Reduction in Hospitals\u27 Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmission rates. Data sources included 2007-2012 American Hospital Association Annual Survey, Area Health Resources Files, the Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependent variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failure, and pneumonia. The independent variable was the presence of HBSNF in a hospital (1 = yes, 0 = no). Control variables included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed using generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected for clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospitals having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with lower readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated with lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as a potential strategy to lower hospitals’ readmission rates

Inverse problem and Bertrand's theorem

The Bertrand's theorem can be formulated as the solution of an inverse problem for a classical unidimensional motion. We show that the solutions of these problems, if restricted to a given class, can be obtained by solving a numerical equation. This permit a particulary compact and elegant proof of Bertrand's theorem.Comment: 11 pages, 3 figure

Robot-Assisted Epiretinal Membrane Peeling: A Prospective Assessment of Pre- and Intra-Operative Times and of Surgeons' Subjective Perceptions.

PURPOSE The Preceyes Surgical System (PSS) is a robotic assistive device that may enhance surgical precision. This study assessed pre- and intra-operative times and surgeons' perceptions of robot-assisted epiretinal membrane peeling (RA-MP). METHODS We analyzed the time requirement of three main tasks: the preparation of the PSS (I), patient preparation (II), and surgery (III). Following surgery, the surgeons were asked questions about their experience. RESULTS RA-MP was performed in nine eyes of nine patients. Task I required an average time of 12.3 min, initially taking 15 min but decreasing to 6 min in the last surgery. Task II showed a mean time of 47.2 (range of 36-65) min. Task III had a mean time of 72.4 (range of 57-100) min. A mean time of 27.9 (range of 9-46) min was necessary for RA-MP. The responses to the questionnaire revealed a trend towards increasing ease and reduced stress as familiarity with the PSS increased. CONCLUSIONS A substantial reduction in pre- and intra-operative times, decreasing to a total of 115 min, was demonstrated. RA-MP was positively anticipated by the surgeons and led to no hand or arm strain while being more complex than manual MP

Sintesis Paduan Co-cr Menggunakan Metode Ultrasonik

Paduan Co-Cr merupakan material tahan suhu tinggi dan tahan korosi. Penelitian ini bertujuan mensistesis serbuk paduan Co-Cr dengan metode ultrasonik, kemudian dilanjutkan dengan proses sintering dalam kapsul kaca kuarsa. Iradiasi ultrasonik yang digunakan pada frekuensi 20 kHz dan amplitudo 40 % dengan komposisi Co : Cr sebesar 80 : 20.Waktu perlakuan sonikasi adalah selama 0 jam, 3 jam, 6 jam, 12 jam, 24 jam, dan 48 jamdalam larutan etanol. Setelah sonikasi selama 48 jam, fasa FCC dari Co mulai bertransformasi menjadi fasa HCP. Perlakuan ultrasonik terhadap campuran Co-Cr juga memberikan efek pengurangan ukuran partikel. Parameter kisi serbuk setelah ultrasonikasi 48 jam adalah: untuk HCP-Co a = b = 0,25074 nmdan c = 0,40699 nm, untuk FCC-Co a = b = c = 0,35411nm, dan untuk BCC-Cr a=b=c=0.28827 nm. Perlakuan ultrasonik selama 48 jam menhasilkan pembentukan paduan Co-Cr dengan persentasi berat sebesar 25,2124. Hasil sintering padatan Co-Cr menunjukkan parameter kisi HCP-Co memiliki nilai yaitu a = b = 0,25230 nm dan c=0,41223 nm, dan FCC-Co a = b = c = 0,35232 nm. Terbentuknya microalloying CoCr diindikasikan dari hasil EDS, teramati partikel yang mempunyai komposisi Co : Cr = 71,25 : 24,45. Paduan Co-Cr yang terbentuk setelah sintering pada 1300 oC adalah sebesar 15,33416 %berat

A critical analysis of COVID-19 research literature: Text mining approach

Objective: Among the stakeholders of COVID-19 research, clinicians particularly experience difficulty keeping up with the deluge of SARS-CoV-2 literature while performing their much needed clinical duties. By revealing major topics, this study proposes a text-mining approach as an alternative to navigating large volumes of COVID-19 literature. Materials and methods: We obtained 85,268 references from the NIH COVID-19 Portfolio as of November 21. After the exclusion based on inadequate abstracts, 65,262 articles remained in the final corpus. We utilized natural language processing to curate and generate the term list. We applied topic modeling analyses and multiple correspondence analyses to reveal the major topics and the associations among topics, journal countries, and publication sources. Results: In our text mining analyses of NIH’s COVID-19 Portfolio, we discovered two sets of eleven major research topics by analyzing abstracts and titles of the articles separately. The eleven major areas of COVID-19 research based on abstracts included the following topics: 1) Public Health, 2) Patient Care & Outcomes, 3) Epidemiologic Modeling, 4) Diagnosis and Complications, 5) Mechanism of Disease, 6) Health System Response, 7) Pandemic Control, 8) Protection/Prevention, 9) Mental/Behavioral Health, 10) Detection/Testing, 11) Treatment Options. Further analyses revealed that five (2,3,4,5, and 9) of the eleven abstract-based topics showed a significant correlation (ranked from moderate to weak) with title-based topics. Conclusion: By offering up the more dynamic, scalable, and responsive categorization of published literature, our study provides valuable insights to the stakeholders of COVID-19 research, particularly clinicians.3417985

Multiband tight-binding theory of disordered ABC semiconductor quantum dots: Application to the optical properties of alloyed CdZnSe nanocrystals

Zero-dimensional nanocrystals, as obtained by chemical synthesis, offer a broad range of applications, as their spectrum and thus their excitation gap can be tailored by variation of their size. Additionally, nanocrystals of the type ABC can be realized by alloying of two pure compound semiconductor materials AC and BC, which allows for a continuous tuning of their absorption and emission spectrum with the concentration x. We use the single-particle energies and wave functions calculated from a multiband sp^3 empirical tight-binding model in combination with the configuration interaction scheme to calculate the optical properties of CdZnSe nanocrystals with a spherical shape. In contrast to common mean-field approaches like the virtual crystal approximation (VCA), we treat the disorder on a microscopic level by taking into account a finite number of realizations for each size and concentration. We then compare the results for the optical properties with recent experimental data and calculate the optical bowing coefficient for further sizes

Symmetry and topology in antiferromagnetic spintronics

Antiferromagnetic spintronics focuses on investigating and using antiferromagnets as active elements in spintronics structures. Last decade advances in relativistic spintronics led to the discovery of the staggered, current-induced field in antiferromagnets. The corresponding N\'{e}el spin-orbit torque allowed for efficient electrical switching of antiferromagnetic moments and, in combination with electrical readout, for the demonstration of experimental antiferromagnetic memory devices. In parallel, the anomalous Hall effect was predicted and subsequently observed in antiferromagnets. A new field of spintronics based on antiferromagnets has emerged. We will focus here on the introduction into the most significant discoveries which shaped the field together with a more recent spin-off focusing on combining antiferromagnetic spintronics with topological effects, such as antiferromagnetic topological semimetals and insulators, and the interplay of antiferromagnetism, topology, and superconductivity in heterostructures.Comment: Book chapte