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Stella S Falconer, Corinne M Karuppan, Emily Kiehne, Shravan Rama
PROBLEM: Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care. METHODS: We performed process analyses to redesign the door-to-vital signs process. We also developed spaghetti diagrams to reconfigure the patient arrival area...
June 13, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Andrew D Hanson, Jeffrey S Amthor, Jiayi Sun, Thomas D Niehaus, Jesse F Gregory, Steven D Bruner, Yousong Ding
Thiamin is essential for plant growth but is short-lived in vivo and energetically very costly to produce - a combination that makes thiamin biosynthesis a prime target for improvement by redesign. Thiamin consists of thiazole and pyrimidine moieties. Its high biosynthetic cost stems from use of the suicide enzyme THI4 to form the thiazole and the near-suicide enzyme THIC to form the pyrimidine. These energetic costs lower biomass yield potential and are likely compounded by environmental stresses that destroy thiamin and hence increase the rate at which it must be made...
August 2018: Plant Science: An International Journal of Experimental Plant Biology
Patrick M Shih
Humans have domesticated many plant species as indispensable sources of food, materials, and medicines. The dawning era of synthetic biology represents a means to further refine, redesign, and engineer crops to meet various societal and industrial needs. Current and future endeavors will utilize plants as the foundation of a bio-based economy through the photosynthetic production of carbohydrate feedstocks for the microbial fermentation of biofuels and bioproducts, with the end goal of decreasing our dependence on petrochemicals...
August 2018: Plant Science: An International Journal of Experimental Plant Biology
Ines Rauschenbach, Ramaydalis Keddis, Diane Davis
We have redesigned a tried-and-true laboratory exercise into an inquiry-based team activity exploring microbial growth control, and implemented this activity as the basis for preparing a scientific poster in a large, multi-section laboratory course. Spanning most of the semester, this project culminates in a poster presentation of data generated from a student-designed experiment. Students use and apply the scientific method and improve written and verbal communication skills. The guided inquiry format of this exercise provides the opportunity for student collaboration through cooperative learning...
2018: Journal of Microbiology & Biology Education: JMBE
Jingfeng Chen, Leilei Sun, Chonghui Guo, Wei Wei, Yanming Xie
BACKGROUND: A clinical pathway (CP) defines a standardized care process for a well-defined patient group that aims to improve patient outcomes and promote patient safety. However, the construction of a new pathway from scratch is a time-consuming task for medical staff because it involves many factors, including objects, multidisciplinary collaboration, sequential design, and outcome measurements. Recently, the rapid development of hospital information systems has allowed the storage of large volumes of electronic medical records (EMRs), and this information constitutes an abundant data resource for building CPs using data-mining methods...
June 11, 2018: Journal of Biomedical Informatics
Diane Naouri, Carlos El Khoury, Christophe Vincent-Cassy, Albert Vuagnat, Jeannot Schmidt, Youri Yordanov
INTRODUCTION: Some major changes have occurred in emergency department (ED) organization since the early 2000s, such as the establishment of triage nurses and short-track systems. The objectives of this study were to describe the characteristics of French EDs organization and users, based on a nationwide cross-sectional survey. METHODS: The French Emergency Survey was a nationwide cross-sectional survey. All patients presenting to all EDs during a 24-hr period of June 2013 were included...
2018: PloS One
Chancellor F Gray, Hernan A Prieto, Andrew T Duncan, Hari K Parvataneni
Background: Total joint arthroplasty (TJA) remains the highest expenditure in the Centers for Medicare and Medicaid Services (CMS) budget. One model to control cost is the Comprehensive Care for Joint Replacement (CJR) model. There has been no published literature to date examining the efficacy of CJR on value-based outcomes. The purpose of this study was to determine the efficacy and sustainability of a multidisciplinary care redesign for total joint arthroplasty under the CJR paradigm at an academic tertiary care center...
June 2018: Arthroplasty Today
Robin B Layton, Todd D Stewart, Paul Harwood, Neil Messenger
The Ilizarov frame is an external fixation device, primarily used for the treatment of complex fractures. The authors postulate that the size and weight of the frame may lead to biomechanical adaptations to gait, independent to any injury. Temporospatial characteristics, kinetics and kinematics were assessed when simulating the use of an Ilizarov frame. Fifteen healthy participants performed walking trials, with and without the simulated frame. Significant changes to temporospatial characteristics were identified, with a decreased mean walking speed (with: 1...
June 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Brandon G Wong, Christopher P Mancuso, Szilvia Kiriakov, Caleb J Bashor, Ahmad S Khalil
Precise control over microbial cell growth conditions could enable detection of minute phenotypic changes, which would improve our understanding of how genotypes are shaped by adaptive selection. Although automated cell-culture systems such as bioreactors offer strict control over liquid culture conditions, they often do not scale to high-throughput or require cumbersome redesign to alter growth conditions. We report the design and validation of eVOLVER, a scalable do-it-yourself (DIY) framework, which can be configured to carry out high-throughput growth experiments in molecular evolution, systems biology, and microbiology...
June 11, 2018: Nature Biotechnology
Elizabeth Gyllstrom, Kimberly Gearin, Donald Nease, Betty Bekemeier, Rebekah Pratt
OBJECTIVE: To describe the degree of public health and primary care collaboration at the local level and develop a model framework of collaboration, the Community Collaboration Health Model (CCHM). DESIGN: Mixed-methods, cross-sectional surveys, and semistructured, key informant interviews. SETTING: All local health jurisdictions in Colorado, Minnesota, Washington, and Wisconsin. PARTICIPANTS: Leaders from each jurisdiction were identified to describe local collaboration...
June 7, 2018: Journal of Public Health Management and Practice: JPHMP
Zainab Al-Taie, Nattapon Thanintorn, Ilker Ersoy, Olha Kholod, Kristen Taylor, Richard Hammer, Dmitriy Shin
Pathway-based analysis holds promise to be instrumental in precision and personalized medicine analytics. However, the majority of pathway-based analysis methods utilize "fixed" or "rigid" data sets that limit their ability to account for complex biological inter-dependencies. Here, we present REDESIGN: RDF-based Differential Signaling Pathway informatics framework. The distinctive feature of the REDESIGN is that it is designed to run on "flexible" ontology-enabled data sets of curated signal transduction pathway maps to uncover high explanatory differential pathway mechanisms on gene-to-gene level...
2018: AMIA Summits on Translational Science Proceedings
Julie M Allen, Raphael LaFrance, Ryan A Folk, Kevin P Johnson, Robert P Guralnick
Massive strides have been made in technologies for collecting genome-scale data. However, tools for efficiently and flexibly assembling raw outputs into downstream analytical workflows are still nascent. aTRAM 1.0 was designed to assemble any locus from genome sequencing data but was neither optimized for efficiency nor able to serve as a single toolkit for all assembly needs. We have completely re-implemented aTRAM and redesigned its structure for faster read retrieval while adding a number of key features to improve flexibility and functionality...
2018: Evolutionary Bioinformatics Online
Lin-Feng You, Jia-Jun Huang, Tao Wei, Shu-Ling Lin, Bing-Hua Jiang, Li-Qiong Guo, Jun-Fang Lin
OBJECTIVES: Taxoid 10β-O-acetyl transferase (DBAT) was redesigned to enhance its catalytic activity and substrate preference for baccatin III and taxol biosynthesis. RESULTS: Residues H162, D166 and R363 were determined as potential sites within the catalytic pocket of DBAT for molecular docking and site-directed mutagenesis to modify the activity of DBAT. Enzymatic activity assays revealed that the kcat /KM values of mutant H162A/R363H, D166H, R363H, D166H/R363H acting on 10-deacetylbaccatin III were about 3, 15, 26 and 60 times higher than that of the wild type of DBAT, respectively...
June 4, 2018: Biotechnology Letters
Sunjoo Kang, Thi Thuy Trang Ho, Thi Anh Phuong Nguyen
Background: Nurses are an essential human resource to ensure a healthy population and support the socio-economic development. However, little research has focused on the capacity development of nurses. Objective: The performance of a capacity development project for an undergraduate nursing program in Vietnam was reviewed to share lessons. Design: A descriptive case report. Setting: A baccalaureate nursing program in Vietnam from June 2014 to June 2016. Methods: A case report was analyzed in terms of the project's process, and the outcomes of 2 years' activities were evaluated...
2018: Frontiers in Public Health
Andrew Hill, Brad Niles, Andrew Cuyegkeng, Ted Powers
TOR is a serine/threonine protein kinase that assembles into distinct TOR Complexes 1 and 2 (TORC1 or TORC2) to regulate cell growth. In mammalian cells, a single mTOR incorporates stably into mTORC1 and mTORC2. By contrast, in Saccharomyces cerevisiae , two highly similar Tor1 and Tor2 proteins exist, where Tor1 assembles exclusively into TORC1 and Tor2 assembles preferentially into TORC2. To gain insight into TOR complex assembly, we used this bifurcation in yeast to identify structural elements within Tor1 and Tor2 that govern their complex specificity...
June 1, 2018: Biomolecules
Mohana Maddula, Laura Adams, Jonathan Donnelly
Background : Transient Ischaemic Attacks (TIA) should be treated as a medical emergency. While high-risk TIAs have higher stroke risks than low-risk patients, there is an inherent limitation to this risk stratification, as some low-risk patients may have undiagnosed high-risk conditions. Inequity of care for TIA patients was observed, such that high-risk patients received urgent assessment through acute admission, while low-risk patients faced long waits for clinical consultation. A redesign of the TIA service was planned to offer timely assessment for all patients and avoid acute admission for high-risk patients...
June 1, 2018: Healthcare (Basel, Switzerland)
Olle Lundberg
In 2015, a national Commission for Equity in Health was appointed by the Swedish Government. In this paper, some key lines of thought from the three reports published by the Commission are summarised. First, the theories and principles for the Commission's work are outlined, in particular regarding the views taken on how health inequalities arise. Second, the importance of process is discussed in relation to cross-sectorial efforts to reduce inequalities in health. More specifically, this brings up some of the proposals made for how to redesign the public health policy framework for cross-sectorial work...
June 2018: Scandinavian Journal of Public Health
Mathias Müller, Rolf Salcher, Nils Prenzler, Thomas Lenarz, Hannes Maier
Introduction: In order to reduce the large variations in clinical outcomes of patients with implanted MED-EL Floating Mass Transducer (FMT) at the round window (RW), several approaches were proposed to optimize FMT-RW coupling. Our previous study showed improved FMT-RW coupling by applying static RW loads utilizing the "Hannover Coupler" (HC) FMT-prosthesis but also demonstrated insufficient low frequency performance. Hence, a redesigned HC version (HCv2) was investigated in this study...
2018: BioMed Research International
Keshav Gupta, Kishanlal Suthar, Sheetal Kumar Jain, Ghanshyam Das Agarwal, Ashish Nayyar
In the present study, a four-stroke cycle gasoline engine is redesigned and converted into a six-stroke cycle engine and experimental study has been conducted using gasoline and acetylene as fuel with water injection at the end of the recompression stroke. Acetylene has been used as an alternative fuel along with gasoline and performance of the six-stroke spark ignition (SI) engine with these two fuels has been studied separately and compared. Brake power and thermal efficiency are found to be 5.18 and 1.55% higher with acetylene as compared to gasoline in the six-stroke engine...
June 2, 2018: Environmental Science and Pollution Research International
Donna M Hackley, Chrispinus H Mumena, Agnes Gatarayiha, Corrado Cancedda, Jane R Barrow
Harvard School of Dental Medicine, University of Maryland School of Dentistry, and the University of Rwanda (UR) are collaborating to create Rwanda's first School of Dentistry as part of the Human Resources for Health (HRH) Rwanda initiative that aims to strengthen the health care system of Rwanda. The HRH oral health team developed three management tools to measure progress in systems-strengthening efforts: 1) the road map is an operations plan for the entire dental school and facilitates delivery of the curriculum and management of human and material resources; 2) each HRH U...
June 2018: Journal of Dental Education
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