antibiotics were commenced on admission, duration of treatment and appropriateness of use. Finally, as sending microbiological samples made up part of the protocol, sample sending frequency was also studied. Results Thirty patients were included in both the COVID-19 and non-COVID-19 baseline subgroups who did not have PCT testing performed. Fifty-two patients were included in the PCT subgroup (27 COVID-19 positive and 25 COVID-19 negative). Following introduction of PCT testing, commencement of antibiotics on admission was reduced overall and in the COVID-19 positive subgroup (P = 0.0426 and P = 0.0446, respectively) with a significant decrease in inappropriate antibiotic prescribing in these two groups (P = 0.011 and P = 0.0157, respectively) and a trend towards reduced prescribing of AWaRe watch group antibiotics such as ceftriaxone. However, once prescribed, there was no difference in duration of antibiotic treatment or the frequency of microbiological sampling. Conclusions The data from this interim data analysis demonstrate that PCT measurement, when combined with routine clinical investigations in the acute respiratory setting, can be used to reduce inappropriate antibiotic prescribing. This was significantly reduced overall and in the COVID-19 positive subgroup but lost statistical significance in the COVID-19 negative subgroup, where it could be hypothesized that heterogeneity and inclusion of respiratory diseases where PCT has previously encountered difficulty in determining the presence of acute bacterial infection may be the cause. The significant effect demonstrated in the COVID-19 positive subgroup suggests particular utility in this patient population.

The Measurement Applications and Development Group at the Oak Ridge National Laboratory has used a FIDLER to characterize a site where numerous localized and dispersed concentrations of uranium had been previously discovered beneath a poured concrete floor. The thick floor impeded the evaluation of the distribution of regions containing uranium without boring numerous holes through the concrete. The purpose of this study was to perform a radiological assessment of the building in preparation for remediation of the site. Integrated counts were taken with the FIDLER probes fixed in place on a systematic grid across the area to be evaluated. The results were then superimposed on a drawing of the area of evaluation. This approach allowed the boundaries of the regions with subsurface contamination to be resolved much better than by using standard survey techniques and decreased the number of borehole samples and subsequent analyses. The study demonstrated that this survey technique provides rapid and essential characterization information and reduces sampling, analytical, and remediation costs.

A measurement survey of the elevation and environmental media in impoundments 3513 (B) and 3524 (A) at the Oak Ridge National Laboratory (ORNL) was conducted during April 1998. The investigation was performed by the Measurement Applications and Development Group of the Life Sciences Division of ORNL at the request of Bechtel Jacobs Company. Measurement activities were conducted at selected locations in order to determine the depth and appearance of the sediment and describe the clay underlying the impoundments prior to remediation. The survey was a follow-up to a previous elevation survey. The survey included the following: collection of sediment/clay cores from selected locations in each impoundment; measurement and documentation of the elevation at the water surface, at the top of sediment, at the top of clay, and at the bottom of each core; visual inspection of each core by a soil scientist to confirm the presence of clay and not material such as fly ash and soda lime compacted over the last 50 years; measurement and documentation of the background beta-gamma radiation level at the time and location of collection of each core, the highest beta-gamma level along the sediment portion of each core, and the highest beta-gamma level along the clay portion of each core; measurement and documentation of the length of the clay and of the sediment portion of each core; photographic documentation of each core; and replacement of each core in the impoundment.

A radiological and chemical characterization survey of impoundments 3539 and 3540 at the Oak Ridge National Laboratory (ORNL) was conducted during December 1997. Impoundments 3539 and 3540 are located in the Surface Impoundments Operable Unit (SIOU) of Waste Area Group 1. The investigation was performed by the Measurement Applications and Development Group of the Life Sciences Division of ORNL at the request of the Department of Energy (DOE) Office of Environmental Restoration. Sampling was conducted in order to quantify the presence of polychlorinated biphenyls (PCBs), Resource Conservation and Recovery Act (RCRA) constituents, and other contaminants of interest in support of the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation for the SIOU> The survey included collection of sediment/clay samples, quality control blank water samples and equipment rinsate samples for chemical and radiological analysis. Results show the samples contain traces of various organic, inorganic, and radioactive materials. Of particular interest are PCB values which demonstrate the impoundments are not regulated under the Toxic Substances Control Act.

This report documents the results of a radiological verification survey conducted at the Chambers Works of the E. I. DuPont Company in Deepwater, New Jersey by a team from the Oak Ridge National Laboratory (ORNL) in response to the Department of Energy's (DOE) Environmental Restoration Program requirements. The survey was to confirm that radioactive residuals previously identified in a portion of a central drainage ditch (the B Ditch) had been remediated to bring that portion of the property into compliance with current U.S. Department of Energy guidelines. The survey was conducted in the spring of 1997 in conjunction with DuPont's remediation and stabilization of the B Ditch to remove elevated levels of 2,4-dinitrotoluene and organic lead compounds. Portions of this ditch were located in an area where former Manhattan Engineering District of the Atomic Energy Commission work was conducted, and an independent verification survey was taken to ensure that this area had been remediated to radionuclide concentrations and activity levels below the applicable guideline limits. The survey included directly measured radiation levels and soil analysis to determine concentrations of uranium, and to compare these data to applicable guidelines. The results of the independent verification survey on this property demonstrate that the remediated and surveyed section of the B Ditch at the DuPont Chambers Works, Deepwater, New Jersey, successfully meets remedial action objectives, and radiological measurements in that portion of the property fall below the limits prescribed by radiological guidelines established for this site.

This field sampling plan describes the methodology to perform an independent radiological verification survey and chemical characterization of a remediated area of the subpile at the Wayne Interim Storage Site, Wayne, New Jersey.Data obtained from collection and analysis of systematic and biased soil samples will be used to assess the status of remediation at the site and verify the final radiological status. The objective of this plan is to describe the methods for obtaining sufficient and valid measurements and analytical data to supplement and verify a radiological profile already established by the Project Remediation Management Contractor (PMC). The plan describes the procedure for obtaining sufficient and valid analytical data on soil samples following remediation of the first layer of the subpile. Samples will be taken from an area of the subpile measuring approximately 30 m by 80 m from which soil has been excavated to a depth of approximately 20 feet to confirm that the soil beneath the excavated area does not exceed radiological guidelines established for the site or chemical regulatory limits for inorganic metals. After the WISS has been fully remediated, the Department of Energy will release it for industrial/commercial land use in accordance with the Record of Decision. This plan provides supplemental instructions to guidelines and procedures established for sampling and analysis activities. Procedures will be referenced throughout this plan as applicable, and are available for review if necessary.

At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted a radiological survey at Two Mile Creek, Tonawanda, New York. The survey was performed in November 1991 and May 1996. The purpose of the survey was to determine if radioactive materials from work performed under government contract at the Linde Air Products Division of Union Carbide Corporation, Tonawanda, New York, had been transported into the creek. The survey included a surface gamma scan in accessible areas near the creek and the collection of soil, sediment, and core samples for radionuclide analyses. Survey results indicate that no significant material originating at the Linde plant is presently in the creek. Three of the 1991 soil sample locations on the creek bank and one near the lake contained slightly elevated concentrations of {sup 238}U with radionuclide distributions similar to that found in materials resulting from former processing activities at the Linde site.

In the mid-1940s, B and T Metals, 425 West Town Street, Columbus, Ohio became one of the first commercial firms to provide extrusion of uranium billets into rods in support of Manhattan Engineer District (MED) operations. The US Department of Energy conducted radiological surveys of these sites to evaluate current radiological conditions as part of the 1974 Formerly Utilized Sites Remedial Action Program (FUSRAP). In 1988 and 1989, a preliminary radiological survey was conducted by ORNL on the commercial property of B and T Metals. Results of the survey indicated that limited and localized residual radioactive material found in the main building and in one area outdoors exceeded current DOE guidelines, and the site was recommended for remediation. In the spring of 1996, a radiological verification survey of this property was conducted by ORNL, the independent verification contractor, in conjunction with decontamination operations conducted under the supervision of Bechtel National, Incorporated. The verification survey included gamma scans of the main building and parts of the grounds, limited beta-gamma scans of the building and roof, limited alpha scans of inside overhead structures, smear sampling, and the collection of samples for radionuclide analysis. This report describes the results of the radiological verification survey of the commercial property of B and T Metals, Columbus, Ohio.

Between October 1952 and February 1957, National Lead of Ohio (NLO), a primary contractor for the Atomic Energy Commission (AEC), subcontracted certain uranium machining operations to Alba Craft Laboratory, Incorporated, located at 10-14 West Rose Avenue, Oxford, Ohio. In 1992, personnel from Oak Ridge National Laboratory (ORNL) confirmed the presence of residual radioactive materials from the AEC-related operations in and around the facility in amounts exceeding the applicable Department of Energy (DOE) guidelines. Above-guideline radiation levels were also found both indoors and outdoors at 525 S. Main Street, a private residential property in the immediate vicinity of the Alba Craft site. This document reports the findings at this private residence. Although the amount of uranium found on the properties posed little health hazard if left undisturbed, the levels were sufficient to require remediation to bring radiological conditions into compliance with current guidelines, thus ensuring that the public and the environment are protected. A team from ORNL conducted a radiological verification survey of the property at 525 S. Main Street, between November 1993 and December 1994. The survey was conducted at the request of DOE and included directly measured radiation levels, the collection and analysis of soil samples to determine concentrations of uranium and certain other radionuclides, and comparison of these data to the guidelines.

Between October 1952 and February 1957, National Lead of Ohio (NLO), a primary contractor for the Atomic Energy Commission (AEC), subcontracted certain uranium machining operations to Alba Craft Laboratory, Incorporated, located at 10-14 West Rose Avenue, Oxford, Ohio. In 1992, personnel from Oak Ridge National Laboratory (ORNL) confirmed the presence of residual radioactive materials from the AEC-related operations in and around the facility in amounts exceeding the applicable Department of Energy (DOE) guidelines. Although the amount of uranium found on the property posed little health hazard if left undisturbed, the levels were sufficient to require remediation to bring radiological conditions into compliance with current guidelines, thus ensuring that the public and the environment are protected. Because it was suspected that uranium may have been used in the past in the immediate vicinity of Alba Craft in a Miami University building a team from ORNL, performed a radiological characterization survey of that structure in January 1994. The survey was conducted at the request of DOE as a precautionary measure to ensure that no radioactive residuals were present at levels exceeding guidelines. The survey included the determination of directly measured radiation levels and the collection of smear samples to detect possible removable alpha and beta-gamma activity levels, and comparison of these data to the guidelines. Results of the survey showed that all measurements were below the applicable guideline limits set by DOE.

Between October 1952 and February 1957, National Lead of Ohio (NLO), a primary contractor for the Atomic Energy Commission (AEC), subcontracted certain uranium machining operations to Alba Craft Laboratory, Incorporated, located at 10-14 West Rose Avenue, Oxford, Ohio. In 1992, personnel from Oak Ridge National Laboratory (ORNL) confirmed the presence of residual radioactive materials from the AEC-related operations in and around the facility in amounts exceeding the applicable Department of Energy (DOE) guidelines. Although the amount of uranium found on the property posed little health hazard if left undisturbed, the levels were sufficient to require remediation to bring radiological conditions into compliance with current guidelines, thus ensuring that the public and the environment are protected. A team from ORNL conducted a radiological verification survey of the former Alba Craft Laboratory property between December 1994 and February 1995. The survey was conducted at the request of DOE and included directly measured radiation levels, the collection and analysis of soil samples to determine concentrations of uranium and certain other radionuclides, and comparison of these data to the guidelines. This document reports the findings of this survey. The results of the independent verification survey of the former Alba Craft Laboratory property demonstrate that all contaminated areas have been remediated to radionuclide concentrations and activity levels below the applicable guideline limits set by DOE.

At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory (ORNL) conducted an independent radiological verification survey at Ottawa Lake, Michigan. The survey was performed in November and December of 1994. The purpose of the survey was to verify that the site was remediated to levels below the DOE guidelines for FUSRAP sites. Results of the independent radiological verification survey at Ottawa Lake, Michigan confirm that the residual uranium contamination at the site is below DOE FUSRAP guidelines for unrestricted use.

The former Associate Aircraft Tool and Manufacturing Company site is located at 3550 Dixie Highway, Fairfield, Ohio. Associate Aircraft Tool and Manufacturing Company produced hollow uranium slugs in a machine shop at the site in 1956. The work was performed for National Lead of Ohio in a contract with the Atomic Energy Commission to augment the capacity of the Feed Materials Production Center at Fernald in the development of nuclear energy for defense-related projects. The current occupant of the building, Force Control, operates a multipurpose machine shop. At the request of the US Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted an independent radiological verification survey at the former Associate Aircraft Tool and Manufacturing Company Site, Fairfield, Ohio. The survey was performed from February to May of 1995. The purpose of the survey was to verify that radioactivity from residues of {sup 238}U was remediated to a level below acceptable DOE guidelines levels.

At the request of the U.S. Department of Energy (DOE), a team from Oak Ridge National Laboratory conducted radiological surveys at the former C. H. Schnoor and Company site, 644 Garfield Street, Springdale, Pennsylvania. The surveys were performed on October 11-13 and November 14-17, 1993, in order to provide a complete characterization prior to site remediation. The surveys included a gamma scan and a scan for surface contamination from alpha and beta-gamma emitters; measurement of direct and removable alpha and beta-gamma levels; systematic FIDLER measurements at the surface of the concrete; and the collection of samples from boreholes for radionuclide analysis. Results of the surveys revealed radionuclide concentrations and surface contamination levels in excess of applicable DOE guidelines for {sup 238}U. Radionuclide distributions were higher than typical background levels for {sup 238}U in the Springdale, Pennsylvania area.

A surface radiological investigation was conducted intermittently from June 1994 to June 1995 at the proposed site for Solid Waste Storage Area (SWSA) 7. The stimulus for this survey was the observation in June 1992 of a man`s trousers became contaminated with {sup 9O}Sr while he was reviewing work on top of the High Flux Isotope Reactor (HFIR) cooling tower. Radiation surveys identified {sup 9O}Sr on the roofs of older buildings at the HFIR site. Since no {sup 9O}Sr was found on buildings built between 1988 and 1990, the {sup 9O}Sr was thought to have been deposited prior to 1988. Later in 1992, beta particles were identified on a bulldozer that had been used in a wooded area southwest of the Health Physics Research Reactor (HPRR) Access Road. More recently in April 1995, {sup 9O}Sr particles were identified on the top side of ceiling tiles in the overhead area of a building in the HFIR Complex. Considering that the proposed SWSA 7 site was located between the HFIR complex and the HPRR Access Road, it was deemed prudent to investigate the possibility that beta particles might also be present at the SWSA 7 site. A possible explanation for the presence of these particles has been provided by long-time ORNL employees and retirees. Strontium-90 as the titanate was developed in the early 1960s as part of the Systems for Nuclear Auxiliary Power (SNAP) Program. Strontium titanate ({sup 90}SrTiO{sub 3}) was produced at the Fission Product Development Laboratory (Building 3517) in the ORNL main plant area. Waste from the process was loaded into a 1-in. lead-lined dumpster, which was transferred to SWSA 5 where it was dumped into a trench. Dumping allowed some articles to become airborne.