Postdischarge 24/7 hotline service for neurology and neurosurgery patients and 1-year impact on readmission rates, unplanned emergency department visits, and patient satisfaction

Objective: Telephone triage is a system in which trained nurses use standardized protocols to evaluate symptoms over the phone and determine the appropriate course of action.Materials and methods: We implemented a protocol for systematic follow up phone calls and telephonic triage to families of neurology and neurosurgery patients after discharge, primarily to improve care transition and to assess its impact on the ratio of visits in the emergency department, readmissions, and overall satisfaction of patients and families. The intervention comprised the implementation of nurse led telephone triage and postdischarge follow up phone calls. After implementing hotline services in mind and brain service line, a retrospective cohort study was conducted to evaluate the impact of hotline services on patient readmissions, emergency department visits, and overall satisfaction rate. We collected data of readmission rate and emergency visits of discharge patients in three periods a prehotline period, immediate posthotline period, and late posthotline period to make comparison. Patients discharged home from the neurology and neurosurgery services from January 2017 to September 2019 were provided with hotline number to call in case of any issue or query. These patients also received postdischarge follow up calls from hotline nurses. We initiated the hotline in October 2017.Results: On analysis, we found a 25% decline in readmission rate in the immediate period of hotline followed by a further decline to 37.2% in the late period as compared to the prehotline period. Among discharge patients visiting the emergency department, we found a decline of 18.5% in the immediate posthotline period which further declined to 77.7% in the later phase as compared to the prehotline period.Conclusion: A standardized telephone system and pathway can be an effective way to improve nurse-patient communication which can further improve health outcomes for many patients

PO10.19 clinical spectrum of pseudo seizures at a tertiary care hospital Karachi: a video EEG based study

Background: Nonepileptic seizures are involuntary episodes of movement, sensation, or behaviors (e.g., vocalization, crying and other expressions of emotion), that do not result from abnormal cortical discharges. The events typically occur in teenage patients with anxiety and affective disorders. Psychotherapy, behavioral therapy, drugs, hypnosis and placebo are mainstay of treatment. There is no published data on clinical characteristics of pseudo-seizures from Pakistan. The objective of our study is to describe the clinical characteristics of pseudoseizures in a tertiary care hospital in Karachi, Pakistan. Methods: This is a descriptive study. Patients with pseudo-seizures were identified from departmental Video EEG monitoring register, over a period of three years (2004 2006). Their neurophysiologic and video recording data was reviewed and their demographic, clinical and neurophysiologic data was recorded and analyzed. SPSS version 15.0 was used for analysis. Results: A total of 132 patients underwent video EEG during the period and 51 (38%) had pseudo-seizures. Their mean age was 26.7±15.3 years. Thirty-two (63%) were female and 19 (37%) were male. Twelve (23.5%) patients were known epileptics. Median recording time was 24 (range; 0.33 55) hours and median number of events was 3 (range; 1 14). Limb movements were most common manifestation (67%) followed by muteness with no response to verbal commands (49%), behavioral symptoms (35.5%), ocular findings i.e. eye blinking and closure (25.5%), depressed conscious level (13.7%), headache (10%) and GI symptoms (10%). Six (11.8%) patients experienced epileptic seizures, in addition to pseudo-seizures. Conclusions: Pseudo-seizures are common in patients referred for video EEG monitoring. It is more common in young women. Limb movements, muteness and behavioral symptoms are most common manifestations. The pseudo-seizures and epileptic seizures may coexist in the same patient

Fabrication and characterization of gold nanowires

This work deals with the production and characterization of gold nanowires. Employing ion track-etched polycarbonate membranes as templates, the wires were electrochemically deposited in the nanopores. Various techniques including scanning electron microscopy, transmission electron microscopy, and x-ray diffraction were used to characterize the nanowires. Electric transport properties as well as the thermal stability of the wires were investigated in detail

Fabrication and characterization of gold nanowires

This work deals with the production and characterization of gold nanowires. Employing ion track-etched polycarbonate membranes as templates, the wires were electrochemically deposited in the nanopores. Various techniques including scanning electron microscopy, transmission electron microscopy, and x-ray diffraction were used to characterize the nanowires. Electric transport properties as well as the thermal stability of the wires were investigated in detail

Resonant plasmonic and vibrational coupling in a tailored nanoantenna for infrared detection

4 pages, 4 figures.-- PACS nrs.: 78.67.Lt, 33.70.-w, 73.20.Mf, 78.30.-j.A novel resonant mechanism involving the interference of a broadband plasmon with the narrowband vibration from molecules is presented. With the use of this concept, we demonstrate experimentally the enormous enhancement of the vibrational signals from less than one attomol of molecules on individual gold nanowires, tailored to act as plasmonic nanoantennas in the infrared. By detuning the resonance via a change in the antenna length, a Fano-type behavior of the spectral signal is observed, which is clearly supported by full electrodynamical calculations. This resonant mechanism can be a new paradigm for sensitive infrared identification of molecular groups.Acknowledgements for financial support are for F. N. and A. P. from the DFG (DFG Pu 193/9), for S. K. from the Higher Education Commission (HEC), Pakistan, and for J. A. from the ETORTEK project of the Government of the Basque Country.Peer reviewe

Diameter dependent failure current density of gold nanowires

Failure current density of single gold nanowires is investigated in this paper. Single wires with diameters ranging from 80 to 720 nm and length 30μm were electrochemically deposited in ion track-etched single-pore polycarbonate membranes. The maximum current density was investigated while keeping the wires embedded in the polymer matrix and ramping up the current until failure occurred. The current density is found to increase with diminishing diameter and the wires with a diameter of 80 nm withstand 1.2 × 1012Am−2 before undergoing failure. Possible reasons for these results are discussed in this paper

Convalescent plasma therapy in the treatment of COVID-19: practical considerations: Correspondence

It is unclear if convalescent plasma can blunt the development of a natural immune response, especially when used prophylactically. There are multiple clinical trials taking place in several countries including in the UK (e.g., REMAP-CAP and RECOVERY Trials). People who have recovered from COVID-19 for more than 28 days, with no transfusion transmitted diseses and who are not pregnant are eligible to participate. Recipients will be followed throughout their hospitalisation and a month after discharge. While we await trial results, we recommend that CPT be considered for patients severely ill with COVID-19 upon hospitalisation

Investigation of size effects in the electrical resistivity of single electrochemically fabricated gold nanowires

Single gold nanowires with diameters ranging between 80 and 300 nm were fabricated by electrochemical deposition in single-pore membranes. The wires were contacted by means of a macroscopic planar electrode on each membrane side. The resistance-versus-diameter behavior was measured and is discussed considering finite-size effects, i.e., additional electron scattering both at the wire surface and at grain boundaries. Resistance-versus-temperature curves display characteristics like a bulk metal that shows a linear behavior down to about 70 K and finally approaches a limited value below 40–50 K with a residual resistivity ratio ρ300 K/ρ20 K≈2.5. The temperature-dependent resistivity data of wires with diameters larger than 200 nm fit well with the model of Mayadas and Shatzkes for grain-boundary scattering, thus confirming that surface scattering is negligible in this range

Tuning the Characteristics of Electrochemically Fabricated Gold Nanowires

We have developed different electrochemical procedures for the production of gold nanowires with variable and controllable crystallographic and morphological properties using etched ion track templates. The texture of the nanowires is tuned by the variation of the electrodeposition parameters. Potentiostatic plating at low overvoltage provides strongly 〈110〉 textured wires for diameters below 100 nm. With the increase in diameter above 100 nm, this texture decreases and the signal from {111} planes becomes more pronounced. Under reverse pulse deposition conditions, 〈100〉 textured wires are generated. The growth mechanism is discussed in detail in terms of the surface energy minimum principle. In addition, wires are shaped in a reliable way from cylindrical to conical geometry by engineering the pore structure in the template