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Flow Sheet (flow + sheet)

Distribution by Scientific Domains

Medical Sciences	50%
Chemistry	50%

Selected Abstracts

Efficient MILP formulations for the simultaneous optimal peptide tag design and downstream processing synthesis

AICHE JOURNAL, Issue 9 2009
João M. Natali
Abstract Novel and efficient linear formulations are developed for the problem of simultaneously performing an optimal synthesis of chromatographic protein purification processes, and the concomitant selection of peptide purification tags, that result in a maximal process improvement. To this end, two formulations are developed for the solution of this problem: (1) a model that minimizes both the number of chromatographic steps in the final purification process flow sheet and the composition of the tag, by use of weighted objectives, while satisfying minimal purity requirements for the final product; and (2) a model that attempts to find the maximal attainable purity under constraints on the maximum number of separation techniques and tag size. Both models are linearized using a previously developed strategy for obtaining optimal piecewise linear approximations of nonlinear functions. Proposed are models to two case studies based on protein mixtures with different numbers of proteins. Results show that the models are capable of solving to optimality all the implemented cases with computational time requirements of under 1 s, on average. The results obtained are further compared with previous nonlinear and linear models attempting to solve the same problem, and, thus, show that the approach represents significant gains in robustness and efficiency. © 2009 American Institute of Chemical Engineers AIChE J, 2009 [source]

Wait Time and Satisfaction with Care and Service at a Nurse Practitioner Managed Clinic

JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2001
FAAN, Frank L. Cole PhD
Purpose To examine the relationships among the various times patients wait for health care and patient satisfaction with nurse practitioner (NP) care and the service component of care in a NP developed and managed clinic. Data Sources Fortyseven patients (78% response rate) responded anonymously to a 15-item questionnaire that measured satisfaction with NP care and an additional 15 items that measured satisfaction with the service component of care. Actual clock times were recorded on a flow sheet that corresponded to the system of care at this clinic. Conclusions Using Pearson Product-Moment Correlation, there were no statistically significant relationships among various wait times and the measures of satisfaction. Implications for Practice Patient satisfaction with NP care is an important indicator of quality of care. Although satisfaction was not related to wait times, NPs must be respectful of the amount of time that patients wait for health care. [source]

Teleconferenced educational detailing: Diabetes education for primary care physicians

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 2 2005
FACPM, Stewart B. Harris MD
Abstract Introduction: Formal didactic continuing medical education (CME) is relatively ineffective for changing physician behaviur. Diabetes mellitus is an increasingly prevalent disease, and interventions to improve adherence to clinical practice guidelines (CPGs) are needed. Methods: A stratified, cluster-randomized, controlled trial design was used to evaluate the effects of a teleconferenced educational detailing (TED) CME on glycemic control (hemoglobin [Hb] A1c) and family physician adherence to national diabetes guidelines. TED employed sequential, small-group, case-based education using CPGs delivered by a diabetes specialist. Medical record audit data from baseline through the end of a 12-month postintervention period were compared for the control and intervention groups. Satisfaction with the intervention was evaluated. Results: Sixty-one physicians provided 660 medical records. The intervention did not affect mean Hb A1c levels but did significantly (p = .04) alter the distribution of patients by category of glycemic control, with fewer in the intervention group in inadequate control (15.8% versus 23.9%). More patients took insulin (alone or with oral agents) in the intervention group (21.2% versus 12.0%, p = .03), and more took oral agents only in the control group (89.0% versus 82.9%, p = .005). More patients in the intervention group had documentation of body mass index (7.8% versus 1.9%, p < .02), eye exam (12.1% versus 5.1%, p = .02), and treatment plan (43.5% versus 23.6%, p = .01) and used a flow sheet (14.6% versus 7.7%, p < .03). Although there was general satisfaction with the teleconferencing format, specialist educators found the format more challenging than the family physicians. Discussion: CME delivered by teleconference was feasible, well attended, well received by participants, and improved some key diabetes management practices and outcomes. [source]

Delay in blood glucose monitoring during an insulin infusion protocol is associated with increased risk of hypoglycemia in intensive care units,

JOURNAL OF HOSPITAL MEDICINE, Issue 6 2009
Rajesh Garg MD
Abstract BACKGROUND: Hypoglycemia during insulin infusion therapy is a major problem. We investigated whether a delay in blood glucose (BG) monitoring during an insulin infusion protocol (IIP) in the intensive care unit (ICU) is associated with hypoglycemia. METHODS: Data were collected for 50 consecutive patients treated with Brigham and Women's Hospital's IIP. Point-of-care BG values were obtained from the bedside paper flow sheets and the exact times of individual measurements were ascertained from an internet-based glucose meter download program. Data were carefully studied for protocol time violations, defined as a delay of >10 minutes after the recommended time for BG measurement. RESULTS: A total of 2309 BG values were evaluated for time violation. A total of 1474 (63.9%) measurements had been obtained at the recommended time or earlier; 835 (36.1%) measurements had been obtained >10 minutes after the recommended time for measurement. There were a significantly higher proportion of BG values <80 mg/dL following the time violation as compared to no time violation (17.8% versus 11.6%; P < 0.001). CONCLUSION: We conclude that the risk of hypoglycemia during insulin infusion therapy is higher after a delay in BG measurement. Journal of Hospital Medicine 2009;4:E5,E7. © 2009 Society of Hospital Medicine. [source]

Optimal synthesis of p -xylene separation processes based on crystallization technology

AICHE JOURNAL, Issue 2 2009
Ricardo M. Lima
Abstract This article addresses the synthesis and optimization of crystallization processes for p-xylene recovery for systems with feed streams of high concentration, a case that arises in hybrid designs where the first step is commonly performed by adsorption. A novel superstructure and its corresponding mixed-integer nonlinear programming (MINLP) model are proposed. The distinct feature of this superstructure is the capability to generate optimum or near optimum flow sheets for a wide range of specifications of p-xylene compositions in the feed stream of the process. To cope with the complexity of the MINLP model, a two-level decomposition approach, consisting of the solution of an aggregated model and a detailed model, is proposed. The results obtained show good performance of the decomposition strategy, and the optimal flow sheets and p-xylene recoveries are in agreement with the results reported in patents. © 2008 American Institute of Chemical Engineers AIChE J, 2009 [source]

Techno-Economic Analysis of Hydrazine Hydrate Technologies

CHEMICAL ENGINEERING & TECHNOLOGY (CET), Issue 9 2010
P. Nikhitha
Abstract The increasing demand of current world production for hydrazine hydrate emphasizes the need to focus on the techno-economic analysis of the existing technologies. Three processes, namely the Raschig process, urea process, and peroxide-ketazine process, are chosen for technical analysis followed by cost estimation and economic assessment. The technical part involves the development of flow sheets, process design, carrying out of calculations as well as estimation of raw materials, labor, utilities, and process equipment by sizing and other sub-components. The economic part comprises the estimation of working capital, fixed capital investment, total capital investment, and total production costs. Economic parameters like net profits, rate of return, payback period, and break-even point are also estimated to perform economic analysis. The results obtained from technical analysis and economical feasibility studies show that the peroxide-ketazine-based hydrazine hydrate technology has clear advantages in terms of raw material consumption and economic competitiveness. [source]