Patient-to-nurse ratios: Balancing quality, nurse turnover, and cost.

We consider the problem of setting appropriate patient-to-nurse ratios in a hospital, an issue that is both complex and widely debated. There has been only limited effort to take advantage of the extensive empirical results from the medical literature to help construct analytical decision models for developing upper limits on patient-to-nurse ratios that are more patient- and nurse-oriented. For example, empirical studies have shown that each additional patient assigned per nurse in a hospital is associated with increases in mortality rates, length-of-stay, and nurse burnout.

Homogeneity and Best Practice Analyses in Hospital Performance Management: An Analytical Framework.

Performance modeling of hospitals using data envelopment analysis (DEA) has received steadily increasing attention in the literature. As part of the traditional DEA framework, hospitals are generally assumed to be functionally similar and therefore homogenous. Accordingly, any identified inefficiency is supposedly due to the inefficient use of inputs to produce outputs.

Balancing control and autonomy in master surgery scheduling: Benefits of ICU quotas for recovery units.

When scheduling surgeries in the operating theater, not only the resources within the operating theater have to be considered but also those in downstream units, e.g., the intensive care unit and regular bed wards of each medical specialty.

Stroke care networks and the impact on quality of care.

Lack of rapidly available neurological expertise, especially in rural areas, is one of the key obstacles in stroke care. Stroke care networks attempt to address this challenge by connecting hospitals with specialized stroke centers, stroke units, and hospitals of lower levels of care. While the benefits of stroke care networks are well-documented, travel distances are likely to increase when patients are transferred almost exclusively between members of the same network.

Simulation-based evaluation of operating room management policies.

Background: Since operating rooms are a major bottleneck resource and an important revenue driver in hospitals, it is important to use these resources efficiently. Studies estimate that between 60 and 70% of hospital admissions are due to surgeries. Furthermore, staffing cannot be changed daily to respond to changing demands.

Quantitative Safety Monitoring in Clinical Trials: Application of Multiple Statistical Methodologies for Infrequent Events.

Background: There are limited quantitative approaches for evaluating rare safety outcomes from controlled clinical trials in either a blinded or unblinded setting. This manuscript demonstrates an application of three statistical methods for quantitative safety monitoring that can be implemented during any phase of a clinical trial, including open-label extension studies.

Methods: An interactive safety monitoring (iSM) tool was developed using R language in the publicly available R-Shiny app and was implemented for three statistical methods of quantitative safety monitoring.

[Bed capacity management in times of the COVID-19 pandemic : A simulation-based prognosis of normal and intensive care beds using the descriptive data of the University Hospital Augsburg].

Background: Following the regional outbreak in China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world, presenting the healthcare systems with huge challenges worldwide. In Germany the coronavirus diseases 2019 (COVID-19) pandemic has resulted in a slowly growing demand for health care with a sudden occurrence of regional hotspots. This leads to an unpredictable situation for many hospitals, leaving the question of how many bed resources are needed to cope with the surge of COVID-19 patients.

A 2D LC-MS/MS Strategy for Reliable Detection of 10-ppm Level Residual Host Cell Proteins in Therapeutic Antibodies.

Methodologies employing LC-MS/MS have been increasingly used for characterization and identification of residual host cell proteins (HCPs) in biopharmaceutical products to ensure their consistent product quality and safety for patients. To improve the sensitivity and reliability for HCP detection, we developed a high pH-low pH two-dimensional reversed phase LC-MS/MS approach in conjunction with offline fraction concatenation. Proof-of -concept was established using a model in which seven proteins spanning a size range of 29-78 kDa are spiked into a purified antibody product to simulate the presence of low-level HCPs.

Correction to: The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals.

The original version of this article unfortunately contained errors. The first column of Tables 5 and 6 in the Appendix section should contain the year of publication instead of the reference number in brackets. The reference citations were then placed in the second column.

The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals.

The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications.

GDC-0879, a BRAF Inhibitor, Protects Kidney Podocytes from Death.

Progressive kidney diseases affect approximately 500 million people worldwide. Podocytes are terminally differentiated cells of the kidney filter, the loss of which leads to disease progression and kidney failure. To date, there are no therapies to promote podocyte survival.

Cell Type-Specific Effects of Mutant DISC1: A Proteomics Study.

Despite the recent progress in psychiatric genetics, very few studies have focused on genetic risk factors in glial cells that, compared to neurons, can manifest different molecular pathologies underlying psychiatric disorders. In order to address this issue, we studied the effects of mutant disrupted in schizophrenia 1 (DISC1), a genetic risk factor for schizophrenia, in cultured primary neurons and astrocytes using an unbiased mass spectrometry-based proteomic approach. We found that selective expression of mutant DISC1 in neurons affects a wide variety of proteins predominantly involved in neuronal development (e.

Operations research in intensive care unit management: a literature review.

The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality.

Case mix planning in hospitals: a review and future agenda.

The case mix planning problem deals with choosing the ideal composition and volume of patients in a hospital. With many countries having recently changed to systems where hospitals are reimbursed for patients according to their diagnosis, case mix planning has become an important tool in strategic and tactical hospital planning. Selecting patients in such a payment system can have a significant impact on a hospital's revenue.

Coevolution of languages and genes on the island of Sumba, eastern Indonesia.

Numerous studies indicate strong associations between languages and genes among human populations at the global scale, but all broader scale genetic and linguistic patterns must arise from processes originating at the community level. We examine linguistic and genetic variation in a contact zone on the eastern Indonesian island of Sumba, where Neolithic Austronesian farming communities settled and began interacting with aboriginal foraging societies approximately 3,500 years ago. Phylogenetic reconstruction based on a 200-word Swadesh list sampled from 29 localities supports the hypothesis that Sumbanese languages derive from a single ancestral Austronesian language.

Switching from latanoprost to fixed-combination latanoprost-timolol: a 21-day, randomized, double-masked, active-control study in patients with glaucoma and ocular hypertension.

Background: Approximately 40% of patients with glaucoma are concomitantly prescribed >or=2 different intraocular pressure (IOP)-lowering medications. An effective and well-tolerated fixed combination of agents requiring once-daily instillation may improve patient compliance.

Objective: The purpose of this study was to compare the efficacy and safety profile of the fixed combination latanoprost 0.

A 5-year, multicenter, open-label, safety study of adjunctive latanoprost therapy for glaucoma.

Objective: To evaluate the 5-year safety and efficacy of adjunctive 0.005% latanoprost once daily.

Methods: Patients with primary open-angle or exfoliation glaucoma who completed a 3-year, open-label, uncontrolled, prospective trial could enter a 2-year extension phase.

Early manifestations of disseminated Mycobacterium avium complex disease: a prospective evaluation.

A nested case-control study was conducted in two trials of prophylaxis for Mycobacterium avium complex (MAC) infection to describe the specific signs, symptoms, and laboratory abnormalities of MAC disease in AIDS. Patients had < or =200/mm3 CD4 cells and a prior AIDS-defining illness. Of 571 patients, 102 (17.

Geographic and seasonal variation in Mycobacterium avium bacteremia among North American patients with AIDS.

Analysis of geographic risk was performed for Mycobacterium avium complex (MAC) bacteremia among North American patients with AIDS. Monthly mycobacterial blood cultures were taken from patients who were placebo recipients in a prospective evaluation of MAC prophylaxis. Of 571 patients, 102 (17.

Treatment of prolactin-secreting macroadenomas with the once-weekly dopamine agonist cabergoline.

Dopamine agonist administration is the primary therapy for macroprolactinomas, but bromocriptine is the only agent approved in the United States. Its use is limited by a high incidence of side effects, a short duration of action, and a lack of effectiveness in some patients. Cabergoline is a long-acting dopamine agonist specific for the D2 receptor that is more effective and better tolerated than bromocriptine in women with microadenomas or idiopathic hyperprolactinemia.

Worsening bone scan in the evaluation of antitumor response during hormonal therapy of breast cancer.

Purpose: Scintigraphic flare in association with response to therapy has been well described in the medical literature. During the course of a recent breast cancer trial, it became apparent that several patients with worsening bone scan but no other clinical evidence of disease progression might have potentially benefited from continued therapy, but had therapy discontinued. A retrospective analysis of this issue was performed to assess the magnitude and scope of this problem.

Multicenter study of cabergoline, a long-acting dopamine receptor agonist, in Parkinson's disease patients with fluctuating responses to levodopa/carbidopa.

We administered cabergoline, a potent, once-a-day dopamine against, to 61 patients with advanced Parkinson's disease (PD) and response fluctuations--"wearing-off" and "on-off" phenomena. The patients were on stable doses of levodopa/carbidopa. During the first 5 weeks, patients were randomized to allow equal numbers to end titration at each of five daily doses of cabergoline from 0.

Multicenter phase II efficacy trial of toremifene in tamoxifen-refractory patients with advanced breast cancer.

Purpose: To explore further the efficacy of high-dose toremifene in patients with advanced breast cancer who had failed to respond to tamoxifen or whose disease had progressed on tamoxifen.

Patients And Methods: One hundred two perimenopausal or postmenopausal women with metastatic breast cancer refractory to tamoxifen were entered onto a phase II clinical trial of toremifene at a dose of 200 mg/d. The study patients consisted of 28 primarily refractory patients; 43 patients who had relapsed after a prior tamoxifen response; and 31 patients who had relapsed while receiving adjuvant tamoxifen.

Conditional rate derivation in the presence of intervening variables using a Markov chain.

When conducting inferential and epidemiologic studies, researchers are often interested in the distribution of time until the occurrence of some specified event, a form of incidence calculation. Furthermore, this interest often extends to the effects of intervening factors on this distribution. In this paper we impose the assumption that the phenomena being investigated are governed by a stationary Markov chain and review how one may estimate the above distribution.