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At least 1,027 records · Page 57Linked to original sources
PubMed2006

Process potential screening - an instrument to improve business processes in hospitals.

OBJECTIVES: Hospitals are increasingly under pressure to optimize their processes. So far, an instrument to systematically identify the potentials for improvement of a given business process is missing. The aim of this project is to develop such an instrument. METHODS: Initially, central aspects of the quality of a hospital process were identified on the basis of a systematic literature review. Secondary to that, criteria to measure quality aspects were defined: More than 300 criteria from medical and business informatics, economics and quality management publications were gathered and systematically aggregated. RESULTS: As a result, the Process Potential Screening (PPS) instrument was developed. The PPS is a matrix containing two axes: Axis I comprises 30 quality aspects referring to results, execution and control of hospital processes. Axis II comprises 16 quality criteria (e.g., customer satisfaction, time). The PPS displays approximately 400 relevant combinations of those quality aspects and quality criteria that help to identify potentials for improvement of a given hospital process. It utilizes different methods for the measurement of the criteria and for application by way of individuals or groups. CONCLUSIONS: In using the PPS, relevant potentials for improvement were identified in ten typical hospital processes. The instrument's practicability must now be examined in further studies by the final target group (e.g., quality or project managers, and the staff responsible for processes).

Hospital Administration↗
PubMed1995

How to achieve comprehensive teamwork in your pediatric dental office through total quality management (TQM).

Teamwork is considered the key to success in any organization. Total Quality Management (TQM) is a systematic process that optimizes quality and copes with change. The process includes customer satisfaction, as the ultimate criterion of quality; worker empowerment; and reliance on statistical process, rather than inspection and continuous improvement. Managers not only adopt new techniques but also a new philosophy, rethinking their roles to become leaders and mentors instead of bosses. Fourteen points, developed during several decades, are considered the cornerstone of quality and teamwork, and they can apply to what we do in the pediatric dental office. Together, these principles should be viewed as an ongoing process that can take up to five years or more and should be managed with the same emphasis as other systems in your office. The dentist, or leader, implements and takes part in the process, which will improve morale by increasing team spirit.

Humans↗
PubMed1986

Requirement for recognition of class II molecules and processed tumor antigen for optimal generation of syngeneic tumor-specific class I-restricted CTL.

The roles of Class II-restricted L3T4+ T cells and of accessory cells (AC) during the in vitro generation of Class I-restricted Lyt-2+ cytotoxic T cells (CTL) specific for a Class II-negative syngeneic tumor cell line, FBL, was examined. Treatment of responder FBL-immune spleen cells with alpha L3T4 plus complement before culture, as well as the direct addition of alpha L3T4 to cultures, diminished the generation of FBL-specific CTL. The contribution of L3T4+ cells could be completely replaced by the addition of exogenous cytokines. The data demonstrate that the optimal generation of FBL-specific Lyt-2+ CTL requires the presence of L3T4+ cells, presumably to provide necessary lymphokines. FBL-specific CTL could not be generated from purified FBL-immune T cells in the absence of AC. Syngeneic Ia+ macrophages (M phi), added at the initiation of culture, restored the response of purified T cells. Pretreatment of M phi with ammonium chloride or chloroquine, or the addition of monoclonal alpha I-Ab antibody at the initiation of culture, inhibited the ability of M phi to reconstitute the CTL response. Finally, the addition of exogenous helper factors could replace M phi and reconstitute the FBL-specific response of AC-depleted immune T cells. These results suggest that during the generation of Lyt-2+ CTL to a syngeneic tumor expressing only Class I MHC antigens, Ia+ AC are required to biochemically process antigen released from the tumor cells and present this modified antigen to Class II-restricted T helper cells.

Animals↗
PubMedDate not supplied

Do bone ingrowth processes produce a globally optimized structure?

A topology optimization program was applied to test the hypothesis that bone adaptation to porous coated implants produces a structure which minimizes the global strain energy density. The program was used to predict the optimal material layout around a porous coated tibial component with multiple cones [Goldstein et al., Trans. 37th ORS, p. 92 (1991)]. The sensitivity of the predicted adaptation to analysis assumptions was assessed and the predicted bone ingrowth and apposition were compared with the experimental findings of Goldstein et al. The results showed that apposition occurred consistently at the cone tips regardless of analysis assumptions. The specific topology of apposition at the cone tips was most sensitive to the assumed loading conditions. A comparison with the experimental results for 11 subdivisions showed that the general predicted location of material agreed with the experimental results (R2 > or = 0.59). However, the program predicted a consolidated bone greater than 1000 microns in thickness at the cone tips, which differed from the porous bone structure found experimentally. This discrepancy was reflected in a refined comparison over 31 subdivisions which did not produce a significant correlation (R2 < or = 0.3). The program also predicted little ingrowth (< 6-7%), indicating that ingrowth past the first bead layer contributed little to the overall bone-implant interface layer stiffness. Based on these results, we conclude, within limitations of a two-dimensional analysis, that bone adaptation to porous coated implants does not produce a structure solely optimized to minimize the global strain energy density. We hypothesize that the final bone structure reflects the need to meet both mechanical and nutritional demands.

Adaptation, Physiological↗
PubMed1990

Children's cognitive triage: optimal retrieval or effortful processing?

Cognitive triage is a surprising nonmonotonic relationship that exists between the order in which children read words out of long-term memory and the memory strengths of those same words. Two forgetting experiments with 7- and 12-year-old children are reported in which fuzzy-trace theory's explanation of this effect was pitted against an effortful processing explanation. The two explanations make different predictions about the relative rates of forgetting for words that are recalled at the primacy and recency positions of output queues. The data consistently favored fuzzy-trace theory's predictions. We discuss the implications of our results for two assumptions that are commonly made in theories of memory development--namely, that recall accuracy is a monotonic-increasing function of memory strength and that recall order is a monotonic-decreasing function of memory strength.

Attention↗
PubMed1981

Optimizing the acquisition and processing of surface electromyographic signals.

Electromyographic (EMG) signals, detected on the skin surface over active muscles, are being used increasingly for the control of prostheses and for investigating and retraining human movement. However, the statistical characteristics of the signal make it difficult toi achieve a processing delay of less than about 100 ms, which is marginal in some applications. Two techniques for reducing this delay are described: (i) signal pre-whitening, based upon digital autoregressive modelling or analogue filtering; an (ii) the use of a multiple electrode array. Successful discrimination between several states in a single muscle is possible in about 50 ms.

Action Potentials↗
PubMed1983

Contribution to the methodology of optimization and in-process control of some physical properties of pharmaceutical bulk substances and granulates.

Many experts consider drug analysis exclusively as a chemical measuring technique. In the pharmaceutical industry, physical and physico-chemical parameters form an integrated part of the quality specification, because they play an essential role both in quality assurance and in the technical and economic aspects of production on the commercial scale. Such physical and physico-chemical properties are analysed by special, non-chemical methods. In their programme of systematic research in this field, the authors have elaborated new methods to test some essential properties of powders and granulates used in the production of compressed tablets. The following test and production methods have been developed: (i) the determination of flowing-sliding characteristics of granulates based on the measurement of the mass-flow (g s(-1)) and mass-flow density (g s(-1) cm(-2)); (ii) the determination of optimum granulometric parameters with regard to tablet diameter; (iii) the direct determination of the temperature-dependent equilibrium vapour pressure; and (iv) the compression of tablets under controlled temperature.

Journal Article↗
PubMed2004

Optimization of a biological process for treating potato chips industry wastewater using a mixed culture of Aspergillus foetidus and Aspergillus niger.

Potato chips industry wastewater was collected and analyzed for biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS) and total carbohydrates. Two Aspergillus species, A. foetidus and A. niger, were evaluated for their ability to grow and produce biomass and reduce the organic load of the wastewater. A. foetidus MTCC 508 and A. niger ITCC 2012 were able to reduce COD by about 60% and produce biomass 2.4 and 2.85 gl(-1), respectively. Co-inoculation of both Aspergillus strains resulted in increased fungal biomass production and higher COD reduction than in individual culture at different culture pH. pH 6 was optimum for biomass production and COD reduction. Amendment of the wastewater with different N and P sources, increased the biomass production and COD reduction substantially. Under standardized conditions of pH 6 and amendment of wastewater with 0.1% KH2PO4 and 0.1% (NH4)2 SO4, a mixed culture gave 90% reduction in COD within 60 h of incubation.

Aspergillus↗
PubMed2004

Treatment of silica effluents: ultrafiltration or coagulation-decantation.

In the electronics industry, the preparation of silicon plates generates effluents that contain a great amount of colloidal silica. Two processes--decantation and ultrafiltration--are studied with in view the treatment of the effluents released by the firm Rockwood Electronic Materials. The feasibility of each of the two processes is studied separately and their operating parameters optimized. Both processes allow the recovery of a great proportion of the initial effluent (over 89%) as transparent and colorless water that can be reused at the start of a line. In view of the results and of the compared advantages and disadvantages of the two processes, ultrafiltration will be selected for the industrial unit.

Colloids↗
PubMed2004

Optimizing the organ procurement process: organizational prerequisites and monitoring strategies in a national network.

The current project sought to collect detailed information on the Italian donation system and in particular on the organization and functioning of the local coordinating centers. The final objective was to provide local and regional institutions with the information required to improve the system. While improving the knowledge of current Italian donation system, the project had constructive purposes. Our intention was to analyze how the national system is working, what the coordinating centers are actually doing, how they are organized, to what extent existing rules are obeyed, and what are the main limits of the system. This analysis sought to lead to the development of a set of proposals that can be summarized in two categories: (1) "intrinsic" actions, that is, those established and implemented at the hospital level; and (2) supporting "extrinsic" actions, that is, those identified by the National Transplant Centre and addressed to the regional and interregional coordinating networks. Finally, the analysis of the application of the existing rules should lead to the development of practice guidelines such that each center conforms to the existing regulations established by European directives.

Brain Injuries↗
PubMed2005

Process intensification using cavitation: optimization of oxidation conditions for synthesis of sulfone.

Cavitation can be effectively used for intensification of chemical reactions due to the production of free radicals and conditions of high temperatures and pressures locally. In the present work, use of cavitation for the intensification of the synthesis of sulfone has been explored. The oxidation of thioether or sulfide to synthesize corresponding sulfone with 30% H(2)O(2) as an oxidant was studied under acoustic cavitation and the results have been compared with the conventional approach based on the use of mechanical agitation. The aim has been also to optimize the different operating conditions viz. molar ratio of reactants to the oxidizing agent, type of the catalyst as well as its concentration, type of the solvent and the reactant concentration, so as to maximize the degree of intensification. It was observed that under the optimized conditions of sonication, the yield of sulfone was about five to six times higher as compared to the conventional approach of using mechanical agitation only.

Catalysis↗
PubMed1999

Optimization of the solidification/stabilization process of MSW fly ash in cementitious matrices.

The solidification/stabilization (S/S) process of municipal solid waste (MSW) fly ash in cementitious matrices was investigated in order to ascertain the feasibility of a washing pretreatment of fly ash with water as a means of maximizing the ash content of cementitious mixtures. Four types of fly ash resulting from different Italian MSW incineration plants and ASTM Type III Portland cement were used in this study. Ash-cement mixtures with different fly ash/cement (FA/C) ratios were made using untreated and washed fly ash. Washing of fly ash with water was realized by a two-stage treatment (liquid/solid=25; mixing time=15 min for each stage). The cementitious mixtures were characterized for water demand, setting time, mechanical strength, and heavy metals leachability. Comparison between the above properties of mixtures incorporating untreated and washed fly ash (particularly, setting characteristics), coupled with economical evaluation of the S/S process when applied to untreated and washed fly ash, proved the feasibility of washing pretreatment as a means of maximizing the incorporation of MSW fly ash in cementitious matrices (ash content up to 75%-90% by weight of total solid).

Air Pollution↗
PubMed2003

Optimization of the preparation process for human serum albumin (HSA) nanoparticles.

Nanoparticles prepared by desolvation and subsequent crosslinking of human serum albumin (HSA) represent promising carriers for drug delivery. Particle size is a crucial parameter, in particular for the in vivo behaviour of nanoparticles after intravenous injection. The objective of the present study is the development of a desolvation procedure for the preparation of HSA-based nanoparticles under the aspect of a controllable particle size between 100 and 300 nm in combination with a narrow size distribution. A pump-controlled preparation method was established which enabled particle preparation under defined conditions. Several factors of the preparation process, such as the rate of addition of the desolvating agent, the pH value and the ionic composition of the HSA solution, the protein concentration, and the conditions of particle purification were evaluated. The pH value of the HSA solution prior to the desolvation procedure was identified as the major factor determining particle size. Varying this parameter, (mean) particle diameters could be adjusted between 150 and 280 nm, higher pH values leading to smaller nanoparticles. Washing the particles by differential centrifugation led to significantly narrower size distributions. The reproducibility of the particle size and particle size distribution under the proposed preparation conditions was demonstrated by sedimentation velocity analysis in the analytical ultracentrifuge and the cellular uptake of those nanoparticles was studied by confocal microscope imaging and FACS analysis. The stability of the resulting nanoparticles was evaluated by pH and buffer titration experiments. Only pH values distinctly outside the isoelectric pH range of HSA and low salt concentrations were able to prevent nanoparticle agglomeration.

Drug Delivery Systems↗
PubMedDate not supplied

Postsynthetic conjugation of biopolymers with high molecular mass poly(ethylene glycol): optimization of a solution process tested on synthetic oligonucleotides.

The reaction of oligonucleotides with high molecular weight monomethoxy poly(ethylene glycol)s (MPEGs) has been tested to set up a convenient procedure for the postsynthetic conjugation in solution of biopolymers. A first oligonucleotide was previously modified in 5', using a liquid-phase procedure, with a linker carrying a terminal primary amino group to enhance its nucleophilic reactivity. Two procedures commonly utilized for the activation of the terminal OH groups of the MPEG were evaluated, that is, the reaction with pNO(2)-phenyl chloroformate and with N,N'-disuccinimidyl carbonate. Both water as well as organic solution conditions were employed and compared. In a second test, a 3'-amino modified, commercial 20-mer was also conjugated in a microscale condition to verify the effect of size and concentration of MPEG on the postsynthetic conjugation of these biopolymers under troublesome synthetic conditions.

Biopolymers↗
PubMedDate not supplied

In pursuit of the optimal fed-batch process for monoclonal antibody production.

Fed-batch culture currently represents the most attractive choice for large scale production for monoclonal antibodies (MAbs), due to its operational simplicity, reliability, and flexibility for implementation in multipurpose facilities. Development of highly productive cell lines, maximization of cell culture longevity, and maintenance of high specific antibody secretion rates through genetic engineering techniques, nutrition supplementation, waste product minimization, and control of environmental conditions are important for the design of high-yield fed-batch processes. Initially simple supplementation protocols have evolved into sophisticated serum-free multi-nutrient feeds that result in MAb titers on the order of 1-2 g/L. Limited research has been published to date on the effect of various culture parameters on potentially important quality issues, such as MAb glycosylation and stability. Although most fed-batch protocols to date have relied on relatively simple control schemes, increasingly sophisticated algorithms must be applied in order to take full advantage of the potentially additive effects of manipulating nutrient and environmental parameters to maximize fed-batch process productivity.

Animals↗