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https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#1
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
December 5, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27902532/lean-six-sigma-to-reduce-intensive-care-unit-length-of-stay-and-costs-in-prolonged-mechanical-ventilation
#2
Stephen Trzeciak, Michael Mercincavage, Cory Angelini, William Cogliano, Emily Damuth, Brian W Roberts, Sergio Zanotti, Anthony J Mazzarelli
OBJECTIVE: Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. DESIGN: Before-and-after cohort study. SETTING: Multidisciplinary intensive care unit (ICU) in an academic medical center...
November 29, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27879005/transient-distention-of-right-posterior-located-sigma-a-new-sonographic-sign-for-the-prenatal-diagnosis-of-anal-atresia
#3
Moshe Bronshtein, Ayala Gover, Ron Beloosesky, Zeev Blumenfeld
We describe a new sonographic sign for the detection of anal atresia in the early midtrimester on transvaginal sonography. In six cases of fetal anal atresia, the finding of a transient, distended, and right-sided sigmoid colon was observed at 13-16 weeks' gestation. Three cases have undergone pregnancy termination due to multiple anomalies. In the other three, the colonic distension resolved by 19 weeks' gestation. In two of these, the finding was isolated, and no other anomalies were detected. In all six cases, anal atresia or cloaca was confirmed on postabortal autopsy or after delivery...
November 23, 2016: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/27862689/applying-lean-six-sigma-methodology-to-reduce-cesarean-section-rate
#4
Ze-Ying Chai, Hua-Min Hu, Xiu-Ling Ren, Bao-Jin Zeng, Ling-Zhi Zheng, Feng Qi
OBJECTIVES: This study aims to reduce cesarean section rate and increase rate of vaginal delivery. METHODS: By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27860065/the-application-of-lean-six-sigma-methodology-to-reduce-the-risk-of-healthcare-associated-infections-in-surgery-departments
#5
Emma Montella, Maria Vincenza Di Cicco, Anna Ferraro, Piera Centobelli, Eliana Raiola, Maria Triassi, Giovanni Improta
RATIONALE: Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. AIMS AND OBJECTIVES: In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. METHODS: The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics...
November 18, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27830937/mass-vaccinations-at-the-united-states-naval-academy
#6
Chrysanthy Ha, Christopher Taylor, Jitendrakumar R Modi
We analyzed the mass influenza vaccination clinic process at the United States Naval Academy to identify gaps and implement changes for improvement. The Lean Six Sigma methodology was employed. Total number of staff members working the clinic and total hours worked were measured at baseline in August 2013 and after implementation in August 2014 to determine improvement. The clinic was moved from a hallway to an auditorium, and a linear patient flow was established. Staff members wore vests for easy identification, and the supply box was reorganized...
November 10, 2016: Health Security
https://www.readbyqxmd.com/read/27818014/utilizing-six-sigma-lean-strategies-to-expedite-emergency-department-ct-scan-throughput-in-a-tertiary-care-facility
#7
Devon Klein, Vandana Khan
No abstract text is available yet for this article.
November 3, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27809529/spin-delocalization-in-a-helical-open-shell-hydrocarbon
#8
Prince Ravat, Peter Ribar, Michel Rickhaus, Daniel Häussinger, Markus Neuburger, Michal Juricek
Neutral open-shell molecules, in which spin density is delocalized through a helical conjugated backbone, hold promise as models for investigating phenomena arising from the interplay of magnetism and chirality. Apart from a handful of examples, however, the chemistry of these compounds remains largely unexplored. Here, we examine the prospect of extending spin-delocalization over a helical backbone in a model compound naphtho[3,2,1-no]tetraphene, the first helically chiral open-shell hydrocarbon, in which one benzene ring is fused to [5]helicene, forming a phenalenyl subunit...
November 3, 2016: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/27801759/endometrial-stromal-sarcoma-arising-in-colorectal-endometriosis
#9
Rania Kilzieh, Natalia Rakislova, Aureli Torné, Rafael Salvador, Alfons Nadal, Jaume Ordi, Adela Saco
The malignant transformation of endometriosis is very uncommon. Whereas 75% of tumors arising from endometriosis arise in the ovary, location in extra-genital organs is rare and mesenchymal neoplasms are exceptional. A 47 year-old woman who underwent hysterectomy with bilateral salpingo-ooforectomy due to endometriosis 13 years before presented with abdominal pain. The magnetic resonance imaging (MRI) showed a 9.7×7.5 cm solid-cystic supravesical mass and a recto-vaginal tumor, as well as endometriotic nodules in the sigma, right parametrium and peritoneum that had significantly increased in size over a six months period...
October 31, 2016: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/27766750/in-vivo-trapping-of-ftsh-substrates-by-label-free-quantitative-proteomics
#10
Jan Arends, Nikolas Thomanek, Katja Kuhlmann, Katrin Marcus, Franz Narberhaus
FtsH is the only membrane-bound and essential protease in Escherichia coli. It is responsible for the degradation of regulatory proteins and enzymes like the heat-shock sigma factor RpoH or LpxC, the key enzyme of lipopolysaccharide biosynthesis. To find new FtsH targets, we trapped substrates in E. coli cells from exponential and stationary growth phase using a proteolytically inactive FtsH variant. Subsequent analysis of the isolated FtsH-substrate complexes by label-free nanoLC-MS/MS revealed more than 50 putative FtsH substrates, among them five already known substrates...
October 21, 2016: Proteomics
https://www.readbyqxmd.com/read/27750013/systematic-investigation-into-the-matsuda-heck-reaction-of-alpha-methylene-lactones-how-conformational-constraints-direct-the-beta-h-elimination-step
#11
Bernd Schmidt, Felix Wolf, Christopher Ehlert
alpha-Methylene-gamma-butyrolactone and alpha-methylene-delta-valerolactone undergo Pd-catalyzed Matsuda-Heck couplings with arene diazonium salts to alpha-benzyl butenolides or pentenolides, respectively, or to alpha-benzylidene lactones. The observed regioselectivity is strongly ring size dependent, with six-membered rings giving exclusively alpha-benzyl pentenolides, whereas the fivemembered alpha-methylene lactone reacts to mixtures of regioisomers with a high proportion of E-alpha-benzylidene-gamma-butyrolactones...
October 17, 2016: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/27749347/using-lean-six-sigma-methodology-to-improve-quality-of-the-anesthesia-supply-chain-in-a-pediatric-hospital
#12
Renée J Roberts, Ashley E Wilson, Zenaide Quezado
Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and soliciting comments from those involved. We used daily distance walked by anesthesia technicians and number of callouts for missing supplies as measurements that we analyzed before and after implementing improvements (anesthesia cart redesign)...
October 3, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27704172/improvement-of-postoperative-pain-control-processes-and-outcomes-in-veterans-of-a-surgical-intensive-care-unit
#13
Melissa S D'Andrea, P Marco Fisichella
BACKGROUND: Postoperative pain remains undertreated in critically ill patients. We hypothesized that the adequacy of pain control in our Surgical Intensive Care Unit (SICU) was above the reported average of 71 % in the literature and that the introduction of the critical care pain observation tool (CPOT) could improve it. We used a Lean Six Sigma methodology to improve our processes and quantify our improvement. PATIENTS AND METHODS: We retrospectively review 713 consecutive veterans admitted to our SICU...
October 4, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27701133/harmonisation-of-serum-dihydrotestosterone-analysis-establishment-of-an-external-quality-assurance-program
#14
Ronda F Greaves, Lisa Jolly, Michaela F Hartmann, Chung Shun Ho, Richard K T Kam, John Joseph, Conchita Boyder, Stefan A Wudy
BACKGROUND: Serum dihydrotestosterone (DHT) is an important analyte for the clinical assessment of disorders of sex development. It is also reportedly a difficult analyte to measure. Currently, there are significant gaps in the standardisation of this analyte, including no external quality assurance (EQA) program available worldwide to allow for peer review performance of DHT. We therefore proposed to establish a pilot EQA program for serum DHT. METHODS: DHT was assessed in the 2015 Royal College of Pathologists of Australasia Quality Assurance Programs' Endocrine program material...
October 4, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27689910/synthesis-electrochemical-characterization-and-linear-free-energy-relationship-of-1-3-diphenyl-6-alkyl-arylfulvenes
#15
Nicholas P Godman, Sonya K Adas, Karl M Hellwig, David W Ball, Gary J Balaich, Scott T Iacono
A series of 1,3-diphenyl-6-alkyl/arylfulvenes was prepared, and the electrochemical properties were investigated. The addition of phenyl groups about the fulvene raised the reduction potential and helped to stabilize the electrochemically generated radical anion. The addition of various functional groups onto the phenyl ring at the 6-position of 1,3,6-triphenylfulvene results in a linear free energy relationship between reduction potential and the Hammett substituent constant, σ. Further extending the conjugation at the 6-position of 1,3-diphenyl-6-arylfulvenes increases the reversibility of the redox reactions, but does not appear to further stabilize the generated radical anion...
October 12, 2016: Journal of Organic Chemistry
https://www.readbyqxmd.com/read/27689576/the-demands-and-benefits-of-ergonomics-in%C3%A2-sri-lankan-apparel-industry-a-case-study-at-mas-holdings
#16
John Abeysekera, Prasanna Illankoon
BACKGROUND: Apparel exports bring in sizeable foreign income to Sri Lanka. To protect and promote this industry is a paramount need. This can be carried out by applying Human Factors/Ergonomics (HFE) which has proved to control negative effects at work places. OBJECTIVES: This paper reports a case study which describes the demands and benefits of HFE in MAS Holdings which owns a large share of the apparel industry in Sri Lanka. METHODS: The study consisted of walk through observation survey, a questionnaire survey and ergonomic work place analysis followed by a training programme to selected employees in three companies...
October 17, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/27681026/process-redesign-for-time-based-emergency-admission-targets
#17
Sandra G Leggat, Richard Gough, Timothy Bartram, Pauline Stanton, Greg J Bamber, Ruth Ballardie, Amrik Sohal
Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010...
September 19, 2016: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/27674959/application-of-six-sigma-approach-to-improve-the-efficiency-of-patient-specific-quality-assurance-in-proton-therapy
#18
J E Rah, D Shin, T H Kim, G Y Kim
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27649591/streamlining-appointment-promotion-and-tenure-procedures-to-promote-early-career-faculty-success
#19
Shannon B Smith, Ann Hollerbach, Annemarie Sipkes Donato, Barbara J Edlund, Teresa Atz, Teresa J Kelechi
A critical component of the progression of a successful academic career is being promoted in rank. Early-career faculty are required to have an understanding of appointment, promotion, and tenure (APT) guidelines, but many factors often impede this understanding, thwarting a smooth and planned promotion pathway for professional advancement. This article outlines the steps taken by an APT committee to improve the promotion process from instructor to assistant professor. Six sigma's DMAIC improvement model was selected as the guiding operational framework to remove variation in the promotion process...
September 2016: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/27624180/the-need-for-secondary-resurfacing-is-affected-by-trochlear-height-in-total-knee-arthroplasty
#20
Lucas Werth, Mo Saffarini, Felix Amsler, Ashraf Abdelkafy, Michael T Hirschmann
PURPOSE: The purpose of the study was to compare the rate of secondary resurfacing in a consecutive series of five different total knee arthroplasty (TKA) systems. It was our hypothesis that different TKA design features such as sulcus angle or trochlear height influence the rate of secondary resurfacing. METHODS: A retrospective study was performed on data from patients who underwent TKA without primary patellar resurfacing from 2004 to 2012 in an university-affiliated hospital...
September 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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