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https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#1
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
#2
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
#3
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
#4
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
#5
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...
September 22, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28945512/improvement-in-quality-metrics-by-the-upmc-enhanced-care-program-a-novel-super-utilizer-program
#6
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
#7
(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. Additionally, author Zane Gates has an ownership interest in the Empower(3) Center for Health, a direct-pay primary care clinic using a subscription coverage model, that additionally provides insurance counseling and prescription programs...
September 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28881959/maboss-2-0-an-environment-for-stochastic-boolean-modeling
#8
Gautier Stoll, Barthélémy Caron, Eric Viara, Aurélien Dugourd, Andrei Zinovyev, Aurélien Naldi, Guido Kroemer, Emmanuel Barillot, Laurence Calzone
Motivation: Modeling of signaling pathways is an important step towards the understanding and the treatment of diseases such as cancers, HIV or auto-immune diseases. MaBoSS is a software that allows to simulate populations of cells and to model stochastically the intracellular mechanisms that are deregulated in diseases. MaBoSS provides an output of a Boolean model in the form of time-dependent probabilities, for all biological entities (genes, proteins, phenotypes, etc.) of the model...
July 15, 2017: Bioinformatics
https://www.readbyqxmd.com/read/28866431/outcomes-of-stage-ii-endometrial-cancer-the-upmc-hillman-cancer-center-experience
#9
Katherine S Chen, Hebist Berhane, Beant S Gill, Alexander Olawaiye, Paniti Sukumvanich, Joseph L Kelley, Michelle M Boisen, Madeleine Courtney-Brooks, John T Comerci, Robert Edwards, Jessica Berger, Sushil Beriwal
PURPOSE: Previous studies of stage II endometrial cancer have included cancers with cervical glandular involvement, a factor no longer associated with risk of recurrence. In order to better assess relapse patterns and the impact of adjuvant therapy, a retrospective analysis was conducted for patients with modern stage II endometrial cancer, defined as cervical stromal invasion. MATERIALS AND METHODS: Patients diagnosed with surgically staged FIGO stage II endometrial cancer at the UPMC Hillman Cancer Center from 1990-2013 were reviewed...
November 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28840507/racial-and-socioeconomic-disparities-in-hysterectomy-route-for-benign-conditions
#10
Amin Sanei-Moghaddam, Chaeryon Kang, Robert P Edwards, Paula J Lounder, Naveed Ismail, Sharon L Goughnour, Suketu M Mansuria, John T Comerci, Faina Linkov
BACKGROUND: The aim of this paper was to explore disparities associated with the route of hysterectomy in the University of Pittsburgh Medical Center (UPMC) health system and to evaluate whether the hysterectomy clinical pathway implementation impacted disparities in the utilization of minimally invasive hysterectomy (MIH). METHODS: We performed a retrospective medical record review of all the patients who have undergone hysterectomy for benign indications at UPMC-affiliated hospitals between fiscal years (FY) 2012 and 2014...
August 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28728614/upper-airway-stimulation-for-treatment-of-obstructive-sleep-apnea-an-evaluation-and-comparison-of-outcomes-at-two-academic-centers
#11
Colin Huntley, Thomas Kaffenberger, Karl Doghramji, Ryan Soose, Maurits Boon
STUDY OBJECTIVES: Data from patients at Thomas Jefferson University Hospital (TJUH) and University of Pittsburgh Medical Center (UPMC) undergoing upper airway stimulation (UAS) were analyzed. We hypothesize that treatment with UAS will improve both subjective and objective outcome measures and results will be reproducible between institutions. METHODS: We reviewed patients undergoing UAS between May 2014 and August 2016. We recorded demographic data, Epworth Sleepiness Scale (ESS), and preoperative and postoperative polysomnographic information...
September 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28686673/focal-areas-of-increased-lipid-concentration-on-the-coating-of-microbubbles-during-short-tone-burst-ultrasound-insonification
#12
Klazina Kooiman, Tom van Rooij, Bin Qin, Frits Mastik, Hendrik J Vos, Michel Versluis, Alexander L Klibanov, Nico de Jong, Flordeliza S Villanueva, Xucai Chen
Acoustic behavior of lipid-coated microbubbles has been widely studied, which has led to several numerical microbubble dynamics models that incorporate lipid coating behavior, such as buckling and rupture. In this study we investigated the relationship between microbubble acoustic and lipid coating behavior on a nanosecond scale by using fluorescently labeled lipids. It is hypothesized that a local increased concentration of lipids, appearing as a focal area of increased fluorescence intensity (hot spot) in the fluorescence image, is related to buckling and folding of the lipid layer thereby highly influencing the microbubble acoustic behavior...
2017: PloS One
https://www.readbyqxmd.com/read/28678602/characteristics-and-outcomes-of-open-globe-trauma-in-the-urban-versus-rural-population-a-single-center-retrospective-review
#13
Roxana Fu, Swarupa Kancherla, Andrew W Eller, Jenny Y Yu
PURPOSE: To examine the characteristics and outcomes of open globe injuries sustained by the urban population compared to the rural population. METHODS: This is a retrospective chart review of 429 patients presenting to University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital with traumatic open globes from July 2005 to July 2013. RESULTS: Rural patients had a longer time which elapsed from injury to presentation (P = 0.023, average 12...
July 5, 2017: Seminars in Ophthalmology
https://www.readbyqxmd.com/read/28592293/plasmobase-a-comparative-database-of-predicted-domain-architectures-for-plasmodium-genomes
#14
Juliana Bernardes, Catherine Vaquero, Alessandra Carbone
BACKGROUND: With the availability of complete genome sequences of both human and non-human Plasmodium parasites, it is now possible to use comparative genomics to look for orthology across Plasmodium species and for species specific genes. This comparative analyses could provide important clues for the development of new strategies to prevent and treat malaria in humans, however, the number of functionally annotated proteins is still low for all Plasmodium species. In the context of genomes that are hard to annotate because of sequence divergence, such as Plasmodium, domain co-occurrence becomes particularly important to trust predictions...
June 7, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28561130/the-effects-of-natural-language-processing-on-cross-institutional-portability-of-influenza-case-detection-for-disease-surveillance
#15
Jeffrey P Ferraro, Ye Ye, Per H Gesteland, Peter J Haug, Fuchiang Rich Tsui, Gregory F Cooper, Rudy Van Bree, Thomas Ginter, Andrew J Nowalk, Michael Wagner
OBJECTIVES: This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance. METHODS: We independently developed two NLP parsers, one at Intermountain Healthcare (IH) in Utah and the other at University of Pittsburgh Medical Center (UPMC) using local clinical notes from emergency department (ED) encounters of influenza...
May 31, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28472458/bis2analyzer-a-server-for-co-evolution-analysis-of-conserved-protein-families
#16
Francesco Oteri, Francesca Nadalin, Raphaël Champeimont, Alessandra Carbone
Along protein sequences, co-evolution analysis identifies residue pairs demonstrating either a specific co-adaptation, where changes in one of the residues are compensated by changes in the other during evolution or a less specific external force that affects the evolutionary rates of both residues in a similar magnitude. In both cases, independently of the underlying cause, co-evolutionary signatures within or between proteins serve as markers of physical interactions and/or functional relationships. Depending on the type of protein under study, the set of available homologous sequences may greatly differ in size and amino acid variability...
May 2, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28380048/a-study-of-the-transferability-of-influenza-case-detection-systems-between-two-large-healthcare-systems
#17
Ye Ye, Michael M Wagner, Gregory F Cooper, Jeffrey P Ferraro, Howard Su, Per H Gesteland, Peter J Haug, Nicholas E Millett, John M Aronis, Andrew J Nowalk, Victor M Ruiz, Arturo López Pineda, Lingyun Shi, Rudy Van Bree, Thomas Ginter, Fuchiang Tsui
OBJECTIVES: This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. METHODS: A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH)...
2017: PloS One
https://www.readbyqxmd.com/read/28344795/validation-of-a-tool-predicting-important-findings-on-computed-tomography-among-crohn-s-disease-patients
#18
REVIEW
Shail M Govani, Akbar K Waljee, Keith E Kocher, Jason M Swoger, Melissa Saul, Peter Dr Higgins
BACKGROUND: Patients with Crohn's disease (CD) are frequently subjected to computed tomography (CT) in the emergency department (ED). This young population is at higher risk of malignancy from radiation exposure. OBJECTIVES: We aimed to validate a decision tool predicting complications (perforation, abscess or other serious finding) on imaging at two sites. METHODS: We conducted a retrospective review of CT outcomes among patients with CD with ED visits at two tertiary care centers...
March 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28339394/global-and-regional-assessment-of-sustained-inflation-pressure-volume-curves-in-patients-with-acute-respiratory-distress-syndrome
#19
Tobias Becher, Philipp Rostalski, Matthias Kott, Andy Adler, Dirk Schadler, Norbert Weiler, Inez Frerichs
Static or quasi-static pressure-volume (P-V) curves can be used to determine the lung mechanical properties of patients suffering from acute respiratory distress syndrome (ARDS). According to the traditional interpretation, lung recruitment occurs mainly below the lower point of maximum curvature (LPMC) of the inflation P-V curve. Although some studies have questioned this assumption, setting of positive end-expiratory pressure 2 cmH2O above the LPMC was part of a "lung-protective" ventilation strategy successfully applied in several clinical trials...
March 24, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28241191/a-large-skin-cancer-screening-quality-initiative-description-and-first-year-outcomes
#20
Laura K Ferris, Melissa I Saul, Yan Lin, Fei Ding, Martin A Weinstock, Alan C Geller, Jian-Min Yuan, Erica Neuren, Spandana Maddukuri, Francis X Solano, John M Kirkwood
Importance: The lack of prospective randomized clinical trials demonstrating that full-body skin examination (FBSE) reduces melanoma morbidity or mortality has prompted an "I" rating from the United States Preventive Services Task Force for population-based skin cancer screening. More data on these screening programs are needed. Objectives: To describe a skin cancer screening quality initiative in a large health care system and to determine if the intervention was associated with screening of a demographically higher-risk population than previous screening programs and if melanoma incidence and thickness differed in screened vs unscreened patients...
August 1, 2017: JAMA Oncology
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