Evaluation of Measure Dx, a Resource to Accelerate Diagnostic Safety Learning and Improvement.

Background: Several strategies have been developed to detect diagnostic errors for organizational learning and improvement. However, few health care organizations (HCOs) have integrated these strategies into routine operations. To address this gap, the Agency for Healthcare Research and Quality released "Measure Dx: A Resource To Identify, Analyze, and Learn From Diagnostic Safety Events" in 2022.

Development and Implementation of a Digital Quality Measure of Emergency Cancer Diagnosis.

Purpose: Missed and delayed cancer diagnoses are common, harmful, and often preventable. Automated measures of quality of cancer diagnosis are lacking but could identify gaps and guide interventions. We developed and implemented a digital quality measure (dQM) of cancer emergency presentation (EP) using electronic health record databases of two health systems and characterized the measure's association with missed opportunities for diagnosis (MODs) and mortality.

Developing electronic clinical quality measures to assess the cancer diagnostic process.

Objective: Measures of diagnostic performance in cancer are underdeveloped. Electronic clinical quality measures (eCQMs) to assess quality of cancer diagnosis could help quantify and improve diagnostic performance.

Materials And Methods: We developed 2 eCQMs to assess diagnostic evaluation of red-flag clinical findings for colorectal (CRC; based on abnormal stool-based cancer screening tests or labs suggestive of iron deficiency anemia) and lung (abnormal chest imaging) cancer.

Electronic Co-design (ECO-design) Workshop for Increasing Clinician Participation in the Design of Health Services Interventions: Participatory Design Approach.

Background: Participation from clinician stakeholders can improve the design and implementation of health care interventions. Participatory design methods, especially co-design methods, comprise stakeholder-led design activities that are time-consuming. Competing work demands and increasing workloads make clinicians' commitments to typical participatory methods even harder.

Adsorption-Mediated Mass Streaming in a Standing Acoustic Wave.

Oscillating flows can generate nonzero, time-averaged fluxes despite the velocity averaging zero over an oscillation cycle. Here, we report such a flux, a nonlinear resultant of the interaction between oscillating velocity and concentration fields. Specifically, we study a gas mixture sustaining a standing acoustic wave, where an adsorbent coats the solid boundary in contact with the gas mixture.

Effects of inoculum source, pH, redox potential and headspace di-hydrogen on rumen in vitro fermentation yields.

This in vitro study aimed at understanding how abiotic, that is chemical and electrochemical potentials, and biotic factors combine to impact the outputs of rumen volatile fatty acid (VFA). Using a 48-run design optimized by means of an exchange algorithm, the curvilinear effects of pH, Eh and partial pressure of dihydrogen (H2) on fermentation yields were investigated in 6-h batch cultures of mixed rumen microbes, fed on glucose so as to bypass the enzymatic hydrolysis and conversion steps preceding the glycolytic pathway. The role played by rumen microbiota in the expression of these effects was explored by testing three inocula grown on feeds supplying a microflora adapted to fibre, slowly degradable or readily degradable starch as the dominant dietary polysaccharide.

Arterial oxygen tension increase 2-3 h after hyperbaric oxygen therapy: a prospective observational study.

Background: Inhalation of hyperbaric oxygen (HBO) has been reported to decrease arterial oxygen tension (PaO(2)) in the early period after exposure. The current investigation aimed at evaluating whether and to what extent arterial blood gases were affected in mechanically ventilated intensive care patients within 6 h after HBO treatment.

Methods: Arterial blood gases were measured in 11 ventilated subjects [nine males, two females, synchronized intermittent mandatory ventilation (SIMV) mode] undergoing HBO therapy for necrotizing soft tissue infection (seven patients), burn injury (two patients), crush injury (one patient) and major abdominal surgery (one patient).

Stenting of the superficial femoral artery after suboptimal balloon angioplasty: one-year results.

Aim: The aim of this study was to analyze the intermediate results of selective stenting of superficial femoral artery (SFA) lesions after a suboptimal balloon angioplasty result.

Methods: We analyzed 70 consecutive patients with claudication or critical limb ischemia due to peripheral arterial occlusive disease who underwent stent implantation of the SFA after unsuccessful balloon-angioplasty. All patients were followed-up immediately after the procedure and 3, 6 and 12 months thereafter.

High prevalence of autoimmune thyroiditis in patients with polycystic ovary syndrome.

Objective: To investigate the prevalence of autoimmune thyroiditis (AIT) in patients with polycystic ovary syndrome (PCOS).

Design: Over a period of 30 months, 175 patients with PCOS were recruited to a prospective multicenter study to evaluate thyroid function and morphology; 168 age-matched women without PCOS were studied as a control group.

Methods: PCOS was defined as a- or oligomenorrhea, hyperandrogenism and exclusion of other disturbances of estrogen or androgen synthesis.

Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by chronic anovulation and hyperandrogenism. PCOS is one of the leading causes of infertility and manifests with hirsutism, acne, and obesity. To investigate its impact on health-related quality of life and sexuality, 50 women with PCOS and 50 controls were evaluated with standardized questionnaires (36-item short-form health survey, symptom checklist revised, and life satisfaction questionnaire).

Hemodynamic and oxygenation profiles in the early period after hyperbaric oxygen therapy: an observational study of intensive-care patients.

Background: We studied whether hemodynamic and oxygenation profiles are altered in critically ill patients after exposure to hyperbaric oxygen (HBO).

Methods: Ten intensive-care patients (two females, eight males) undergoing HBO treatment after major abdominal surgery, after burn injury and after CO poisoning were included. All subjects were put on mechanical ventilation and received continuous sedation, and had HBO treatment at 2.

Differential lung ventilation and emergency hyperbaric oxygenation for repair of a tracheal tear.

Purpose: To report the anaesthetic management of a case of tracheal rupture, using different types of ventilation and additional hyperbaric oxygenation (HBO).

Clinical Features: An 8 cm postintubation tracheal tear was repaired in a 66-yr-old woman with acute myocardial reinfarction, mediastinal and subcutaneous emphysema, cardiac failure and unrecognized lymphoma. Intraoperative monitoring included dual oximetry: arterial (SaO2) and mixed venous saturations (SvO2).

Resource utilisation in haemophiliacs treated in Europe: results from the European Study on Socioeconomic Aspects of Haemophilia Care. The European Socioeconomic Study Group.

The objectives of our study was to answer the following questions: (1) What are the socioeconomic costs and benefits of different haemophilia treatment strategies? (2) Which savings can be achieved through a comprehensive care program? (3) How are haemophiliacs integrated into their social life? (4) What are the annual costs of treating haemophilia from a third party payer perspective? In this cross-sectional study, 840 consecutive haemophiliacs attending 16 haemophiliac treatment centres in 10 European countries at were entered in the study. The following six parameters were analysed: sociodemographic patient data, the type of substitution (on demand or prophylaxis), transfusion-transmitted diseases, the functional joint status, quality of life as well as the total costs of therapy. Three kinds of substitution modalities were distinguished: on demand therapy, pure and modified prophylaxis.

Operations on patients deemed "unfit for operation and anaesthesia": what are the consequences?

Background: The decision "patient unfit for anaesthesia and operation" is likely to cause a delay of the scheduled operation. This retrospective evaluation was done: 1) to determine the correctness of preoperative tentative diagnoses of coexisting diseases making anaesthesia and operation excessively risky in relation to the physician's training status; 2) to examine the question of whether preoperative medical management modified according to the anaesthesiologist's suggestions had a positive impact on the perioperative course.

Methods: The medical records of patients scheduled for elective non-cardiac surgery who were rated "unfit for operation and anaesthesia" were evaluated.

B1 bradykinin receptors and carboxypeptidase M are both upregulated in the aorta of pigs after LPS infusion.

Bradykinin receptor subtypes were characterized in aortic cryosections obtained from healthy normal pigs, animals that were given an LPS infusion, and animals that came with a pre-existing infection or inflammation to the laboratory by binding studies and in vitro autoradiography. In control aorta a single class of high affinity B2 binding sites, located within the endothelium, but with no significant binding of B1 ligand were identified. No major changes in the expression of B2 BK receptors were noted in inflammed tissues.

Comparison of two preoperative indices to predict perioperative mortality in non-cardiac thoracic surgery.

Objective: The preoperative classifications: physical status of the American Society of Anesthesiologists (ASA-PS) and/or cardiac risk index (CRI) of Goldman are widely used to estimate the perioperative risk in patients undergoing noncardiac throacic surgery. We tried to determine the validity of both methods in predicting the perioperative mortality in 845 consecutive patients scheduled for major elective noncardiac thoracic surgery.

Methods: Preoperatively, each patient was assigned 2 independent estimations of risk according to the ASA-score (ASA grade, I-IV) and CRI score (CRI grade, I-IV), respectively.

Prehospital point of care testing of blood gases and electrolytes - an evaluation of IRMA.

BACKGROUND: This study evaluated the feasibility of blood gas analysis and electrolyte measurements during emergency transport prior to hospital admission. RESULTS: A portable, battery-powered blood analyzer was used on patients in life threatening conditions to determine pH, pCO2, pO2, sodium, potassium and ionized calcium. Arterial blood was used for blood gas analysis and electrolyte measurements.

Socioeconomic impact of haemophilia care: results of a pilot study.

Fifty consecutive haemophiliacs were entered into a pilot study of socioeconomic impact of haemophilia treatment. The Short Form 36 was used as an instrument for the assessment of quality of life. Direct and indirect costs were analysed.

Autoradiographic visualization of B1 bradykinin receptors in porcine vascular tissues in the presence or absence of inflammation.

B1 bradykinin receptors were visualized by using the B1 bradykinin receptor agonist [3H]des-Arg10-kallidin in receptor autoradiography experiments. Cryosections were prepared from arterial vessels from a healthy control pig, a pig with pre-existing inflammation and an animal with experimental sepsis induced by an infusion of bacterial lipopolysaccharide (LPS). Only diffusely scattered silver grains with no preference for a distinct tissue structure were detected on emulsion-coated coverslips above the cryosections from the healthy control animal.

[Socioeconomic studies of hemostaseologic therapy and anticoagulation].

Since hemostaseologic therapies have a great impact on the budget of public health insurance companies, the therapy of hemophilia, prophylaxis of thrombosis and thrombolysis should be evaluated in a socioeconomic way. The substitution therapy in hemophilia is consuming a great deal of health care resources. The patients require an expensive, chronic therapy which enables them to be integrated in a normal social life.

MTF Maximization at Low Spatial Frequencies.

A merit function suggested by Lenskii has been generalized to make it applicable to optical systems with noncircular and/or partially obscured apertures. An independent derivation makes clear the relation between Lenskii's merit function and one due to Hopkins. A slight modification of the merit function relates it more accurately to the MTF.