Associations of Emergency Department Length of Stay With Publicly Reported Quality-of-care Measures.

OBJECTIVE: The Institute of Medicine identified emergency department (ED) crowding as a critical threat to patient safety. We assess the association between changes in publicly reported ED length of stay (LOS) and changes in quality-of-care measures in a national cohort of hospitals. METHODS: Longitudinal analysis of 2012 and 2013 data from the American Hospital Association (AHA) Survey, Center for Medicare and Medicaid Services (CMS) Cost Reports, and CMS Hospital Compare. We included hospitals reporting Hospital Compare timeliness measure of LOS for admitted patients. We used AHA and CMS data to incorporate hospital predictors of interest. We used the method of first differences to test for relationships in the change over time between timeliness measures and six hospital-level measures. RESULTS: The cohort consisted of 2,619 hospitals. Each additional hour of ED LOS was associated with a 0.7% decrease in proportion of patients giving a top satisfaction rating, a 0.7% decrease in proportion of patients who would definitely recommend the hospital, and a 6-minute increase in time to pain management for long bone fracture (p \u3c 0.01 for all). A 1-hour increase in ED LOS is associated with a 44% increase in the odds of having an increase in left without being seen (95% confidence interval = 25% to 68%). ED LOS was not associated with hospital readmissions (p = 0.14) or time to percutaneous coronary intervention (p = 0.14). CONCLUSION: In this longitudinal study of hospitals across the United States, improvements in ED timeliness measures are associated with improvements in the patient experience

Graph Neural Networks with Generated Parameters for Relation Extraction

Recently, progress has been made towards improving relational reasoning in machine learning field. Among existing models, graph neural networks (GNNs) is one of the most effective approaches for multi-hop relational reasoning. In fact, multi-hop relational reasoning is indispensable in many natural language processing tasks such as relation extraction. In this paper, we propose to generate the parameters of graph neural networks (GP-GNNs) according to natural language sentences, which enables GNNs to process relational reasoning on unstructured text inputs. We verify GP-GNNs in relation extraction from text. Experimental results on a human-annotated dataset and two distantly supervised datasets show that our model achieves significant improvements compared to baselines. We also perform a qualitative analysis to demonstrate that our model could discover more accurate relations by multi-hop relational reasoning

Comunidad de cianobacterias en los sedimentos del estuario del río Perla en China

Cyanobacterial community diversity in the sediment of the Pearl River Estuary in China was evaluated in this study by denaturing gradient gel electrophoresis (DGGE) during the wet and dry seasons. Nucleotide sequences obtained from DGGE bands were classified into five cyanobacterial clusters, including Synechococcus, Cyanobium, Chroococcus, Prochlorales and Tolypothrix. Synechococcus was identified as the dominant cyanobacterial group in the sediment samples; its distribution varied from the inner estuary to the outer estuary, with a wide range of salinity adaptation. Observed patterns of cyanobacterial communities changed markedly between sampling sites and seasons, suggesting that most cyanobacteria were not delivered via fresh water. Canonical correspondence analysis was conducted to determine the relationship between environmental variables and bacterial community structures during the dry season. The results suggested that the cyanobacterial community was significantly influenced by pH, salinity, PO4-P and NO3-N in sediments.La diversidad de la comunidad de cianobacterias en el sedimento del estuario del río Perla en China fue evaluada en este estudio por electroforesis en gel de gradiente desnaturalizante (DGGE) durante las estaciones húmeda y seca. Las secuencias de nucleótidos obtenidas de bandas DGGE se clasificaron en cinco grupos de cianobacterias, incluyendo Synechococcus, Cyanobium, Chroococcus, Prochlorales y Tolypothrix. Synechococcus fue identificado como el grupo dominante de cianobacterias en las muestras de sedimento, su distribución varió desde la parte interna del estuario hasta la externa, con un amplio rango de adaptación a la salinidad. Los patrones observados de las comunidades de cianobacterias cambiaron marcadamente entre diferentes sitios de muestreo en diferentes estaciones del año y sugirió que la mayoría de las cianobacterias no provenían a través del agua dulce. Se realizó un análisis de correspondencia canónica (CCA) para determinar la relación entre variables ambientales y estructuras de las comunidades bacterianas durante la estación seca. Los resultados sugirieron que las distintas comunidades de cianobacterias estaban significativamente influenciadas por el pH, salinidad, PO4-P y NO3-N en los sedimentos

Understanding Simulations of Thin Accretion Disks by Energy Equation

We study the fluctuations of standard thin accretion disks by linear analysis of the time-dependent energy equation together with the vertical hydrostatic equilibrium and the equation of state. We show that some of the simulation results in Hirose et al. (2009b), such as the time delay, the relationship of power spectra, and the correlation between magnetic energy and radiation energy, can be well understood by our analytic results.Comment: 13 pages, 3 figure, accepted for publication in Ap

MCRS2 represses the transactivation activities of Nrf1

<p>Abstract</p> <p>Background</p> <p>Nrf1 [p45 nuclear factor-erythroid 2 (p45 NF-E2)-related factor 1], a member of the CNC-bZIP (CNC basic region leucine zipper) family, is known to be a transcriptional activator by dimerization with distinct partners, such as Maf, FosB, c-Jun, JunD, etc. The transcriptional roles of CNC-bZIP family are demonstrated to be involved in globin gene expression as well as the antioxidant response. For example, CNC-bZIP factors can regulate the expression of detoxification proteins through AREs, such as expression of human gamma-glutamylcysteine synthetases (GCS), glutathione S-transferases (GST), UDP-glucuronosyl transferase (UDP-GT), NADP (H) quinone oxidoreductase (NQOs), etc. To further explore other factor(s) in cells related to the function of Nrf1, we performed a yeast two-hybrid screening assay to identify any Nrf1-interacting proteins. In this study, we isolated a cDNA encoding residues 126–475 of MCRS2 from the HeLa cell cDNA library. Some functions of MCRS1 and its splice variant-MSP58 and MCRS2 have been previously identified, such as transforming, nucleolar sequestration, ribosomal gene regulation, telomerase inhibition activities, etc. Here, we demonstrated MCRS2 can function as a repressor on the Nrf1-mediated transactivation using both in vitro and in vivo systems.</p> <p>Results</p> <p>To find other proteins interacting with the CNC bZIP domain of Nrf1, the CNC-bZIP region of Nrf1 was used as a bait in a yeast two-hybrid screening assay. MCRS2, a splicing variant of p78/MCRS1, was isolated as the Nrf1-interacting partner from the screenings. The interaction between Nrf1 and MCRS2 was confirmed <it>in vitro </it>by GST pull-down assays and <it>in vivo </it>by co-immunoprecipitation. Further, the Nrf1-MCRS2 interaction domains were mapped to the residues 354–447 of Nrf1 as well as the residues 314–475 of MCRS2 respectively, by yeast two-hybrid and GST pull-down assays. By immunofluorescence, MCRS2-FLAG was shown to colocalize with HA-Nrf1 in the nucleus and didn't result in the redistribution of Nrf1. This suggested the existence of Nrf1-MCRS2 complex in vivo. To further confirm the biological function, a reporter driven by CNC-bZIP protein binding sites was also shown to be repressed by MCRS2 in a transient transfection assay. An artificial reporter gene activated by LexA-Nrf1 was also specifically repressed by MCRS2.</p> <p>Conclusion</p> <p>From the results, we showed MCRS2, a new Nrf1-interacting protein, has a repression effect on Nrf1-mediated transcriptional activation. This was the first ever identified repressor protein related to Nrf1 transactivation.</p

Seroprevalence of Bartonella in Eastern China and analysis of risk factors

<p>Abstract</p> <p>Background</p> <p><it>Bartonella </it>infections are emerging in the Zhejiang Province of China. However, there has been no effort to date to explore the epidemiology of these infections in this region, nor to identify risk factors associated with exposure to <it>Bartonella</it>. The aim of this study was to investigate the seroprevalence of <it>Bartonella </it>in both patients bitten by dogs and blood donors (for control) in Eastern China, and to identify risk factors associated with exposure to <it>Bartonella</it>. As no previous data for this region have been published, this study will provide baseline data useful for <it>Bartonella </it>infection surveillance, control, and prevention.</p> <p>Methods</p> <p>Blood samples were collected from industrial rabies clinic attendees and blood donors living in eight areas of the Zhejiang Province of China, between December 2005 and November 2006. An indirect immunofluorescent antibody test was used to determine the presence of <it>Bartonella </it>in these samples. Risk factors associated with <it>Bartonella </it>exposure were explored using Chi-square tests and logistic regression analysis of epidemiological data relating to the study's participants.</p> <p>Results</p> <p><it>Bartonella </it>antibodies were detected in 19.60% (109/556) of blood samples. Seroprevalence varied among the eight areas surveys, ranging from over 32% in Hangzhou to only 2% in Jiangshan (X²= 28.22, P < 0.001). We detected a significantly higher prevalence of <it>Bartonella </it>antibodies in people who had been bitten by dogs than in blood donors (X²= 13.86, P < 0.001). Seroprevalence of <it>Bartonella </it>was similar among males (18.61%, n = 317) and females (20.92%, n = 239).</p> <p>Conclusions</p> <p><it>Bartonella </it>antibodies were encountered in people living across Zhejiang Province and the seropositivity rate among those exposed to dog bites was significantly higher than that among blood donors, indicating that dog bites may be a risk factor for <it>Bartonella </it>infection.</p