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surge capacity

Mersedeh TariVerdi, Elise Miller-Hooks, Thomas Kirsch
Mass casualty incidents are a concern in many urban areas. A community's ability to cope with such events depends on the capacities and capabilities of its hospitals for handling a sudden surge in demand of patients with resource-intensive and specialized medical needs. This paper uses a whole-hospital simulation model to replicate medical staff, resources, and space for the purpose of investigating hospital responsiveness to mass casualty incidents. It provides details of probable demand patterns of different mass casualty incident types in terms of patient categories and arrival patterns, and accounts for related transient system behavior over the response period...
March 19, 2018: Disaster Medicine and Public Health Preparedness
Nicholas Dainiak
A high-casualty incident may result in a significant human toll due to the inability of a community to meet the health care demands of the population. A successful medical response requires health care facilities to not only communicate and integrate medical services, meet surge capacity, protect health care workers and implement triage and treatment protocols, but also to provide the venue for clinical management of acute radiation injuries and their associated infections. Today, clinical management is primarily guided by the recommendations of a Consultancy that were made at the World Health Organization (WHO)...
March 2, 2018: Journal of Radiation Research
Aleksandra Leszczynska, J Mary Murphy
Vascular calcification (VC) has witnessed a surge of interest. Vasculature is virtually an omnipresent organ and has a notably high capacity for repair throughout embryonic and adult life. Of the vascular diseases, atherosclerosis is a leading cause of morbidity and mortality on account of ectopic cartilage and bone formation. Despite the identification of a number of risk factors, all the current theories explaining pathogenesis of VC in atherosclerosis are far from complete. The most widely accepted response to injury theory and smooth muscle transdifferentiation to explain the VC observed in atherosclerosis is being challenged...
2018: Frontiers in Bioengineering and Biotechnology
Rachel M Peters, Thomas J Hipper, Esther D Chernak
OBJECTIVE: This study seeks to determine the capacity of community primary care practices to meet the needs of patients during public health emergencies and to identify the barriers and resources necessary to participate in a coordinated response with public safety agencies. METHODS: The self-administered web-based survey was distributed in January 2014 via e-mail to primary care providers in Pennsylvania using the listservs of several professional societies. RESULTS: A total of 179 primary care providers participated in the survey...
February 22, 2018: Disaster Medicine and Public Health Preparedness
Linda W Xu, Silvia D Vaca, Juliet Nalwanga, Christine Muhumuza, Daniel Vail, Benjamin J Lerman, Joel Kiryabwire Surg, Hussein Ssenyonjo, John Mukasa, Michael Muhumuza, Michael M Haglund, Gerald Grant
BACKGROUND: In the past decade, neurosurgery in Uganda experienced increasing surgical volume and a new residency training program. While research has examined surgical capacity, minimal data exists on the patient population treated by neurosurgery and their eventual outcomes in sub-Saharan Africa. METHODS: Patients admitted to Mulago National Referral Hospital neurosurgical ward over two years (2014 and 2015) were documented in a prospective database. 1167 were discharged with documented phone numbers, thus eligible for follow-up...
February 7, 2018: World Neurosurgery
E Ter Avest, B T Onnes, T van der Vaart, M J Land
INTRODUCTION: Emergency department (ED) crowding is a contemporary problem. Solutions are multiple, but often involve a lengthy implementation process and/or substantial funding. Therefore, it is important that in the meanwhile, we aim to identify simple strategies, focussing on optimising efficiency of the available resources, which can be adopted in the ED here and now. METHODS: We made a careful analysis of inflow, throughput and outflow data of all 24,823 patients visiting the ED of a large teaching hospital in the year 2015, and looked in more detail at the 10 days with the longest average throughput times...
January 2018: Netherlands Journal of Medicine
Jasmine L Jacobs-Wingo, Heather A Cook, William H Lang
BACKGROUND: Mass casualty incidents may increase patient volume suddenly and dramatically, requiring hospitals to expeditiously manage bed inventories to release acute care beds for disaster victims. Electronic patient tracking systems combined with unit walk-throughs can identify patients for rapid discharge. The New York City (NYC) Department of Health and Mental Hygiene's 2013 Rapid Patient Discharge Assessment (RPDA) aimed to determine the maximum number of beds NYC hospitals could make available through rapid patient discharge and to characterize discharge barriers...
January 2018: Quality Management in Health Care
Martin Weinhold, Edeltraud Mast-Gerlach, Vera Meyer
Filamentous fungi are fascinating microorganisms. One of the reasons why it is so worthwhile to take a closer look at them is their capacity to produce secondary metabolites. Some of these substances have the potential to be of great use for mankind, such as it was the case with penicillin and its discovery in 1928. Almost a century later, the situation in healthcare could possibly turn back to the state before the development of the first antibiotics. Due to an overuse of antibiotics we are facing a surge of multiresistant bacteria that are not inhibited by any of the currently known drugs...
2017: Fungal Biology and Biotechnology
Alexander Lubsch, Klaas Timmermans
Dissolved inorganic phosphorus (DIP) is an essential macronutrient for maintaining metabolism and growth in autotrophs. Little is known about DIP-uptake kinetics and internal P-storage capacity in seaweeds, such as Ulva lactuca (Chlorophyta). Ulva lactuca is a promising candidate for biofiltration purposes and mass commercial cultivation. We exposed U. lactuca to a wide range of DIP concentrations (1 - 50 μmol · L-1 ) and a non-limiting concentration of dissolved inorganic nitrogen (DIN; 5000 μmol · L-1 ) under fully controlled laboratory conditions in a 'pulse-and-chase' assay over 10 days...
December 14, 2017: Journal of Phycology
Michelle Nichols, Fred Stephen Sarfo, Arti Singh, Suparna Qanungo, Frank Treiber, Bruce Ovbiagele, Raelle Saulson, Sachin Patel, Carolyn Jenkins
BACKGROUND: There has been a tremendous surge in stroke prevalence in sub-Saharan Africa. Hypertension (HTN), the most potent, modifiable risk factor for stroke, is a particular challenge in sub-Saharan Africa. Culturally sensitive, efficacious HTN control programs that are timely and sustainable are needed, especially among stroke survivors. Mobile health (mHealth) technology and task-shifting offer promising approaches to address this need. METHODS: Using a concurrent triangulation design, we collected data from stroke survivors, caregivers, community leaders, clinicians and hospital personnel to explore the barriers, facilitators and perceptions toward mHealth related to HTN management among poststroke survivors in Ghana...
December 2017: American Journal of the Medical Sciences
Samuel E Shartar, Brooks L Moore, Lori M Wood
OBJECTIVES: Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care...
December 2017: Southern Medical Journal
Ameer Khusro, Chirom Aarti, Azger Dusthackeer, Paul Agastian
In the last few years, the demand for the tremendous therapeutic applications of indigenous probiotic bacteria from diversified fermented food products has surged. In view of this, the present study was documented to evaluate the anti-tubercular and probiotic properties of coagulase-negative staphylococci (CNS) indigenous to Koozh, a traditional fermented food product of South India. A total of 18 isolates were purified from Koozh, and tested for anti-tubercular activity against Mycobacterium tuberculosis H37Rv using luciferase reporter phage (LRP) assay...
January 2018: Microbial Pathogenesis
Charles E Coffey, Valda Carter, Eric Wei, Douglass Hutcheon, John P Gruen, Annie Anonas-Ternate, Rebecca Sandoval, Annie Marquez, Laura Sarff, Brad Spellberg
No abstract text is available yet for this article.
November 22, 2017: American Journal of Medicine
David Burmeister, Mohamud Daya, Christopher Sampson
With influenza season intensifying, many EDs report strong surges in flu related volume. Although illness severity does not appear to be atypical, hospitals that see high numbers of older patients and the chronically ill face extra challenges meeting the needs of patients who have added susceptibility to flu-related complications. Experts note that all flu strains circulating this year appear to be sensitive to antiviral medications. In mid-February, the CDC reported the number of flu cases was still on the increase in most regions of the country, with 28 states reporting a high incidence of influenza-like illness...
April 2017: ED Management: the Monthly Update on Emergency Department Management
Tasha Stehling-Ariza, Adrienne Lefevre, Dinorah Calles, Kpandja Djawe, Richard Garfield, Michael Gerber, Margherita Ghiselli, Coralie Giese, Ashley L Greiner, Adela Hoffman, Leigh Ann Miller, Lisa Moorhouse, Carlos Navarro-Colorado, James Walsh, Dante Bugli, Cyrus Shahpar
The 2014-2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise...
December 2017: Emerging Infectious Diseases
M Prikken, A van der Weiden, R S Kahn, H Aarts, N E M van Haren
BACKGROUND: The sense of self-agency, i.e., experiencing oneself as the cause of one's own actions, is impaired in patients with schizophrenia. Normally, inferences of self-agency are enhanced when actual outcomes match with pre-activated outcome information, where this pre-activation can result from explicitly set goals (i.e., goal-based route) or implicitly primed outcome information (i.e., prime-based route). Previous research suggests that patients show specific impairments in the prime-based route, implicating that they do not rely on matches between implicitly available outcome information and actual action-outcomes when inferring self-agency...
September 20, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
Katherine Walker, Michael Ben-Meir
Emergency medicine was once exclusively provided in public hospitals in Australia, but now over half a million consultations per annum are in private (7% total emergency consultations). Private EDs have excess capacity and are staffed by senior doctors (majority FACEM) with open access to investigations and broad specialist inpatient services. Public EDs struggle with rising attendances and overcapacity. Private hospitals have high levels of patient satisfaction and aim to optimise service provision. A major barrier to private ED attendances is out-of-pocket costs...
October 26, 2017: Emergency Medicine Australasia: EMA
Michael DiLeo, Arthur Ley, Andrew E Nixon, Jie Chen
The capture process employed in monoclonal antibody downstream purification is not only the most critically impacted process by increased antibody titer resulting from optimized mammalian cell culture expression systems, but also the most important purification step in determining overall process throughput, product quality, and economics. Advances in separation technology for capturing antibodies from complex feedstocks have been one focus of downstream purification process innovation for past 10 years. In this study, we evaluated new generation chromatography resins used in the antibody capture process including Protein A, cation exchange, and mixed mode chromatography to address the benefits and unique challenges posed by each chromatography approach...
November 15, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Ana Alexandre, Alexandra Baeta, Aschwin H Engelen, Rui Santos
Seagrasses dominate shallow coastal environments where nitrogen (N) availability in the water column is often sporadic and mainly in the form of pulses. We investigated the N uptake competition between seagrasses and seaweeds through a series of (15)N surge uptake experiments combining single-species and mixed incubations across ammonium concentrations. N surge uptake rates of seagrasses were 2 to 14-fold higher than those of seaweeds in the majority of combinations, showing that seagrasses are generally in a competitive advantage over seaweeds in N-poor environments with N-pulses...
October 20, 2017: Scientific Reports
Matthew F Toerper, Gabor D Kelen, Lauren M Sauer, Jamil D Bayram, Christina Catlett, Scott Levin
The National Center for the Study of Preparedness and Catastrophic Event Response (PACER) has created a publicly available simulation tool called Surge (accessible at to estimate surge capacity for user-defined hospitals. Based on user input, a Monte Carlo simulation algorithm forecasts available hospital bed capacity over a 7-day period and iteratively assesses the ability to accommodate disaster patients. Currently, the tool can simulate bed capacity for acute mass casualty events (such as explosions) only and does not specifically simulate staff and supply inventory...
October 18, 2017: Disaster Medicine and Public Health Preparedness
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