bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the discharge process by embedding a discharge facilitator in a resident team
Authors: Finn Kathleen M. , Heffner Rebecca , Chang Yuchiao , Bazari Hasan , Hunt Daniel , Pickell Karen , Berube Rhodes , Raju Shveta , Farrell Elizabeth , Iyasere Christiana , Thompson Ryan , O'Malley Terrence , O'Donnell Walter , Karson Andrew 
Published: October 2011

AbstractBACKGROUND:Hospital discharges are vulnerable periods for patient safety, especially in teaching hospitals where discharges are done by residents with competing demands. We sought to assess whether embedding a nurse practitioner on a medical team to help physicians with the discharge process would improve communication, patient follow‐up, and hospital reutilization.METHODS:A 5‐month randomized controlled trial was conducted on the medical service at an academic tertiary‐care hospital. A nurse practitioner was randomly assigned to 1 resident team to complete discharge paperwork, arrange follow‐up appointments and prescriptions, communicate discharge plans with nursing and primary care physicians, and answer questions from discharged patients.RESULTS:Intervention patients had more discharge summaries completed within 24 hours (67% vs 47%, P < 0.001). Similarly, they had more follow‐up appointments scheduled by the time of discharge (62% vs 36%, P < 0.0001) and attended those appointments more often within 2 weeks (36% vs 23%, P < 0.0002). Intervention patients knew whom to call with questions (95% vs 85%, P = 0.003) and were more satisfied with the discharge process (97% vs 76%, P < 0.0001). Attending rounds on the intervention team finished on time (45% vs 31%, P = 0.058), and residents signed out on average 46 minutes earlier each day. There was no significant difference between the groups in 30‐day emergency department visits or readmissions.CONCLUSIONS:Helping resident physicians with the discharge process improves many aspects of discharge communication and patient follow‐up, and saves residents' time, but had no effect on hospital reutilization for a general medicine population. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine.
Behaviors of successful interdisciplinary hospital quality improvement teams
Authors: Santana Calie , Curry Leslie A. , Nembhard Ingrid M. , Berg David N. , Bradley Elizabeth H. 
Published: October 2011

AbstractBACKGROUND:Although interdisciplinary hospital quality improvement (QI) teams are both prevalent and associated with success of (QI) efforts, little is known about the behaviors of successful interdisciplinary QI teams.OBJECTIVE:We examined the specific behaviors of interdisciplinary QI teams in hospitals that successfully redesigned care for patients with ST‐elevation myocardial infarction (STEMI) and reduced door‐to‐balloon times.DESIGN:Qualitative study.PARTICIPANTS:Researchers interviewed 122 administrators, providers, and staff in 11 hospitals with substantial improvements in door‐to‐balloon times.MEASUREMENTS:Using data from the in‐depth qualitative interviews, the authors identified themes that described the behaviors of interdisciplinary QI teams in successful hospitals.RESULTS:Teams focused on 5 behaviors: (1) motivating involved hospital staff toward a shared goal, (2) creating opportunities for learning and problem‐solving, (3) addressing the impact of changes to care processes on staff, (4) protecting the integrity of the new care processes, and (5) representing each involved clinical discipline effectively.CONCLUSIONS:The behaviors observed may enhance a QI team's ability to motivate the various disciplines involved, understand the care process they must change, be responsive to front‐line concerns while maintaining control over the improvement process, and share information across all levels of the hospital hierarchy. Teams in successful hospitals did not avoid interdisciplinary conflict, but rather allowed each discipline to contribute to the team from its own perspective. Successful QI teams addressed the concerns of each involved discipline, modified protocols guided by clinical outcomes, and became conduits of information on changes to care processes to both executive managers and front‐line staff. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine
Hospital quality and patient safety competencies: Development, description, and recommendations for use
Authors: O'Leary Kevin J. , Afsar‐manesh Nasim , Budnitz Tina , Dunn Andrew S. , Myers Jennifer S. 
Published: October 2011

AbstractBACKGROUND:Hospitalists are poised to have a tremendous impact on improving the quality of care for hospitalized patients. However, many hospitalists are inadequately prepared to engage in efforts to improve quality, because medical schools and residency programs have not traditionally emphasized healthcare quality and patient safety in their curricula.METHODS:Through a multistep process, the Society of Hospital Medicine (SHM) Quality Improvement Education (QIE) subcommittee developed the Hospital Quality and Patient Safety (HQPS) Competencies to provide a framework for developing and assessing curricula and other professional development experiences. This article describes the development, provides definitions, and makes recommendations on the use of the HQPS Competencies.RESULTS:The 8 areas of competence include: Quality Measurement and Stakeholder Interests, Data Acquisition and Interpretation, Organizational Knowledge and Leadership Skills, Patient Safety Principles, Teamwork and Communication, Quality and Safety Improvement Methods, Health Information Systems, and Patient Centeredness. Reflecting differing levels of hospitalist involvement in healthcare quality, 3 levels of expertise within each area of competence have been established: basic, intermediate, and advanced. Standards for each competency area use carefully selected action verbs to reflect educational goals for hospitalists at each level.CONCLUSIONS:Formal incorporation of the HQPS Competencies into professional development programs, and innovative educational initiatives and curricula, will help provide current hospitalists and the next generations of hospitalists with the needed skills to be successful. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine
Interdisciplinary teamwork in hospitals: A review and practical recommendations for improvement
Authors: O'Leary Kevin J. , Sehgal Niraj L. , Terrell Grace , Williams Mark V. ,   for the High Performance Teams and the Hospital of the Future Project Team
Published: October 2011

AbstractRecognizing the importance of teamwork in hospitals, senior leadership from the American College of Physician Executives (ACPE), the American Hospital Association (AHA), the American Organization of Nurse Executives (AONE), and the Society of Hospital Medicine (SHM) established the High Performance Teams and the Hospital of the Future project. This collaborative learning effort aims to redesign care delivery to provide optimal value to hospitalized patients. With input from members of this initiative, we prepared this report which reviews the literature related to teamwork in hospitals. Teamwork is critically important to provide safe and effective hospital care. Hospitals with high teamwork ratings experience higher patient satisfaction, higher nurse retention, and lower hospital costs. Elements of effective teamwork have been defined and provide a framework for assessment and improvement efforts in hospitals. Measurement of teamwork is essential to understand baseline performance, and to demonstrate the utility of resources invested to enhance it and the subsequent impact on patient care. Interventions designed to improve teamwork in hospitals include localization of physicians, daily goals of care forms and checklists, teamwork training, and interdisciplinary rounds. Though additional research is needed to evaluate the impact on patient outcomes, these interventions consistently result in improved teamwork knowledge, ratings of teamwork climate, and better understanding of patients' plans of care. The optimal approach is implementation of a combination of interventions, with adaptations to fit unique clinical settings and local culture. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine
Patient satisfaction with hospital care provided by hospitalists and primary care physicians
Authors: Seiler Adrianne , Visintainer Paul , Brzostek Richard , Ehresman Michael , Benjamin Evan , Whitcomb Winthrop , Rothberg Michael B. 
Published: October 2011

AbstractBACKGROUND:Compared to hospital care provided by primary care physicians (PCPs), the hospitalist model provides equal‐to‐superior efficiency and outcomes; however, little is known about how the model affects patient satisfaction.METHODS:Random patient satisfaction telephone interviews were conducted on discharged adult medicine inpatients at 3 Massachusetts hospitals between 2003 and 2009. Questionnaires included variables assessing patient satisfaction with various physician care domains. Patient age, gender, admission year, education level, language, illness severity, emergency room admission status, institution, and attending physician type were extracted from billing records. We used adjusted multivariable models to compare patient satisfaction with hospitalists and PCPs for domains of: physician care quality, physician behavior, pain management, communication.RESULTS:Inpatients completed discharge surveys for 8295 encounters (3597 hospitalist, 4698 PCP). Multivariate‐adjusted satisfaction scores for physician care quality were slightly higher for PCPs than hospitalists (4.24 vs 4.20, P = 0.04); there was no statistical difference at any individual hospital, and no difference among different hospitalist groups. Patient ratings of hospitalists and PCPs for behavior, pain control, and communication were equivalent (all P values >0.23). In multivariable models, hospitalists and PCPs had similar adjusted proportions in the highest satisfaction category (79.2% vs 80.5%, respectively, P = 0.17) and lowest category (5.1% vs 4.5%, respectively, P = 0.19). Quality ratings of both groups improved equivalently (P slope interaction = 0.47) but significantly over time (PCP 4.21 (2003) to 4.36 (2009), hospitalist 4.11 to 4.33, P Δ <0.001).CONCLUSIONS:Patients appear similarly satisfied with inpatient care provided by several hospitalist models and by primary care physicians. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine.
Early in vivo changes in calcium ions, oxidative stress markers, and ion channel immunoreactivity following partial injury to the optic nerve
Authors: Wells Jonathan , Kilburn Matthew R. , Shaw Jeremy A. , Bartlett Carole A. , Harvey Alan R. , Dunlop Sarah A. , Fitzgerald Melinda 
Published: October 2011

AbstractCNS injury is often localized but can be followed by more widespread secondary degenerative events that usually result in greater functional loss. Using a partial transection model in rat optic nerve (ON). we recently demonstrated in vivo increases in the oxidative stress‐associated enzyme MnSOD 5 min after injury. However, mechanisms by which early oxidative stress spreads remain unclear. In the present study, we assessed ion distributions, additional oxidative stress indicators, and ion channel immunoreactivity in ON in the first 24 hr after partial transection. Using nanoscale secondary ion mass spectroscopy (NanoSIMS), we demonstrate changes in the distribution pattern of Ca ions following partial ON transection. Regions of elevated Ca ions in normal ON in vivo rapidly decrease following partial ON transection, but there is an increasingly punctate distribution at 5 min and 24 hr after injury. We also show rapid decreases in catalase activity and later increases in immunoreactivity of the advanced glycation end product carboxymethyl lysine in astrocytes. Increased oxidative stress in astrocytes is accompanied by significantly increased immunoreactivity of the AMPA receptor subunit GluR1 and aquaporin 4 (AQP4). Taken together, the results indicate that Ca ion changes and oxidative stress are early events following partial ON injury that are associated with changes in GluR1 AMPA receptor subunits and altered ionic balance resulting from increased AQP4. © 2011 Wiley Periodicals, Inc.
Effect of 25‐hydroxyvitamin D3 and 1 α,25 dihydroxyvitamin D3 on differentiation and apoptosis of human osteosarcoma cell lines
Authors: Thompson Lindsey , Wang Shanshan , Tawfik Ossama , Templeton Kimberly , Tancabelic Jakica , Pinson David , Anderson H. Clarke , Keighley John , Garimella Rama 
Published: October 2011

AbstractOsteosarcoma (OS) is a malignant bone tumor predominantly affecting children and adolescents. OS has a 60% survival rate with current treatments; hence, there is a need to identify novel adjuncts to chemotherapeutic regimens. In this pilot study, we investigated the dose‐response to 1α,25‐dihdroxyvitamin D3 (1,α 25(OH)2D3) and 25‐hydroxyvitamin D3 (25(OH)D3) by human OS cell lines, SaOS‐2, and 143B. We hypothesized that 1,α 25(OH)2D3 and 25(OH)D3 would stimulate differentiation and induce apoptosis in OS cells in a dose‐dependent manner. Human OS cell lines, SaOS‐2, and 143B, were treated with 1,α 25(OH)2D3 or 25(OH)D3 or an ethanol control, respectively, at concentrations ranging from 1 to 1,000 nM. Ki67 (a marker of cellular proliferation) immunocytochemistry revealed no significant changes in the expression of Ki‐67 or MIB‐1 in 1α,25(OH)2D3 or 25(OH)D3 treated SaOS‐2 or 143B cells. Both control and 1α,25(OH)2D3 treated SaOS‐2 and 143B cells expressed vitamin D receptor (VDR). Markers of osteoblastic differentiation in 143B cells and SaOS‐2 cells were induced by both 25(OH)D3 and 1α,25(OH)2D, and evident by increases in alkaline phosphatase (ALP) activity, osteocalcin (OCN) mRNA expression, and mineralization of extra‐cellular matrix (ECM) by alizarin red staining. An increasing trend in apoptosis in response to 25(OH)D3, in both SaOS‐2 and 143B cells was detected by terminal deoxynucleotidyl transferase (TdT)‐mediated dUTP nick end labeling (TUNEL) staining. With 1α,25(OH)2D3 treatment, apoptosis was evident at higher concentrations only. These preliminary findings suggest that OS cells express VDR and respond to 25(OH)D3 and 1α,25(OH)2D3 by undergoing differentiation and apoptosis. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:831–844, 2012
An efficient combination of supercritical fluid extraction and high‐speed counter‐current chromatography to extract and purify (E)‐ and (Z)‐diastereomers of α‐asarone and β‐asarone from Acorus tatarinowii Schott
Authors: Wang Daijie , Geng Yanling , Fang Lei , Shu Xikai , Liu Jianhua , Wang Xiao , Huang Luqi 
Published: October 2011

AbstractIn this study, supercritical fluid extraction (SFE) was used to extract essential oil from Acorus tatarinowii Schott under the pressure of 25 MPa and temperature of 35°C. Two (E)‐ and (Z)‐diastereomers of α‐asarone and β‐asarone were separated and purified by high‐speed counter‐current chromatography (HSCCC) with a two‐phase solvent system composed of n‐hexane–ethyl acetate–methanol–water (1:0.2:1:0.3, v/v). The separation yielded a total of 39 mg of α‐asarone and 463 mg of β‐asarone from 1.0 g of essential oil in one‐step separation with the purity of 98.9 and 99.1%, respectively, as determined by HPLC. The chemical structures of these compounds were identified by EI‐MS, 1H‐, and 13C‐NMR.
P‐Stereogenic Optically Active Polymer and the Complexation Behavior
Authors: Morisaki Yasuhiro , Suzuki Kentaro , Imoto Hiroaki , Chujo Yoshiki 
Published: October 2011

AbstractThe synthetic details of the P‐stereogenic optically active polymer and the complexation behavior with palladium and platinum complexes are reported. The polymer consists of P‐stereogenic bisphosphine units and the conjugated phenylene‐ethynylene units alternately. The P‐stereogenic bisphosphine moieties can coordinate to transition metals such as palladium and platinum, leading to a change in the conformation.
Polymers for Anion Recognition and Sensing
Authors: Rostami Ali , Taylor Mark S. 
Published: October 2011

AbstractIn biological systems, the selective and high‐affinity recognition of anionic species is accomplished by macromolecular hosts (anion‐binding proteins) that have been “optimized” through evolution. Surprisingly, it is only recently that chemists have systematically attempted to develop anion‐responsive synthetic macromolecules for potential applications in medicine, national security, or environmental monitoring. Recent results indicating that unique features of polymeric systems such as signal amplification, multivalency, and cooperative behavior may be exploited productively in the context of anion recognition and sensing are documented. The wide variety of interactions—including Lewis acid/base, ion‐pairing, and hydrogen bonding—that have been employed for this purpose is reflected in the structural diversity of anion‐responsive macromolecules identified to date.
Narrow band gap D–A copolymer of indacenodithiophene and diketopyrrolopyrrole with deep HOMO level: Synthesis and application in field‐effect transistors and polymer solar cells
Authors: Wang Xiaochen , Luo Hao , Sun Yeping , Zhang Maojie , Li Xiaoyu , Yu Gui , Liu Yunqi , Li Yongfang , Wang Haiqiao 
Published: October 2011

AbstractA novel fused ladder alternating D–A copolymer, PIDT–DPP, with alkyl substituted indacenodithiophene (IDT) as donor unit and diketopyrrolopyrrole (DPP) as acceptor unit, was designed and synthesized by Pd‐catalyzed Stille‐coupling method. The copolymer showed good solubility and film‐forming ability combining with good thermal stability. PIDT–DPP exhibited a broad absorption band from 350 to 900 nm with an absorption peak centered at 735 nm. The optical band gap determined from the onset of absorption of the polymer film was 1.37 eV. The highest occupied molecular orbital level of the polymer is as deep as −5.32 eV. The solution‐processed organic field‐effect transistor (OFETs) was fabricated with bottom gate/top contact geometry. The highest FET hole mobility of PIDT–DPP reached 0.065 cm2 V−1 s−1 with an on/off ratio of 4.6 × 105. This mobility is one of the highest values for narrow band gap conjugated polymers. The power conversion efficiency of the polymer solar cell based on the polymer as donor was 1.76% with a high open circuit voltage of 0.88 V. To the best of our knowledge, this is the first report on the photovoltaic properties of alkyl substituted IDT‐based polymers. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2012
Concepts for a pattern‐oriented analysis ensemble based on observational uncertainties
Authors: Gorgas T. , Dorninger M. 
Published: October 2011

AbstractThe idea is proposed of an analysis ensemble of deterministic, model‐independent analyses. The ensemble is based on random perturbations of irregularly distributed observations. The purpose of implementing an analysis ensemble is to define uncertainties in analysis fields due to their observational background and errors. As one possible application, the uncertainty information could, in future, be used to define confidence intervals for verification measures depending on the reference data. The analysis system VERA and a high‐resolution Central European observation network are used as a testbed for the development of the methodology. Several approaches for defining weights for the perturbation fields are investigated and compared. Basic weights are determined by a sophisticated data quality control scheme producing error estimates for observations. These estimates can be combined with additional information attempting to include more explicitly the spatial structure of the observed fields in the ensemble. The information is provided by either a principal component analysis of a time series of analysis fields or a 2D‐discrete wavelet transform. Strengths and weaknesses of the different adjustments for ensemble analysis perturbations are discussed. It is shown that perturbations provided by the wavelet‐based approach lead to useful results for several meteorological parameters tested. Copyright © 2011 Royal Meteorological Society
A semi‐implicit non‐hydrostatic dynamical kernel using finite elements in the vertical discretization
Authors: Simarro Juan , Hortal Mariano 
Published: October 2011

AbstractThis work is a first step in the direction of implementing a high‐order finite‐element discretization in the vertical in the non‐hydrostatic version of the HARMONIE model. The present dynamical core of the HARMONIE model is shared with the ECMWF and the ALADIN models and uses a horizontal spectral discretization and a semi‐implicit semi‐Lagrangian time stepping scheme, all of which are maintained in this work. Trying to implement a finite‐element discretization in the non‐hydrostatic version of the HARMONIE model has been found to be very difficult due to the set of prognostic variables used and the mass‐based vertical coordinate. A different set of prognostic variables and a hybrid vertical coordinate based on height are tested here on a vertical slice non‐hydrostatic kernel. A stability analysis of the linear model has been done. To evaluate the model stability and accuracy, a set of test cases from the literature are presented in the linear and nonlinear regimes, with and without orography. An iterative centred‐implicit scheme can be applied to avoid instability related to steep orography, although this reduces the efficiency of the model. The novel aspects with respect to existing non‐hydrostatic model kernels are the use of cubic finite elements in the vertical discretization, the use of a height‐based vertical coordinate in conjunction with a spectral discretization in the horizontal, and the coordinate‐independent formulation of each element of the model including the semi‐Lagrangian advection. Copyright © 2011 Royal Meteorological Society
The adsorption of CO2, H2CO3, HCO3− and CO32− on Cu2O (111) surface: First‐principles study
Authors: Wu Huanwen , Zhang Ning , Cao Zhiji , Wang Hongming , Hong Sanguo 
Published: October 2011

AbstractThe adsorption of CO2, and its derivatives, H2CO3, HCO, and CO, on Cu2O (111) surface has been investigated by first‐principles calculations based on the density functional theory at B3LYP hybrid functional level. The Cu2O (111) surface has been modeled using an embedded cluster method,in which the quantum clusters plus some ab initio ion model potentials were inserted in an array of point charges. On the surface, H2CO3 was dissociated into an H+ and an HCO ion. Among the CO2 species, HCO was the only activated species on the surface. The results suggest that the reduction of CO2 on Cu2O (111) surface can start from the form of HCO. © 2011 Wiley Periodicals, Inc. Int J Quantum Chem, 2011
Carbohydrate force fields
Authors: Foley B. Lachele , Tessier Matthew B. , Woods Robert J. 
Published: October 2011

AbstractCarbohydrates present a special set of challenges to the generation of force fields. First, the tertiary structures of monosaccharides are complex merely by virtue of their exceptionally high number of chiral centers. In addition, their electronic characteristics lead to molecular geometries and electrostatic landscapes that can be challenging to predict and model. The monosaccharide units can also interconnect in many ways, resulting in a large number of possible oligosaccharides and polysaccharides, both linear and branched. These larger structures contain a number of rotatable bonds, meaning they potentially sample an enormous conformational space. This article briefly reviews the history of carbohydrate force fields, examining and comparing their challenges, forms, philosophies, and development strategies. Then it presents a survey of recent uses of these force fields, noting trends, strengths, deficiencies, and possible directions for future expansion. © 2011 John Wiley & Sons, Ltd.This article is categorized under:

Molecular and Statistical Mechanics > Molecular Mechanics