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https://www.readbyqxmd.com/read/29735765/characterization-of-flagellar-and-toxin-phase-variation-in-clostridiodes-difficile-ribotype-012-isolates
#1
Brandon R Anjuwon-Foster, Natalia Maldonado-Vazquez, Rita Tamayo
Clostridiodes difficile causes diarrheal diseases mediated in part by the secreted toxins TcdA and TcdB. C. difficile produces flagella that also contribute to motility and bacterial adherence to intestinal cells during infection. Flagellum and toxin gene expression are linked via the flagellar alternative sigma factor, SigD. Recently, we identified a "flagellar switch" upstream of the early flagellar biosynthesis operon that mediates phase variation of both flagellum and toxin production in C. difficile strain R20291...
May 7, 2018: Journal of Bacteriology
https://www.readbyqxmd.com/read/29692587/sigma-metrics-as-a-tool-for-evaluating-the-performance-of-internal-quality-control-in-a-clinical-chemistry-laboratory
#2
B Vinodh Kumar, Thuthi Mohan
OBJECTIVE: Six Sigma is one of the most popular quality management system tools employed for process improvement. The Six Sigma methods are usually applied when the outcome of the process can be measured. This study was done to assess the performance of individual biochemical parameters on a Sigma Scale by calculating the sigma metrics for individual parameters and to follow the Westgard guidelines for appropriate Westgard rules and levels of internal quality control (IQC) that needs to be processed to improve target analyte performance based on the sigma metrics...
April 2018: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/29689761/rf-ablation-thermal-simulation-model-parameter-sensitivity-analysis
#3
Xiaoru Wang, Hongjian Gao, Shuicai Wu, Yanping Bai, Zhuhuang Zhou
OBJECTIVE: The aim of the research is to obtain the relative influences of some critical electro-thermal parameters on the ablation temperature and lesion volume during temperature-controlled radiofrequency ablation (RFA) of liver tumor by parameter sensitivity analysis. METHODS: The finite element method (FEM) has been used to establish the simulation model of RFA temperature field, and the sensitivity of the tissue parameters has been analyzed. The effects of six parameters have been taken into account, including the thermal specific capacity (Cp), the thermal conductivity (k), the electrical conductivity (Sigma), the density (rho), the dielectric constant (Epsilon) and the resistance (R)...
April 10, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29569543/effect-of-nutritional-supplement-on-bone-marrow-derived-mesenchymal-stem-cells-from-aplastic-anaemia
#4
Shihua Luo, Yinghai Chen, Lifen Zhao, Xia Qi, Xiaoyan Miao, Huimin Zhou, Li Jia
Aplastic anaemia (AA) is characterised by pancytopenia resulting from a marked reduction in haemopoietic stem cells (HSC). The regulation of haemopoiesis depends on the interaction between HSC and various cells of the bone marrow (BM) microenvironment, including BM-derived mesenchymal stromal cells (BMSC). The purpose of this study was to analyse the biological effect of nutritional supplement (NS), a dietary supplement consisting of thirty-six compounds: amino acids, nucleotides, vitamins and micronutrients on the BMSC of AA rats...
April 2018: British Journal of Nutrition
https://www.readbyqxmd.com/read/29548356/operating-room-efficiency
#5
David H Rothstein, Mehul V Raval
The operating room is the financial hub of any hospital, and maximizing operating room efficiency has important implications for cost savings, patient satisfaction, and medical team morale. Over the past decade, manufacturing principles and processes such as Lean and Six Sigma have been applied to various aspects of healthcare including the operating room. Although time consuming, process mapping and deep examinations of each step of the patient journey from pre-operative visit to post-operative discharge can have multiplicative benefits that extend from cost savings to maintaining the focus on improving quality and patient safety...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548024/utilizing-lean-six-sigma-methodology-to-improve-the-authored-works-command-approval-process-at-naval-medical-center-san-diego
#6
Michelle M Valdez, Maureen Liwanag, Charles Mount, Rechell Rodriguez, Elisea Avalos-Reyes, Andrew Smith, David Collette, Michael Starsiak, Richard Green
Introduction: Inefficiencies in the command approval process for publications and/or presentations negatively impact DoD Graduate Medical Education (GME) residency programs' ability to meet ACGME scholarly activity requirements. A preliminary review of the authored works approval process at Naval Medical Center San Diego (NMCSD) disclosed significant inefficiency, variation in process, and a low level of customer satisfaction. In order to facilitate and encourage scholarly activity at NMCSD, and meet ACGME requirements, the Executive Steering Council (ESC) chartered an interprofessional team to lead a Lean Six Sigma (LSS) Rapid Improvement Event (RIE) project...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29523411/applying-lean-six-sigma-methodology-in-radiotherapy-lessons-learned-by-the-breast-daily-repositioning-case
#7
Pietro Mancosu, Giorgia Nicolini, Giulia Goretti, Fiorenza De Rose, Davide Franceschini, Chiara Ferrari, Giacomo Reggiori, Stefano Tomatis, Marta Scorsetti
BACKGROUND & PURPOSE: Lean Six Sigma Methodology (LSSM) was introduced in industry to provide near-perfect services to large processes, by reducing improbable occurrence. LSSM has been applied to redesign the 2D-2D breast repositioning process (Lean) by the retrospective analysis of the database (Six Sigma). MATERIALS & METHODS: Breast patients with daily 2D-2D matching before RT were considered. The five DMAIC (define, measure, analyze, improve, and control) LSSM steps were applied...
March 6, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29518383/autoverification-process-improvement-by-six-sigma-approach-clinical-chemistry-immunoassay
#8
Edward W Randell, Garry Short, Natasha Lee, Allison Beresford, Margaret Spencer, Marina Kennell, Zoë Moores, David Parry
OBJECTIVE: This study examines effectiveness of a project to enhance an autoverification (AV) system through application of Six Sigma (DMAIC) process improvement strategies. DESIGN AND METHODS: Similar AV systems set up at three sites underwent examination and modification to produce improved systems while monitoring proportions of samples autoverified, the time required for manual review and verification, sample processing time, and examining characteristics of tests not autoverified...
May 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29476659/the-evolutionary-impact-of-intragenic-flia-promoters-in-proteobacteria
#9
Devon M Fitzgerald, Carol Smith, Pascal Lapierre, Joseph T Wade
In Escherichia coli, one sigma factor recognizes the majority of promoters, and six 'alternative' sigma factors recognize specific subsets of promoters. The alternative sigma factor FliA (σ28 ) recognizes promoters upstream of many flagellar genes. We previously showed that most E. coli FliA binding sites are located inside genes. However, it was unclear whether these intragenic binding sites represent active promoters. Here, we construct and assay transcriptional promoter-lacZ fusions for all 52 putative FliA promoters previously identified by ChIP-seq...
May 2018: Molecular Microbiology
https://www.readbyqxmd.com/read/29450731/is-mini-percutaneous-nephrolithotomy-a-safe-alternative-to-extracorporeal-shockwave-lithotripsy-in-pediatric-age-group-in-borderline-stones-a-randomized-prospective-study
#10
Ahmed Farouk, Ahmed Tawfick, Mohamed Shoeb, Mahmoud A Mahmoud, Diaa Eldin Mostafa, Mohamed Hasan, Hany M Abdalla
PURPOSE: The extracorporeal shockwave lithotripsy (ESWL) remains the most common first line of treatment for renal stones in the pediatric population. The purpose of this study is to evaluate and compare the outcomes of the ESWL and mini-percutaneous nephrolithotomy (mini-PCNL). PATIENTS AND METHODS: A total of 108 patients younger than 12 years of age with 1-2 cm single renal stone (pelvic or calyceal) were randomized into two groups, each containing 54 patients...
February 15, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29371778/evaluation-of-preanalytical-quality-indicators-by-six-sigma-and-pareto-s-principle
#11
Sweta Kulkarni, R Ramesh, A R Srinivasan, C R Wilma Delphine Silvia
Preanalytical steps are the major sources of error in clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of laboratory and its quality measures. Hence in the present study six sigma and Pareto principle was applied to preanalytical quality indicators to evaluate the clinical biochemistry laboratory performance. This observational study was carried out for a period of 1 year from November 2015-2016...
January 2018: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/29345145/process-improvement-methodologies-uncover-unexpected-gaps-in-stroke-care
#12
Anthony D Kuner, Andrew J Schemmel, B Dustin Pooler, John-Paul J Yu
Background The diagnosis and treatment of acute stroke requires timed and coordinated effort across multiple clinical teams. Purpose To analyze the frequency and temporal distribution of emergent stroke evaluations (ESEs) to identify potential contributory workflow factors that may delay the initiation and subsequent evaluation of emergency department stroke patients. Material and Methods A total of 719 sentinel ESEs with concurrent neuroimaging were identified over a 22-month retrospective time period. Frequency data were tabulated and odds ratios calculated...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29323160/glutathione-s-transferase-gst-of-american-cockroach-periplaneta-americana-classes-isoforms-and-allergenicity
#13
Nitat Sookrung, Onrapak Reamtong, Rojana Poolphol, Nitaya Indrawattana, Watee Seesuay, Nawannaporn Saelim, Pongsakorn Tantilipikorn, Chaweewan Bunnag, Wanpen Chaicumpa, Anchalee Tungtrongchitr
Insect glutathione S-transferases (GSTs) play important roles in insecticide/drug resistance and stress response. Medically, GSTs of house dust mites (Dermatophagoides pteronyssinus and Blomia tropicalis) and German cockroach (Blattella germanica) are human allergens. In this study, classes, isoforms and B-cell and allergenic epitopes of GST of American cockroach, Periplaneta americana, the predominant species in the tropics and subtropics were investigated for the first time. Enzymatically active native and recombinant P...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29183994/translation-efficiency-is-maintained-at-elevated-temperature-in-escherichia-coli
#14
Gareth J Morgan, David H Burkhardt, Jeffery W Kelly, Evan T Powers
Cellular protein levels are dictated by the balance between gene transcription, mRNA translation, and protein degradation, among other factors. Translation requires the interplay of several RNA hybridization processes, which are expected to be temperature-sensitive. We used ribosome profiling to monitor translation in Escherichia coli at 30 °C and to investigate how this changes after 10-20 min of heat shock at 42 °C. Translation efficiencies are robustly maintained after thermal heat shock and after mimicking the heat-shock response transcriptional program at 30 °C by overexpressing the heat shock σ factor encoded by the rpoH gene...
January 19, 2018: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29183577/identification-and-characterisation-of-seventeen-glutathione-s-transferase-genes-from-the-cabbage-white-butterfly-pieris-rapae
#15
Su Liu, Yu-Xing Zhang, Wen-Long Wang, Bang-Xian Zhang, Shi-Guang Li
Insect glutathione S-transferases (GSTs) play essential roles in the detoxification of insecticides and other xenobiotic compounds. The cabbage white butterfly, Pieris rapae, is an economically important agricultural pest. In this study, 17 cDNA sequences encoding putative GSTs were identified in P. rapae. All cDNAs include a complete open reading frame and were designated PrGSTd1-PrGSTz2. Based on phylogenetic analysis, PrGSTs were divided into six classes (delta, epsilon, omega, sigma, theta and zeta). The exon-intron organizations of these PrGSTs were also analysed...
November 2017: Pesticide Biochemistry and Physiology
https://www.readbyqxmd.com/read/29144874/evaluation-of-interfacial-gap-volume-of-two-low-shrinkage-composites-using-micro-computed-tomography
#16
Hna Al Nahedh, N S Sibai
OBJECTIVES: To investigate the efficacy of X-ray micro-computed tomography (μCT) in the detection and quantification of interfacial gap formation in standardized Class I and Class II resin composite restorations, to compare the interfacial gaps for two low-shrinkage resin composites with a methacrylate composite material, and to determine any correlation between the cavity configuration factor (C-factor) and the volume of gaps formed. METHODS AND MATERIALS: Sixty standardized Class I and Class II cavities were prepared and divided into six groups...
November 2017: Operative Dentistry
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#17
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#18
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
December 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#19
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
April 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29072887/axiomatic-design-of-a-framework-for-the-comprehensive-optimization-of-patient-flows-in-hospitals
#20
Gabriele Arcidiacono, Dominik T. Matt, Erwin Rauch
Lean Management and Six Sigma are nowadays applied not only to the manufacturing industry but also to service industry and public administration. The manifold variables affecting the Health Care system minimize the effect of a narrow Lean intervention. Therefore, this paper aims to discuss a comprehensive, system-based approach to achieve a factual holistic optimization of patient flows. This paper debates the efficacy of Lean principles applied to the optimization of patient flows and related activities, structures, and resources, developing a theoretical framework based on the principles of the Axiomatic Design...
2017: Journal of Healthcare Engineering
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