The influence of a Sprint optimization and training intervention on time spent in the electronic health record (EHR).

Objective: We report the influence of Sprint electronic health record (EHR) training and optimization on clinician time spent in the EHR.

Materials And Methods: We studied the Sprint process in one academic internal medicine practice with 26 providers. Program offerings included individualized training sessions, and the ability to clean up, fix, or build new EHR tools during the 2-week intervention.

Multidisciplinary Sprint Program Achieved Specialty-Specific EHR Optimization in 20 Clinics.

Objective: The objective of the study was to highlight and analyze the outcomes of software configuration requests received from Sprint, a comprehensive, clinic-centered electronic health record (EHR) optimization program.

Methods: A retrospective review of 1,254 Sprint workbook requests identified (1) the responsible EHR team, (2) the clinical efficiency gained from the request, and (3) the EHR intervention conducted.

Results: Requests were received from 407 clinicians and 538 staff over 31 weeks of Sprint.

Clinical informatics accelerates health system adaptation to the COVID-19 pandemic: examples from Colorado.

Objective: Large health systems responding to the coronavirus disease 2019 (COVID-19) pandemic face a broad range of challenges; we describe 14 examples of innovative and effective informatics interventions.

Materials And Methods: A team of 30 physician and 17 nurse informaticists with an electronic health record (EHR) and associated informatics tools.

Results: To meet the demands posed by the influx of patients with COVID-19 into the health system, the team built solutions to accomplish the following goals: 1) train physicians and nurses quickly to manage a potential surge of hospital patients; 2) build and adjust interactive visual pathways to guide decisions; 3) scale up video visits and teach best-practice communication; 4) use tablets and remote monitors to improve in-hospital and posthospital patient connections; 5) allow hundreds of physicians to build rapid consensus; 6) improve the use of advance care planning; 7) keep clinicians aware of patients' changing COVID-19 status; 8) connect nurses and families in new ways; 9) semi-automate Crisis Standards of Care; and 10) predict future hospitalizations.

Optimization Sprints: Improving Clinician Satisfaction and Teamwork by Rapidly Reducing Electronic Health Record Burden.

Objective: To evaluate a novel clinic-focused Sprint process (an intensive team-based intervention) to optimize electronic health record (EHR) efficiency.

Methods: An 11-member team including 1 project manager, 1 physician informaticist, 1 nurse informaticist, 4 EHR analysts, and 4 trainers worked in conjunction with clinic leaders to conduct on-site EHR and workflow optimization for 2 weeks. The Sprint intervention included clinician and staff EHR training, building specialty-specific EHR tools, and redesigning teamwork.

Dynamic recruitment of microRNAs to their mRNA targets in the regenerating liver.

Background: Validation of physiologic miRNA targets has been met with significant challenges. We employed HITS-CLIP to identify which miRNAs participate in liver regeneration, and to identify their target mRNAs.

Results: miRNA recruitment to the RISC is highly dynamic, changing more than five-fold for several miRNAs.

An evaluation of the SPIFE 3000 semi-automated gel electrophoresis system for the identification of hemoglobin variants and comparison of relative electrophoretic mobilities with manual gel electrophoresis methods.

Laboratory identification of hemoglobin (Hb) variants can involve multiple techniques. The use of semi-automated instruments that perform gel electrophoresis and staining, such as the SPIFE 3000 electrophoresis system, can greatly reduce the labor required for these commonly used techniques. We performed a comparison of the method involved in SPIFE 3000 system with those of manual gel electrophoresis.

Immunogenic properties of plant-derived recombinant smallpox vaccine candidate pB5.

The extracellular virion membrane protein B5 is a potent inducer of immune responses capable of protecting mice and primates against poxvirus infections. Here, we examined the antibody response induced in mice immunized intramuscularly (i.m.

Hb Jeddah [alpha68(E17)Asn-->His (alpha1)]: a newly recognized alpha chain variant, seen in combination with Hb S [beta6(A3)Glu-->Val], and found in three separate families of middle eastern origin.

We report a previously unrecognized alpha chain variant identified in three families from Saudi Arabia, Yemen and Abu Dhabi. The index patient presented for hemoglobinopathy screening and was identified to have both this novel alpha chain variant and Hb S [beta6(A3)Glu-->Val, GAG(-->)GTG]. Hb Jeddah results from a point mutation (AAC(-->)CAC) at codon 68 in exon 2 of the alpha1 gene.

Smallpox subunit vaccine produced in Planta confers protection in mice.

We report here the in planta production of the recombinant vaccinia virus B5 antigenic domain (pB5), an attractive component of a subunit vaccine against smallpox. The antigenic domain was expressed by using efficient transient and constitutive plant expression systems and tested by various immunization routes in two animal models. Whereas oral administration in mice or the minipig with collard-derived insoluble pB5 did not generate an anti-B5 immune response, intranasal administration of soluble pB5 led to a rise of B5-specific immunoglobulins, and parenteral immunization led to a strong anti-B5 immune response in both mice and the minipig.

Mechanical properties of biomimetic tissue adhesive based on the microbial transglutaminase-catalyzed crosslinking of gelatin.

Fibrin sealants are a type of soft tissue adhesive that employs biochemical reactions from the late stages of the blood coagulation cascade. Intrinsic to these adhesives are a structural protein and a transglutaminase crosslinking enzyme. We are investigating an alternative biomimetic adhesive based on gelatin and a calcium-independent microbial transglutaminase (mTG).

Mammalian germ-line transgenesis by transposition.

Transposons have been used in invertebrates for transgenesis and insertional mutagens in genetic screens. We tested a functional transposon called Sleeping Beauty in the one-cell mouse embryo. In this report, we describe experiments in which transposon vectors were injected into one-cell mouse embryos with mRNA expressing the SB10 transposase enzyme.

Transition from school to community living.

The transition process by which a student with moderate to severe disabilities is prepared to leave the school setting and enter into employment and community living is legally mandated and includes provisions for occupational therapy and other related services. This transition requires a team approach in which members collaborate to determine objectives with the student and his or her family in the domains of domestic, community, recreational, and vocational living. Assessment and intervention focus on functional activities that are chronologically age-appropriate and environmentally based.

Early mortality and temperature regulation in burned mice following administration of catecholamines and adrenergic receptor blocking drugs.

The effect of catecholamines and adrenergic receptor blocking drugs on mortality and body temperature was studied in mice subjected to burn, tourniquet, and endotoxin shock at an environmental temperature of 25 degrees C. Epinephrine and norepinephrine (0.5 mg/kg) injected intraperitoneally postburn increased shock mortality significantly (p less than 0.

Effect of thermal trauma on numbers and function of T and B cells from mouse spleen.

Swiss-Webster female mice were given a moderately severe burn, and studies were carried out on the number and function of T and B cells from the spleens of burned and normal mice. The results showed a significant decrease (p less than 0.05) in the number of T and B cells for 2-3 days after burning with a rapid return to normal and a subsequent rise above normal at 14 and 21 days postburn (p less than 0.

The role of histamine in burn, tourniquet and endotoxin shock in mice.

The release of histamine and mortality was studied in mice after various types of experimental shock. In burn shock, serum histamine rose significantly after injury, but there was no correlation between increased serum histamine and high mortality as a consequence of several therapy regimens. For example, after treatment with histamine or Compound 48/80 before burning, there was a rise of serum histamine, yet shock mortality fell significantly.