The Target: BP program helped us to standardize our procedure for blood pressure determination across the clinic as a whole, thus leading to improved patient outcomes and quality of care delivery”said Thomas Mihelich, M.D., Chief Quality Officer at Utica Park Clinic in Tulsa, Oklahoma, one of 340 clinics receiving Gold level recognition this year. Of the 103 million Americans with high blood pressure, less than half of them have it controlled to a healthy level. Through the Target: BP program, healthcare providers have access to tools and resources to not only help them remain mindful of blood pressure management but help more of their patients become involved with their care and health goals in order to get their blood pressure under control.Related StoriesHealthy blood vessels could help stave off cognitive declineDon’t ignore diastolic blood pressure values, say researchersScientists turn type A blood into universal type O, potentially doubling blood transfusion stocks“A driving force behind Target: BP’s goal of improving cardiovascular health is the physician and patient partnership,” said AHA President Ivor Benjamin, M.D., FAHA. “No single risk factor has more impact on the nation’s death rates from cardiovascular disease than high blood pressure. We are pleased to see more and more practices prioritize blood pressure control and collaborate with their patients to achieve the program’s goal of reducing heart disease and strokes in their communities.”Experts agree that high blood pressure can often be managed effectively when patients work with their physician to create and follow a treatment plan.“Although we have the tools to effectively treat high blood pressure, many patients face a variety of barriers making it difficult to successfully manage the condition. Target: BP is meant to facilitate ways around those barriers,” said AMA President Barbara L. McAneny, M.D. “We applaud the physicians who are already working hard to control their patients’ blood pressure. And, because we know that improving control rates by just a few percentage points can lead to tens of thousands of additional hypertensive patients with controlled blood pressure, we will continue to urge more physician practices, health systems and patients to join this effort to prioritize blood pressure control. By increasing the national blood pressure control rate, we will be able to save many more lives and improve health outcomes for patients throughout the nation.”More than 1,650 physician practices and health systems nationwide have joined Target: BP™ since 2015, sharing a common goal to reduce the number of adult patients with uncontrolled blood pressure and improve health outcomes associated with heart disease. Launched in 2017, the Target: BP Recognition Program is an extension of Target: BP™. More information about Target: BP and a full list of this year’s recognized participants can be found at TargetBP.org. Source:https://www.ama-assn.org/ Oct 19 2018American Heart Association and American Medical Association award physician practices and health systems with Target: BP™ Recognition Program designation for their commitment to prioritize blood pressure control within the communities they serve The American Heart Association (AHA) and the American Medical Association (AMA) today recognized 802 physician practices and health systems from across the country for their commitment to reducing the number of Americans who have heart attacks and strokes each year. As part of the annual Target: BP Recognition Program, run jointly by the two associations since 2017, these practices are being recognized for their commitment to helping more patients improve blood pressure control.More than 8.7 million people with high blood pressure are represented by this year’s 802 program participants. The highest level of achievement in the program is to reach a control rate of 70 percent or more, signifying Gold status. According to this year’s Target: BP data, nearly half of Target: BP Recognition Program participants reached Gold status—with these health care organizations achieving on average 77 percent of their hypertensive patients’ blood pressure controlled. Data for the program is based on high blood pressure control being defined as less than 140/90 mmHg.
Source:https://www.pennmedicine.org/news/news-releases/2018/november/yelp-reviews-reveal-strengths-and-weaknesses-of-emergency-departments-and-urgent-care-clinics Reviewed by James Ives, M.Psych. (Editor)Nov 12 2018Yelp reviews reveal that emergency departments are viewed as being higher quality but lacking in service as compared to urgent care centers, which patients rate the opposite, according to a new study from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study results, published this month in the Annals of Emergency Medicine, provide a unique opportunity for researchers and clinicians to learn from online reviews, which provide a raw narrative from consumers.”Today’s world is very digital, and it’s very common for consumers to rate a restaurant, hotel or service online, a practice that is spilling over into health care,” said the study’s lead author, Anish Agarwal, MD, a National Clinician Scholars fellow and Emergency Medicine physician at Penn Medicine. “As an emergency department physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers. Health systems and clinicians can learn a lot about the communities they treat and how people experience the services they provide by looking to online ratings and reviews.”In this new study, researchers, with the help of an automated system, analyzed high (five-star) and low (one-star) Yelp reviews for both emergency departments and urgent care centers, two venues that patients can select from when in need of acute care.Researchers identified key themes in the five-star reviews of emergency departments, including bedside manner, treatment of family members, and access to care on nights and weekends. Urgent care centers were unique in receiving five-star reviews more often for factors including ease of refilling prescriptions and being positively recommended by others.On the other side, emergency departments received negative remarks for speed of care, while urgent care centers received one-star reviews as a result of poor reception experiences and patients lacking confidence in the care received.”We are seeing more and more that patients are sharing their experiences online, and they’re looking to social media platforms and online communities to help inform their decision-making,” said Kevin B. Mahoney, executive vice president and chief administrative officer of the University of Pennsylvania Health System. “Within these review and rating websites lies a trove of decision-making data that we can and should be culling through to help inform how care is delivered, and what matters most to our patients in emergency situations.”Related StoriesIt is okay for women with lupus to get pregnant with proper care, says new studyAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyOlympus Europe and Cytosurge join hands to accelerate drug development, single cell researchUrgent care centers have proliferated widely across the country in the past 15 years. Between 2007 and 2016, visits increased by more than 1,700 percent. But while emergency departments have established surveys for patients and their families to report their experiences, there is not a clear equivalent for gathering direct feedback from patients who visit urgent care centers.The study’s senior author, Raina Merchant, MD, director of the Penn Medicine Center for Digital Health and an associate professor in Emergency Medicine, believes Yelp reviews could fill a knowledge gap.”Online reviews provide a rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings” said Merchant. “These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to patients based on their expressed needs.”The researchers analyzed more than 100,000 Yelp reviews, posted between 2005 and 2017–in the midst of the urgent care boom–tied to 1,566 emergency departments and 5,601 from urgent care centers. During the study period, an average of one new review for an emergency department or an urgent care center appeared every hour of every day.The reviews fell largely on one end of the spectrum or the other: five stars or one star. Roughly 47 percent of emergency department and 30 percent of urgent care center reviews fell in the one-star category. The disproportionate amount of negative reviews for acute care facilities, compared to other entities reviewed online, like hotels or restaurants, could be a result of what is at stake for the consumer.”If a restaurant provides you with a quick meal exactly as advertised, they meet your expectations,” Merchant said. “With healthcare, things are different. People are often critically ill, the outcomes are uncertain, and the wait can be long–which are all things that sometimes can’t be controlled.”The research team found that each type of facility received similar five-star reviews for comfort, cleanliness of facilities, pediatric care, and professionalism. One-star reviews for poor phone experiences, long wait times, billing difficulties, and pain management were tied to both emergency departments and urgent care centers.Moving forward, the researchers hope to find more nontraditional sources to provide clues about patient experiences and use them to enhance care quality. read more
Source:https://wyss.harvard.edu/predicting-leaky-heart-valves-with-3d-printing/ Reviewed by James Ives, M.Psych. (Editor)Dec 11 2018New integrated workflow improves valve sizing accuracy during aortic valve replacement proceduresMore than one in eight people aged 75 and older in the United States develop moderate-to-severe blockage of the aortic valve in their hearts, usually caused by calcified deposits that build up on the valve’s leaflets and prevent them from fully opening and closing. Many of these older patients are not healthy enough to undergo open heart surgeries; instead, they have artificial valves implanted into their hearts using a procedure called transcatheter aortic valve replacement (TAVR), which deploys the valve via a catheter inserted into the aorta. There are challenges with this procedure, however, including the need to choose the perfect-sized heart valve without ever actually looking at the patient’s heart: too small, and the valve can dislodge or leak around the edges; too large, and the valve can rip through the heart, carrying a risk of death. Like Goldilocks, cardiologists are looking for a TAVR valve size that is “just right”.Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University have created a novel 3D printing workflow that allows cardiologists to evaluate how different valve sizes will interact with each patient’s unique anatomy, before the medical procedure is actually performed. This protocol uses CT scan data to produce physical models of individual patients’ aortic valves, in addition to a “sizer” device to determine the perfect replacement valve size. The work was performed in collaboration with researchers and physicians from Brigham and Women’s Hospital, The University of Washington, Massachusetts General Hospital, and the Max Planck Institute of Colloids and Interfaces, and is published in the Journal of Cardiovascular Computed Tomography.”If you buy a pair of shoes online without trying them on first, there’s a good chance they’re not going to fit properly. Sizing replacement TAVR valves poses a similar problem, in that doctors don’t get the opportunity to evaluate how a specific valve size will fit with a patient’s anatomy before surgery,” said James Weaver, Ph.D., a Senior Research Scientist at the Wyss Institute who is a corresponding author of the paper. “Our integrative 3D printing and valve sizing system provides a customized report of every patient’s unique aortic valve shape, removing a lot of the guesswork and helping each patient receive a more accurately sized valve.”When a patient needs a replacement heart valve, they frequently get a CT scan, which takes a series of X ray images of the heart to create a 3D reconstruction of its internal anatomy. While the outer wall of the aorta and any associated calcified deposits are easily seen on a CT scan, the delicate “leaflets” of tissue that open and close the valve are often too thin to show up well. “After a 3D reconstruction of the heart anatomy is performed, it often looks like the calcified deposits are simply floating around inside the valve, providing little or no insight as to how a deployed TAVR valve would interact with them,” Weaver explained.To solve that problem, Ahmed Hosny, who was a Research Fellow at the Wyss Institute at the time, created a software program that uses parametric modeling to generate virtual 3D models of the leaflets using seven coordinates on each patient’s valve that are visible on CT scans. The digital leaflet models were then merged with the CT data and adjusted so that they fit into the valve correctly. The resulting model, which incorporates the leaflets and their associated calcified deposits, was then 3D printed into a physical multi-material model.Related StoriesCancer incidence among children and young adults with congenital heart diseaseSmoking triples the risk of death from cardiovascular diseaseTeam approach to care increases likelihood of surviving refractory cardiogenic shockThe team also 3D printed a custom “sizer” device that fits inside the 3D-printed valve model and expands and contracts to determine what size artificial valve would best fit each patient. They then wrapped the sizer with a thin layer of pressure-sensing film to map the pressure between the sizer and the 3D-printed valves and their associated calcified deposits, while gradually expanding the sizer.”We discovered that the size and the location of the calcified deposits on the leaflets have a big impact on how well an artificial valve will fit into a calcified one,” said Hosny, who is currently at the Dana-Farber Cancer Institute. “Sometimes, there was just no way a TAVR valve would fully seal a calcified valve, and those patients could actually be better off getting open-heart surgery to obtain a better-fitting result.”In addition, the multi-material design of the 3D-printed valve models, which incorporate flexible leaflets and rigid calcified deposits into a fully integrated shape, could much more accurately mimic the behavior of real heart valves during artificial valve deployment, as well as provide haptic feedback as the sizer is expanded.The team tested their system against data from 30 patients who had already undergone TAVR procedures, 15 of whom had developed leaks from valves that were too small. The researchers predicted, based on how well the sizer fit into the 3D printed models of their aortic valves, what size valve each patient should have received, and whether they would experience leaks after the procedure. The system was able to successfully predict leak outcome in 60-73% of the patients (depending on the type of valve the patient had received), and determined that 60% of the patients had received the appropriate size of valve.”Being able to identify intermediate- and low-risk patients whose heart valve anatomy gives them a higher probability of complications from TAVR is critical, and we’ve never had a non-invasive way to accurately determine that before,” said co-author Beth Ripley, M.D., Ph.D, an Assistant Professor in the Department of Radiology at the University of Washington who was a Cardiovascular Imaging Fellow at Brigham and Women’s Hospital when the study was done. “Those patients might be better served by surgery, as the risks of an imperfect TAVR result might outweigh its benefits.” Additionally, being able to physically simulate the procedure might inform future iterations of valve designs and deployment approaches.The team has made their leaflet modeling software and 3D printing protocol freely available online for researchers or clinicians who wish to use them. They hope their project will serve as a springboard for evolvable biomedical design that keeps pace with the market’s state of the art.”At the core of the personalized medicine challenge is the realization that one medical treatment will not serve all patients equally well, and that therapies should be tailored to the individual,” said Wyss Institute Founding Director Donald Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at Harvard Medical School and the Vascular Biology Program at Boston Children’s Hospital, as well as Professor of Bioengineering at Harvard’s School of Engineering and Applied Sciences. “This principle applies to medical devices as well as drugs, and it is exciting to see how our community is innovating in this space and attempting to translate new personalized approaches from the lab and into the clinic.” read more
Source:http://web.era-edta.org/ Reviewed by Alina Shrourou, B.Sc. (Editor)Apr 10 2019The link between brain dysfunction and advanced kidney disease was first noted in 1930, so it is not a new finding. Experts spoke of ‘dialysis dementia’ or ‘uremic encephalopathy’. What is new, however, is the finding that mild cognitive impairment (MCI) may already be present in earlier stages of CKD, affecting approximately one in two CKD patients (prevalence varies in studies between 30% and 60%). In contrast to ‘normal’ dementia, CKD-related MCI is not age-related, meaning the cognitive impairment exceeds that expected of the normal aging process. It usually worsens with declining glomerular filtration rate (GFR) of patients – the lower the GFR, the higher the risk of being affected by cognitive impairments.Related StoriesLow dose of endotoxin could have protective effect on men at risk of acute kidney injuryChronic kidney disease patients are excluded from clinical trialsIndigestion remedy improves survival in people with late-stage CKDThe pathogenesis appears complex, involving a variety of factors besides vascular disease – the most frequent trigger for ‘standard’ dementia in elderly people. Dialysis does not help or stop the process of cognitive decline, thus experts believe that factors which are not corrected completely by dialysis, for example the clearance of middle molecules, uncontrolled secondary hyperparathyroidism and anemia, may further the process of cognitive impairment.’One interesting finding, though, is that kidney transplantation appears to slow cognitive decline’, explains Professor Giovambattista Capasso, one of the authors of a review recently published in NDT. ‘This highlights the importance of transplantation, because we have no other intervention strategies once cognitive decline has been diagnosed in CKD patients.’The paucity of intervention strategies is the reason why there is no routine screening for MCI in CKD patients. The authors of the review emphasize that cognitive decline is one of many manifestations of brain damage that clearly accompany the decline of kidney function. Other manifestations include sleep disorders and depression, both of which are also common in CKD patients. ‘Chronic kidney disease is an illness that obviously affects the body and the brain. The latter has been neglected by research, but new tools in neuroscience, such as tractography or two-photon microscopy hold out the promise of gaining further insights in the pathogenesis of MCI so that we might identify therapy targets and be able to treat it one day’, explains Professor Capasso.’Until then, we have to be aware that CKD is a severe disease which affects not only the kidneys, but also other organs systems and the brain – even in early stages. This is why we should strengthen CKD prevention strategies and raise awareness for this illness that is much more severe than most people think’, adds Professor Carmine Zoccali, president of the ERA-EDTA. read more
Citation: Digital rail network mapping achieves efficiencies (2018, April 30) retrieved 18 July 2019 from https://phys.org/news/2018-04-digital-rail-network-efficiencies.html The EU-funded Skylynx (Upgrading Railways from the Air) project has underlined the benefits of digitalising Europe’s rail network. By more cost-effectively targeting the maintenance of assets along the line, the need to put workers in harm’s way is reduced, allowing operators to allocate staff to more valuable tasks. The deployment of assets can also be more efficiently planned. “Rail operators have in the past visualised the rail corridor using paper and technical drawings,” explains project coordinator Jorge Lopez-Sanchez from SigmaRail in Spain. “What we propose instead is something like a Google Maps app for railways. Pictures are taken by drone, with 3-D ‘street views’ achieved through 3-D cameras. Our Sigma-Q technology also tags assets and relevant information that will be useful for the design, operation and maintenance of tracks.”Europe’s secret success A key aim of the project has been to facilitate the efficient deployment of the European Railway Traffic Management System (ERTMS), a relatively unheralded European success story, according to Lopez-Sanchez. “Before ERTMS, each European country had its own signalling system,” he explains. “This meant that if you wanted to send a train from London to Amsterdam for example, you either had to change trains or equip trains with multiple signalling equipment, which is expensive or slow. This is how the idea to create one single system across Europe came about.”ERTMS is now Europe’s de facto standard signalling system, and for new lines being constructed in Europe, there is no alternative. ERTMS has also become a global success, and is being deployed in countries including Saudi Arabia, Australia and Mexico. The deployment of ERTMS however remains a challenge. Europe’s legacy of multiple automatic train protection systems has slowed progress and required huge political effort in order to agree on a system that is suitable for all EU members. Lopez-Sanchez also points out the technical challenges in creating a system that is truly functional across all EU Member States, as well as deploying advanced systems along old rail lines. Digitalising rail networksGathering data on the state of these lines is therefore crucial. “Deploying advanced signalling systems such as ERTMS requires operators to know the exact location of safety-related rail assets such as signals and danger points,” explains Lopez-Sanchez. “You can imagine that a system designed to carry thousands of people at a speed of up to 350 km/h requires a high degree of accuracy.” This was the starting point of the Skylynx project; applying cutting-edge technology to develop the digital models of rail corridors. “The benefits for industry are huge,” says Lopez-Sanchez. “Workers for example will not be required to gather data from the tracks, since this task can be accomplished using drones. This will significantly improve safety. Rail companies will be able to quickly identify lines in need of maintenance, saving time and money. At the end of the day, operational efficiencies will translate into lower costs for the general public.” Credit: Skylynx EU-funded researchers have been able to gather accurate geographical data through the use of drones, remote sensing and 360-degree cameras to deliver digital 3-D models of railway lines. This will assist rail and infrastructure companies in assessing tracks throughout their lifecycle. Satellites helping to modernise railways Provided by CORDIS Explore further This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. read more
© 2019 AFP Samsung Electronics—the flagship company of the sprawling Samsung Group, by far the biggest of the family-controlled conglomerates that dominate the South’s economy—spent nearly eight years developing the Galaxy Fold Samsung delays launch of folding Galaxy smartphone The Galaxy Fold has been widely promoted as the “world’s first foldable smartphone” The move by the world’s biggest smartphone maker—announced after reviewers provided with early devices reported screens breaking within days of use—comes less than three years after its Galaxy Note 7 disaster.The company said the Galaxy Fold, which had been due for its US release on Friday, “needs further improvements” before customers can receive it and a new release date will be announced in the coming weeks.Samsung Electronics—the flagship company of the sprawling Samsung Group, by far the biggest of the family-controlled conglomerates that dominate the South’s economy—spent nearly eight years developing the Galaxy Fold.It has been widely promoted as the “world’s first foldable smartphone” and is part of its strategy to propel growth with groundbreaking gadgets, while rivals such as China’s Huawei have been racing to bring similar devices to market.Kim Dae-ho, an analyst at Institute for Global Economy, said Samsung can regain customer trust as long as it identifies the problem and releases the perfected Fold “in the quickest possible time”.”Samsung is facing its biggest test ever,” he said. “If they manage to pull this one off, it can bring greater success. Right now it is standing at the crossroads of destiny.” Citation: Samsung facing crucial test over Galaxy Fold delay, analysts warn (2019, April 23) retrieved 17 July 2019 from https://phys.org/news/2019-04-samsung-crucial-galaxy-analysts.html Samsung earlier this month launched the 5G version of its top-end Galaxy S10 device but faces increasing competition from Huawei across different price ranges, and has warned of a more than 60 percent plunge in first-quarter operating profit in the face of weakening markets.Independent technology analyst Rob Enderle said the failure of a flagship item could send Samsung buyers to rivals.”If a halo product fails, people don’t trust that you build quality stuff,” Enderle said.”It can do incredible damage. And Huawei is moving up like a rocket, so this could be good for Huawei.”Samsung Electronics shares closed down 0.33 percent in Seoul on Tuesday.’Pre-emptive action’But analysts say that while the decision to delay may hurt Samsung’s brand reputation in the short term, it could ultimately prevent it from repeating the critical mistakes of 2016, which cost it billions of dollars. Explore further That year, Samsung’s reputation suffered a major blow after a damaging worldwide recall of Galaxy Note 7 devices over exploding batteries. South Korean tech giant Samsung Electronics is “facing its biggest test ever”, analysts said Tuesday after it delayed the release of its $2,000 foldable phone over screen problems. At the time, the firm showed a slow response to initial reports of the devices catching fire, claiming the hazard was only limited to a “small fraction of phones” manufactured.But it later ended up announcing a recall of 2.5 million smartphones after several devices exploded. It eventually traced the problem to the batteries, but decided to kill off the model for good.Analyst Kim said the tech giant’s approach with the Fold was quite different from the way it handled the Note 7 fiasco.”Back in 2016, Samsung was overconfident with its technology,” and did not respond to the initial reports immediately, he said. “As a result, the damage was enormous,” he said.”The fact that Samsung is delaying the release of the Fold—although the problem isn’t as serious as the one Note 7 had—means it is taking pre-emptive action this time.” Samsung’s reputation suffered a major blow in 2017 after a damaging worldwide recall of Galaxy Note 7 devices over exploding batteries This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. read more