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Clinical workflow

Rhys Salter, Douglas C Beshore, Steven L Colletti, Liam Evans, Yong Gong, Roy Helmy, Yong Liu, Cheri M Maciolek, Gary Martin, Natasa Pajkovic, Richard Phipps, James Small, Jonathan Steele, Ronald de Vries, Headley Williams, Iain J Martin
1. Metabolite identification is an integral part of both preclinical and clinical drug discovery and development. Synthesis of drug metabolites is often required to support definitive identification, preclinical safety studies and clinical trials. 2. Here we describe the use of microbial biotransformation as a tool to produce drug metabolites, complementing traditional chemical synthesis and other biosynthetic methods such as hepatocytes, liver microsomes, and recombinant human drug metabolizing enzymes. 3...
August 17, 2018: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
M J Riblett, G E Christensen, E Weiss, G D Hugo
PURPOSE: To demonstrate the feasibility of using a purely data-driven, a posteriori respiratory motion modeling and reconstruction compensation method to improve 4D-CBCT image quality under clinically relevant image acquisition conditions. METHODS: Evaluated workflows that utilized a combination of groupwise deformable image registration and motion-compensated image reconstruction algorithms. Groupwise registration is an approach that simultaneously registers all temporal frames of a 4D image to a common reference instead of one at a time so as to minimize the influence of any individual time point on the global smoothness or accuracy of the resulting deformation model...
August 17, 2018: Medical Physics
Michael Ta, Changchuan Yin, Gary Lee Smith, Wenbo Xu
Multiplexed molecular barcoded amplicon sequencing has been previously demonstrated to improve the sensitivity of low-frequency variant detection. Molecular barcoded reads can be used to identify and correct amplification biases introduced during library preparation and sequencing errors. We propose a generic workflow to improve variant calling accuracy that takes advantage of molecular barcoded sequencing reads by applying a base score correction method to duplicate or overlapping read pairs across the targeted panel...
August 17, 2018: Journal of Computational Biology: a Journal of Computational Molecular Cell Biology
Raniah N Aldekhyyel, Genevieve B Melton, Bruce Lindgren, Yan Wang, Michael B Pitt
OBJECTIVES: Implement a novel pain-management interface that is used to bring real-time, patient-reported pain assessments to the inpatient television and evaluate the impact of implementation on the pain-management clinical workflow, patient engagement, and nursing pain reassessments. METHODS: We developed a pain-management tool interfacing 4 stand-alone technologies: a television-based, interactive patient care system; electronic health record system; nursing call system; and pharmacy inventory-management system...
August 16, 2018: Hospital Pediatrics
Alexandra F Dalton, Corey Lyon, Bennett Parnes, Douglas Fernald, Carmen L Lewis
PURPOSE: The purpose of this project was to: (1) develop a strategy for primary care quality measurement using an environmental scan and interviews to identify best practices and candidate measures; (2) present recommendations to facilitate successful measurement. METHODS: Following stakeholder interviews and review of existing measures, we created a three-tiered recommendation system for selecting and implementing measures. We also developed a framework for reviewing and prioritizing measures and prepared a detailed project report...
August 14, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Francesco Mangano, Giovanni Veronesi
Aim: To compare the outcome of digital versus analog procedures for the restoration of single implants. Methods: Over a two-year period (2014-2016), all patients who had been treated in a dental center with a single implant were randomly assigned to receive either a monolithic zirconia crown, fabricated with digital workflow ( test group), or a metal-ceramic crown, fabricated with analog workflow ( control group). All patients were followed for 1 year after the delivery of the final crown...
2018: BioMed Research International
Kaylee R Mastrianni, William E Kemnitzer, Kevin W P Miller
Catecholamines are integral neurotransmitters in the central and peripheral nervous system. Clinically, catecholamine levels are determined to help diagnose disease and measure corresponding therapeutic effectiveness. However, manual extraction of catecholamines and their metabolites may be labor-intensive and user-variable and require a variety of peripheral laboratory devices, especially at low sample concentrations. Here, we propose a novel solid-phase extraction (SPE) method using patented dispersive pipette extraction (DPX) tip technology...
August 15, 2018: SLAS Technology
Avantika H Dang, Lauren N Gjolaj, And Helen Peck
PURPOSE: This study's purpose was to optimize the efficiency of and to design a scalable research scheduling team to meet the growing demands of an academic cancer center with increasing clinical trial accruals. METHODS: The Plan, Do, Study, Act improvement methodology was deployed to increase the efficiency of research scheduling, to reduce non-value-added (NVA) activities, and to reduce cycle time to meet takt time. In the Plan phase, voice-of-the-customer interviews were conducted...
August 15, 2018: Journal of Oncology Practice
Matteo Maspero, Mark H F Savenije, Anna M Dinkla, Peter R Seevinck, Martijn P W Intven, Ina M Juergenliemk-Schulz, Linda G W Kerkmeijer, Cornelis A T Van den Berg
To enable magnetic resonance (MR)-only radiotherapy and facilitate modelling of radiation attenuation in humans, synthetic-CT (sCT) images need to be generated. Considering the application of MR-guided radiotherapy and online adaptive replanning, sCT generation should occur within minutes. This work aims at assessing whether an existing deep learning network can rapidly generate sCT images to be used for accurate MR-based dose calculations in the entire pelvis.
 A study was conducted on data of 91 patients with prostate (59), rectal (18) and cervical (14) cancer who underwent external beam radiotherapy acquiring both CT and MRI for patients' simulation...
August 15, 2018: Physics in Medicine and Biology
Yura Lee, Min-Young Jung, Gee Won Shin, Sangwoo Bahn, Taezoon Park, Insook Cho, Jae-Ho Lee
Objectives: The usability of clinical information systems (CISs) is known to be an essential consideration in ensuring patient safety as well as integrating clinical flow. This study aimed to determine how usability and safety guidelines of CIS consider clinical workflow through a systematic review in terms of the target systems, methodology, and guideline components of relevant articles. Methods: A literature search was conducted for articles published from 2000 to 2015 in PubMed, Cochrane, EMBASE, Web of Science, and CINAHL...
July 2018: Healthcare Informatics Research
Anna M Dinkla, Jelmer M Wolterink, Matteo Maspero, Mark H F Savenije, Joost J C Verhoeff, Enrica Seravalli, Ivana Išgum, Peter R Seevinck, Cornelis A T van den Berg
PURPOSE: This work aims to facilitate a fast magnetic resonance (MR)-only workflow for radiation therapy of intracranial tumors. Here, we evaluate whether synthetic computed tomography (sCT) images generated with a dilated convolutional neural network (CNN) enable accurate MR-based dose calculations in the brain. METHODS AND MATERIALS: We conducted a retrospective study of 52 patients with brain tumors who underwent both computed tomography (CT) and MR imaging for radiation therapy treatment planning...
June 4, 2018: International Journal of Radiation Oncology, Biology, Physics
Jenna E Reno, Sean T O'Leary, Jennifer Pyrzanowski, Steven Lockhart, Jacob Thomas, Amanda F Dempsey
OBJECTIVE: To evaluate the relative use, usefulness, and facilitators and barriers to use, as perceived by providers, of five different components in an HPV vaccine communication intervention-which was found to be effective at improving HPV vaccination rates. METHODS: Four serial surveys of 108 providers (MD, NP, or PA) from intervention clinics involved in the study assessed use and usefulness of the 5 communication intervention components over a 12-month period...
August 11, 2018: Academic Pediatrics
Bhavika K Patel, Christina Ferraro, Heidi E Kosiorek, Vilert A Loving, Carl D'Orsi, Mary Newell, Richard J Gray
OBJECTIVE: The purpose of this study was to assess radiologists' choice of imaging modality for the evaluation of clinical symptoms of physiologic nipple discharge (e.g., bilateral discharge, multiple-duct orifices, and yellow, green, or white color) and pathologic nipple discharge (e.g., unilateral discharge, single-duct orifices, spontaneous and serous discharge, and clear or bloodstained color). MATERIALS AND METHODS: An online survey was sent to lead interpreting physicians at mammography facilities accredited by the American College of Radiology (ACR)...
August 14, 2018: AJR. American Journal of Roentgenology
Hannah L Williams, Kathy Walsh, Austin Diamond, Anca Oniscu, Zandra C Deans
The clinical utility of next-generation sequencing (NGS) for a diverse range of targets is expanding, increasing the need for multiplexed analysis of both DNA and RNA. However, translation into daily use requires a rigorous and comprehensive validation strategy. The aim of this clinical validation was to assess the performance of the Ion Torrent Personal Genome Machine (IonPGM™ ) and validate the Oncomine™ Focus DNA and RNA Fusion panels for clinical application in solid tumour testing of formalin-fixed, paraffin-embedded (FFPE) tissue...
August 13, 2018: Virchows Archiv: An International Journal of Pathology
Joseph J Titano, Marcus Badgeley, Javin Schefflein, Margaret Pain, Andres Su, Michael Cai, Nathaniel Swinburne, John Zech, Jun Kim, Joshua Bederson, J Mocco, Burton Drayer, Joseph Lehar, Samuel Cho, Anthony Costa, Eric K Oermann
Rapid diagnosis and treatment of acute neurological illnesses such as stroke, hemorrhage, and hydrocephalus are critical to achieving positive outcomes and preserving neurologic function-'time is brain'1-5 . Although these disorders are often recognizable by their symptoms, the critical means of their diagnosis is rapid imaging6-10 . Computer-aided surveillance of acute neurologic events in cranial imaging has the potential to triage radiology workflow, thus decreasing time to treatment and improving outcomes...
August 13, 2018: Nature Medicine
Oliver Lung, Mathew Fisher, Anthony Erickson, Charles Nfon, Aruna Ambagala
Differential diagnosis of diseases that share common clinical signs typically requires the performance of multiple independent diagnostic tests to confirm diagnosis. Diagnostic tests that can detect and discriminate between multiple differential pathogens in a single reaction may expedite, reduce costs and streamline the diagnostic testing workflow. Livestock hemorrhagic diseases like classical swine fever (CSF), African swine fever (ASF), and vesicular diseases such as foot-and-mouth disease (FMD), vesicular stomatitis (VS) and swine vesicular disease (SVD) can have an enormous impact on the livestock industry and economy of countries that were previously free of the diseases...
August 13, 2018: Transboundary and Emerging Diseases
Manuel Algora, Gloria Grabski, Anna Liza Batac-Castro, James Gibbs, Nyaradzo Chada, Sharhabil Humieda, Shafeeq Ahmad, Peter Anderson, Priscila I Figueroa, Imran Mirza, Laila AbdelWareth
CONTEXT: - Opening a new hospital is a once in a lifetime experience and can be very inspiring for those involved in its activation. However, establishing a safe transfusion practice in a greenfield environment comes with unique challenges and opportunities. OBJECTIVE: - To highlight critical activation components such as on-boarding of new personnel, establishing clinical practices, and integrating critical laboratory software. DESIGN: - Our staff initially faced challenges in standardizing transfusion medicine clinical practice inside the laboratory...
August 13, 2018: Archives of Pathology & Laboratory Medicine
Yi-Hsien Chen, Shondra M Pruett-Miller
The availability of human pluripotent stem cells (hPSCs) and progress in genome engineering technology have altered the way we approach scientific research and drug development screens. Unfortunately, the procedures for genome editing of hPSCs often subject cells to harsh conditions that compromise viability: a major problem that is compounded by the innate challenge of single-cell culture. Here we describe a generally applicable workflow that supports single-cell cloning and expansion of hPSCs after genome editing and single-cell sorting...
August 4, 2018: Stem Cell Research
J F Cornelius, J Schipper, A Tortora, Z Krause-Molle, M Smuga, A K Petridis, H J Steiger
OBJECTIVE: To evaluate a new surgical tool combining suction and monopolar neurostimulation ("stimulation-sucker") for tumors of the cerebello-pontine angle (CPA). The usefulness for continuous (time) and dynamic (space) facial nerve mapping was studied. METHODS: Patients operated with the stimulation-sucker for a CPA tumor between April 2016 and May 2017 in a tertiary care center were identified. Clinical charts were retrospectively evaluated. The minimum follow-up time of patients was 12 months...
August 9, 2018: World Neurosurgery
April Savoy, Himalaya Patel, Mindy E Flanagan, Joanne K Daggy, Alissa L Russ, Michael Weiner
Communication breakdowns in the referral process negatively impact clinical workflow and patient safety. There is a lack of evidence demonstrating the impact of published design recommendations addressing contributing issues with consultation order templates. This study translated the recommendations into a computer-based prototype and conducted a comparative usability evaluation. With a scenario-based simulation, 30 clinicians (referrers) participated in a within-group, counterbalanced experiment comparing the prototype with their present electronic order entry system...
November 2018: Applied Ergonomics
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