Standardizing the Operative Note: A Way to Improve the Quality of Data Collection to Optimize Patient Care

INTRODUCTION: The standard surgical operative note serves an essential role in documenting the details of an operation; however common key details of the operative note are often omitted. This study investigated the effectiveness of implementing a Laparoscopic Cholecystectomy (LC) specific, intraoperative data collection template directly in the electronic health record to be used as an addition to the standard dictated operative note. We hypothesized that intraoperative data collection would lead to a more complete operative report. METHODS: In this single center study, we retrospectively analyzed 211 operative notes prior to implementing an intraoperative template and 680 operative notes post template initiation. The data in the operative notes was then compared to the operative note template on seven selected variables. A chi-squared test for independence and a proportions test was used to assess the data and a significance was set to p \u3c 0.005. RESULTS: Intraoperative recording of the key data points increased documentation of five of the seven selected variables. Significantly more postoperative reports included information on stone spillage, the placement of drains, use of irrigation, intraoperative cholangiogram, and peri-operative antibiotics when completed with the template in comparison to the dictated operative report group without the intraoperative template, with a p \u3c 0.001. CONCLUSION: Our study demonstrates that “real time” collection of several predefined key data points significantly improves the accuracy and completeness of the standard operative note

Ariel - Volume 1 Number 3

Copyright 1969 Arie

Ferroelectric Properties of PbZrO₃-BiFeO₃ Solid Solutions

Solid solutions of BiFeO and PbZrO3 were investigated for crystallographic and dielectric properties. A new pseudocubic perovskite phase was found, which has been tentatively indexed as orthorhombic with the same unit cell as PbZrO3 but with dielectric properties characteristic of a ferroelectric substance. The Curie point in this series of solid solutions has a minimum of about 155°C at a composition of about (PbZrO3)0.80 (BiFeO3)0.20, which at room temperature lies on the boundary between the orthorhombic antiferroelectric and the pseudocubic ferroelectric phases. This composition has a relative dielectric constant of 800 at room temperature and shows appreciable dielectric nonlinearity. The Curie point rises to about 400°C for (PbZrO3)0.50 (BiFeO3)0.50 and is extrapolated to about 900°C for pure BiFeO3, in agreement with previous data from similar solid solutions. It is felt that this is additional evidence that the distortion from cubic symmetry in BiFeO3 may be of ferroelectric origin

Dielectric Properties of Solid Solutions of BiFeO₃ with Pb(Ti, Zr)O₃ At High Temperature and High Frequency

Solid solutions of BiFeO3 with PbTiO3, PbTi0.5Zr0.5O3, and PbZrO3 were prepared. The crystallographic data on these solutions, which are basically perovskitic, are given. The dielectric constants of the materials were determined at a frequency of 0.53 GHz and at temperatures up to 800°C. Dielectric Curie points were found in solutions containing up to 90 mole % BiFeO3. These results leave little doubt that BiFeO3 is ferroelectric or antiferroelectric. The extrapolated Curie point for BiFeO3 is above 850°C. BiFeO3 appears more likely to be ferroelectric than antiferroelectric, but the distinction between the two classifications may not be sharp

Human Immunodeficiency Virus Type 1 Counseling and Testing Program in the Prenatal Setting

Objective: The objectives of this study were to ascertain the acceptance rate of human immunodeficiency virus type 1 (HIV-1) testing in a high-prevalence area and to describe the sociodemographic and clinical characteristics of seropositive women diagnosed in the prenatal setting

Nonlinear Decline-Rate Dependence and Intrinsic Variation of Type Ia Supernova Luminosities

Published B and V fluxes from nearby Type Ia supernovae are fitted to light-curve templates with 4-6 adjustable parameters. Separately, B magnitudes from the same sample are fitted to a linear dependence on B-V color within a post-maximum time window prescribed by the CMAGIC method. These fits yield two independent SN magnitude estimates B_max and B_BV. Their difference varies systematically with decline rate Delta m_15 in a form that is compatible with a bilinear but not a linear dependence; a nonlinear form likely describes the decline-rate dependence of B_max itself. A Hubble fit to the average of B_max and B_BV requires a systematic correction for observed B-V color that can be described by a linear coefficient R = 2.59 +- 0.24, well below the coefficient R_B ~ 4.1 commonly used to characterize the effects of Milky Way dust. At 99.9% confidence the data reject a simple model in which no color correction is required for SNe that are clustered at the blue end of their observed color distribution. After systematic corrections are performed, B_max and B_BV exhibit mutual rms intrinsic variation equal to 0.074 +- 0.019 mag, of which at least an equal share likely belongs to B_BV. SN magnitudes measured using maximum-luminosity or CMAGIC methods show comparable rms deviations of order ~ 0.14 mag from the Hubble line. The same fit also establishes a 95% confidence upper limit of 486 km/s on the rms peculiar velocity of nearby SNe relative to the Hubble flow.Comment: 21 pages, 11 figures, 10 tables, to appear in The Astrophysical Journal, uses emulateapj_051214.cl

Genome-wide association scan for QTL and their positional candidate genes associated with internal organ traits in chickens

Background: Poultry breeding programs have been focused on improvement of growth and carcass traits, however, this has resulted in correlated changes in internal organ weights and increased incidence of metabolic disorders. These disorders can affect feed efficiency or even cause death. We used a high density SNP array (600 K, Affymetrix) to estimate genomic heritability, perform genome-wide association analysis, and identify genomic regions and positional candidate genes (PCGs) associated with internal organ traits in an F2 chicken population. We integrated knowledge of haplotype blocks, selection signature regions and sequencing data to refine the list of PCGs. Results: Estimated genomic heritability for internal organ traits in chickens ranged from low (LUNGWT, 0.06) to high (GIZZWT, 0.45). A total of 20 unique 1 Mb windows identified on GGA1, 2, 4, 7, 12, 15, 18, 19, 21, 27 and 28 were significantly associated with intestine length, and weights or percentages of liver, gizzard or lungs. Within these windows, 14 PCGs were identified based on their biological functions: TNFSF11, GTF2F2, SPERT, KCTD4, HTR2A, RB1, PCDH7, LCORL, LDB2, NR4A2, GPD2, PTPN11, ITGB4 and SLC6A4. From those genes, two were located within haplotype blocks and three overlapped with selection signature regions. A total of 13,748 annotated sequence SNPs were in the 14 PCGs, including 156 SNPs in coding regions (124 synonymous, 26 non-synonymous, and 6 splice variants). Seven deleterious SNPs were identified in TNFSF11, NR4A2 or ITGB4 genes. Conclusions: The results from this study provide novel insights to understand the genetic architecture of internal organ traits in chickens. The QTL detection performed using a high density SNP array covered the whole genome allowing the discovery of novel QTL associated with organ traits. We identified PCGs within the QTL involved in biological processes that may regulate internal organ growth and development. Potential functional genetic variations were identified generating crucial information that, after validation, might be used in poultry breeding programs to reduce the occurrence of metabolic disorders