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https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#1
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29757766/comorbidities-associated-with-early-mortality-in-adults-with-spina-bifida
#2
Brad E Dicianno, Adam Sherman, Christian Roehmer, Christina K Zigler
OBJECTIVE: The purpose of this quality improvement project was to identify secondary conditions and medical comorbidities in adult patients with spina bifida and to determine which factors were associated with an earlier age of death. DESIGN: Retrospective chart review of 487 patients who attended the University of Pittsburgh Medical Center (UPMC) Adult Spina Bifida Clinic between August 1, 2005 and June 6, 2017. RESULTS: Out of 487 patients who had received care at the UPMC Adult Spina Bifida Clinic, 48 were deceased...
May 11, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29727061/international-telecytology-current-applications-and-future-potential
#3
Justin E Caron, Yong Ying, Qin Ye, Lirong Cheng, Jian Yu Rao
International telecytology can improve patient care by increasing access to regional and international expertise in cytopathology. The majority of international telecytology studies published to date have been based on static telepathology platforms. Overall concordance rates for these studies ranged from 71% to 93%. This is comparable to the concordance rates published for other studies comparing diagnoses made by digital still images to reference glass slides, which vary from 80% to 95%. Static telepathology systems are relatively cheap and easy to use, and have the potential to increase access to international experts in developing countries with limited resources...
May 4, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29673195/thermal-calcination-based-production-of-sno%C3%A2-nanopowder-an-analysis-of-sno%C3%A2-nanoparticle-characteristics-and-antibacterial-activities
#4
Naif Mohammed Al-Hada, Halimah Mohamed Kamari, Anwar Ali Baqer, Abdul H Shaari, Elias Saion
SnO₂ nanoparticle production using thermal treatment with tin(II) chloride dihydrate and polyvinylpyrrolidone capping agent precursor materials for calcination was investigated. Samples were analyzed using X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), energy dispersive X-ray (EDX), transmission electron microscopy (TEM), Fourier Transform Infrared Spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), diffuse UV-vis reflectance spectra, photoluminescence (PL) spectra and the electron spin resonance (ESR)...
April 17, 2018: Nanomaterials
https://www.readbyqxmd.com/read/29610050/upmc-s-blueprint-for-building-a-high-value-health-care-system
#5
Donna Keyser, Jane Kogan, Marion McGowan, Pamela Peele, Diane Holder, William Shrank
National-level demonstration projects and real-world studies continue to inform health care transformation efforts and catalyze implementation of value-based service delivery and payment models, though evidence generation and diffusion of learnings often occurs at a relatively slow pace. Rapid-cycle learning models, however, can help individual organizations to more quickly adapt health care innovations to meet the challenges and demands of a rapidly changing health care landscape. Integrated delivery and financing systems (IDFSs) offer a unique platform for rapid-cycle learning and innovation...
March 30, 2018: Healthcare
https://www.readbyqxmd.com/read/29548340/utilizing-clinical-pathways-and-web-based-conferences-to-improve-quality-of-care-in-a-large-integrated-network-using-breast-cancer-radiation-therapy-as-the-model
#6
Katherine S Chen, Scott M Glaser, Allison E Garda, John A Vargo, M Saiful Huq, Dwight E Heron, Sushil Beriwal
BACKGROUND: Clinical pathways outline criteria for dose homogeneity and critical organ dosimetry. Based upon an internal audit showing suboptimal compliance with dosimetric parameters in whole breast irradiation (WBI), we conducted a mandatory web-based teaching conference for the network. This study reports the impact of this initiative on subsequent treatment plans. METHODS: Radiation treatment plans were collected for the 10 most recent patients receiving WBI at 16 institutions within the UPMC Hillman Cancer Center network...
March 16, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29481944/prior-endovascular-intervention-is-not-detrimental-to-pedal-bypasses-for-ischemic-wounds
#7
Abhisekh Mohapatra, Mikayla N Lowenkamp, Jon C Henry, Aureline Boitet, Efthimios D Avgerinos, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
BACKGROUND: Endovascular strategies are often preferred for revascularization of ischemic foot wounds secondary to infrapopliteal disease because of the less invasive technique and faster recovery. Bypass is typically reserved for failures or lesions not amenable to balloon angioplasty. However, the effects of an endovascular-first approach on subsequent bypass grafts are largely unknown. This study evaluates the effects of prior endovascular tibial interventions (PTIs) on successive bypasses to pedal targets...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29288014/efficacy-of-different-cooling-technologies-for-therapeutic-temperature-management-a-prospective-intervention-study
#8
Petra Sonder, Gladys N Janssens, Albertus Beishuizen, Connie L Henry, Jon C Rittenberger, Clifton W Callaway, Cameron Dezfulian, Kees H Polderman
BACKGROUND: Mild therapeutic hypothermia (32-36 °C) is associated with improved outcomes in patients with brain injury after cardiac arrest (CA). Various devices are available to induce and maintain hypothermia, but few studies have compared the performance of these devices. We performed a prospective study to compare four frequently used cooling systems in inducing and maintaining hypothermia followed by controlled rewarming. METHODS: We performed a prospective multi-centered study in ten ICU's in three hospitals within the UPMC health system...
March 2018: Resuscitation
https://www.readbyqxmd.com/read/29275307/challenges-in-the-analysis-of-outcomes-for-surgical-compared-to-radiotherapy-treatment-of-prostate-cancer
#9
Scott M Glaser, Ronny Kalash, Dante R Bongiorni, Mark S Roberts, Goundappa K Balasubramani, Bruce L Jacobs, Sushil Beriwal, Dwight E Heron, Joel S Greenberger
BACKGROUND/AIM: Prostate cancer can be treated with radical prostatectomy (RP), external-beam radiotherapy (EBRT), or brachytherapy (BT). These modalities have similar cancer-related outcomes. We used an innovative method to analyze the cost of such treatment. MATERIALS AND METHODS: We queried our Institution's Insurance Division [University of Pittsburgh Medical Center (UPMC) Health Plan] beneficiaries from 2003-2008, who were diagnosed with prostate cancer and also queried the UPMC tumor registry for all patients with prostate cancer treated at our Institution...
January 2018: In Vivo
https://www.readbyqxmd.com/read/29232528/upmc-s-population-health-management-strategy-a-road-map-to-high-value-health-care
#10
Marion McGowan, Donna J Keyser, Suzanne Kinsky, Ellen Beckjord, Rosanne DeGrazia, William Shrank
No abstract text is available yet for this article.
December 12, 2017: Population Health Management
https://www.readbyqxmd.com/read/29200844/down-top-nanofabrication-of-binary-cdo-x-zno-1-x-nanoparticles-and-their-antibacterial-activity
#11
Naif Mohammed Al-Hada, Halimah Mohamed Kamari, Che Azurahanim Che Abdullah, Elias Saion, Abdul H Shaari, Zainal Abidin Talib, Khamirul Amin Matori
In the present study, binary oxide (cadmium oxide [CdO])x (zinc oxide [ZnO])1-x nanoparticles (NPs) at different concentrations of precursor in calcination temperature were prepared using thermal treatment technique. Cadmium and zinc nitrates (source of cadmium and zinc) with polyvinylpyrrolidone (capping agent) have been used to prepare (CdO)x (ZnO)1-x NPs samples. The sample was characterized by X-ray diffraction (XRD), scanning electron microscopy, energy-dispersive X-ray (EDX), transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) spectroscopy...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/29183021/digital-applications-in-cytopathology-problems-rationalizations-and-alternative-approaches
#12
MULTICENTER STUDY
Nikolaos Chantziantoniou, Maheswari Mukherjee, Amber D Donnelly, Liron Pantanowitz, R Marshall Austin
OBJECTIVE: The aim of this work was to raise awareness of problems using digital applications for examining, teaching, and applying telecytology at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia; University of Nebraska Medical Center (UNMC), Omaha, NE, USA; and University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA. The objective was to rationalize problems and propose alternative digital approaches. STUDY DESIGN: We sought to identify solutions to improve the following: (a) interpretive examination scores at KAMC for complex cytological templates (i...
2018: Acta Cytologica
https://www.readbyqxmd.com/read/29175548/radiology-report-annotation-using-intelligent-word-embeddings-applied-to-multi-institutional-chest-ct-cohort
#13
Imon Banerjee, Matthew C Chen, Matthew P Lungren, Daniel L Rubin
We proposed an unsupervised hybrid method - Intelligent Word Embedding (IWE) that combines neural embedding method with a semantic dictionary mapping technique for creating a dense vector representation of unstructured radiology reports. We applied IWE to generate embedding of chest CT radiology reports from two healthcare organizations and utilized the vector representations to semi-automate report categorization based on clinically relevant categorization related to the diagnosis of pulmonary embolism (PE)...
January 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#14
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/29138742/hysterectomy-pathway-as-the-global-engine-of-practice-change-implications-for-value-in-care
#15
Amin Sanei-Moghaddam, Sharon Goughnour, Robert Edwards, John Comerci, Joseph Kelley, Nicole Donnellan, Faina Linkov, Suketu Mansuria
Introduction: In 2012, University of Pittsburgh Medical Center (UPMC) introduced a hysterectomy clinical pathway to reduce the number of total abdominal hysterectomies performed for benign gynecological indications. This study focused on exploring physician and patient factors impacting the utilization of hysterectomy clinical pathways. Methods: An online survey with 24 questions was implemented to explore physicians' attitudes and perceived barriers toward implementing the pathway...
2017: Central Asian Journal of Global Health
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#16
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29067647/sino-u-s-partnerships-in-research-education-and-patient-care-the-experience-of-the-university-of-pittsburgh-and-upmc
#17
REVIEW
Arthur S Levine, Margaret C McDonald, Charles E Bogosta
In 2011, the University of Pittsburgh School of Medicine (UPSOM) and Tsinghua University formed a partnership to further the education of Tsinghua medical students. These students come to UPSOM as visiting research scholars for two years of their eight-year MD curriculum. During this time, the students, who have completed four years at Tsinghua, work full-time in medical school laboratories and research programs of their choice, essentially functioning as graduate students. In their first two months in Pittsburgh, the scholars have a one-week orientation to biomedical research, followed by two-week rotations in four labs selected on the basis of the scholars' scientific interests, after which they choose one of these labs for the remainder of the two years...
October 23, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/29028884/protein-protein-interaction-specificity-is-captured-by-contact-preferences-and-interface-composition
#18
Francesca Nadalin, Alessandra Carbone
Motivation: Large-scale computational docking will be increasingly used in future years to discriminate protein-protein interactions at the residue resolution. Complete cross-docking experiments make in silico reconstruction of protein-protein interaction networks a feasible goal. They ask for efficient and accurate screening of the millions structural conformations issued by the calculations. Results: We propose CIPS (Combined Interface Propensity for decoy Scoring), a new pair potential combining interface composition with residue-residue contact preference...
February 1, 2018: Bioinformatics
https://www.readbyqxmd.com/read/28945512/improvement-in-quality-metrics-by-the-upmc-enhanced-care-program-a-novel-super-utilizer-program
#19
Jodie Bryk, Gary S Fischer, Anita Lyons, Swati Shroff, Thuy Bui, Deborah Simak, Wishwa Kapoor
The aim was to evaluate pre-post quality of care measures among super-utilizer patients enrolled in the Enhanced Care Program (ECP), a primary care intensive care program. A pre-post analysis of metrics of quality of care for diabetes, hypertension, cancer screenings, and connection to mental health care for participants in the ECP was conducted for patients enrolled in ECP for 6 or more months. Patients enrolled in ECP showed statistically significant improvements in hemoglobin A1c, retinal exams, blood pressure measurements, and screenings for colon cancer, and trends toward improvement in diabetic foot exams and screenings for cervical and breast cancer...
September 25, 2017: Population Health Management
https://www.readbyqxmd.com/read/28905669/correction-notice
#20
(no author information available yet)
Agee, M. D., & Gates, Z. (2014). The Impact of an Insurance Administration-Free Primary Care Office on Hospital Admissions: A Community-Level Comparison With Traditional Fee-for-Service Family Practice Groups. Journal of Primary Care & Community Health, 5, 202-207. doi: 10.1177/2150131914522123 The following Conflict of Interest statement was originally omitted and will be added to the article: Author Zane Gates's affiliation, UPMC Altoona, is the parent organization of Partnering for Health Services...
October 2017: Journal of Primary Care & Community Health
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