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Tsao J.,Novartis | Tsao J.,McKinsey and Co. | Kozerke S.,ETH Zurich
Journal of Magnetic Resonance Imaging

In recent years, there has been an explosive growth of magnetic resonance imaging (MRI) techniques that allow faster scan speed by exploiting temporal or spatiotemporal redundancy of the images. These techniques improve the performance of dynamic imaging significantly across multiple clinical applications, including cardiac functional examinations, perfusion imaging, blood flow assessment, contrast-enhanced angiography, functional MRI, and interventional imaging, among others. The scan acceleration permits higher spatial resolution, increased temporal resolution, shorter scan duration, or a combination of these benefits. Along with the exciting developments is a dizzying proliferation of acronyms and variations of the techniques. The present review attempts to summarize this rapidly growing topic and presents conceptual frameworks to understand these techniques in terms of their underlying mechanics and connections. Techniques from view sharing, keyhole, k-t, to compressed sensing are covered. J. Magn. Reson. Imaging 2012;36:543-560. © 2012 Wiley Periodicals, Inc. Source

Corbett S.,McKinsey and Co.
Healthcare Papers

The authors of "Chartbook: Shining a Light on the Quality of Healthcare in Canada," focus on building a Canadian healthcare performance baseline, highlighting opportunities to improve the system and then raising policy questions. This is a thoughtful approach to gaining awareness of the relative performance across the Canadian healthcare system. In essence, it is necessary to first establish a felt need, identify areas to improve and then ensure the system will implement the necessary changes to improve. The authors build a reasonable case for why improvements are necessary, and they identify key barriers that must be removed to actually realize improvements and offer a wide range of policy recommendations. However, not all of these recommendations are focused on the key point of ensuring that there are incentives in place to drive participants to implement changes. Source

Cohen S.B.,McKinsey and Co.
The American journal of managed care

In healthcare, consumerism is not a product or program. Instead, it is an orientation to new care delivery models that encourage and enable greater patient responsibility through the intelligent use of information technology. Despite the promise of consumerism, current approaches have not fully realized the potential benefits of improved outcomes and lower cost. We recommend 4 guiding principles to ensure that next-generation innovation yields the returns that providers, patients, and other stakeholders expect: (1) keep the consumer at the center of innovation, (2) keep it simple, (3) link products and services to a broader "ecosystem" of care, and (4) encourage health in addition to treating illness. Now may be a particularly compelling time to invest in a consumerist approach. Source

Pak J.,Stanford University | Maniar J.M.,Stanford University | Maniar J.M.,McKinsey and Co. | Mello C.C.,Stanford University | Fire A.,Stanford University

The effectiveness of RNA interference (RNAi) in many organisms is potentiated through the signal-amplifying activity of a targeted RNA-directed RNA polymerase (RdRP) system that can convert a small population of exogenously-encountered dsRNA fragments into an abundant internal pool of small interfering RNA (siRNA). As for any biological amplification system, we expect an underlying architecture that will limit the ability of a randomly encountered trigger to produce an uncontrolled and self-escalating response. Investigating such limits in Caenorhabditis elegans, we find that feed-forward amplification is limited by biosynthetic and structural distinctions at the RNA level between (1) triggers that can produce amplification and (2) siRNA products of the amplification reaction. By assuring that initial (primary) siRNAs can act as triggers but not templates for activation, and that the resulting (secondary) siRNAs can enforce gene silencing on additional targets without unbridled trigger amplification, the system achieves substantial but fundamentally limited signal amplification. © 2012 Elsevier Inc. Source

Turner A.W.,University of Melbourne | Mulholland W.J.,McKinsey and Co. | Taylor H.R.,University of Melbourne
Clinical and Experimental Ophthalmology

Background: This paper aims to describe models for service integration between ophthalmology and optometry when conducting outreach eye services. The effect of good coordination on clinical activity and cost-effectiveness is examined. Design: Cross-sectional case study based on remote outreach ophthalmology services in Australia. Participants: Key stake-holders from eye services in nine outreach regions participated in the study. Methods: Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' levels of coordination. Records of clinical activity were used to statistically compare the effects of good coordination. Main Outcome Measures: Clinical activity (surgery and clinic consultation rates), waiting times and costs per attendance. Surgical case rate being the proportion of surgery that results from a clinic. Results: Service integration between optometry and ophthalmology resulted in an increased surgical case rate for ophthalmology clinics (R 2=0.57). There were trends towards increased clinical activity and reduced waiting times, and costs/attendance were stable. Conclusions: Coordination of eye services with better integration of ophthalmology and optometry roles may improve efficiency of services for patients. Coordination of eye services has multiple facets including facilitating engagement with the local community, eye professions and health facilities. The varied roles of eye health coordination require further definition and appropriate funding. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists. Source

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