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3.
J Invest Surg ; 33(3): 265-270, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30212251

RESUMO

Introduction: ATTEMPTS to enforce optimization practices for operating room (OR) efficiency are often interpreted as a "pressure for production" which threatens patient safety. The aim of this study is to assess if and how improvements in OR efficiency affect patient safety and thus the quality of care. Methods: In an attempt to optimize OR efficiency, a new OR management approach "Integrated Practice Improvement Solutions" (IPIS) was developed at the Weiler Division of Montefiore Medical Center in 2011. IPIS is a flexible managerial system based on elements of multiple practice improvement methodologies incorporated into an open source framework. It was implemented in 2012. The data presented covers the period from 2012 through 2014 when the system was temporarily discontinued due to administrative restructuring. Data from 2011 was used as a baseline. The impact of IPIS on patient safety and quality of care was assessed based on quality improvement and patient safety (QIPS) Committee reports covering the same period of time. Results: IPIS implementation resulted in an increase in surgical workload by an average of 10.7%, an increase in OR and anesthesia revenues by 18.5% and 6.9%, respectively, and decreases in turnover time by 15% and overtime for the anesthesia staff by 26%. Based on QIPS reports, the total number of complications potentially attributable to "production pressure" was 0.25%, 0.2% and 0.16% in 2012, 2013 and 2014, respectively compared to 0.21% in 2011 (p = 0.56). Conclusions: Gradual implementation of a methodologically structured improvement in OR efficiency has no negative impact on patient safety and quality of care.


Assuntos
Eficiência Organizacional , Salas Cirúrgicas , Benchmarking , Humanos , Melhoria de Qualidade
4.
Ecol Lett ; 23(2): 348-358, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31814305

RESUMO

Network metrics are widely used to infer the roles of mutualistic animals in plant communities and to predict the effect of species' loss. However, their empirical validation is scarce. Here we parameterized a joint species model of frugivory and seed dispersal with bird movement and foraging data from tropical and temperate communities. With this model, we investigate the effect of frugivore loss on seed rain, and compare our predictions to those of standard coextinction models and network metrics. Topological coextinction models underestimated species loss after the removal of highly linked frugivores with unique foraging behaviours. Network metrics informed about changes in seed rain quantity after frugivore loss. However, changes in seed rain composition were only predicted by partner diversity. Nestedness, closeness, and d' specialisation could not anticipate the effects of rearrangements in plant-frugivore communities following species loss. Accounting for behavioural differences among mutualists is critical to improve predictions from network models.


Assuntos
Dispersão de Sementes , Animais , Benchmarking , Aves , Frutas , Plantas
5.
Plant Dis ; 104(1): 168-178, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31697224

RESUMO

Apple scab, caused by Venturia inaequalis, is the most common fruit and foliar disease in commercial apple production worldwide. Early in the production season, preventative contact fungicide sprays are essential for protecting highly susceptible continuously unfolding and expanding young leaves. In South Africa, mancozeb is a key contact fungicide used for controlling apple scab early in the season. The current study developed deposition benchmarks indicative of the biological efficacy of mancozeb against apple scab, using a laboratory-based apple seedling model system. The model system employed a yellow fluorescent pigment that is known to be an effective tracer of mancozeb deposition. A concentration range of mancozeb (0.15 to 1 times the registered dosage) and fluorescent pigment concentrations was sprayed onto seedling leaves, which yielded various fluorescent particle coverage (FPC%) levels. Modeling of the FPC% values versus percent disease control yielded different benchmark values when disease quantification was conducted using two different methods. Thermal infrared imaging (TIRI) disease quantification resulted in a benchmark model where 0.40%, 0.79%, and 1.35 FPC% yielded 50, 75, and 90% apple scab control, respectively. These FPC% values were higher than the benchmarks (0.10, 0.20, and 0.34 FPC%, respectively) obtained with quantitative real-time PCR (qPCR) disease quantification. The qPCR benchmark model is recommended as a guideline for evaluating the efficacy of mancozeb sprays on leaves in apple orchards since the TIRI benchmark model underestimated disease control. The TIRI benchmark model yielded 68% disease control at the lowest mancozeb dosage, yet no visible lesion developed at this dosage. Both benchmark models showed that mancozeb yielded high levels of disease control at very low concentrations; for the qPCR benchmark model the FPC% value of the FPC90 (90% control) corresponded to 0.15 times that of the registered mancozeb concentration in South Africa, i.e., 85% lower than the registered dosage.


Assuntos
Ascomicetos , Malus , Maneb , Doenças das Plantas , Zineb , Ascomicetos/efeitos dos fármacos , Benchmarking , Malus/microbiologia , Maneb/química , Maneb/farmacologia , Doenças das Plantas/prevenção & controle , Folhas de Planta/microbiologia , África do Sul , Zineb/química , Zineb/farmacologia
7.
J Nurs Adm ; 50(1): 34-39, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31804410

RESUMO

OBJECTIVE: An Automated Data Entry Process Technology tool was developed to free nurses from data entry tasks, thus creating time for patient care and other activities associated with improvements in performance and job satisfaction. BACKGROUND: Manually transferring data from patient measurement devices to electronic health records (EHRs) is an intensive, error-prone task that diverts nurses from patient care while adversely affecting job performance and employee satisfaction. METHODS: Performance improvement analytics were used to compare matched sets of manual and automated EHR data entries for 1933 consecutive vital signs records created by 49 RNs and certified nursing assistants in a 23-bed medical-surgical unit at a large tertiary hospital. Performance and quality effects were evaluated via nurses' responses to a postintervention survey. RESULTS: Data errors decreased from approximately 20% to 0; data transfer times were reduced by 5 minutes to 2 hours per measurement event; nurses had more time for direct patient care; and job satisfaction improved. CONCLUSION: Data entry automation eliminates data errors, substantially reduces delays in getting data into EHRs, and improves job satisfaction by giving nurses more time for direct patient care. Findings are associated with improvements in quality, work performance, and job satisfaction, key goals of nursing leaders.


Assuntos
Benchmarking , Registros Eletrônicos de Saúde , Satisfação no Emprego , Processo de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital , California , Unidades Hospitalares , Humanos , Processo de Enfermagem/economia
8.
J Nurs Adm ; 50(1): 22-27, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809453

RESUMO

This article describes a practice improvement initiative (PII) demonstrating the impact of doctorate of nursing practice (DNP) skills beyond direct patient care. The Donna Wright Competency Assessment Model, AACN DNP Essentials, and National Organization of Nurse Practitioner Faculties nurse practitioner competencies framed the PII. The DNP graduates planned, implemented, and evaluated an assessment of 1,055 staff nurses on shift hand-off, physical assessment, and hand hygiene. Results indicated that 95% of the staff nurses scored 100% on competency assessment. The PII model was adopted for future competency evaluation.


Assuntos
Benchmarking , Modelos de Enfermagem , Profissionais de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Humanos , Estados Unidos
10.
Sci Total Environ ; 698: 134251, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31783467

RESUMO

Wild boar populations have increased dramatically over the last decades throughout Europe and in France in particular. While hunting is considered the most efficient way to control game populations, many local conflicts persist after the hunting period due to remaining high densities of wild boar despite the large number of animals culled every year. Therefore, increasing the efficiency of hunting is a timely issue. Herein, we assessed how hunting effort can be measured, and we determined whether the hunting effort carried out by hunters explains the observed hunting pressure. We measured the characteristics and results of all hunts that occurred in the experimental forest of Châteauvillain-Arc-en-Barrois (Northeastern France), and we modelled the number of animals culled as a function of the hunting effort, measured by the number of beaters, hunters, and dogs, as well as the size of the hunting area. We also accounted for variables suspected to affect the hunting efficiency achieved with a given effort, such as time of day (AM/PM), the month during which hunting occurred. We found that more posted hunters, larger hunted areas, and hunts carried out early in the season, i.e. before February, increased the number of culled animals. Our model can be used by wildlife managers to adjust hunting effort in order to reach the hunting pressure expected to meet management objectives.


Assuntos
Animais Selvagens , Conservação dos Recursos Naturais , Animais , Benchmarking , Europa (Continente) , Sus scrofa
11.
Bioresour Technol ; 298: 122558, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31862395

RESUMO

Excessive utilization of fossil fuels has resulted in serious concerns about climate change. Integrating biorefinery technology to convert waste-derived-lignocellulosic biomass into biofuels and biopolymers has become an emerging topic toward our sustainable future. Pretreatment to fractionate the building block chemicals from the biomass is a crucial unit operation to ease the downstream processes in biorefinery. However, application of solvents and chemicals in the process can create many operational and environmental challenges in sensitive areas like highly populated cities. To shed light on how to determine a green biorefinery, this study presents the sustainability metrics of various pretreatment techniques and their operational risks during urbanization. The proposed green indexes include fractionation outputs, chemical recyclability, operational profile, and safety factors. In line with the design principles of lignin valorization, the issue of urban biomass and water-and-energy nexus are addressed to support future development and application of urban biorefinery for municipal waste management.


Assuntos
Benchmarking , Lignina , Biocombustíveis , Biomassa
12.
Metas enferm ; 22(10): 22-27, dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185328

RESUMO

Objetivo: determinar el grado de satisfacción de los usuarios del servicio de hemodiálisis tras una innovación organizacional. Método: estudio descriptivo transversal realizado en usuarios del servicio de hemodiálisis del Hospital de la Santa Creu (Tarragona). Se administró el cuestionario SERVQHOS modificado para hemodiálisis y se comparó la satisfacción reportada previa y posterior al cambio. La comparación de medias se analizó mediante la t de Student para muestras relacionadas. Resultados: de 80 usuarios que cumplían los criterios de inclusión se obtuvieron 43 encuestas válidas. El perfil mayoritario del usuario que contestó fue el de un varón (76,2%), de 71,7 años, sin estudios o con estudios primarios (85,7%), pensionista o jubilado (90,5%). Aunque en la satisfacción global la opción "muy satisfecho" disminuyó un 7,5% después del cambio, el resultado no fue estadísticamente significativo, como tampoco fueron las diferencias de los 20 ítems del cuestionario. Conclusiones: el mantenimiento de la satisfacción obtenido refuerza el aumento de eficiencia alcanzado con el cambio organizativo y confirma factores de éxito en innovación, animando en la búsqueda de estrategias para reducir costes sin comprometer buenos resultados


Objective: to determine the level of satisfaction of the users of the Hemodialysis Unit after an organizational innovation. Method: a descriptive cross-sectional study conducted in users of the Hemodialysis Unit of the Hospital de la Santa Creu (Tarragona). The SERVQHOS questionnaire modified for hemodialysis was administered, and the satisfaction previously reported was compared with the satisfaction after the change. The comparison of means was analyzed through Student's t test for paired samples. Results: out of those 80 users who met the inclusion criteria, 43 valid surveys were obtained. The predominant profile of the user who answered the survey was: male (76.2%), 71.7-year-old, no formal education or primary school completed (85.7%), pensioner or retired (90.5%). Even though in Overall Satisfaction, there was a 7.5% reduction in the "Very Satisfied" option after the change, this result and the differences in the 20 questionnaire items were not statistically significant. Conclusions: the sustained satisfaction achieved reinforces the increase in efficiency reached with the organizational change, and confirms factors of success in innovation, encouraging the search for strategies in order to reduce costs without compromising good results


Assuntos
Humanos , Masculino , Feminino , Idoso , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Satisfação do Paciente , Unidades Hospitalares de Hemodiálise/organização & administração , Inovação Organizacional , Estudos Transversais , Inquéritos e Questionários , Benchmarking
13.
Anticancer Res ; 39(11): 6317-6324, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704862

RESUMO

BACKGROUND/AIM: The aim of this study was to evaluate N-acetylgalactosamine-6-sulfatase (GALNS) as a new biomarker candidate for detecting lung cancer. Glycodelin or PAEP, the serum levels of which are known to be elevated in lung and other cancers, served as a benchmark for comparison. PATIENTS AND METHODS: A total of 170 serum samples from healthy controls and patients with pneumonia, lung cancer, breast cancer, colon cancer, liver cancer, and head and neck cancer were analyzed for the levels of GALNS and PAEP by ELISA. RESULTS: The median serum levels of GALNS and PAEP in all cancer types as well as pneumonia patients were significantly higher than those of the healthy controls. CONCLUSION: In addition to previously known cancers, the median serum levels of PAEP were also found to be higher in liver and head and neck cancer patients. GALNS and PAEP are promising general biomarkers for multiple cancers and deserve further evaluation.


Assuntos
Biomarcadores Tumorais/sangue , Condroitina Sulfatases/sangue , Glicodelina/sangue , Neoplasias Pulmonares/sangue , Área Sob a Curva , Benchmarking , Neoplasias da Mama/sangue , Estudos de Casos e Controles , Linhagem Celular Tumoral , Neoplasias do Colo/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Neoplasias de Cabeça e Pescoço/sangue , Humanos , Neoplasias Hepáticas/sangue , Pulmão/metabolismo , Neoplasias Pulmonares/diagnóstico , Masculino , Pneumonia/sangue
15.
Genome Biol ; 20(1): 202, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31594544

RESUMO

BACKGROUND: A series of miRNA-disease association prediction methods have been proposed to prioritize potential disease-associated miRNAs. Independent benchmarking of these methods is warranted to assess their effectiveness and robustness. RESULTS: Based on more than 8000 novel miRNA-disease associations from the latest HMDD v3.1 database, we perform systematic comparison among 36 readily available prediction methods. Their overall performances are evaluated with rigorous precision-recall curve analysis, where 13 methods show acceptable accuracy (AUPRC > 0.200) while the top two methods achieve a promising AUPRC over 0.300, and most of these methods are also highly ranked when considering only the causal miRNA-disease associations as the positive samples. The potential of performance improvement is demonstrated by combining different predictors or adopting a more updated miRNA similarity matrix, which would result in up to 16% and 46% of AUPRC augmentations compared to the best single predictor and the predictors using the previous similarity matrix, respectively. Our analysis suggests a common issue of the available methods, which is that the prediction results are severely biased toward well-annotated diseases with many associated miRNAs known and cannot further stratify the positive samples by discriminating the causal miRNA-disease associations from the general miRNA-disease associations. CONCLUSION: Our benchmarking results not only provide a reference for biomedical researchers to choose appropriate miRNA-disease association predictors for their purpose, but also suggest the future directions for the development of more robust miRNA-disease association predictors.


Assuntos
Biologia Computacional/métodos , Doença/genética , MicroRNAs , Benchmarking , Bases de Dados Genéticas
17.
Genome Biol ; 20(1): 205, 2019 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-31597556
18.
Genome Biol ; 20(1): 213, 2019 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-31639029

RESUMO

BACKGROUND: Accurate fusion transcript detection is essential for comprehensive characterization of cancer transcriptomes. Over the last decade, multiple bioinformatic tools have been developed to predict fusions from RNA-seq, based on either read mapping or de novo fusion transcript assembly. RESULTS: We benchmark 23 different methods including applications we develop, STAR-Fusion and TrinityFusion, leveraging both simulated and real RNA-seq. Overall, STAR-Fusion, Arriba, and STAR-SEQR are the most accurate and fastest for fusion detection on cancer transcriptomes. CONCLUSION: The lower accuracy of de novo assembly-based methods notwithstanding, they are useful for reconstructing fusion isoforms and tumor viruses, both of which are important in cancer research.


Assuntos
Fusão Gênica , Genômica/métodos , Neoplasias/metabolismo , Software , Transcriptoma , Benchmarking , Neoplasias/genética , Análise de Sequência de RNA
19.
Genome Biol ; 20(1): 208, 2019 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-31639030

RESUMO

BACKGROUND: Human tissue is increasingly being whole genome sequenced as we transition into an era of genomic medicine. With this arises the potential to detect sequences originating from microorganisms, including pathogens amid the plethora of human sequencing reads. In cancer research, the tumorigenic ability of pathogens is being recognized, for example, Helicobacter pylori and human papillomavirus in the cases of gastric non-cardia and cervical carcinomas, respectively. As of yet, no benchmark has been carried out on the performance of computational approaches for bacterial and viral detection within host-dominated sequence data. RESULTS: We present the results of benchmarking over 70 distinct combinations of tools and parameters on 100 simulated cancer datasets spiked with realistic proportions of bacteria. mOTUs2 and Kraken are the highest performing individual tools achieving median genus-level F1 scores of 0.90 and 0.91, respectively. mOTUs2 demonstrates a high performance in estimating bacterial proportions. Employing Kraken on unassembled sequencing reads produces a good but variable performance depending on post-classification filtering parameters. These approaches are investigated on a selection of cervical and gastric cancer whole genome sequences where Alphapapillomavirus and Helicobacter are detected in addition to a variety of other interesting genera. CONCLUSIONS: We provide the top-performing pipelines from this benchmark in a unifying tool called SEPATH, which is amenable to high throughput sequencing studies across a range of high-performance computing clusters. SEPATH provides a benchmarked and convenient approach to detect pathogens in tissue sequence data helping to determine the relationship between metagenomics and disease.


Assuntos
Metagenômica/métodos , Neoplasias/microbiologia , Sequenciamento Completo do Genoma , Alphapapillomavirus/isolamento & purificação , Benchmarking , Helicobacter/isolamento & purificação , Humanos
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