Constrained D-optimal Design for Paid Research Study

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Joint distribution of the actual and scheduled follow-up visits (n = 65,539).

<p>Joint distribution of the actual and scheduled follow-up visits (n = 65,539).</p

The association between outpatient follow-up visits and all-cause non-elective 30-day readmissions: A retrospective observational cohort study

<div><p>Background</p><p>As an effort to reduce hospital readmissions, early follow-up visits were recommended by the Society of Hospital Medicine. However, published literature on the effect of follow-up visits is limited with mixed conclusions. Our goal here is to fully explore the relationship between follow-up visits and the all-cause non-elective 30-day readmission rate (RR) after adjusting for confounders.</p><p>Methods and results</p><p>To conduct this retrospective observational study, we extracted data for 55,378 adult inpatients from Advocate Health Care, a large, multi-hospital system serving a diverse population in a major metropolitan area. These patients were discharged to Home or Home with Home Health services between June 1, 2013 and April 30, 2015. Our findings from time-dependent Cox proportional hazard models showed that follow-up visits were significantly associated with a reduced RR (adjusted hazard ratio: 0.86; 95% CI: 0.82–0.91), but in a complicated way because the interaction between follow-up visits and a readmission risk score was significant with p-value < 0.001. Our analysis using logistic models on an adjusted data set confirmed the above findings with the following additional results. First, time matter. Follow-up visits within 2 days were associated with the greatest reduction in RR (adjusted odds ratio: 0.72; 95% CI: 0.63–0.83). Visits beyond 2 days were also associated with a reduction in RR, but the strength of the effect decreased as the time between discharge and follow-up visit increased. Second, the strength of such association varied for patients with different readmission risk scores. Patients with a risk score of 0.113, high but not extremely high risk, had the greatest reduction in RR from follow-up visits. Patients with an extremely high risk score (> 0.334) saw no RR reduction from follow-up visits. Third, a patient was much more likely to have a 2-day follow-up visit if that visit was scheduled before the patient was discharged from the hospital (30% versus < 5%).</p><p>Conclusions</p><p>Follow-up visits are associated with a reduction in readmission risk. The timing of follow-up visits can be important: beyond two days, the earlier, the better. The effect of follow-up visits is more significant for patients with a high but not extremely high risk of readmission.</p></div

Characteristics of patients with and without follow-up visits for survival models (n = 55,378).

<p>Characteristics of patients with and without follow-up visits for survival models (n = 55,378).</p

The effect of early follow-up visits on readmission risk for patients with different raw risk scores.

<p>The effect of early follow-up visits on readmission risk for patients with different raw risk scores.</p

Comparison of Readmission Rate (RR) for Patients with (YF) and without (NF) follow-up visits on or before various days.

<p>Comparison of Readmission Rate (RR) for Patients with (YF) and without (NF) follow-up visits on or before various days.</p

Characteristics of patients in follow up visit and no follow up visit groups for logistic models (n = 30,702).

<p>Characteristics of patients in follow up visit and no follow up visit groups for logistic models (n = 30,702).</p

Estimated hazard ratio for a follow-up visit for patients with different risk scores.

<p>Estimated hazard ratio for a follow-up visit for patients with different risk scores.</p

PLLA Nanofibrous Paper-Based Plasmonic Substrate with Tailored Hydrophilicity for Focusing SERS Detection

We report a new paper-based surface enhanced Raman scattering (SERS) substrate platform contributed by a poly­(l-lactic acid) (PLLA) nanofibrous paper adsorbed with plasmonic nanostructures, which can circumvent many challenges of the existing SERS substrates. This PLLA nanofibrous paper has three-dimensional porous structure, extremely clean surface with good hydrophobicity (contact angle is as high as 133.4°), and negligible background interference under Raman laser excitation. Due to the strong electrostatic interaction between PLLA nanofiber and cetyltrimethylammonium bromide (CTAB) molecules, the CTAB-coated gold nanorods (GNRs) are efficiently immobilized onto the fibers. Such a hydrophobic paper substrate with locally hydrophilic SERS-active area can confine analyte molecules and prevent the random spreading of molecules. The confinement leads to focusing effect and the GNRs-PLLA SERS substrate is found to be highly sensitive (0.1 nM Rhodamine 6G and malachite green) and exhibit excellent reproducibility (∼8% relative standard deviation (RSD)) and long-term stability. Furthermore, it is also cost-efficient, with simple fabrication methodology, and demonstrates high sample collection efficiency. All of these benefits ensure that this GNRs-PLLA substrate is a really perfect choice for a variety of SERS applications

Probability of changing ego’s playing active sports score in the next time step, based on ego’s and average alters’ current active sports score.

<p>The playing active sports score is the frequency in the past week: 0 = not at all; 1 = 1 or 2 times; 2 = 3 or 4 times; 3 = 5 or more times. Egos may increase by one level, decrease by one level, or stay at the same level.</p