Reducing the length of stay for patients stranded in the emergency department: A single-center prospective study of 18,631 patients in China.

The purpose of this study was to reduce the length of stay (LOS) for patients stranded in the emergency department (ED) of a Grade III A hospital in China, and to improve patient flow and increase bed capacity. We utilized a pre-/postintervention design and employed the Six Sigma methodology, which is based on the DMAIC cycle (define, measure, analyze, improve, and control), to evaluate and improve the existing process. Data from 18,631 patients who were stranded in the ED were collected and analyzed. The median LOS for stranded patients decreased from 17.21 (6.22, 27.36) hours to 13.45 (5.56, 25.85) hours (P < .05). Similarly, the median LOS for admitted patients decreased from 19.64 (7.77, 27.68) hours to 15.92 (6.19, 26.24) hours (P < .05). The median LOS for patients with an ED triage Level IV decreased from 16.15 (5.80, 26.62) hours to 12.59 (5.20, 24.97) hours (P < .05). In addition, the average hospitalization days of hospitalized patients decreased from 0.92 days to 0.82 days (P < .05). Furthermore, the bed utilization rate increased from 66.79% to 72.29% (P < .05). The number of bed turnovers in the ED resuscitation room increased from 20.30 to 21.96 (P < .05). We had effectively met our goal of minimizing ED patient LOS. Six Sigma method can effectively shorten patient LOS by measuring and analyzing the key factors affecting patient LOS, and by implementing measures such as strict implementation of emergency classification and triage system, establishment of multidisciplinary cooperative team, reasonable allocation of human resources, information management of bed resources, and improvement of performance appraisal scheme to improve and control the effectiveness of patient LOS.

Helicobacter pylori increases the risk of carotid plaque formation: a clinical evidence.

Background and aim: Since the relation between Helicobacter pylori (H. pylori) and atherosclerosis has been evidenced, we aimed to analyze whether there is a relationship between the patient's H. pylori infection and age, gender, BMI, blood lipids, and carotid plaque formation.Methods: 810 patients from January 2016 to December 2019 were enrolled in this study, and divided the subjects into H. pylori (+) group and H. pylori (-) group based on the results of UBT. To analyze whether H. pylori infection is related to gender, age, BMI, blood lipids, and neck vascular plaque formation.Results: The single-factor analysis showed that the BMI ≥ 25kg/m2, triglycerides >1.7 mmol/l, the formation of cervical plaques were significantly higher in patients infected with H. pylori in compared to normal cases. Also, multi-variant logistic regression analysis showed that H. pylori infection affects the BMI ≥ 25kg/m2 and triglycerides >1.7 mmol/l to induce vascular plaque. Also, we showed that patients with H. pylori infection are 1.424 times higher than the non-infected group to have triglycerides more elevated than 1.7mmol/l.Conclusion: In this study, we conclude that H. pylori infection is an independent risk factor for higher BMI (>25), triglyceride (>1.7 mmol/l), and neck vascular plaque formation. The multi-variant analysis showed that patients with H. pylori infection are prone to have higher BMI, triglycerides, and neck vascular plaque formation over 1.4-times higher in non-infected individuals.KEY MESSAGESH. pylori infection is an independent risk factor for higher BMI, triglyceride, and neck vascular plaque formation.H. pylori can accelerate vascular plaque formation through increasing BMI and triglyceride.

Lead-Free Perovskite Narrow-Bandgap Oxide Semiconductors of Rare-Earth Manganates.

Tremendous success has been achieved in photovoltaic (PV) applications, but PV-generated electricity still cannot compete with traditional power in terms of price. Chemically stable and nontoxic all-oxide solar cells made from earth-abundant resources fulfill the requirements for low-cost manufacturing under ambient conditions and thus are promising as the next-generation approach to solar cells. However, the main obstacles to developing all-oxide solar cells are the spectral absorbers. Besides photovoltaics, novel chemically stable, nontoxic, and earth-abundant narrow-bandgap semiconductors are desired for photochemical applications in photodetectors, photoelectrodes, or photocatalysts. Herein, were report novel lead-free perovskite narrow-bandgap rare-earth semiconductors, YMnO3, HoMnO3, ErMnO3, and YbMnO3, which were identified by screening a family of perovskite rare-earth manganates, RMnO3 (R = Y, La, Ce, Pr, Nd, Sm, Gd, Tb, Dy, Ho, Er, and Yb). The sharp edge observed in their absorption spectra indicates the existence of band gaps, further confirmed with laser Raman fluorescence spectra. Good periodic on-off photoelectronic response was observed in 8 of the 12 members (i.e., R = La, Pr, Nd, Sm, Gd, Tb, Dy, and Yb). Among them, YbMnO3 is approved as an n-type semiconductor with a direct band gap near 1.35 eV, whose theoretical Shockley-Queisser efficiency is approximately 33.7% for single-p-n-junction solar cells. This work sheds light on exploring stable oxide semiconductors with a narrow band gap for future applications.