Realizing the Value of EHR Systems: Critical Success Factors

Now that a majority of hospitals and primary care physicians have made the transition to electronic health record (EHR) systems, realizing value from this investment has become a major issue. The issue raises two key questions: Why do so many EHR implementations continue to fall short of achieving intended healthcare outcome goals? What differentiates those that succeed from those that fall short? This article builds on prior research using a systems framework to analyze the EHR implementation process. It focuses on ten common themes (CSFs) that appear to differentiate institutions which achieve positive healthcare outcomes from those that do not. Results are highly relevant for healthcare institutions now seeking to focus on realizing the value of their EHR systems

Lifestyle Intervention’s Effect and Predictive Value on Weight Loss for University Employees

Obesity is a costly and pervasive risk factor that requires attention to reduce chronic disease rates. This study evaluated the effect of a lifestyle medicine intervention, Complete Health Improvement Program (CHIP), on reducing weight, blood pressure, lipid levels, and hemoglobin A1c. A secondary aim was to build a preliminary predictive model for computing new participants’ potential weight change from CHIP. We evaluated pre- and post-intervention biometric data of 68 individuals who completed a 10-week CHIP intervention at a Midwestern university clinic. Significant reductions (p \u3c 0.05) were observed in weight, diastolic blood pressure, total cholesterol, low-density lipoprotein, and A1c. Regression analyses indicated that the best linear model for predicting change in weight was a one-predictor model with systolic blood pressure. The CHIP intervention effectively promoted weight loss and meaningful reductions in chronic disease risk factors. Larger samples are needed for future regression analyses to create a more robust linear model

Goal-Focused Emotion-Regulation Therapy (GET) for young adult survivors of testicular cancer: a pilot randomized controlled trial of a biobehavioral intervention protocol.

BackgroundTesticular cancer diagnosis and treatment, especially given its threat to sexuality and reproductive health, can be distressing in the formative period of young adulthood and the majority of young survivors experience impairing, distressing, and modifiable adverse outcomes that can persist long after medical treatment. These include psychological distress, impairment in pursuit of life goals, persistent physical side effects, elevated risk of secondary malignancies and chronic illness, and biobehavioral burden (e.g., enhanced inflammation, dysregulated diurnal stress hormones). However, few targeted interventions exist to assist young survivors in renegotiating life goals and regulating cancer-related emotions, and none focus on reducing the burden of morbidity via biobehavioral mechanisms. This paper describes the methodology of a randomized controlled biobehavioral trial designed to investigate the feasibility and preliminary impact of a novel intervention, Goal-focused Emotion-Regulation Therapy (GET), aimed at improving distress symptoms, emotion regulation, goal navigation skills, and stress-sensitive biomarkers in young adult testicular cancer patients.MethodsParticipants will be randomized to receive six sessions of GET or Individual Supportive Therapy (ISP) delivered over 8 weeks. In addition to indicators of intervention feasibility, we will measure primary (depressive and anxiety symptoms) and secondary (emotion regulation and goal navigation skills, career confusion) psychological outcomes prior to (T0), immediately after (T1), and 12 weeks after (T2) intervention. Additionally, identified biomarkers will be measured at baseline and at T2.DiscussionGET may have the potential to improve self-regulation across biobehavioral domains, improve overall cancer adjustment, and address the need for targeted supportive care interventions for young adult cancer survivors.Trial registrationClinicaltrials.gov, NCT04150848. Registered on 28 October 2019

A new record of Percursaria percursa (Ulvaceae, Ulvales) on the North Island, New Zealand

The filamentous green alga Percursaria percursa (Ulvaceae, Ulvales) was recorded for the first time on the North Island of New Zealand at mokoroa Estuary, Tauranga Harbour. This species is previously known within New Zealand from only two records, both from the South Island. In Tauranga Harbour, this species was restricted to anoxic estuarine sediments where mangrove forests had been mulched, and mulchate left in situ. Percursaria percursa was found intertwined with Ulva spp. and Rhizoclonium spp. Surveys of other North and South Island estuaries suggest that this alga, although occurring as part of nuisance green algal blooms in Tauranga Harbour, has only colonized human-impacted locations, and has not yet been observed in natural' estuarine ecosystems in New Zealand. As this species was found intertwined with other mat-forming filamentous green algae, it can easily be misidentified in the field, leading to both over- and under-reporting of species occurrence

Endothelial cells derived from patients' induced pluripotent stem cells for sustained factor VIII delivery and the treatment of hemophilia A.

Hemophilia A (HA) is a bleeding disorder characterized by spontaneous and prolonged hemorrhage. The disease is caused by mutations in the coagulation factor 8 gene (F8) leading to factor VIII (FVIII) deficiency. Since FVIII is primarily produced in endothelial cells (ECs) in a non-diseased human being, ECs hold great potential for development as a cell therapy for HA. We showed that HA patient-specific induced pluripotent stem cells (HA-iPSCs) could provide a renewable supply of ECs. The HA-iPSC-derived ECs were transduced with lentiviral vectors to stably express the functional B domain deleted F8 gene, the luciferase gene, and the enhanced green fluorescent protein gene (GFP). When transplanted intramuscularly into neonatal and adult immune deficient mice, the HA-iPSC-derived ECs were retained in the animals for at least 10-16 weeks and maintained their expression of FVIII, GFP, and the endothelial marker CD31, as demonstrated by bioluminescence imaging and immunostaining, respectively. When transplanted into HA mice, these transduced HA-iPSC-derived ECs significantly reduced blood loss in a tail-clip bleeding test and produced therapeutic plasma levels (11.2%-369.2%) of FVIII. Thus, our studies provide proof-of-concept that HA-iPSC-derived ECs can serve as a factory to deliver FVIII for the treatment of HA not only in adults but also in newborns

Line tension and structure of smectic liquid crystal multilayers at the air-water interface

At the air/water interface, 4,-8-alkyl[1,1,-biphenyl]-4-carbonitrile (8CB) domains with different thicknesses coexist in the same Langmuir film, as multiple bilayers on a monolayer. The edge dislocation at the domain boundary leads to line tension, which determines the domain shape and dynamics. By observing the domain relaxation process starting from small distortions, we find that the line tension is linearly dependent on the thickness difference between the coexisting phases in the film. Comparisons with theoretical treatments in the literature suggest that the edge dislocation at the boundary locates near the center of the film, which means that the 8CB multilayers are almost symmetric with respect to the air/water interface.Comment: 21 pages, 6 figure

A New Class of Photoresponsive Surfactants

Recently, surface tension has been shown to be important in emerging high technologies, such as in pumping and control of flow in microfluidic devices, in microchemical analysis of complex fluids, and in rapid DNA screening, etc. Advances in these new technologies will depend strongly on the availability of flexible methods for controlling surface tension. Photo-control using a photoresponsive surfactant is a potentially attractive route to accomplishing many of the tasks required in these processes. Photoresponsive surfactants typically incorporate an azobenzene group as the functional unit which experiences reversible trans-to-cis photoisomerization under different irradiation conditions. The photoisomerization usually causes a change in surface tension. Obviously, a large change in surface tension under different illumination conditions will be highly desirable in practical applications. However, the largest change in surface tension as reported in the literature is only 3 mN/m which is too small to generate any significant effect. In this presentation, we report a new class of photoresponsive surfactants which exhibit excellent performance in surface tension control. Under different illumination conditions, the change in surface tension can be as large as 11.0 mN/m. Experimental results are presented for two new photoresponsive surfactants. A discussion of experimental results follows.Singapore-MIT Alliance (SMA

A Multidimensional Urban Land Cover Change Analysis in Tempe, AZ

Rapid population growth leading to significant conversion of rural to urban lands requires deep understanding on how the human population interacts with the built-environment. Our research goal is to explore methodologies on how to analyze multidimensional urban change with the consideration of time, space, and landscape patterns. Using NAIP high resolution satellite images and LIDAR data, we were able to derive land cover classification maps and normalized height difference at different time periods. Then we performed the 2D, 3D and landscape pattern change analysis for a case study area. The research results show that a combination of 2D, 3D and landscape pattern change analysis can provide a comprehensive understanding of urban change, and the results will help urban planners and decision makers to better understand the status of urban transformation and design city for the future