Improving Colon Cancer Screening in a Resident Ambulatory Clinic

AIM Statement: Our aim at Wednesday JHAP was to increase the rate of colorectal cancer screenings from 44.3% to 60% from September 2016 to May 2017 (9 months)https://jdc.jefferson.edu/patientsafetyposters/1032/thumbnail.jp

Investigation of gold nanorods as a sensing material in plasmonic sensor for triclopyr butotyl detection

Gold nanorods (GNRs) have a unique optical property of metal nanoparticles (MNPs) due to the localised surface plasmon resonance (LSPR) effect, which depends on the size, shape and dielectric property of the surrounding medium. LSPR, or commonly known as the plasmonic effect, refers to the optical phenomena resulting from the interaction of free electrons on a nano-sized metal surface with incident light at specific wavelengths. The plasmonic effect of rod-shaped nanoparticles shows dual absorption bands corresponding to transverse surface plasmon resonance (t-SPR) and longitudinal surface plasmon resonance (l-SPR). These two bands are sensitive to size changes and the surrounding medium’s refractive index. In GNR formation, particles size, homogeneity and shape are crucial elements to be investigated during the synthesis process. Therefore, three parameters are studied in this research, which are centrifugation speed, seed solution concentration and growth solution ageing period. Through the variation of parameters during the synthesis procedure, the optimum GNRs with a surface density of 74.81 %, an average length of 59.80 ± 0.53 nm and an average width of 14.14 ± 0.19 nm produce an aspect ratio of 4.23 ± 0.36 via the seed�mediated growth method (SMGM). The optimum GNR sample is prepared by adding 10 µl of a seed solution into a raw growth solution and left undisturbed for 20 hours and then centrifuged at a rotational speed of 5000 rpm. The optical spectrum from that sample exhibits two plasmon bands at the transverse axis of 535.02 nm and the longitudinal axis of 782.65 nm. For sensing application, the GNRs are used as a sensing material to detect the targeted analyte, namely triclopyr butotyl (Cଵଷ Hଵ଺ClଷNOସ). The sensitivity, stability and repeatability of GNRs in deionized water and triclopyr butotyl medium is studied by observing the changes in the absorption intensity and the peak position of the plasmon resonance. The optical response of 10 % triclopyr butotyl without GNRs shows no significant peaks and proves that GNRs are able to increase the ability of detection through the plasmonic effect. In sensitivity testing, it is found that the presence of triclopyr butotyl changes the absorption intensity and shifts the resonance peak position of the GNRs. The vi detection limit of GNRs is as low as 3 %. Furthermore, the GNRs depict good response during 600 seconds of the stability test. Moreover, the fast response and recovery time in the change of medium observed in five cycles show good repeatability of GNRs

Got Diabetes? With Us, You\u27ll Have Complete Diabetic Care

AIM: By April 2016, we aim to improve Complete Diabetic Care of Thursday JHAP Clinic\u27s patients with diabetes by 50%. * These authors contributed equallyhttps://jdc.jefferson.edu/patientsafetyposters/1007/thumbnail.jp

Risk Factor Analysis for 30-Day Readmission Rates of Newly Tracheostomized Children

Objectives: Pediatric patients undergo tracheostomy for a variety of reasons; however, medical complexity is common among these patients. Although tracheostomy may help to facilitate discharge, these patients may be at increased risk for hospital readmission. The purpose of this study was to evaluate our institutional rate of 30-day readmission for patients discharged with new tracheostomies and to identify risk factors associated with readmission. Study Design: A retrospective cohort study was conducted for all pediatric patients ages 0-18 years with new tracheostomies at our institution over a 36-month period. Methods: A chart review was performed for all newly tracheostomizedchildren from 2013 to 2016. We investigated documented readmissions within 30 days of discharge, reasons for readmission, demographic variables including age and ethnicity, initial discharge disposition, co-morbidities, and socioeconomic status estimated by mean household income by parental zip code. Results: 45 patients were discharged during the study time period. A total of 13 (28.9%) required readmission within 30 days of discharge. Among these 13 patients, the majority (61.5%) were readmitted for lower airway concerns, many (30.8%) were admitted for reasons unrelated to tracheostomy or respiratory concerns, and only one patient (7.7%) was readmitted for a reason related to tracheostomy itself (tracheostomalbreakdown). Age, ethnicity, discharge disposition, co-morbidities, and socioeconomic status were not associated with differences in readmission rates. Patients readmitted within 30 days had a higher number of admissions within the first year. Conclusion: Pediatric patients with new tracheostomies are at high risk for readmission after discharge from initial hospitalization. The readmissions are most likely secondary to underlying medical complexity rather than issues related specifically to the tracheostomy procedure.https://jdc.jefferson.edu/patientsafetyposters/1046/thumbnail.jp

Assessing the Burden of Unnecessary Central Venous Catheters in Patients on Medical-Surgical Floors

Project goals: Our project goals are to: a) assess the burden of unnecessary PICCs and other non-tunneled central lines on med-surg units at TJUH and b) understand the underlying reasons behind the problem. In the first phase of our project we conducted an audit of med-surg unit PICCs and other non-tunneled central lines with the goal of obtaining a rough estimate of the number of line days that are unnecessary. SMART AIM By December 31, 2017, the TJUH medical-surgical floors will reduce the number of unnecessary PICC lines by 30%.https://jdc.jefferson.edu/patientsafetyposters/1024/thumbnail.jp

Application of particle swarm optimization for solving optimal generation plant location problem

The global demand for energy especially-in-developing-countries,-has-been witnessing a tremendous growth due to rapid population growth, economic growth and developing industrial sectors. Therefore, it is necessary to forecast the future energy needs and expand generation capacity to meet the increasing peak demand.-This-paper-presents-an-optimization approach to determine the optimal location for installing a new generator in which the technical, economic and environmental aspects are all taken into consideration. The location that yields the minimum fuel costs, total emission and system loss is considered as the optimal generation plant location. The- formulated- objective- function- and- its constraints compose an optimization problem is solved using particle swarm optimization (PSO). The proposed PSO based optimization approach is tested on IEEE 14-bus system and IEEE 30-bus system to illustrate the potential of the new approach. The simulation results have shown that the proposed approach is indeed capable of determining the optimal generation location that can save much overall fuel cost as well as reduce the total emissions of generators and losses in the network

The Use of Palliative Performance Score in Patients with End-Stage Liver Disease

● Palliative Care services are often underutilized in patients with End-Stage Liver Disease (ESLD) and often only initiated at the end of life ● The Palliative Performance Score (PPS) is an important tool used in Palliative Care to assess functional status ● PPS has five functional dimensions: ambulation, activity level and evidence of disease, self-care, oral intake, and level of consciousness ● The aim of this study is to determine if there is a correlation between Model for End-Stage Liver Disease (MELD) score and PPS in ESLD patients ● MELD is used to predict mortality and to prioritize liver transplant allocation in ESLD patientshttps://jdc.jefferson.edu/medposters/1011/thumbnail.jp