Home Telehealth in Heat Failure Patients

Aim: Technology holds a great potential to improve the quality of health care delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure. Rationale: TH has been successfully utilized by agencies to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning. Methods: Utilizing the OASIS-C database, a retrospective analysis was conducted examining 22-months of heart failure patient data from one home care agency in southern California. Seventy patients receiving TH were compared to patients who received usual home care nursing services. Results: No major differences in baseline socio-demographics were found between the two groups. While receiving home health care services, the non-TH patients had a 21% all-cause hospital re-admission rate, compared to the home TH patients with a 10% all-cause re-admission rate. Statistical differences were found between groups on the variables of fall risk, vision, smoking, shortness-of-breath, the ability to bathe and take oral meds, along with having been discharged from a skilled nursing facility in the past 2weeks

The Critical Importance of the Distribution Variable in Formulating a Marketing Strategy

Perhaps, the one aspect of the marketing mix process that has been most ignored by recreation managers is the fourth P --or Place variable. Recent study data indicate that poor distribution decisions can contribute substantially to the non-use or under-utilization of park and recreation programs and facilities. Managers of leisure service organizations should take several steps to ensure greater accessibility of their services to potential· target markets

Monotone graph limits and quasimonotone graphs

The recent theory of graph limits gives a powerful framework for understanding the properties of suitable (convergent) sequences $(G_n)$ of graphs in terms of a limiting object which may be represented by a symmetric function $W$ on $[0,1]$, i.e., a kernel or graphon. In this context it is natural to wish to relate specific properties of the sequence to specific properties of the kernel. Here we show that the kernel is monotone (i.e., increasing in both variables) if and only if the sequence satisfies a `quasi-monotonicity' property defined by a certain functional tending to zero. As a tool we prove an inequality relating the cut and $L^1$ norms of kernels of the form $W_1-W_2$ with $W_1$ and $W_2$ monotone that may be of interest in its own right; no such inequality holds for general kernels.Comment: 38 page

On the Concept of a Notational Variant

In the study of modal and nonclassical logics, translations have frequently been employed as a way of measuring the inferential capabilities of a logic. It is sometimes claimed that two logics are “notational variants” if they are translationally equivalent. However, we will show that this cannot be quite right, since first-order logic and propositional logic are translationally equivalent. Others have claimed that for two logics to be notational variants, they must at least be compositionally intertranslatable. The definition of compositionality these accounts use, however, is too strong, as the standard translation from modal logic to first-order logic is not compositional in this sense. In light of this, we will explore a weaker version of this notion that we will call schematicity and show that there is no schematic translation either from first-order logic to propositional logic or from intuitionistic logic to classical logic

Supersonic aeroelastic instability results for a NASP-like wing model

An experimental study and an analytical study have been conducted to examine static divergence for hypersonic-vehicle wing models at supersonic conditions. A supersonic test in the Langley Unitary Plan Wind Tunnel facility was conducted for two wind-tunnel models. These models were nearly identical with the exception of airfoil shape. One model had a four-percent maximum thickness airfoil and the other model had an eight-percent maximum thickness airfoil. The wing models had low-aspect ratios and highly swept leading edges. The all-movable wing models were supported by a single-pivot mechanism along the wing root. For both of the wind-tunnel models, configuration changes could be made in the wing-pivot location along the wing root and in the wing-pivot pitch stiffness. Three divergence conditions were measured for the four-percent thick airfoil model in the Mach number range of 2.6 to 3.6 and one divergence condition was measured for the eight-percent thick airfoil model at a Mach number of 2.9. Analytical divergence calculations were made for comparison with experimental results and to evaluate the parametric effects of wing-pivot stiffness, wing-pivot location, and airfoil thickness variations. These analyses showed that decreasing airfoil thickness, moving the wing-pivot location upstream, or increasing the pitch-pivot stiffness have the beneficial effect of increasing the divergence dynamic pressures. The calculations predicted the trend of experimental divergence dynamic pressure with Mach number accurately; however, the calculations were approximately 25 percent conservative with respect to dynamic pressure

On the relation of Voevodsky's algebraic cobordism to Quillen's K-theory

Quillen's algebraic K-theory is reconstructed via Voevodsky's algebraic cobordism. More precisely, for a ground field k the algebraic cobordism P^1-spectrum MGL of Voevodsky is considered as a commutative P^1-ring spectrum. There is a unique ring morphism MGL^{2*,*}(k)--> Z which sends the class [X]_{MGL} of a smooth projective k-variety X to the Euler characteristic of the structure sheaf of X. Our main result states that there is a canonical grade preserving isomorphism of ring cohomology theories MGL^{*,*}(X,U) \tensor_{MGL^{2*,*}(k)} Z --> K^{TT}_{- *}(X,U) = K'_{- *}(X-U)} on the category of smooth k-varieties, where K^{TT}_* is Thomason-Trobaugh K-theory and K'_* is Quillen's K'-theory. In particular, the left hand side is a ring cohomology theory. Moreover both theories are oriented and the isomorphism above respects the orientations. The result is an algebraic version of a theorem due to Conner and Floyd. That theorem reconstructs complex K-theory via complex cobordism.Comment: LaTeX, 18 pages, uses XY-pi

XPS and AFM study of interaction of organosilane and sizing with e-glass fibre surface

Organosilanes are often used in commercial sizings for glass fibres to provide wettability with the resin and promote strong interfacial adhesion to the matrix in a fibre reinforced polymer composite. The silane treatment is introduced as part of a complex deposition from an aqueous emulsion immediately at the spinaret and determines the optimum properties of the cured composite. To understand the interaction of organosilanes contained in sizings for glass surfaces, XPS was used to investigate the adsorption of γ-aminopropyltriethoxysilane (APS) from a simple sizing system containing a polyurethane (PU) film former. It has been found that both APS and the sizing (containing APS and PU) deposits on E-glass fibre surfaces contained components of differing hydrolytic stability. The differences observed in the AFM images of APS coated E-glass fibres before and after water extraction also confirmed that the APS deposit contained components with different water solubility