(α, β)-Zb-Geraghty type contraction in b-metric-like spaces via b-simulation function

The aim of this paper is to introduce the notion of (α, β)-Zb-Geraghty type contraction via b-simulation function and use this contraction to establish a common fixed point theorem for a pair of self-mappings in the context of a b-metric-like space. Our result extends and generalizes the result of Matthews [21], Khojasteh et al. [20], Demma et al. [15], Chandok [12] and some others also. We deduce some corollaries from our main result and provide examples to illustrate our results. Moreover, we apply our result to obtain a solution of second order differential equation.Publisher's Versio

Abstract 103: Clinical Process and Outcome Improvements Based on Within Site Communication: Insights from the Patient Navigator Acute Myocardial Infarction and Heart Failure Program

Background: Team communication about hospital quality efforts in acute myocardial infarction and heart failure (AMI-HF) may affect compliance with hospital transitional care metrics. Methods: At 2 years, hospitals (n=35) participating in the Patient Navigator Program completed surveys on 5 types of communication (sharing meeting minutes, regular team meetings or conference calls with team leaders, a shared checklist, and electronic medical record (EMR)-directed communication) supporting program implementation. Results were assessed for association with 3 outcomes (30-day unadjusted AMI-HF readmission and in-hospital risk adjusted AMI death) and 14 processes: left ventricular systolic dysfunction evaluation, prescription of renin-angiotensin system and beta-blocker medications; identifying HF cases pre-discharge; medication reconciliation documentation on admission, discharge and both times [AMI-HF); planned follow-up in 7 days [HF]; documentation of self-care education and when to call healthcare providers [AMI-HF] and documentation of medication instructions, timing, and changes [AMI-HF]). In STEMI and NSTEMI, performance composites, overall defect free care and referral to cardiac rehabilitation were assessed. Univariate analyses were completed. Results: There were no differences in process or outcome metrics for sharing meeting minutes, regular team meetings or conference calls with leaders or using a shared checklist. EMR-directed communication was associated with a greater likelihood of discharge medication reconciliation (100% vs 68.4%, p=.027) and prescribed medication documentation, 100% vs 66.7%, p=.024). Sites that used 2-5 vs 0-1 communication types were more likely to identify patients with HF pre-discharge (100% vs 60%, p=.018), perform discharge medication reconciliation (100% vs 66.7%, p=.021), complete education documentation (93.3% vs 58.8%, p=.041) and medication instruction documentation (100% vs 64.7%, p=.019); but they were less likely to improve STEMI performance composite scores (37.5% vs 76.5%, p=.036). Conclusion: Team communication via EMR and using 2+ communication methods promoted some process metric improvements. Some communication methods may have had low use and process and outcome metrics that were unchanged may have been underpowered to detect differences

Complexes of Cu(II) with Some Biologically Active Dihydroxycoumarins

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A circulating biomarker risk-prediction model correlates with CHADS-2 risk score in chronic atrial fibrillation

AbstractBackgroundInflammation and oxidative stress have been linked to the origin and persistence of atrial fibrillation (AF). CHADS-2 scoring system is a risk stratification schema well validated in prognostication of stroke in AF. We evaluated the association of markers of oxidative stress and inflammation with CHADS-2 scores in chronic AF patients.MethodsCHADS-2 scores were calculated for 64 subjects with chronic AF. Serum markers of inflammation [C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin 1β (IL-1β), tumor necrosis factor-α (TNF-α)] and of oxidative stress [derivatives of reactive oxygen metabolites (DROMs) and isoprostanes (IsoPs)] were measured.ResultsTwenty subjects were categorized as 0 (no risk), 24 as 1 (intermediate risk) and 20 as 2 (severe risk) based on their CHADS-2 scores. High sensitivity-CRP (CHADS-2 0=40.0%, 1=70.0%, 2=90.0%; p=0.003) and DROMs (CHADS-2 0=45%, 1=78%, 2=80%; p=0.04) were positively associated with the CHADS-2 risk score. Subjects with intermediate to severe CHADS-2 risk retained significant associations with abnormal hs-CRP (OR: 5.3, 95%CI: 1.1–25.0) and DROMs (adjusted OR: 6.7, 95%CI: 1.2–38.8) after adjusting for gender and hypertension. In a multiple logistic interaction model, there was no significant interaction between hs-CRP and DROMs in their association with CHADS-2 risk categories (p=0.64). A biomarker risk-model, combining hs-CRP and DROMs, correlated well with the CHADS-2 risk categories (r=0.49, p<0.001).ConclusionsA biomarker risk-model using a combination of hs-CRP and DROMs correlates well with CHADS-2 risk scores in chronic AF. Either or both of these markers may add predictive power to future stroke risk prediction models