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https://www.readbyqxmd.com/read/29453154/unique-pharmacology-of-a-novel-allosteric-agonist-sensitizer-insulin-receptor-monoclonal-antibody
#1
Simon A Hinke, Anne M Cieniewicz, Thomas Kirchner, Katharine D'Aquino, Rupesh Nanjunda, Jason Aligo, Robert Perkinson, Philip Cooper, Ken Boayke, Mark L Chiu, Steve Jarantow, Eilyn R Lacy, Yin Liang, Dana L Johnson, Jean M Whaley, Russell B Lingham, Anthony J Kihm
OBJECTIVE: Insulin resistance is a key feature of Type 2 Diabetes (T2D), and improving insulin sensitivity is important for disease management. Allosteric modulation of the insulin receptor (IR) with monoclonal antibodies (mAbs) can enhance insulin sensitivity and restore glycemic control in animal models of T2D. METHODS: A novel human mAb, IRAB-A, was identified by phage screening using competition binding and surface plasmon resonance assays with the IR extracellular domain...
February 3, 2018: Molecular Metabolism
https://www.readbyqxmd.com/read/29444853/interprofessional-teamwork-innovation-model-itim-to-promote-communication-and-patient-centred-coordinated-care
#2
Jing Li, Preetham Talari, Andrew Kelly, Barbara Latham, Sherri Dotson, Kim Manning, Lisa Thornsberry, Colleen Swartz, Mark V Williams
BACKGROUND: Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM). METHODS: This quality improvement (QI) study was conducted at an academic medical centre...
February 14, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29435843/nutrition-management-for-the-head-and-neck-cancer-patient
#3
Denise Ackerman, Meghan Laszlo, Arlene Provisor, Adern Yu
Head and neck cancer (HNC) patients often face multiple nutritional challenges before, during, and after treatment due to the close proximity of the cancer to organs that are vital for normal eating function. Common treatment-related side effects, such as dysphagia, odynophagia, dysgeusia, xerostomia, thick saliva, mucositis, nausea, and vomiting, all further impair the patient's ability to maintain adequate oral intake. Malnutrition and unintentional weight loss in HNC patients during and after treatment are associated with poorer treatment outcomes, increased morbidity and mortality, and poor quality of life, even in overweight and obese patients whose Body Mass Index (BMI) is not suggestive of malnutrition...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29432036/effects-of-a-meal-feeding-regimen-and-the-availability-of-fresh-alfalfa-on-growth-performance-and-meat-and-bone-quality-of-broiler-genotypes
#4
B Koçer, M Bozkurt, G Ege, A E Tüzün, R Konak, O Olgun
1. The aim of this study was to identify a feeding regimen that encourages good pasture use in slow (SG) and fast (FG) growing broiler genotypes under free-range management. 2. SG and FG birds fed on either an ad libitum (ADB) or a meal feeding (MEF) programme was given free outdoor access with or without fresh alfalfa from d 22 to 72 and from d 22 to 45, respectively. In two consecutive trials, 800 birds of each genotype were included in a factorial design using groups of 40 birds replicated 5 times. 3. Fresh alfalfa consumption did not improve growth performance and meat quality attributes, whereas the feeding regimen had significant implications...
February 12, 2018: British Poultry Science
https://www.readbyqxmd.com/read/29428749/effect-of-altering-the-type-of-dietary-carbohydrate-early-postpartum-on-reproductive-performance-and-milk-production-in-pasture-grazed-dairy-cows
#5
S McDougall, S Leane, S T Butler, J R Roche, C R Burke
The objective of this study was to assess the effect of increasing dietary starch for approximately 30 d postpartum on reproduction outcomes in pasture-grazed, seasonal-calving dairy cows. Cows (n = 948) from 3 commercial herds were blocked by age (2, 3, and >3 yr), breed, and expected calving date and randomly assigned to 1 of 2 postpartum treatment groups: high starch (34.7 ± 1.9% nonstructural carbohydrate; mean ± SD) or low starch (22.5 ± 0.4% nonstructural carbohydrate). The high-starch group in all 3 farms received 4...
February 7, 2018: Journal of Dairy Science
https://www.readbyqxmd.com/read/29415717/implementing-large-scale-fast-track-diagnostics-in-a-comprehensive-cancer-center-pre-and-post-measurement-data
#6
W H van Harten, N Goedbloed, A H Boekhout, S Heintzbergen
BACKGROUND: In general, patients with a cancer suspicion visit the hospital multiple times before diagnosis is completed. Using various "operations management" techniques a few fast track diagnostic services were implemented in the Netherlands Cancer Institute (NKI) in 2006. Growing patient numbers and increasing process complexity, led to diminished service levels. To decrease the amount of patient visits and to extend these services beyond the (obvious) breast cancer services, fast track diagnostics is now implemented for all 18 cancer types that present with a frequency of minimally one per week...
February 7, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29412091/the-finnish-healthcare-services-lean-management
#7
Susanna Hihnala, Lilja Kettunen, Marjo Suhonen, Hanna Tiirinki
Purpose The purpose of this paper is to discuss health services managers' experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers' work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews...
February 5, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29394908/intermittent-fasting-energy-balance-and-associated-health-outcomes-in-adults-study-protocol-for-a-randomised-controlled-trial
#8
Iain Templeman, Dylan Thompson, Javier Gonzalez, Jean-Philippe Walhin, Sue Reeves, Peter J Rogers, Jeffrey M Brunstrom, Leonidas G Karagounis, Kostas Tsintzas, James A Betts
BACKGROUND: Prior studies have shown that intermittent fasting is capable of producing improvements in body weight and fasted health markers. However, the extent to which intermittent fasting incurs compensatory changes in the components of energy balance and its impact on postprandial metabolism are yet to be ascertained. METHODS: A total of 30-36 lean participants and 30-36 overweight/obese participants will be recruited to provide two separate study groups who will undergo the same protocol...
February 2, 2018: Trials
https://www.readbyqxmd.com/read/29383639/clinical-correlates-and-pharmacological-management-of-asian-patients-with-concomitant-diabetes-mellitus-and-heart-failure
#9
REVIEW
Yvonne May Fen Chia, Tiew-Hwa Katherine Teng, Chanchal Chandramouli, Jonathan Yap, Michael MacDonald, Carolyn S P Lam
Asia is the center of convergence of the twin epidemics of diabetes mellitus (DM) and heart failure (HF). The regional and ethnic diversity across Asia, along with a high prevalence of a young, lean diabetic phenotype, emphasizes the importance of targeted public health strategies that address the unique needs of Asian patients with DM and HF. This review discusses the epidemiology, clinical correlates, pharmacological management, and outcomes of Asian patients with concomitant DM and HF.
January 31, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29383073/using-medical-student-quality-improvement-projects-to-promote-evidence-based-care-in-the-emergency-department
#10
Michael W Manning, Eric W Bean, Andrew C Miller, Suzanne J Templer, Richard S Mackenzie, David M Richardson, Kristin A Bresnan, Marna R Greenberg
Introduction: The Association of American Medical Colleges' (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to "identify system failures and contribute to a culture of safety and improvement." We set out to determine the feasibility of using medical students' action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism)...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29382022/optimum-end-tidal-concentration-of-sevoflurane-to-facilitate-supraglottic-airway-device-insertion-with-propofol-at-induction-allowing-spontaneous-respiration-in-obese-patients-a-prospective-observational-study
#11
Hai-Xia Wang, Hui-Hui Miao, Xue Gao, Wei Wei, Guan-Nan Ding, Ye Zhang, Ming Tian
Obese patients are more likely to encounter with difficult airway management, and supraglottic airway device has been adopted to facilitate tracheal intubation. The optimum anesthetic concentration for obese patients to insert a supraglottic airway device with spontaneous respiration has not been investigated. This study was designed to determine the end-tidal concentration of sevoflurane that would provide acceptable condition for supraglottic airway device insertion with propofol at induction in obese patients without using neuromuscular blockade...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29376141/physical-therapy-considerations-for-chronic-kidney-disease-and-secondary-sarcopenia
#12
Haniel J Hernandez, Gideon Obamwonyi, Michael O Harris-Love
Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance...
January 5, 2018: Journal of functional morphology and kinesiology
https://www.readbyqxmd.com/read/29362057/nutritional-issues-and-positive-living-in-human-immunodeficiency-virus-aids
#13
REVIEW
William Andrew Clark, Eileen M Cress
Nutritional counseling has been shown to improve dietary intake in individuals with human immunodeficiency virus (HIV)/AIDS. Registered dietitians/nutritionists can individualize diet interventions to optimize effectiveness in treating metabolic consequences of the HIV infection or highly active antiretroviral therapy. Nutrition management for individuals infected with HIV can be helpful in maintaining lean body weight, combating oxidative stress, reducing complications from hyperglycemia and hyperlipidemia, and managing gastrointestinal function...
March 2018: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29356192/how-much-of-toyota-s-philosophy-is-embedded-in-health-care-at-the-organisational-level-a-review
#14
Alain Antierens, Dimitri Beeckman, Sofie Verhaeghe, Dries Myny, Ann Van Hecke
AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies. BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care. EVALUATION: Sixty studies were identified for the final analysis...
January 22, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29333569/an-integrated-fuzzy-based-advanced-eutrophication-simulation-model-to-develop-the-best-management-scenarios-for-a-river-basin
#15
Rallapalli Srinivas, Ajit Pratap Singh
Assessment of water quality status of a river with respect to its discharge has become prerequisite to sustainable river basin management. The present paper develops an integrated model for simulating and evaluating strategies for water quality management in a river basin management by controlling point source pollutant loadings and operations of multi-purpose projects. Water Quality Analysis and Simulation Program (WASP version 8.0) has been used for modeling the transport of pollutant loadings and their impact on water quality in the river...
January 14, 2018: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29309315/predicting-heparin-responsiveness-in-children-before-cardiopulmonary-bypass-a-retrospective-cohort-study
#16
Sayaka Nakamura, Osami Honjo, Lynn Crawford-Lean, Celeste Foreman, Minako Sano, James D O'Leary
BACKGROUND: Inadequate or excess administration of unfractionated heparin for cardiopulmonary bypass (CPB) can cause significant harm. Age-dependent differences in the pharmacodynamics and pharmacokinetics of heparin contribute to increased variability of heparin responsiveness in children. The aims of the current study were to (1) examine the correlation between predicted and observed heparin responsiveness in children before CPB measured using the Hemostasis Management System (HMS) Plus (Medtronic, Minneapolis, MN), (2) describe age-specific reference intervals for heparin sensitivity index (HSI) observed in children, and (3) test predictive models of HSI using preoperative clinical and laboratory data...
January 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29288636/the-effect-of-aggression-i-the-increases-of-metabolic-cost-and-mobilization-of-fat-reserves-in-male-striped-hamsters
#17
Xiao-Ming Xu, Qing-Sheng Chi, Jing Cao, Zhi-Jun Zhao
Aggression can benefit individuals by enhancing their dominance and thereby their ability to acquire and retain resources that increase survival or fitness. Engaging in aggressive behavior costs energy and how animals manage their energy budget to accommodate aggression remains unclear. We conducted three experiments to examine changes in physiological, behavioral and hormonal markers indicative of energy budget in male striped hamsters subject to resident-intruder aggression tests. Body temperature, metabolic rate and serum corticosterone levels significantly increased in resident hamsters immediately after the introduction of intruders...
December 27, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/29280903/framework-for-research-on-implementation-of-process-redesigns
#18
Mahima Ashok, Dorothy Hung, Lucia Rojas-Smith, Michael T Halpern, Michael Harrison
BACKGROUND: Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. METHODS: Using literature scans and expert comment on draft frameworks based on the Consolidated Framework for Implementation Research, a team of researchers developed the PR framework for the Agency for Healthcare Research and Quality...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29246539/using-lean-methodologies-to-streamline-processing-of-requests-for-durable-medical-equipment-and-supplies-for-children-with-complex-conditions
#19
Elise Fields, Smriti Neogi, Pamela J Schoettker, Jennifer Lail
BACKGROUND: An improvement team from the Complex Care Center at our large pediatric medical center participated in a 60-day initiative to use Lean methodologies to standardize their processes, eliminate waste and improve the timely and reliable provision of durable medical equipment and supplies. METHODS: The team used value stream mapping to identify processes needing improvement. Improvement activities addressed the initial processing of a request, provider signature on the form, returning the form to the sender, and uploading the completed documents to the electronic medical record...
December 12, 2017: Healthcare
https://www.readbyqxmd.com/read/29241148/obesity-exacerbates-the-acute-metabolic-side-effects-of-olanzapine
#20
Logan K Townsend, Willem T Peppler, Natasha D Bush, David C Wright
Olanzapine is a second-generation antipsychotic used in the management of schizophrenia and various off-label conditions. The acute metabolic responses of olanzapine recapitulate many of the side effects associated with obesity. Obesity rates are high in the schizophrenic population, but it is unknown whether pre-existing obesity-associated metabolic dysfunction augments the acute side effects of olanzapine. To address this question, we compared the responses to olanzapine in lean and high-fat diet-induced (HFD) obese mice...
December 8, 2017: Psychoneuroendocrinology
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