DNA polymerase theta-mediated DNA repair is a functional dependency and therapeutic vulnerability in DNMT3A deficient leukemia cells.

Myeloid malignancies carrying somatic DNMT3A mutations (DNMT3Amut) are usually resistant to standard therapy. DNMT3Amut leukemia cells accumulate toxic DNA double strand breaks (DSBs) and collapsed replication forks, rendering them dependent on DNA damage response (DDR). DNA polymerase theta (Polθ), a key element in Polθ-mediated DNA end-joining (TMEJ), is essential for survival and proliferation of DNMT3Amut leukemia cells.

Deep learning supported machine vision system to precisely automate the wild blueberry harvester header.

An operator of a wild blueberry harvester faces the fatigue of manually adjusting the height of the harvester's head, considering spatial variations in plant height, fruit zone, and field topography affecting fruit yield. For stress-free harvesting of wild blueberries, a deep learning-supported machine vision control system has been developed to detect the fruit height and precisely auto-adjust the header picking teeth rake position. The OpenCV AI Kit (OAK-D) was used with YOLOv4-tiny deep learning model with code developed in Python to solve the challenge of matching fruit heights with the harvester's head position.

The case for a population standardized infection ratio (SIR): A metric that marries the device SIR to the standardized utilization ratio (SUR).

Background: The device standardized infection ratio (SIR) is used to compare unit and hospital performance for different publicly reported infections. Interventions to reduce unnecessary device use may select a higher-risk population, leading to a paradoxical increase in SIR for some high-performing facilities. The standardized utilization ratio (SUR) adjusts for device use for different units and facilities.

Taking advantage of public reporting: An infection composite score to assist evaluating hospital performance for infection prevention efforts.

Background: The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance.

Methods: We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical site infections, and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections.

Compounding pharmacy conundrum: "we cannot live without them but we cannot live with them" according to the present paradigm.

Compounding pharmacies serve a critical role in modern health care to meet special patient care needs. Although the US Food and Drug Administration (FDA) has clearly delineated jurisdiction over drug companies and products manufactured under Good Manufacturing Practice (GMP) regulations to ensure quality, potency, and purity, compounding pharmacies are regulated by the State Boards and are not registered by the FDA. In recent years, some compounding pharmacies acted like a manufacturer, preparing large amounts of injectable drugs with interstate activities.

Clinical quality is independently associated with favorable bond ratings.

The relation between clinical quality and bond rating for nonprofit hospitals has been proposed but never fully studied. We analyzed the relation between bond rating, clinical quality measures (The Joint Commission/Centers for Medicare and Medicaid Services [CMS] core measures), and balance sheet and income statement financial measures of 236 hospitals across the United States that are rated by Moody's Investors Service and that reported clinical quality measures to CMS during the study period. We found a statistically significant relation between higher quality measures and more favorable bond ratings.

Accelerating best care at baylor dallas.

A culture of quality improvement (QI) is needed to bridge the gap between possible STEEEP (safe, timely, effective, efficient, equitable, and patient-centered) care and actual usual care. Baylor Health Care System (BHCS) developed Accelerating Best Care at Baylor (ABC Baylor), an innovative educational program that teaches health care leaders the theory and techniques of rapid-cycle QI. Course participants learn general principles of continuous QI, as well as health care-specific QI techniques, and finish the course by designing and implementing their own QI project.

A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

Objective: To investigate the effectiveness of a quality improvement educational program in rural hospitals.

Design: Hospital-randomized controlled trial.

Participants: A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool.

Linking joint commission inpatient core measures and national patient safety goals with evidence.

As an initiative of Baylor Health Care System's Best Care Committee, we summarized the association between the Joint Commission's hospital core measures/safety goals and patient outcomes. This summary (which will be formatted as a small, laminated card) can be used by change leaders to communicate the relevance of clinical quality goals. By disseminating this evidence broadly, we aim to further invest clinical staff in delivery of specific care processes, maximize care efforts related to core measures, and extend quality improvement efforts within our organization.

The effects of interdisciplinary outpatient geriatrics on the use, costs and quality of health services in the fee-for-service environment.

Background And Aims: To evaluate the effect of interdisciplinary outpatient geriatrics on the use, cost, and quality of health services in a fee-for-service (FFS) environment of two networks of primary care clinics operated by a not-for-profit provider organization in Dallas County, Texas.

Methods: The Senior Health Network (SHN) provides interdisciplinary primary care to patients aged 55 years or older; the Health Texas Provider Network (HTPN) provides "usual" primary care to patients of all ages. We conducted a two-year retrospective cohort study of 13,098 fee-for-service Medicare beneficiaries who had 2+ visits to one of the networks in 2000.

Challenges in conducting a hospital-randomized trial of an educational quality improvement intervention in rural and small community hospitals.

The study design for this hospital-randomized controlled trial of an educational quality improvement intervention in rural and small community hospitals, following the implementation of a Web-based quality benchmarking and case review tool, specified a control group and a rapid-cycle quality improvement education group of >or= 30 hospitals each. Of the 64 hospitals initially interested in participating, 7 could not produce the required quality data and 10 refused consent to randomization. Of the 23 hospitals randomized to the educational intervention, 16 completed the educational program, 1 attended the didactic sessions but did not complete the required quality improvement project, 3 enrolled in "make-up" sessions, and 3 were unable to attend.

Risk factors for 30-day hospital readmission in patients ≥65 years of age.

The objective of the study was to develop and validate predictors of 30-day hospital readmission using readily available administrative data and to compare prediction models that use alternate comorbidity classifications. A retrospective cohort study was designed; the models were developed in a two-thirds random sample and validated in the remaining one-third sample. The study cohort consisted of 29,292 adults aged 65 or older who were admitted from July 2002 to June 2004 to any of seven acute care hospitals in the Dallas-Fort Worth metropolitan area affiliated with the Baylor Health Care System.

Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills.

A hospital-randomized controlled trial of an educational quality improvement intervention in rural and small community hospitals in Texas following implementation of information technology.

Rural and small community hospitals typically have few resources and little experience with quality improvement (QI) and, on average, demonstrate poorer quality of care than larger facilities. Formalized QI education shows promise in improving quality, but little is known about its effect in rural and small community hospitals. The authors describe a randomized controlled trial assigning 47 rural and small community Texas hospitals to such a program (n = 23) or to the control group (n = 24), following provision of a Web-based quality benchmarking and case review tool.

Effectiveness of diabetes resource nurse case management and physician profiling in a fee-for-service setting: a cluster randomized trial.

Nurses with advanced training-diabetes resource nurses (DRNs)-can improve care for people with diabetes in capitated payment settings. Their effectiveness in fee-for-service settings has not been investigated. We conducted a 12-month practice-randomized trial involving 22 practices in a fee-for-service metropolitan network with 92 primary care physicians caring for 1891 Medicare patients ≥65 years with diabetes mellitus.

Quality of care of Medicare patients with diabetes in a metropolitan fee-for-service primary care integrated delivery system.

Diabetes care in the United States is suboptimal. Although closed-panel health maintenance organizations (HMOs) and the Department of Veterans Affairs (VA) report performance superior to national norms, fee-for-service performance is uncertain. To address this issue, 3 outcome and 5 process indicators were measured for 2010 Medicare diabetes patients across 22 sites in a large, fee-for-service primary care group practice.

Differences in end-of-life preferences between congestive heart failure and dementia in a medical house calls program.

Objectives: To compare end-of-life preferences in elderly individuals with dementia and congestive heart failure (CHF).

Design: Retrospective case-control study.

Setting: Geriatrician-led interdisciplinary house-call program using an electronic medical record.

Early repolarization: an electrocardiographic predictor of enhanced aerobic fitness.

The presence or absence of early repolarization on the electrocardiogram at rest was correlated with aerobic exercise capacity in healthy volunteers from the Baltimore Longitudinal Study of Aging. Patients with early repolarization had both longer treadmill exercise duration and higher peak oxygen consumption than age-and gender-matched control subjects.

The relationship between aerobic exercise capacity and circulating IGF-1 levels in healthy men and women.

Objectives: To determine whether aerobic capacity is associated independently with insulin-like growth factor-I (IGF-1) levels in healthy community-dwelling men and women.

Setting: The Baltimore Longitudinal Study on Aging (BLSA).

Design: A cross-sectional analysis of data from the population-based cohort of the Baltimore Longitudinal Study of Aging (BLSA).