Outlier admissions of medical patients: Prognostic implications of outlying patients. The experience of the Hospital of Mestre

ABSTRACT The admission of a patient in wards other than the appropriate ones, known as the patient outlying phenomenon, involves both Medicine and Geriatric Units of many Hospitals. The aims were to learn more about the prognosis of the outlying patients, we investigated 3828 consecutive patients hospitalized in Medicine and Geriatrics of our hub Hospital during the year 2012. We compared patients\u2019 mean hospital length of stay, survival, and early readmission according to their outlying status. The mean hospital length of stay did not significantly differ between the two groups, either for Medicine (9.8 days for outliers and 10.0 for in-ward) or Geriatrics (13.0 days for both). However, after adjustment for age and sex, the risk of death was about twice as high for outlier patients admitted into surgical compared to medical areas (hazard ratio 1.8, 1.2-2.5 95% confidence interval). Readmission within 90 days from the first discharge was more frequent for patients admitted as outliers (26.1% vs 14.2%, P<0.0001). We highlight some critical aspects of an overcrowded hospital, as the shortage of beds in Medicine and Geriatrics and the potential increased clinical risk denoted by deaths or early readmission for medical outlier patients when assigned to inappropriate wards. There is the need to reorganize beds allocation involving community services, improve in-hospital bed management, an extent diagnostic procedures for outlier patients admitted in nonmedical wards

Inverted perovskite solar cells with transparent hole transporting layer based on semiconducting nickel oxide

Perovskite (CH3NH3PbI3) solar cells (PSCs) were produced in the inverted architecture employing transparent nickel oxide (NiO) as hole transporting layer (HTL). The different functional layers of the photoconversion device were solution processed in ambient conditions the HTL of NiO being prepared via sol-gel and successively deposited by spin-coating. The conditions of preparation of the transparent HTL were optimized through the stabilization of the nickel-containing sol with bulky alcohols and strong inorganic acids. The photoactive layer of CH3NH3PbI3 was deposited in air at high relative humidity (ca. 50-60%). The electron selective contact was constituted by spin coated 3H-cyclopropa[1,9] [5,6]fullerene-C60-Ih-3'-butanoic acid 3'-phenyl methyl ester (PCBM) with solution processed 2,9-Dimethyl-4,7-diphenyl-1,10-phenanthroline (bathocuproine, BCP) as interlayer. The deposition of CH3NH3PbI3 in ambient conditions as well as the processing of the BCP interlayer from solution simplified enormously the entire procedure of device fabrication. The largest value of photoconversion efficiency (PCE) we achieved with the inverted architecture photocells was 14 % with an average PCE of 12 %. The solar cells displayed an hysteresis-free behavior with excellent time stability of the maximum power output

TG, FT-IR and NMR characterization of n-C16H34 contaminated alumina and silica after mechanochemical treatment

This paper deals with the application of mechanochemistry to model systems composed of alumina or silica artificially contaminated with n-C16H34. The mechanochemical treatment was carried out by means of a ring mill for times ranging from 10 to 40 h. Thermogravimetry and infrared and nuclear magnetic resonance spectroscopies were used for the characterization of the mechanochemical products. The results have indicated that, in the case of alumina, almost all the contaminant n-C16H34 undergoes a complex oxidative reaction path whose end products are strongly held on the surface. These end products are most likely made of crosslinked, partially oxidized hydrocarbon chains bond to the solid surface via COO− groups. In the case of silica, the hydrocarbon undergoes a different, equally complex reaction path, but to a lower extent. In this case the end products are most probably carbonylic compounds and graphitic carbon. Then, for both solid matrices, the mechanochemical treatment promotes significant modification of the chemical nature of the polluting hydrocarbon with end products much more difficult to remove from the surface. As the systems studied are models of sites contaminated by aliphatic hydrocarbon, the results are worthy of consideration in relation to the mobility of the contaminants in the environment

Do methadone and buprenorphine have the same impact on psychopathological symptoms of heroin addicts?

<p>Abstract</p> <p>Background</p> <p>The idea that the impact of opioid agonist treatment is influenced by the psychopathological profile of heroin addicts has not yet been investigated, and is based on the concept of a specific therapeutic action displayed by opioid agents on psychopathological symptoms. In the present report we compared the effects of buprenorphine and methadone on the psychopathological symptoms of 213 patients (106 on buprenorphine and 107 on methadone) in a follow-up study lasting 12 months.</p> <p>Methods</p> <p>Drug addiction history was collected by means of the Drug Addiction History Rating Scale (DAH-RS) and psychopathological features were collected by means of the Symptom Checklist-90 (SCL-90), using a special five-factor solution. Toxicological urinalyses were carried out for each patient during the treatment period.</p> <p>Results</p> <p>No statistically significant differences were detected in psychopathological symptoms, including 'worthlessness-being trapped', 'somatization', and 'panic-anxiety'. Methadone proved to be more effective on patients characterized by 'sensitivity-psychoticism', whereas buprenorphine was more effective on patients displaying a 'violence-suicide' symptomatology.</p> <p>Conclusions</p> <p>Heroin-dependent patients with psychiatric comorbidities may benefit from opioid agonist treatment not only because it targets their addictive problem, but also, precisely due to this, because it is effective against their mental disorder too.</p

Immigrant community integration in world cities

As a consequence of the accelerated globalization process, today major cities all over the world are characterized by an increasing multiculturalism. The integration of immigrant communities may be affected by social polarization and spatial segregation. How are these dynamics evolving over time? To what extent the different policies launched to tackle these problems are working? These are critical questions traditionally addressed by studies based on surveys and census data. Such sources are safe to avoid spurious biases, but the data collection becomes an intensive and rather expensive work. Here, we conduct a comprehensive study on immigrant integration in 53 world cities by introducing an innovative approach: an analysis of the spatio-temporal communication patterns of immigrant and local communities based on language detection in Twitter and on novel metrics of spatial integration. We quantify the "Power of Integration" of cities --their capacity to spatially integrate diverse cultures-- and characterize the relations between different cultures when acting as hosts or immigrants.Comment: 13 pages, 5 figures + Appendi

The future search for low-frequency axions and new physics with the FLASH resonant cavity experiment at Frascati National Laboratories

We present a proposal for a new experiment, the FINUDA magnet for Light Axion SearcH (FLASH), a large resonant-cavity haloscope in a high static magnetic field which is planned to probe new physics in the form of dark matter (DM) axions, scalar fields, chameleons, hidden photons, as well as high frequency gravitational waves (GWs). Concerning the QCD axion, FLASH will search for these particles as the DM in the mass range (0.49-1.49) ueV, thus filling the mass gap between the ranges covered by other planned searches. A dedicated Microstrip SQUID operating at ultra-cryogenic temperatures will amplify the signal. The frequency range accessible overlaps with the Very High Frequency (VHF) range of the radio wave spectrum and allows for a search in GWs in the frequency range (100-300) MHz. The experiment will make use of the cryogenic plant and magnet of the FINUDA experiment at INFN Frascati National Laboratories near Rome (Italy); the operations needed to restore the functionalities of the apparatus are currently underway. We present the setup of the experiment and the sensitivity forecasts for the detection of axions, scalar fields, chameleons, hidden photons, and GWs

Performance Assessment in Fingerprinting and Multi Component Quantitative NMR Analyses

An interlaboratory comparison (ILC) was organized with the aim to set up quality control indicators suitable for multicomponent quantitative analysis by nuclear magnetic resonance (NMR) spectroscopy. A total of 36 NMR data sets (corresponding to 1260 NMR spectra) were produced by 30 participants using 34 NMR spectrometers. The calibration line method was chosen for the quantification of a five-component model mixture. Results show that quantitative NMR is a robust quantification tool and that 26 out of 36 data sets resulted in statistically equivalent calibration lines for all considered NMR signals. The performance of each laboratory was assessed by means of a new performance index (named Qp-score) which is related to the difference between the experimental and the consensus values of the slope of the calibration lines. Laboratories endowed with a Qp-score falling within the suitable acceptability range are qualified to produce NMR spectra that can be considered statistically equivalent in terms of relative intensities of the signals. In addition, the specific response of nuclei to the experimental excitation/relaxation conditions was addressed by means of the parameter named NR. NR is related to the difference between the theoretical and the consensus slopes of the calibration lines and is specific for each signal produced by a well-defined set of acquisition parameters

Search for heavy neutral lepton production in K+ decays

A search for heavy neutral lepton production in K + decays using a data sample collected with a minimum bias trigger by the NA62 experiment at CERN in 2015 is reported. Upper limits at the 10−7 to 10−6 level are established on the elements of the extended neutrino mixing matrix |Ue4| 2 and |Uμ4| 2 for heavy neutral lepton mass in the ranges 170–448 MeV/c2 and 250–373 MeV/c2, respectively. This improves on the previous limits from HNL production searches over the whole mass range considered for |Ue4|2 and above 300 MeV/c2 for |Uμ4|2