Empirical research in healthcare operations: past research, present understanding, and future opportunities

We examine the published empirical literature in healthcare operations management over the last 20 years. We note several unique characteristics of the research in healthcare operations, including a focus on operational and organizational variables, an interest in the underlying mechanisms that explain operational causal pathways, and an interest in economic and managerial implications. We organize the prior findings under five distinct themes: importance of operational variables, importance of volume, routing patients through healthcare systems, to err is human, and managing the improvement process. We also identify several key areas of future research, including personalized medicine, value based healthcare, and connected health. We conclude with a call to action for greater engagement with the medical community in areas where tools and insights of operations management can bring about improvements in healthcare delivery

Effect of non-vacuum thermal annealing on high indium content InGaN films deposited by pulsed laser deposition

InGaN films with 33% and 60% indium contents were deposited by pulsed laser deposition (PLD) at a low growth temperature of 300 °C. The films were then annealed at 500-800 °C in the non-vacuum furnace for 15 min with an addition of N(2) atmosphere. X-ray diffraction results indicate that the indium contents in these two films were raised to 41% and 63%, respectively, after annealing in furnace. In(2)O(3) phase was formed on InGaN surface during the annealing process, which can be clearly observed by the measurements of auger electron spectroscopy, transmission electron microscopy and x-ray photoelectron spectroscopy. Due to the obstruction of indium out-diffusion by forming In(2)O(3) on surface, it leads to the efficient increment in indium content of InGaN layer. In addition, the surface roughness was greatly improved by removing In(2)O(3) with the etching treatment in HCl solution. Micro-photoluminescence measurement was performed to analyze the emission property of InGaN layer. For the as-grown InGaN with 33% indium content, the emission wavelength was gradually shifted from 552 to 618 nm with increasing the annealing temperature to 800 °C. It reveals the InGaN films have high potential in optoelectronic applications

An Efficient Data Structure for Dynamic Two-Dimensional Reconfiguration

In the presence of dynamic insertions and deletions into a partially reconfigurable FPGA, fragmentation is unavoidable. This poses the challenge of developing efficient approaches to dynamic defragmentation and reallocation. One key aspect is to develop efficient algorithms and data structures that exploit the two-dimensional geometry of a chip, instead of just one. We propose a new method for this task, based on the fractal structure of a quadtree, which allows dynamic segmentation of the chip area, along with dynamically adjusting the necessary communication infrastructure. We describe a number of algorithmic aspects, and present different solutions. We also provide a number of basic simulations that indicate that the theoretical worst-case bound may be pessimistic.Comment: 11 pages, 12 figures; full version of extended abstract that appeared in ARCS 201

Molecular lens applied to benzene and carbon disulfide molecular beams

A molecular lens of the nonresonant dipole force formed by focusing a nanosecond IR laser pulse has been applied to benzene and CS2 molecular beams. Using the velocity map imaging technique for molecular ray tracing, characteristic molecular lens parameters including the focal length (f ), minimum beam width (W), and distance to the minimum beam width position (D) were determined. The laser intensity dependence of the observed lens parameters was in good agreement with theoretical predictions. W was independent of the laser peak intensity (I-0), whereas f and D varied linearly with 1/I-0. The differences in lens parameters between the molecular species were well correlated with the polarizability per mass values of the molecules. A high chromatographic resolution of Rs = 0.84 was achieved between the images of benzene molecular beams undeflected and deflected by the lens. The possibilities for a new type of chromatography are discussed.open293

Mammographic screening before age 50 years in the UK: comparison of the radiation risks with the mortality benefits

Mammographic screening before age 50 years is less effective than at older ages and the associated radiation risks are higher. We estimated how many breast cancer deaths could be caused and how many could be prevented by a decade of annual two-view mammographic screening starting at ages 20, 30 and 40 years, respectively, in the UK; for all women, and for women with first-degree relatives affected with breast cancer. We extrapolated from a radiation risk model to estimate the number of radiation-induced breast cancer deaths, and used results from randomised trials, which suggest a reduction in breast cancer mortality of 10–20% in women invited to screening before age 50 years, to estimate the number of deaths that could be prevented. The net change in breast cancer deaths was defined as the number of radiation-induced deaths minus the number of prevented deaths. For all women, assuming a reduction in mortality from screening of 20%, a decade of annual screening was estimated to induce more deaths than it prevents if started at age 20 years and at age 30 years (net increase=0.86 and 0.37 breast cancer deaths, respectively, per 1000 women screened). The corresponding estimate for screening starting at age 40 years was a net decrease of 0.46 deaths/1000 women screened and a zero net change assuming a 10% mortality reduction. Results for women with first-degree relatives with breast cancer were generally in the same direction but, because their background incidence rates are higher, the net increases or decreases were greater. In conclusion, our estimates suggest that a decade of annual two-view mammographic screening before age 40 years would result in a net increase in breast cancer deaths, and that starting at age 40 years could result in a material net decrease only if breast cancer mortality is reduced by about 20% or more in women screened. Although these calculations were based on a number of uncertain parameters, in general, the conclusions were not altered when these parameters were varied within a feasible range

Compression medullaire lente secondaire a un lymphome de Burkitt intra - rachidien

Le lymphome de Burkitt (LB) appartient au groupe des lymphomes malins non hodgkiniens (LMNH) à cellules B. Il sévit de façon endémique chez l’enfant africain en région intertropicale. La rareté des localisations neuro-méningées dont médullaires a été rapportée. Nous rapportons le cas d’un jeune garçon présentant une localisation médullaire secondaire de LB maxillo-facial. Il avait présenté de façon lentement progressive dans un contexte d’amaigrissement et de tumeur maxillo-faciale, un syndrome de compression médullaire dorsale dont le diagnostic a été confirmé au myéloscanner dorsal. L’histologie de la tumeur maxillo faciale après biopsie révélait un LB. Une chimiothérapie a permis une disparition complète de la tumeur maxillo-faciale à la fin du 1er mois et une récupération neurologique au bout d’un an. La localisation secondaire intra rachidienne d’un LB bien que rare doit être présente à l’esprit surtout en face d’une compression médullaire lente survenue dans un contexte de tumeur maxillo-faciale chez l’enfant

Analysis and Prediction of the Metabolic Stability of Proteins Based on Their Sequential Features, Subcellular Locations and Interaction Networks

The metabolic stability is a very important idiosyncracy of proteins that is related to their global flexibility, intramolecular fluctuations, various internal dynamic processes, as well as many marvelous biological functions. Determination of protein's metabolic stability would provide us with useful information for in-depth understanding of the dynamic action mechanisms of proteins. Although several experimental methods have been developed to measure protein's metabolic stability, they are time-consuming and more expensive. Reported in this paper is a computational method, which is featured by (1) integrating various properties of proteins, such as biochemical and physicochemical properties, subcellular locations, network properties and protein complex property, (2) using the mRMR (Maximum Relevance & Minimum Redundancy) principle and the IFS (Incremental Feature Selection) procedure to optimize the prediction engine, and (3) being able to identify proteins among the four types: “short”, “medium”, “long”, and “extra-long” half-life spans. It was revealed through our analysis that the following seven characters played major roles in determining the stability of proteins: (1) KEGG enrichment scores of the protein and its neighbors in network, (2) subcellular locations, (3) polarity, (4) amino acids composition, (5) hydrophobicity, (6) secondary structure propensity, and (7) the number of protein complexes the protein involved. It was observed that there was an intriguing correlation between the predicted metabolic stability of some proteins and the real half-life of the drugs designed to target them. These findings might provide useful insights for designing protein-stability-relevant drugs. The computational method can also be used as a large-scale tool for annotating the metabolic stability for the avalanche of protein sequences generated in the post-genomic age

Most vital segment barriers

We study continuous analogues of "vitality" for discrete network flows/paths, and consider problems related to placing segment barriers that have highest impact on a flow/path in a polygonal domain. This extends the graph-theoretic notion of "most vital arcs" for flows/paths to geometric environments. We give hardness results and efficient algorithms for various versions of the problem, (almost) completely separating hard and polynomially-solvable cases

Palmaria palmata (Dulse) as an unusual maritime aetiology of hyperkalemia in a patient with chronic renal failure: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hyperkalemia is rare in individuals with normal renal function, regardless of dietary intake. This is due to the ability of the kidneys to adapt to increasing serum potassium concentrations. In patients with renal compromise, potassium homeostasis can become impaired. <it>Palmaria palmata </it>(dulse) is an edible seaweed known to be very rich in potassium. We report a case of hyperkalemia precipitated by the consumption of dulse by a patient with known renal disease.</p> <p>Case Presentation</p> <p>A 66-year-old Caucasian woman with diabetes and chronic renal disease presented to our emergency department with nausea, vomiting, and worsening malaise, which had been present for less than a day. She had undergone electrocardiogram monitoring, which showed bradycardia, and periods of asystole. Our patient denied any other symptoms. Laboratory analysis revealed a serum potassium level of 8.6 mmol/L (normal range 3.5 to 4.9 mmol/L). Although our patient was taking some medications known to influence renal function, the only recent change that she could recount was that she had consumed approximately 200 g of dulse within the preceding 24 hours. A diagnosis of hyperkalemia was made, and the patient was treated successfully, and discharged home in her pre-morbid state.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first published report of hyperkalemia due to dulse consumption. Dulse is high in potassium, with concentrations upwards of 34 times greater than that found in bananas. Caution should be taken in prescribing medications with potential adverse renal effects for patients with known renal impairment. In such instances, renal function should be monitored closely. Patients should be counseled to avoid dietary sources high in potassium, with particular attention paid to unusual geographical dietary variations.</p