Analysis of Clinic Layouts and Patient-Centered Procedural Innovations Using Discrete-Event Simulation

Abstract

Given that healthcare costs in the U.S. continue to climb, engineering managers can help address this situation by identifying designs for cost savings. Using discrete-event simulation, the layout of four different healthcare clinic scenarios considered in a redesign program named Patient Aligned Care Teams were studied. Model 1 is an existing layout in many clinics and Model 2 is staff-centered, while Models 3 and 4 provide additional space including common hallway(s). Our main conclusion is that Model 4 reduces patient travel distances and average queueing waits, while also providing the best privacy in accordance with HIPAA and the most security for the staff.     

Extraction,optimisation and characterisation of phenolics from Thymus vulgaris L.: phenolic content and profiles in relation to antioxidant,antidiabetic and antihypertensive properties

The objectives of this study were to examine varying extraction conditions of Thymus vulgaris L. as related to phenolic content and profiles of the extracts and their antioxidant, antihypertensive and antidiabetic properties. Phenolics were extracted under various conditions pertaining to free and bound phenolics, solvent type and combination of extraction time and temperature, and these extracts were evaluated in terms of their antioxidant activities and inhibitory activities of angiotensin‐converting enzyme (ACE), α‐glucosidase and α‐amylase. The acetone–water solvent mixture (1:1; v/v) produced the extract with the greatest phenolic content, antioxidant activity and inhibitory activities of ACE and α‐glucosidase. The optimal extraction temperature for maximum phenolic content and antioxidant activity associated with methanol extraction was 60 °C, whereas a lower temperature at 40 °C was required to maximise inhibitory activities for ACE, α‐glucosidase and α‐amylase. An inverse relationship was seen between antioxidant and glucosidase inhibitory activities vs. the ACE and α‐amylase inhibitory activities, which suggests the need for extractions to be directed to specific bioactivities of thyme extracts. Generally, the results indicate major differences in phenolic profiles among the tested extraction conditions with thymol as the predominant phenolic seen in most extractions, while gallic acid, rosmarinic acid or diosmin also predominated in other extracts. Extracts with the same predominant phenolic compound and similar phenolic content showed major disparities in their ACE, glucosidase and α‐amylase inhibitory activities, indicating that the major phenolic profiles of thyme extracts may not be necessarily related to the degree of inhibition of ACE, glucosidase and α‐amylase enzymes.     

The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet

The Mediterranean diet is considered one of the healthiest diets in the world. This is often attributed to low saturated fat consumption, moderate wine consumption, and high vegetable consumption. However, herbs and spices associated with these diets may also play an important role in the quality of this diet. This review summarizes the most recent research regarding the anti-diabetic, anti-inflammatory, anti-hyperlipidemic and anti-hypertensive properties of this collection of culinary species. Additionally, this review briefly summarizes studies performed on lesser known herbs from around the world, with the goal of identifying new culinary species that may be useful in the treatment or prevention of diseases.     

Membrane treatment of side-stream cooling tower water for reduction of water usage

A pilot study was conducted to determine whether membrane treatment on a side stream of recirculating cooling-tower water could reduce overall water usage and discharge. The treated permeate was returned to the cooling tower while the concentrate was discharged to the sanitary sewer. Flow rates, pressures and water chemistry were monitored. The pilot demonstrated potential substantial water savings. Maximum make-up water and discharge reduction were 16% and 49%, respectively. As high as possible permeate recovery is needed to maximize water conservation. Silica scaling on the membranes limited water savings in this pilot. Development of membranes with a solute-rejection capacity less than the 92% average of the membranes used in the pilot would assist in optimizing water savings. Decreased water outlays compensated for the additional energy used by membrane treatment. Scaling control is critical for economic operation.