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https://www.readbyqxmd.com/read/28650874/lean-daily-management-exploring-the-effectiveness-in-reducing-product-returns-and-overnight-shipment-occurrences-in-a-materials-management-department
#1
Savanah Hopkins, Marcea Walter, Sandra Collins
Lean Daily Management (LDM) is a performance improvement process used by health care organizations to reduce waste and increase value. Designed to transform health care professionals into organizational problem solvers, LDM tools have been used throughout the health care industry, but full integration of this performance improvement initiative has largely evaded health care organizations. To demonstrate the effectiveness of LDM, research was conducted to evaluate the costs associated with product returns and overnighted products as monitored by a materials management department, which found that these were specific areas where excessive resources were frequently used...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28649480/the-role-of-organizational-culture-in-operating-room-turnaround-time
#2
David Ninan, Janet Zhu, Amanda Kore, Elizabeth Wasson, Tricia Fullerton, Barbara Ninan
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28649243/distinct-blood-and-visceral-adipose-tissue-regulatory-t-cell-and-innate-lymphocyte-profiles-characterize-obesity-and-colorectal-cancer
#3
Gloria Donninelli, Manuela Del Cornò, Marina Pierdominici, Beatrice Scazzocchio, Rosaria Varì, Barbara Varano, Ilenia Pacella, Silvia Piconese, Vincenzo Barnaba, Massimo D'Archivio, Roberta Masella, Lucia Conti, Sandra Gessani
Visceral adipose tissue (VAT) is a main site where metabolic and immunologic processes interplay to regulate, at local and systemic level, the inflammatory status and immune response. Obesity-associated inflammation and immune dysfunctions are inextricably linked to tumor but, in spite of intense efforts, the mechanisms underpinning this association remain elusive. In this report, we characterized the profile of VAT-associated and circulating innate lymphocyte and regulatory T (Treg) cell subsets underlying inflammatory conditions, such as obesity and colorectal cancer (CRC)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28646876/not-all-waits-are-equal-an-exploratory-investigation-of-emergency-care-patient-pathways
#4
Dawn Swancutt, Sian Joel-Edgar, Michael Allen, Daniel Thomas, Heather Brant, Jonathan Benger, Richard Byng, Jonathan Pinkney
BACKGROUND: Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals...
June 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28641779/macrophage-functions-in-lean-and-obese-adipose-tissue
#5
REVIEW
Dylan Thomas, Caroline Apovian
Interactions between macrophages and adipocytes influence both metabolism and inflammation. Obesity-induced changes to macrophages and adipocytes lead to chronic inflammation and insulin resistance. This paper reviews the various functions of macrophages in lean and obese adipose tissue and how obesity alters adipose tissue macrophage phenotypes. Metabolic disease and insulin resistance shift the balance between numerous pro- and anti-inflammatory regulators of macrophages and create a feed-forward loop of increasing inflammatory macrophage activation and worsening adipocyte dysfunction...
July 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28641285/role-of-glycyrrhizin-in-the-reduction-of-inflammation-in-diabetic-kidney-disease
#6
Vikram Thakur, Syeda Nargis, Mayra Gonzalez, Swetak Pradhan, Daniel Terreros, Munmun Chattopadhyay
BACKGROUND: Diabetic kidney disease (DKD) is one of the most debilitating complications of type 2 diabetes. Recent evidence suggests chronic inflammation to be one of the causal factors of DKD. The mechanisms entailed are not completely elucidated except that a variety of cytokines play a major role in this process. High mobility group box 1 (HMGB1) is a pro-inflammatory toll-like receptor-4 (TLR4)-binding cytokine that is involved in inflammation-associated gene expression. This investigation was designed to assess the involvement of HMGB1, TLR-4, and nuclear factor (NF)-κB in the development of DKD and to evaluate that whether blocking HMGB1 by its natural inhibitor Glycyrrhizin (GLC) can reduce the progression of the disease...
June 23, 2017: Nephron
https://www.readbyqxmd.com/read/28641233/large-eddy-simulation-and-experimental-study-on-vented-gasoline-air-mixture-explosions-in-a-semi-confined-obstructed-pipe
#7
Guoqing Li, Yang Du, Shimao Wang, Sheng Qi, Peili Zhang, Wenzhuo Chen
In this work, LES simulation coupled with a TFC sub-grid combustion model has been performed in a semi-confined pipe (L/D=10, V=10L) in the presence of four hollow-square obstacles (BR=49.8%) with circular hollow cross-section, in order to study the premixed gasoline-air mixture explosions. The comparisons between simulated results and experimental results have been conducted. It was found that the simulated results were in good agreement with experimental data in terms of flame structures, flame locations and overpressure time histories...
June 15, 2017: Journal of Hazardous Materials
https://www.readbyqxmd.com/read/28630601/international-society-of-sports-nutrition-position-stand-diets-and-body-composition
#8
REVIEW
Alan A Aragon, Brad J Schoenfeld, Robert Wildman, Susan Kleiner, Trisha VanDusseldorp, Lem Taylor, Conrad P Earnest, Paul J Arciero, Colin Wilborn, Douglas S Kalman, Jeffrey R Stout, Darryn S Willoughby, Bill Campbell, Shawn M Arent, Laurent Bannock, Abbie E Smith-Ryan, Jose Antonio
Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient composition; eating styles) and their influence on body composition. The ISSN has concluded the following. 1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype. 2) All body composition assessment methods have strengths and limitations. 3) Diets primarily focused on fat loss are driven by a sustained caloric deficit...
2017: Journal of the International Society of Sports Nutrition
https://www.readbyqxmd.com/read/28630458/the-value-of-instability-an-investigation-of-intra-subject-variability-in-brain-activity-among-obese-adolescent-girls
#9
L O Bauer, R J Houston
BACKGROUND: The present study investigated the value of intra-subject variability (ISV) as a metric for revealing differences in cognition and brain activation associated with an obese versus lean body mass. METHODS: Ninety-six adolescents with a lean body mass (BMI %-ile=5-85), and 92 adolescents with an obese body mass (BMI %-ile >=95), performed two tasks (Stroop and Go/NoGo) challenging response inhibition skills. The standard deviations and averages of their reaction time and P300 electroencephalographic responses to task stimuli were computed across trials...
June 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28630415/integrating-genome-and-transcriptome-profiling-for-elucidating-the-mechanism-of-muscle-growth-and-lipid-deposition-in-pekin-ducks
#10
Liyuan Wang, Xiangxiang Li, Jun Ma, Yawen Zhang, Hao Zhang
Muscle growth and lipid deposition are co-ordinately regulated processes. Cherry Valley Pekin duck is a lean-type duck breed with high growth rate, whereas the native Pekin duck of China has high lipid deposition. Phenotypic analysis showed that native Pekin ducks have smaller fibre diameter and larger density in the breast muscle at 3 weeks of age and higher intramuscular fat content at 6 weeks of age than those in Cherry Valley Pekin ducks. We detected 17 positively selected genes (PSGs) by comparing genes mainly involved with muscle organ development, muscle contraction, peroxisome proliferator activated receptor signalling pathway, and fatty acid metabolism...
June 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28630279/obesity-and-p16-ink4a-down-regulation-activate-breast-adipocytes-and-promote-their-pro-tumorigenicity
#11
Huda H Al-Khalaf, Mrad Amir, Falah Al-Mohanna, Asma Tulbah, Adher Al-Sayed, Abdelilah Aboussekhra
Obesity is increasingly recognized as a risk factor for breast cancer development. However, the molecular basis of obesity-related breast carcinogenesis remains elusive. In this study, we have shown that obesity reduces the level of the tumor suppressor p16(INK4A) protein in breast adipocytes, which showed active features and strong pro-carcinogenic potential both in vitro and in orthotopic tumor xenografts, as compared to mature adipocytes from lean women. Furthermore, obesity triggered epithelial-to-mesenchymal transition (EMT) in breast ductal epithelial cells...
June 19, 2017: Molecular and Cellular Biology
https://www.readbyqxmd.com/read/28627179/water-lean-solvents-for-post-combustion-co2-capture-fundamentals-uncertainties-opportunities-and-outlook
#12
David J Heldebrant, Phillip K Koech, Vassiliki-Alexandra Glezakou, Roger Rousseau, Deepika Malhotra, David C Cantu
This review is designed to foster the discussion regarding the viability of postcombustion CO2 capture by water-lean solvents, by separating fact from fiction for both skeptics and advocates. We highlight the unique physical and thermodynamic properties of notable water-lean solvents, with a discussion of how such properties could translate to efficiency gains compared to aqueous amines. The scope of this review ranges from the purely fundamental molecular-level processes that govern solvent behavior to bench-scale testing, through process engineering and projections of process performance and cost...
June 19, 2017: Chemical Reviews
https://www.readbyqxmd.com/read/28614432/characteristics-of-nursing-professionals-and-the-practice-of-ecologically-sustainable-actions-in-the-medication-processes
#13
Patricia de Oliveira Furukawa, Isabel Cristina Kowal Olm Cunha, Mavilde da Luz Gonçalves Pedreira, Patricia Beryl Marck
Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument...
June 8, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28614127/a-hospital-is-not-just-a-factory-but-a-complex-adaptive-system-implications-for-perioperative-care
#14
Aman Mahajan, Salim D Islam, Michael J Schwartz, Maxime Cannesson
Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28612831/abdominal-obesity-and-type-2-diabetes-in-asian-indians-dietary-strategies-including-edible-oils-cooking-practices-and-sugar-intake
#15
REVIEW
S Gulati, A Misra
Obesity and type 2 diabetes are increasing in rural and urban regions of South Asia including India. Pattern of fat deposition in abdomen, ectopic fat deposition (liver, pancreas) and also low lean mass are contributory to early-onset insulin resistance, dysmetabolic state and diabetes in Asian Indians. These metabolic perturbations are further exacerbated by changing lifestyle, diet urbanization, and mechanization. Important dietary imbalances include increasing use of oils containing high amount of trans fatty acids and saturated fats (partially hydrogenated vegetable oil, palmolein oil) use of deep frying method and reheating of oils for cooking, high intake of saturated fats, sugar and refined carbohydrates, low intake of protein, fiber and increasing intake of processed foods...
June 14, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28602904/a-hybrid-approach-to-automatic-de-identification-of-psychiatric-notes
#16
Hee-Jin Lee, Yonghui Wu, Yaoyun Zhang, Jun Xu, Hua Xu, Kirk Roberts
De-identification, or identifying and removing protected health information (PHI) from clinical data, is a critical step in making clinical data available for clinical applications and research. This paper presents a natural language processing system for automatic de-identification of psychiatric notes, which was designed to participate in the 2016 CEGS N-GRID shared task Track 1. The system has a hybrid structure that combines machine leaning techniques and rule-based approaches. The rule-based components exploit the structure of the psychiatric notes as well as characteristic surface patterns of PHI mentions...
June 7, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28586671/trends-and-frontiers-for-the-science-and-management-of-the-oceans
#17
EDITORIAL
Peter J Mumby
People have an enduring fascination with the biology of the oceans. When the BBC's 'Blue Planet' series first aired on British television almost a quarter of the nation tuned in. As the diversity of science in this special issue of Current Biology attests, the ocean presents a challenging environment for study while also exhibiting some of the most profound and disruptive symptoms of global change. Marine science has made major advances in the past few decades, which were primarily made possible through important technological innovations...
June 5, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28572967/which-product-characteristics-are-preferred-by-chinese-consumers-when-choosing-pork-a-conjoint-analysis-on-perceived-quality-of-selected-pork-attributes
#18
Xiu Q Ma, Julia M Verkuil, Helene C Reinbach, Lene Meinert
Due to the economic growth achieved by China over the past 20 years, Chinese consumers have changed their purchasing behavior regarding meat. Instead of buying locally produced pork, they are increasingly willing to purchase imported pork. A conjoint analysis investigated how intrinsic pork attributes (fat content and processing) and extrinsic pork attributes (origin, price, and packaging) relate to the perceived quality of pork and the choices made by Chinese consumers. A questionnaire distributed among a sample of Chinese consumers (n = 81) revealed that processing (fresh/frozen) is the most important determinant of pork choice (36%), followed by fat content (27%), origin (18%), price (12%), and packaging (6...
May 2017: Food Science & Nutrition
https://www.readbyqxmd.com/read/28552386/tools-and-methods-for-quality-improvement-and-patient-safety-in-perinatal-care
#19
Amy T Nathan, Heather C Kaplan
The quality of health care is now recognized to vary widely in all medical specialties, including perinatal medicine. A national focus on quality improvement (QI) and patient safety is prompting providers to change and improve the care given to patients. All QI and safety efforts require the use of an improvement model to manage the complex process of improving care. This article reviews the most common frameworks in use today, including the Model for Improvement, Six Sigma, and Lean. Specific tools such as affinity, key driver and fishbone diagrams, process maps and statistical process control, as well as checklists are reviewed, with examples from the perinatal literature to illustrate their use in perinatal QI efforts...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28550704/integrating-engagement-and-improvement-work-in-a-pediatric-hospital
#20
Mireille Brosseau, Diane Gagnon, Kristina Rohde, Jennifer Schellinck
Although geared towards a common goal - improved patient-centred care - quality improvement strategies and patient engagement-focused approaches are often developed and conducted in silos. The lack of integration may lead, on the one hand, to the uptake of patient suggestions that do not always take into consideration implications for the delivery of quality care and, on the other hand, to inadequate understanding of patient views required to create optimal services. The Children's Hospital of Eastern Ontario (CHEO)'s action plans to address gaps in patient engagement and quality improvement, two of its priority areas, were initially carried out in isolation of each other...
2017: Healthcare Quarterly
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