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https://www.readbyqxmd.com/read/29352339/effect-of-time-to-operation-on-value-of-care-in-acute-care-surgery
#1
Tyler J Loftus, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: As reimbursement models evolve, there is increasing emphasis on maximizing value-based care for inpatient conditions. We hypothesized that longer intervals between admission and surgery would be associated with worse outcomes and increased costs for acute care surgery patients, and that these associations would be strongest among patients with high-risk conditions. METHODS: We performed a 5-year retrospective analysis of three risk cohorts: appendectomy (low-risk for morbidity and mortality, n = 618), urgent hernia repair (intermediate-risk, n = 80), and laparotomy for intra-abdominal sepsis with temporary abdominal closure (sTAC; high-risk, n = 102)...
January 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29349570/assessment-of-ten-density-functionals-through-the-use-of-local-hyper-softness-to-get-insights-about-the-catalytic-activity-iron-based-organometallic-compounds-for-ethylene-polymerization-as-testing-molecules
#2
Jorge I Martínez-Araya, Daniel Glossman-Mitnik
Ten functionals were used to assess their capability to compute a local reactivity descriptor coming from the Conceptual Density Functional Theory on a group of iron-based organometallic compounds that have been synthesized by Zohuri, G.H. et al. in 2010; these compounds bear the following substituent groups: H-, O2N- and CH3O- at the para position of the pyridine ring and their catalytic activities were experimentally measured by these authors. The present work involved a theoretical analysis applied on the aforementioned iron-based compounds thus leading to suggest a new 2,6-bis(imino)pyridine catalyst based on iron(II) bearing a fluorine atom whose possible catalytic activity is suggested to be near the catalytic activity of the complex bearing a hydrogen atom as a substituent group by means of the so called local hyper-softness (LHS) thus opening a chance to estimate a possible value of catalytic activity for a new catalyst that has not been synthesized yet without simulating the entire process of ethylene polymerization...
January 18, 2018: Journal of Molecular Modeling
https://www.readbyqxmd.com/read/29348925/volume-estimates-in-chronic-hemodialysis-patients-by-the-watson-equation-and-bioimpedance-spectroscopy-and-the-impact-on-the-kt-vurea-calculation
#3
Nazanin Noori, Ron Wald, Arti Sharma Parpia, Marc B Goldstein
Background: Accurate assessment of total body water (TBW) is essential for the evaluation of dialysis adequacy (Kt/Vurea). The Watson formula, which is recommended for the calculation of TBW, was derived in healthy volunteers thereby leading to potentially inaccurate TBW estimates in maintenance hemodialysis recipients. Bioimpedance spectroscopy (BIS) may be a robust alternative for the measurement of TBW in hemodialysis recipients. Objectives: The primary objective of this study was to evaluate the accuracy of Watson formula-derived TBW estimates as compared with TBW measured with BIS...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29347982/emergency-department-hyperoxia-is-associated-with-increased-mortality-in-mechanically-ventilated-patients-a-cohort-study
#4
David Page, Enyo Ablordeppey, Brian T Wessman, Nicholas M Mohr, Stephen Trzeciak, Marin H Kollef, Brian W Roberts, Brian M Fuller
BACKGROUND: Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU)...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29346031/2016-new-horizons-lecture-beyond-imaging-radiology-of-tomorrow
#5
Hedvig Hricak
This article is based on the New Horizons lecture delivered at the 2016 Radiological Society of North America Annual Meeting. It addresses looming changes for radiology, many of which stem from the disruptive effects of the Fourth Industrial Revolution. This is an emerging era of unprecedented rapid innovation marked by the integration of diverse disciplines and technologies, including data science, machine learning, and artificial intelligence-technologies that narrow the gap between man and machine. Technologic advances and the convergence of life sciences, physical sciences, and bioengineering are creating extraordinary opportunities in diagnostic radiology, image-guided therapy, targeted radionuclide therapy, and radiology informatics, including radiologic image analysis...
January 18, 2018: Radiology
https://www.readbyqxmd.com/read/29345801/individual-psychological-therapy-in-an-acute-inpatient-setting-service-user-and-psychologist-perspectives
#6
Catherine Small, Nancy Pistrang, Vyv Huddy, Claire Williams
OBJECTIVES: The acute inpatient setting poses potential challenges to delivering one-to-one psychological therapy; however, there is little research on the experiences of both receiving and delivering therapies in this environment. This qualitative study aimed to explore service users' and psychologists' experiences of undertaking individual therapy in acute inpatient units. It focused on the relationship between service users and psychologists, what service users found helpful or unhelpful, and how psychologists attempted to overcome any challenges in delivering therapy...
January 18, 2018: Psychology and Psychotherapy
https://www.readbyqxmd.com/read/29345516/association-between-weather-related-factors-and-cardiac-arrest-of-presumed-cardiac-etiology-a-prospective-observational-study-based-on-out-of-hospital-care-data
#7
Mario Hensel, Daniel Geppert, Jan F Kersten, Markus Stuhr, Jürgen Lorenz, Sebastian Wirtz, Thoralf Kerner
OBJECTIVE: The objective of this study was to determine the association between weather-related factors and out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology. METHODS: This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and data from the local weather station were evaluated over a 5-year period. Weather data (temperature, humidity, air pressure, wind speed) were obtained every minute and matched with the associated rescue mission data...
January 18, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29345395/patient-carer-and-public-involvement-in-major-system-change-in-acute-stroke-services-the-construction-of-value
#8
Christopher McKevitt, Angus I G Ramsay, Catherine Perry, Simon J Turner, Ruth Boaden, Charles D A Wolfe, Naomi J Fulop
BACKGROUND: Patient and public involvement is required where changes to care provided by the UK National Health Service are proposed. Yet involvement is characterized by ambiguity about its rationales, methods and impact. AIMS: To understand how patients and carers were involved in major system changes (MSCs) to the delivery of acute stroke care in 2 English cities, and what kinds of effects involvement was thought to produce. METHODS: Analysis of documents from both MSC projects, and retrospective in-depth interviews with 45 purposively selected individuals (providers, commissioners, third-sector employees) involved in the MSC...
January 18, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29344985/probing-the-microscopic-environment-of-23-na-ions-in-brain-tissue-by-mri-on-the-accuracy-of-different-sampling-schemes-for-the-determination-of-rapid-biexponential-t2-decay-at-low-signal-to-noise-ratio
#9
Jonathan M Lommen, Sebastian Flassbeck, Nicolas G R Behl, Sebastian Niesporek, Peter Bachert, Mark E Ladd, Armin M Nagel
PURPOSE: To investigate and to reduce influences on the determination of the short and long apparent transverse relaxation times ( T2,s*, T2,l*) of 23 Na in vivo with respect to signal sampling. METHODS: The accuracy of T2* determination was analyzed in simulations for five different sampling schemes. The influence of noise in the parameter fit was investigated for three different models. A dedicated sampling scheme was developed for brain parenchyma by numerically optimizing the parameter estimation...
January 17, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29344743/response-to-different-furosemide-doses-predicts-aki-progression-in-icu-patients-with-elevated-plasma-ngal-levels
#10
Ryo Matsuura, Yohei Komaru, Yoshihisa Miyamoto, Teruhiko Yoshida, Kohei Yoshimoto, Rei Isshiki, Kengo Mayumi, Tetsushi Yamashita, Yoshifumi Hamasaki, Masaomi Nangaku, Eisei Noiri, Naoto Morimura, Kent Doi
BACKGROUND: Furosemide responsiveness (FR) is determined by urine output after furosemide administration and has recently been evaluated as a furosemide stress test (FST) for predicting severe acute kidney injury (AKI) progression. Although a standardized furosemide dose is required for FST, variable dosing is typically employed based on illness severity, including renal dysfunction in the clinical setting. This study aimed to evaluate whether FR with different furosemide doses can predict AKI progression...
January 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29344689/early-versus-late-tracheostomy-in-trauma-patients-a-propensity-matched-cohort-study-of-5-years-data-at-a-single-institution-in-korea
#11
Byung Hee Kang, Jayun Cho, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: Although there have been many studies dealing with tracheostomy timing in trauma patients, the optimal timing is still being debated. This study aimed to compare outcomes between early tracheostomy (ET) and late tracheostomy (LT) in trauma populations to estimate the optimal timing of tracheostomy after intubation. METHODS: We retrospectively reviewed the 5 years' data of trauma patients who underwent tracheostomy during their acute intensive care unit (ICU) stay...
January 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29343977/cost-effectiveness-analysis-of-six-therapies-for-the-treatment-of-lower-urinary-tract-symptoms-due-to-benign-prostatic-hyperplasia
#12
James C Ulchaker, Melissa S Martinson
Objective: To conduct a cost-effectiveness analysis from payers' perspectives of six treatments for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and to examine positioning of these modalities in the marketplace for the best use of health care funds and quality-of-life benefits for patients. Methods: The economic analysis was conducted with a Markov model to compare combination prescription drug therapy (ComboRx), minimally invasive therapies (MITs) including convective radiofrequency (RF) water vapor thermal therapy (Rezūm®), conductive RF thermal therapy (Prostiva®), and prostatic urethral lift (UroLift®), and invasive surgical procedures including photovaporization of the prostate (Greenlight® PVP) and transurethral resection of the prostate (TURP)...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29343864/electrochemical-and-friction-characteristics-of-metallic-glass-composites-at-the-microstructural-length-scales
#13
Aditya Ayyagari, Vahid Hasannaeimi, Harpreet Arora, Sundeep Mukherjee
Metallic glass composites represent a unique alloy design strategy comprising of in situ crystalline dendrites in an amorphous matrix to achieve damage tolerance unseen in conventional structural materials. They are promising for a range of advanced applications including spacecraft gears, high-performance sporting goods and bio-implants, all of which demand high surface degradation resistance. Here, we evaluated the phase-specific electrochemical and friction characteristics of a Zr-based metallic glass composite, Zr56...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29343156/patient-contributions-during-primary-care-consultations-for-hypertension-after-self-reporting-via-a-mobile-phone-self-management-support-system
#14
Ulrika Bengtsson, Karin Kjellgren, Inger Hallberg, Mona Lundin, Åsa Mäkitalo
OBJECTIVE: This paper reports on how the clinical consultation in primary care is performed under the new premises of patients' daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients' contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. DESIGN: A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis...
January 18, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29343100/the-effect-of-an-orthopedic-hand-surgeon-s-attire-on-patient-confidence-and-trust
#15
Vince W Lands, Ajith Malige, Chinenye O Nwachuku, Kristofer S Matullo
BACKGROUND: Multiple studies have concluded that patients are more likely to understand and trust physicians who dress in more formal attire (shirt and tie) as opposed to casual attire (t-shirts and jeans). The white coat has repeatedly been reported as a major source of trust and confidence in a patient's eyes. METHODS: This study explores the effect an orthopedic hand surgeon's attire has on a patient's perception of their surgeon's clinical values. All patients 18 years of age and older who visited our orthopedic hand surgeon's suburban outpatient practice were asked to participate in our survey-based study...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29342077/use-of-a-new-international-classification-of-health-interventions-for-capturing-information-on-health-interventions-relevant-to-people-with-disabilities
#16
Nicola Fortune, Richard Madden, Ann-Helene Almborg
Development of the World Health Organization's International Classification of Health Interventions (ICHI) is currently underway. Once finalised, ICHI will provide a standard basis for collecting, aggregating, analysing, and comparing data on health interventions across all sectors of the health system. In this paper, we introduce the classification, describing its underlying tri-axial structure, organisation and content. We then discuss the potential value of ICHI for capturing information on met and unmet need for health interventions relevant to people with a disability, with a particular focus on interventions to support functioning and health promotion interventions...
January 17, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29342070/an-evaluation-of-industry-relationships-among-contributors-to-aaos-clinical-practice-guidelines-and-appropriate-use-criteria
#17
Jake X Checketts, Courtney Cook, Matt Vassar
BACKGROUND: A long-standing relationship between orthopaedic surgeons and industry has made financial conflicts of interest a concerning issue. Research supports that financial conflicts of interest can influence both medical research and clinical practice. Financial conflicts of interest may also influence clinical practice guideline recommendations and their corresponding appropriate use criteria. Because of the influential nature of these guidelines, it is imperative that care be taken to minimize bias during guideline development...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342009/how-academic-health-systems-can-achieve-population-health-in-vulnerable-populations-through-value-based-care-the-critical-importance-of-establishing-trusted-agency
#18
Donald E Wesson, Heather E Kitzman
Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve...
January 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#19
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
January 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29341818/medicine-as-it-should-be-teaching-team-and-teamwork-during-a-palliative-care-clerkship
#20
Barbara A Head, Christian Davis Furman, Andrew M Lally, Kimberly Leake, Mark Pfeifer
BACKGROUND: Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. OBJECTIVE: Our objective was to assess the learning of senior medical students during a palliative care rotation. DESIGN: A constant comparison method based on grounded theory was used in this qualitative study. SETTING/SUBJECTS: Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship...
January 17, 2018: Journal of Palliative Medicine
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