The Experts below are selected from a list of 263745 Experts worldwide ranked by ideXlab platform
Joshua N. Goldstein - One of the best experts on this subject based on the ideXlab platform.
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reducing door to puncture times for intra arterial stroke therapy a pilot quality improvement project
Journal of the American Heart Association, 2014Co-Authors: Brijesh P Mehta, Thabele M Lesliemazwi, Ronil V Chandra, Donnie L Bell, Chung Huan J Sun, James D Rabinov, Natalia S Rost, Joshua A Hirsch, Lee H Schwamm, Joshua N. GoldsteinAbstract:Background Delays to intra‐arterial therapy (IAT) lead to worse outcomes in stroke patients with proximal occlusions. Little is known regarding the magnitude of, and reasons for, these delays. In a pilot quality improvement (Qi) project, we sought to examine and improve our door‐puncture times. Methods and Results For anterior‐circulation stroke patients who underwent IAT, we retrospectively calculated in‐hospital time delays associated with various phases from patient arrival to groin puncture. We formulated and then implemented a process change targeted to the phase with the greatest delay. We examined the impact on time to treatment by comparing the pre‐ and post‐Qi cohorts. One hundred forty‐six patients (93 pre‐ vs. 51 post‐Qi) were analyzed. In the pre‐Qi cohort (ie, sequential process), the greatest delay occurred from imaging to the neurointerventional (NI) suite (“picture‐suite”: median, 62 minutes; interquartile range [IQR], 40 to 82). A Qi measure was instituted so that the NI team and anesthesiologist were assembled and the suite set up in parallel with completion of imaging and decision making. The post‐Qi (ie, parallel process) median picture‐to‐suite time was 29 minutes (IQR, 21 to 41; P <0.0001). There was a 36‐minute reduction in median door‐to‐puncture time (143 vs. 107 minutes; P <0.0001). Parallel workflow and presentation during work hours were independent predictors of shorter door‐puncture times. Conclusions In‐hospital delays are a major obstacle to timely IAT. A simple approach for achieving substantial time savings is to mobilize the NI and anesthesia teams during patient evaluation and treatment decision making. This parallel workflow resulted in a >30‐minute (25%) reduction in median door‐to‐puncture times.
Sarika Jain - One of the best experts on this subject based on the ideXlab platform.
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a randomized phase ii trial of fulvestrant with or without ribociclib after progression on aromatase inhibition plus cyclin dependent kinase 4 6 inhibition in patients with unresectable or metastatic hormone receptor positive her2 negative breast can
Journal of Clinical Oncology, 2017Co-Authors: Kevin Kalinsky, Prabhjot Singh Mundi, Codruta Chiuzan, Melissa K Accordino, Meghna S Trivedi, Joseph A Sparano, Amy Tiersten, Ruth Oregan, Francisco J Esteva, Sarika JainAbstract:TPS1112Background: CDK4/6i, including palbociclib and ribociclib (R), have demonstrated remarkable benefit in progression free survival (PFS) in patients (pts) with HR+, HER2- MBC with anti-estrogen therapy. Switching between anti-estrogen therapies at disease progression is standard of care in the treatment of HR+ MBC. We evaluate the strategy of switching anti-estrogen therapy to fulvestrant (F) and maintaining CDK4/6 inhibition with R in pts with HR+, HER2- MBC who have progressed on an AI + CDK4/6i. Methods: Trial Design Phase II, multi-center, randomized, double-blind, placebo-controlled trial to evaluate F +/- R in pts with HR+, HER2- MBC who have previously progressed on any AI + CDK4/6i: Screened at 2 different scenarios: Scenario 1: Before receiving any CDK4/6i Scenario 2: Time of progression of disease (POD) while being treated with an AI + CDK4/6i Intervention At randomization, pts assigned 1:1 to either a) F + R or b) F + placebo, with treatment given in 4-week cycles. Major Eligibility Criter...
Wang Tie-jun - One of the best experts on this subject based on the ideXlab platform.
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The Qi Great Wall and Qi-Lu business war
Journal of Taishan University, 2005Co-Authors: Wang Tie-junAbstract:Abstrcat Generally,it is partial to study such a historic cultural heritage as the Qi Great Wall just in military perspective. The partiality is caused, to a greater extent, by the stereotype thinking of Confucianist concepts. Actually, by comparative study of zuo zhuanandguanzi, the emerging of Qi in The Spring and Autumn Period, is not only a military victory, even more an economic one; building the Qi Great Wall is not only the demand of political struggle, still more the demand of economic competition; the Qi Great Wall serves not only as a military defence, but as a strong weapon for the Qi business prosperity.
Sun Fang - One of the best experts on this subject based on the ideXlab platform.
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Qi-Chu relationship and the Qi Great Wall
Journal of Taishan University, 2005Co-Authors: Sun FangAbstract:Abstrcat The Qi Great Wall is an important achaeological heritage to study the Qi historical culture and reflect its relationship with other states. The relationship between the Qi state and the Chu State, the Eastern State and the Southern State respectively, plays a vital role in the situational development of other states. The Qi Great Wall, a direct outcome of powers contending for hegemony, has not only witnessed the complex evolution of the Qi-Chu relationship, but fully embodied the collision and communication of the Central Plains culture and the Jingchu culture in the Qi-Lu land.
Brijesh P Mehta - One of the best experts on this subject based on the ideXlab platform.
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reducing door to puncture times for intra arterial stroke therapy a pilot quality improvement project
Journal of the American Heart Association, 2014Co-Authors: Brijesh P Mehta, Thabele M Lesliemazwi, Ronil V Chandra, Donnie L Bell, Chung Huan J Sun, James D Rabinov, Natalia S Rost, Joshua A Hirsch, Lee H Schwamm, Joshua N. GoldsteinAbstract:Background Delays to intra‐arterial therapy (IAT) lead to worse outcomes in stroke patients with proximal occlusions. Little is known regarding the magnitude of, and reasons for, these delays. In a pilot quality improvement (Qi) project, we sought to examine and improve our door‐puncture times. Methods and Results For anterior‐circulation stroke patients who underwent IAT, we retrospectively calculated in‐hospital time delays associated with various phases from patient arrival to groin puncture. We formulated and then implemented a process change targeted to the phase with the greatest delay. We examined the impact on time to treatment by comparing the pre‐ and post‐Qi cohorts. One hundred forty‐six patients (93 pre‐ vs. 51 post‐Qi) were analyzed. In the pre‐Qi cohort (ie, sequential process), the greatest delay occurred from imaging to the neurointerventional (NI) suite (“picture‐suite”: median, 62 minutes; interquartile range [IQR], 40 to 82). A Qi measure was instituted so that the NI team and anesthesiologist were assembled and the suite set up in parallel with completion of imaging and decision making. The post‐Qi (ie, parallel process) median picture‐to‐suite time was 29 minutes (IQR, 21 to 41; P <0.0001). There was a 36‐minute reduction in median door‐to‐puncture time (143 vs. 107 minutes; P <0.0001). Parallel workflow and presentation during work hours were independent predictors of shorter door‐puncture times. Conclusions In‐hospital delays are a major obstacle to timely IAT. A simple approach for achieving substantial time savings is to mobilize the NI and anesthesia teams during patient evaluation and treatment decision making. This parallel workflow resulted in a >30‐minute (25%) reduction in median door‐to‐puncture times.
