An agile standardized work procedure for cleaning the operating room

Purpose: This research aimed to reduce the turnover time (non-operative time) in the operating room (OR) at a US Northwestern hospital. Design/methodology/approach: Data collection consisted of observation and interviews of the aides, circulating nurses, and surgical techs to identify causes of delays and long turnovers. It was determined that the turnover could be divided into two stages: cleaning the room and setting up for the next surgery. The research team met with the staff (aides) to create a standard operating procedure for the cleaning stage. It was decided to create an agile standard procedure that would allow the process to be completed the same way effectively with any number of people ranging from 1 to 3. The flexibility accounts for the number of people who are to complete the procedure and considers that some of them are only available during portions of the cleaning stage due to multiple turnovers or duties. Findings: The agile cleaning procedure reduced the cleaning time by 2.2 minutes (15.7% of the total time) and the standard deviation by 3.30 minutes. A decrease in variability represents more consistent turnovers, creating more predictable times for scheduling surgeries in the future. Originality/value: This research proposes a novel approach to standardized work that quickly adapts to the number of workers available. The agile standardized work procedure (ASWP) allows the process to be completed the same way every time effectively with any number of peoplePeer Reviewe

Improving the registration process in a healthcare facility with lean principles

Purpose: Process improvement in service industries, like the registration process in a hospital, can be achieved with the application of lean principles. In this specific case, lean principles were essential to analyze and improve patient satisfaction in a hospital in Montana. The clinics involved in the study included pediatrics (P), internal medicine (IM), and cardiology/pulmonary (CP). The purpose of this study was to address difficulties regarding patient satisfaction on the registration and check-in processes. Design/methodology/approach: Direct observations and patient surveys were initially made to understand the processes and identify the initial causes of dissatisfaction. A value stream map (VSM) was then used to further break down the patient flow’s complexity. A Fishbone diagram and a Concept Map were completed to find the root of the dissatisfaction. Findings: The information obtained from the lean tools showed that patients questioned the need for having a central registration in combination with the check-in process when this combination generates duplications of steps that cause unwanted delays. Several recommendations were explored by the engineering team to mitigate these delays and improve the registration process reducing the number of patients complaints by 40%. Practical implications: This project illustrated the application of lean principles to resolve issues regarding a central registration format in a healthcare facility. Originality/value: A Concept Map was used as a tool to help the organization develop creative and new ways of looking at and solving process deficienciesPeer Reviewe

Pendampingan Penyusunan Laporan Keuangan Dengan EFA Pada KPN SMP Negeri 20 Kota Padang

The target of the service is the Public Servant Cooperative (KPN) SMP Negeri 20 Padang which is one of the KPNs in Padang City, this PKM is a continuation of the output of previous community service activities in the form of technical guidance, to ensure that partners are able to apply Excel For Accounting properly and correct, so that they can present financial reports in accordance with the Regulation of the Minister of Cooperatives and SMEs Number 13 of 2015. It is hoped that after this assistance the Treasurer will be able to prepare annual financial reports properly and correctly in accordance with the Minister of Cooperatives and SMEs Regulation No. 13 of 2015 concerning Accounting Guidelines for Savings and Loans by Cooperatives. This activity was carried out in the form of assistance in preparing KPN Financial Reports for SMP Negeri 20 Padang City using Excel For Accounting (EFA) with the prepared modules. This mentoring activity will continue for the preparation of financial reports as of January 31, 2023

Analysis of the molecular profile of endometrial cancer depending on microsatelite instability

Introduction/Background MLH1 is the MMR gene most frequently mutated or epimutated in endometrial cancer and its hypermethylation is found in the vast majority of MMR-deficient EC cases. The high rate of raw data accumulation with reference to cancer genomics as well as the development of bioinformatics algorithms necessary for the re-analysis of cohorts are key elements for obtaining new smart data. Methodology In the present study we aimed to re-analyze a set of genomic data obtained by sequencing 197 EC samples and downloaded from the public database cBioPortal for Cancer Genomics - Endometrial Cancer (MSK, 2018). The aim of the research was to separate the genomic data into two cohorts based on the presence or absence of microsatellite instability and analyze the molecular profile of these cohorts. Results As a result, two sets of data were obtained: SM (Microsatellite Stability) – 153 samples IM (Microsatellite Instability) – 25 samples In the MS cohort, an almost 2-fold higher frequency of changes in the tumor suppressor TP53 is observed, while in IM – a considerably increased rate of PTEN, ARID1A, MLL2, JAK1, POLE, MLH1, MSH6, MSH2 and PMS1 mutations (figure 1). SNV (Single Nucleotide Variation) classes in the IM group compared to SM have higher rates of T>C transitions that are associated with mutational signature no. 5 and lower C>G transversions - markers of signature 13 (figure 2). TMB in the two study groups revealed an index of less than 10 mut/Mb in MS and more than 10 mut/Mb in MI (figure 3). Conclusion Comparative analysis of molecular data in the two subtypes of CE reveals major differences in the mutational profile. A higher frequency of deletions with the displacement of the reading frame is observed in the SI cohort. TMB index in IM reveals tumors with MI have a better response to treatment with immune checkpoint inhibitors.peer-reviewe

Association between Ancestry-Specific 6q25 Variants and Breast Cancer Subtypes in Peruvian Women

Background: Breast cancer incidence in the United States is lower in Hispanic/Latina (H/L) compared with African American/ Black or Non-Hispanic White women. An Indigenous American breast cancer-protective germline variant (rs140068132) has been reported near the estrogen receptor 1 gene. This study tests the association of rs140068132 and other polymorphisms in the 6q25 region with subtype-specific breast cancer risk in H/Ls of high Indigenous American ancestry. Methods: Genotypes were obtained for 5,094 Peruvian women with (1,755) and without (3,337) breast cancer. Associations between genotype and overall and subtype-specific risk for the protective variant were tested using logistic regression models and conditional analyses, including other risk-associated polymorphisms in the region. Results: We replicated the reported association between rs140068132 and breast cancer risk overall [odds ratio (OR), 0.53; 95% confidence interval (CI), 0.47-0.59], as well as the lower odds of developing hormone receptor negative (HR-) versus HR+ disease (OR, 0.77; 95% CI, 0.61-0.97). Models, including HER2, showed further heterogeneity with reduced odds for HR+HER2+ (OR, 0.68; 95% CI, 0.51-0.92), HR-HER2+ (OR, 0.63; 95% CI, 0.44-0.90) and HR-HER2- (OR, 0.77; 95% CI, 0.56-1.05) compared with HR+HER2-. Inclusion of other risk-associated variants did not change these observations. Conclusions: The rs140068132 polymorphism is associated with decreased risk of breast cancer in Peruvians and is more protective against HR- and HER2+ diseases independently of other breast cancer-associated variants in the 6q25 region. Impact: These results could inform functional analyses to understand the mechanism by which rs140068132-G reduces risk of breast cancer development in a subtype-specific manner. They also illustrate the importance of including diverse individuals in genetic studies.National Institutes of HealthRevisión por pare

SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference

Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field

Eurasian consumers' food safety beliefs and trust issues in the age of COVID ‐19: evidence from an online survey in 15 countries

Eurasian consumers' food safety beliefs and trust issues in the age of COVID ‐19: evidence from an online survey in 15 countries Igor Tomasevic Faculty of Agriculture University of Belgrade Belgrade Serbia German Institute of Food Technologies (DIL) Quakenbrück Germany Department of Dairy Technology and Functional Foods, Faculty of Food Sciences and Biotechnology University of Life Sciences in Lublin Lublin Poland https://orcid.org/0000-0002-1611-2264 Garegin Hambardzumyan Armenian National Agrarian University Yerevan Armenia Gayane Marmaryan Armenian National Agrarian University Yerevan Armenia Aleksandra Nikolic Faculty of Agriculture and Food Sciences University of Sarajevo Sarajevo Bosnia and Herzegovina Alen Mujcinovic Faculty of Agriculture and Food Sciences University of Sarajevo Sarajevo Bosnia and Herzegovina Weizheng Sun School of Food Science and Engineering South China University of Technology Guangzhou China https://orcid.org/0000-0001-5769-4275 Xiao‐Chen Liu School of Food Science and Engineering South China University of Technology Guangzhou China Danijela Bursać Kovačević Faculty of Food Technology and Biotechnology University of Zagreb Zagreb Croatia Anica Bebek Markovinović Faculty of Food Technology and Biotechnology University of Zagreb Zagreb Croatia Nino Terjung German Institute of Food Technologies (DIL) Quakenbrück Germany Volker Heinz German Institute of Food Technologies (DIL) Quakenbrück Germany Maria Papageorgiou Department of Food Science and Technology International Hellenic University Thessaloniki Greece Adriana Skendi Department of Food Science and Technology International Hellenic University Thessaloniki Greece Gunjan Goel Department of Microbiology Central University of Haryana Mahendragarh India https://orcid.org/0000-0002-8761-929X Mamta Raghav Department of Life Sciences RPS Degree College Mahendragarh India Antonella Dalle Zotte Department of Animal Medicine, Production and Health University of Padova Padova Italy Dimitar Nakov Faculty of Agriculture "Goce Delcev" University in Stip Shtip Republic of North Macedonia Faculty of Medical Sciences "Goce Delcev" University in Stip Shtip Republic of North Macedonia Valentina Velkoska Faculty of Agriculture "Goce Delcev" University in Stip Shtip Republic of North Macedonia Bartosz G. Sołowiej Department of Dairy Technology and Functional Foods, Faculty of Food Sciences and Biotechnology University of Life Sciences in Lublin Lublin Poland Anastasia A. Semenova V. M. Gorbatov Federal Research Center for Food Systems Moscow Russia Oksana A. Kuznetsova V. M. Gorbatov Federal Research Center for Food Systems Moscow Russia Miroslav Krocko Department of Technology and Quality of Animal Products, Faculty of Biotechnology and Food Sciences Institute of Food Sciences, Slovak University of Agriculture in Nitra Nitra Slovakia Viera Duckova Department of Technology and Quality of Animal Products, Faculty of Biotechnology and Food Sciences Institute of Food Sciences, Slovak University of Agriculture in Nitra Nitra Slovakia Jose M. Lorenzo Centro Tecnológico de la Carne de Galicia Ourense Spain https://orcid.org/0000-0002-7725-9294 Noemi Echegaray Centro Tecnológico de la Carne de Galicia Ourense Spain https://orcid.org/0000-0002-7393-2955 Emel Oz Department of Food Engineering, Agriculture Faculty Atatürk University Erzurum Türkiye https://orcid.org/0000-0003-3766-2713 Fatih Oz Department of Food Engineering, Agriculture Faculty Atatürk University Erzurum Türkiye https://orcid.org/0000-0002-5300-7519 Ilija Djekic Faculty of Agriculture University of Belgrade Belgrade Serbia Abstract BACKGROUND This investigation provides an important insight into Eurasian consumers' food safety beliefs and trust issues influenced by the COVID‐19 pandemic. An online survey was conducted in 15 European and Asian countries involving more than 4000 consumers. RESULTS It has confirmed that different socioeconomic characteristics, cultural aspects and education levels shape food safety perceptions within Eurasian countries. The COVID‐19 pandemic influenced their beliefs and trust in food safety, which is relatively low on average. However, it is significantly higher for European consumers (especially European Union ones) compared to their Asian counterparts. Both Asian and European respondents agreed that food fraud and climate changes represent a food safety issue. However, European consumers were less concerned regarding the food safety of genetically modified foods and meat and dairy analogs/hybrids. Asian consumers were, to a greater extent, worried about the risk of getting COVID‐19 from food, restaurants, food retail establishments and home food deliveries. CONCLUSION Eurasian consumers have put their greatest extent of trust, when food safety assurance is concerned, into food scientists and food producers holding a food safety certificate. Broadly, they are uncertain to what extent their federal governments and food inspectors are competent, able and efficient in ensuring food safety. Higher education of Eurasian consumers was followed by increased food safety confidence in all parts of the food chain. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. 07 13 2023 jsfa.12815 10.1002/jsfa.12815 2 10.1002/crossmark_policy onlinelibrary.wiley.com true 2023-02-27 2023-06-21 2023-07-13 http://creativecommons.org/licenses/by-nc-nd/4.0/ 10.1002/jsfa.12815 https://onlinelibrary.wiley.com/doi/10.1002/jsfa.12815 https://onlinelibrary.wiley.com/doi/pdf/10.1002/jsfa.12815 10.1097/PHH.0000000000001470 10.4315/JFP-21-096 10.1186/s12889-022-12568-4 10.1007/s10551-015-2690-5 10.1037/ipp0000074 10.1007/BF02249397 10.1016/j.foodqual.2017.09.012 10.1093/heapro/daw024 10.1016/S0195-6663(03)00112-0 10.1080/18692729.2017.1256987 10.1080/15287394.2016.1174008 10.1016/B978-0-12-381504-0.00041-X 10.1016/j.foodcont.2020.107800 Studies in Systems, Decision and Control Azzam Z 25 10.1016/j.appet.2021.105309 10.2139/ssrn.4053920 LimA XuJandYuYeds Consumer Food Demand Shifts in the COVID‐19 Pandemic: An Empirical Study Based on Retail Sales Data. Lecture Notes in Networks and Systems; 2023 Consumer Food Demand Shifts in the COVID‐19 Pandemic: An Empirical Study Based on Retail Sales Data. 10.3390/math10091394 Econ Pol Wkly Kaicker N 16 57 2022 Food consumption expenditures and the COVID‐19 pandemic in India 10.1016/j.appet.2022.106313 10.1016/j.foodcont.2020.107089 10.3390/foods11030432 10.1016/j.foodcont.2020.107238 10.1016/j.tifs.2003.08.004 Kodeks profesionalne etike Univerziteta u Beogradu Serbia 193 2016 10.1111/j.1365-2648.2004.03185.x 10.1016/j.foodcont.2022.109216 10.1016/j.appet.2022.106265 10.1016/B978-0-12-813148-0.00001-3 Basic statistics: a modern approach Hamburg M 548 1985 Fundamentals of Biostatistics Rosner B 2011 10.1016/j.jretconser.2011.08.007 10.1108/00070700210418767 Ageing Europe: looking at the lives of older people in the EU:2 020th edition Eurostat 2020 CIA Median Age‐The World Factbook: Central Intelligence Agency(2022). Available from:https://www.cia.gov/the-world-factbook/field/median-age/country-comparison. 10.1016/j.jpolmod.2015.05.002 Higher education across asia: an overview of issues and strategies ADB 66 2011 10.1016/j.tifs.2019.10.005 Rapid alert system for food and feed‐alert and cooperation network: 2021 annual report RASFF 2021 10.1016/j.foodres.2016.08.028 10.1007/s13593-022-00778-4 BhavanaTandRoshanD Europe meat substitute market by product type source and category: regional opportunity analysis and industry forecast 2021‐2027 allied market research(2021). Nils‐GerritW Plant‐based milk and dairy alternatives in Europe‐statistics & facts: Statista(2022). Available from:https://www.statista.com/topics/10162/milk-and-dairy-alternatives-in-europe/#topicOverview. Nils‐GerritW Retail sales value of milk and milk alternatives worldwide in 2020 by region: Statista(2021). Available from:https://www.statista.com/topics/10162/milk-and-dairy-alternatives-in-europe/#topicOverview. 10.1016/j.appet.2011.06.010 10.1007/978-3-030-12453-3_53 10.1108/CAER-08-2015-0102 10.1111/ijcs.12345 10.1371/journal.pone.0126060 10.1080/14636778.2012.743269 10.1016/j.meatsci.2019.107965 10.1016/j.tifs.2013.01.003 Coronavirus: no Evidence that Food Is a Source or Transmission Route EFSA 2020 10.1016/S0140-6736(20)30211-7 10.1016/j.foodcont.2015.07.028 10.1016/j.ijhm.2021.102960 10.1016/j.ijhm.2021.102988 10.1016/j.jretconser.2022.102972 10.1016/j.ijhm.2020.102821 10.1016/j.ijgfs.2021.100330 10.1016/j.gfs.2022.100658 10.1016/j.meatsci.2015.12.008 10.1016/j.tifs.2020.08.020 10.1111/ijcs.12184 EFSA Food Safety in the EU: report(2022). 10.3390/foods10102490 10.4102/hsag.v26i0.1407 10.1016/j.foodcont.2022.109377 10.1016/j.foodcont.2013.11.022 10.1016/j.ijhm.2021.102905 10.1002/agr.21414 10.1016/j.fct.2020.111170 10.1016/j.appet.2004.05.003 10.1016/j.jneb.2018.03.013 10.1016/j.emj.2017.02.00

Coupling Wearable Devices and Decision Theory in the United States Emergency Department Triage Process: A Narrative Review

This research was motivated by the nurses’ decision-making process in the current emergency department (ED) triage process in the United States. It explores how continuous vital signs monitoring can be integrated into the ED. The article presents four shortcomings on current ED triage systems and proposes a new conceptual clinical decision support model that exploits the benefits of combining wireless wearable devices with Multi-Attribute Utility Theory to address those shortcomings. A literature review was conducted using various engineering and medical research databases, analyzing current practices and identifying potential improvement opportunities. The results from the literature review show that advancements in wireless wearable devices provide opportunities to enhance current ED processes by monitoring patients while they wait after triage and, therefore, reduce the risk of an adverse event. A dynamic mathematical decision support model to prioritize patients is presented, creating a feedback loop in the ED. The coupling of wearable devices (to collect data) with decision theory (to synthesize and organize the information) can assist in reducing sources of uncertainty inherent to ED systems. The authors also address the feasibility of the proposed conceptual model

Etički aspekti u radu sa žrtvama nasilja nad starijim osobama

Cilj je ovog rada produbiti razumijevanje etičkih dilema i izazova u radu stručnjaka pomagačkih profesija u području nasilja nad starijim osobama. Nasilje prema ljudima u starijoj dobi je višedimenzionalan i složen medicinski, pravni i društveni problem. Najčešći su sukobi u pravu starijih osoba na autonomiju/samoodređenje i dužnosti stručnjaka da ih zaštiti. Nepostojanje jasnih i ujednačenih definicija, zakonskih propisa i smjernica za djelovanje otežava stručnjacima rad, izbor strategija i intervencija u nekoj situaciji. Osim navedenih etičkih izazova, pojavljuje se i izazov dužnosti prijavljivanja nasilja, pri čemu stručnjaci nemaju jasne upute ni zaštitu, zatim manjak edukacije za specifično područje nasilja nad starijim osobama te neostvarivosti djelovanja multidisciplinarnog pristupa. Nadalje, stručnjacima je izazov u radu i niska razina društvene osviještenosti za ovu problematiku te percepcija starijih osoba koje ne žele pomoć, odnosno nisu sklone prijavljivanju. Polazeći od teorijskog znanja, profesionalnog iskustva, vrijednosnih načela propisanih u profesionalnim etičkim kodeksima, poznavanja okvira za donošenje etičkih odluka te napose poznavanja individualnih obilježja i situacije u kojima se nasilje dogodilo ili se događa, stručnjacima bi u najvećem broju slučajeva trebalo biti moguće donijeti ispravnu, etički utemeljenu odluku