Rate and predictors for non-attendance of patients undergoing hospital outpatient treatment for chronic diseases: a register-based cohort study.

Failure to keep medical appointments results in inefficiencies and, potentially, in poor outcomes for patients. The aim of this study is to describe non-attendance rate and to investigate predictors of non-attendance among patients receiving hospital outpatient treatment for chronic diseases. We conducted a historic, register-based cohort study using data from a regional hospital and included patients aged 18 years or over who were registered in ongoing outpatient treatment courses for seven selected chronic diseases on July 1, 2013. A total of 5895 patients were included and information about their appointments was extracted from the period between July 1, 2013 and June 30, 2015. The outcome measure was occurrence of non-attendance. The associations between non-attendance and covariates (age, gender, marital status, education level, occupational status, specific chronic disease and number of outpatient treatment courses) were investigated using multivariate logistic regression models, including mixed effect. During the two-year period, 35% of all patients (2057 of 5895 patients) had one or more occurrences of non-attendance and 5% of all appointments (4393 of 82,989 appointments) resulted in non-attendance. Significant predictors for non-attendance were younger age (OR 4.17 for 18 ≤ 29 years as opposed to 80+ years), male gender (OR 1.35), unmarried status (OR 1.39), low educational level (OR 1.18) and receipt of long-term welfare payments (OR 1.48). Neither specific diseases nor number of treatment courses were associated with a higher non-attendance rate. Patients undergoing hospital outpatient treatments for chronic diseases had a non-attendance rate of 5%. We found several predictors for non-attendance but undergoing treatment for several chronic diseases simultaneously was not a predictor. To reduce non-attendance, initiatives could target the groups at risk. This study was approved by the Danish Data Protection Agency (Project ID 18/35695 )

Inflammatory markers and incident mobility limitation in the elderly

OBJECTIVES: To examine the relationship between indicators of inflammation and the incidence of mobility limitation in older persons. DESIGN: Prospective cohort study: the Health, Aging and Body Composition Study. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: A total of 2,979 men and women, aged 70 to 79, without mobility limitation at baseline. MEASUREMENTS: Serum levels of interleukin (IL)-6, tumor necrosis factor alpha (TNFα), and C-reactive protein (CRP) and soluble cytokine receptors (IL-2sR, IL-6sR, TNFsR1, TNFsR2) were measured. Mobility limitation was assessed and defined as reporting difficulty or inability to walk one-quarter of a mile or to climb 10 steps during two consecutive semiannual assessments over 30 months. RESULTS: Of the 2,979 participants, 30.1% developed incident mobility limitation. After adjustment for confounders (demographics, prevalent conditions at baseline, body composition), the relative risk (RR) of incident mobility limitation per standard deviation (SD) increase was 1.19 (95% confidence interval (CI) = 1.10-1.28) for IL-6, 1.20 (95% CI = 1.12-1.29) for TNFα and 1.40 (95% CI = 1.18-1.68) for CRP. The association between inflammation and incident mobility limitation was especially strong for the onset of more severe mobility limitation and when the levels of multiple inflammatory markers were high. When persons with baseline or incident cardiovascular disease events or persons who were hospitalized during study follow-up were excluded, findings remained similar. In a subset (n = 499), high levels of the soluble receptors IL2sR and TNFsR1 (per SD increase: RR = 1.23 (95% CI = 1.04-1.46) and RR = 1.28 (95% CI = 1.04-1.57), respectively) were also associated with incident mobility limitation. CONCLUSION: Findings suggest that inflammation is prognostic for incident mobility limitation over 30 months, independent of cardiovascular disease events and incident severe illness

Inflammatory Markers and Onset of Cardiovascular Events: Results from the Health ABC Study

Background - Inflammation plays an important role in cardiovascular disease. The aim of this study is to investigate the predictive value of several inflammatory markers on the incidence of cardiovascular events in well-functioning older persons. Methods and Results - The subjects were 2225 participants 70 to 79 years old, without baseline cardiovascular disease, who were enrolled in the Health, Aging, and Body Composition study. Incident coronary heart disease (CHD), stroke, and congestive heart failure (CHF) events were detected during an average follow-up of 3.6 years. Blood levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-\uce\ub1 (TNF-\uce\ub1) were assessed. After adjustment for potential confounders, IL-6 was significantly associated with all outcomes (CHD events, per IL-6 SD increase: RR, 1.27; 95% CI, 1.10 to 1.48; stroke events, per IL-6 SD increase: RR, 1.45; 95% CI, 1.12 to 1.86; CHF events, per IL-6 SD increase: RR, 1.72; 95% CI, 1.40 to 2.12). TNF-\uce\ub1 showed significant associations with CHD (per TNF-\uce\ub1 SD increase: RR, 1.22; 95% CI, 1.04 to 1.43) and CHF (per TNF-\uce\ub1 SD increase: RR, 1.59; 95% CI, 1.30 to 1.95) events. CRP was significantly associated with CHF events (per CRP SD increase: RR, 1.48; 95% CI, 1.23 to 1.78). A composite summary indicator of inflammation showed a strong association with incident cardiovascular events, with an especially high risk if all 3 inflammatory markers were in the highest tertile. Conclusions - Findings suggest that inflammatory markers are independent predictors of cardiovascular events in older persons

Impact of stream impurities on compressor power requirements for CO2 pipeline transportation

The economic viability of Carbon Capture and Sequestration (CCS) as a means of mitigating CO2 emissions is significantly dependent on the minimisation of costs associated with the compression and transportation of the captured CO2. This paper describes the development and application of a rigorous thermodynamic model to compute and compare power requirements for various multistage compression strategies for CO2 streams containing typical impurities originating from various capture technologies associated with industrial and power emission sectors. The compression options examined include conventional multistage integrally geared centrifugal compressors, supersonic shockwave compressors and multistage compression combined with subcritical liquefaction and pumping. The study shows that for all the compression options examined, the compression power reduces with the increase in the purity of the CO2 stream, while the inter-stage cooling duty is predicted to be significantly higher than the compression power demand. For CO2 streams carrying less than 5% impurities, multistage compression combined with liquefaction and subsequent pumping from ca 62 bar pressure can offer higher efficiency than conventional gas-phase compression. In the case of a raw/dehumidified oxy-fuel CO2 stream of ca 85% purity, subcritical liquefaction at 62 bar pressure is shown to increase the cooling duty by ca 50% as compared to pure CO2

Branching Fractions for D0 -> K+K- and D0 -> pi+pi-, and a Search for CP Violation in D0 Decays

Using the large hadroproduced charm sample collected in experiment E791 at Fermilab, we have measured ratios of branching fractions for the two-body singly-Cabibbo-suppressed charged decays of the D0: (D0 -> KK)/(D0 -> Kpi) = 0.109 +- 0.003 +- 0.003, (D0 -> pipi)/(D0 -> Kpi) = 0.040 +- 0.002 +- 0.003, and (D0 -> KK)/(D0 -> pipi) = 2.75 +- 0.15 +- 0.16. We have looked for differences in the decay rates of D0 and D0bar to the CP eigenstates K+K- and pi+pi-, and have measured the CP asymmetry parameters A_CP(K+K-) = -0.010 +- 0.049 +- 0.012 and A_CP(pi+pi-) = -0.049 +- 0.078 +- 0.030, both consistent with zero.Comment: 10 Postscript pages, including 2 figures. Submitted to Phys. Lett.

Asymmetries between the production of D+ and D- mesons from 500 GeV/c pi- nucleon interactions as a function of xF and pt**2

We present asymmetries between the production of D+ and D- mesons in Fermilab experiment E791 as a function of xF and pt**2. The data used here consist of 74,000 fully-reconstructed charmed mesons produced by a 500 GeV/c pi- beam on C and Pt foils. The measurements are compared to results of models which predict differences between the production of heavy-quark mesons that have a light quark in common with the beam (leading particles) and those that do not (non-leading particles). While the default models do not agree with our data, we can reach agreement with one of them, PYTHIA, by making a limited number of changes to parameters used

Search for CP Violation in Charged D Meson Decays

We report results of a search for CP violation in the singly Cabibbo-suppressed decays D+ -> K- K+ pi+, phi pi+, K*(892)0 K+, and pi- pi+ pi+ based on data from the charm hadroproduction experiment E791 at Fermilab. We search for a difference in the D+ and D- decay rates for each of the final states. No evidence for a difference is seen. The decay rate asymmetry parameters A(CP), defined as the difference in the D+ and D- decay rates divided by the sum of the decay rates, are measured to be: A(CP)(K K pi) = -0.014 +/- 0.029, A(CP)(phi pi) = -0.028 +/- 0.036, A(CP)(K*(892) K) = -0.010 +/- 0.050, and A(CP)(pi pi pi) = -0.017 +/- 0.042.Comment: 13 pages, 5 figures, 1 table; Elsevier LaTe

Search for Rare and Forbidden Dilepton Decays of the D+, Ds, and D0 Charmed Mesons

We report the results of a search for flavor-changing neutral current, lepton-flavor violating, and lepton-number violating decays of D+, Ds, and D0 mesons (and their antiparticles) into modes containing muons and electrons. Using data from Fermilab charm hadroproduction experiment E791, we examine the pi,l,l and K,l,l decay modes of D+ and Ds and the l+l- decay modes of D0. No evidence for any of these decays is found. Therefore, we present branching-fraction upper limits at 90% confidence level for the 24 decay modes examined. Eight of these modes have no previously reported limits, and fourteen are reported with significant improvements over previously published results.Comment: 12 pages, 3 figures, LaTeX, elsart.cls, epsf.sty, amsmath.sty Submitted to Physics Letters

Measurement of the form-factor ratios for D+ --> K* l nu

The form factor ratios rv=V(0)/A1(0), r2=A2(0)/A1(0) and r3=A3(0)/A1(0) in the decay D+ --> K* l nu, K* -->K-pi+ have been measured using data from charm hadroproduction experiment E791 at Fermilab. From 3034 (595) signal (background) events in the muon channel, we obtain rv=1.84+-0.11+-0.09, r2=0.75+-0.08+-0.09 and, as a first measurement of r3, we find 0.04+-0.33 +-0.29. The values of the form factor ratios rv and r2 measured for the muon channel are combined with the values of rv and r2 that we have measured in the electron channel. The combined E791 results for the muon and electron channels are rv=1.87+-0.08+-0.07 and r2=0.73+-0.06+-0.08.Comment: 9 pages + 3 figures ; submitted to PL