407 research outputs found
Burden of Substance Abuse-Related Admissions to the Medical ICU
Background
Admissions to the ICU related to alcohol, prescription drugs, and illicit drugs are shown to be widespread and costly. In 1993, a study revealed 28% of ICU admissions at Johns Hopkins Hospital were related to substance abuse and accrued 39% of costs. Since then, health-care expenditures have increased, and substance abuse treatment admissions have risen. We conducted a study to provide updated data on ICU utilization and costs related to licit and illicit abuse at a large county hospital in Indianapolis, Indiana.
Methods
All admissions to the medical ICU at Eskenazi Hospital from March to October 2017 were reviewed. Demographics, reason for admission, relation to substance abuse and specific substance, ICU and hospital length of stay, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, mortality, insurance status, and hospital charges were collected based on chart review.
Results
A total of 611 admissions generated $74,587,280.35 in charges. A total of 25.7% of admissions related to substance abuse accounted for 23.1% of total charges. Illicit drugs were 13% of total admissions, generating 11% of charges. Alcohol-related admissions were 9.5% of total admissions, generating 7.6% of charges. Prescription drugs were 2.9% of admissions, generating 4.2% of charges. Of the substance abuse admissions, patients were generally men and 40 to 64 years of age, with longer ICU stay, higher APACHE II scores, and higher mortality.
Conclusions
Substance abuse admissions make up almost a one-quarter of resources used by our ICU. Patients tend to be younger and sicker with a higher risk of death. Identifying and accurately describing the landscape of this current health crisis will help us take appropriate action in the future
Remarkable thermal stability of gold nanoparticles functionalised with ruthenium phthalocyanine complexes
© 2016 IOP Publishing Ltd. A gold nanoparticle (AuNP) ruthenium phthalocyanine (RuPc) nanocomposite has been synthesised that exhibits high thermal stability. Electrical resistance measurements revealed that the nanocomposite is stable up to âŒ320 °C. Examination of the nanocomposite and the RuPc stabiliser complex using thermogravimetric analysis and differential scanning calorimetry show that the remarkable thermal stability is due to the RuPc molecules, which provide an effective barrier to sintering of the AuNPs
Charge state switching of Cu acceptors in ZnO nanorods
© 2017 Author(s). Undoped and Ga-doped ZnO nanorods both exhibit an intense green luminescence (GL) band centered at âŒ2.4 eV. Unlike the defect-related GL in undoped nanorods, the GL band in Ga-doped nanorods displays a periodic fine structure separated by 72 meV, which consists of doublets with an energy spacing of 30 ± 3 meV. The emergence of the structured GL is due to the Cu+ state being stabilized by the rise in the Fermi level above the 0/- (Cu2+/Cu+) charge transfer level as a result of Ga donor incorporation. From a combination of optical characterization and simulation using the Brownian oscillator model, the doublet fine structures are shown to originate from two hole transitions with the Cu+ state located at 390 meV above the valence band
Meta-analysis of generalized additive models in neuroimaging studies
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231772.pdf (publisher's version ) (Open Access)Analyzing data from multiple neuroimaging studies has great potential in terms of increasing statistical power, enabling detection of effects of smaller magnitude than would be possible when analyzing each study separately and also allowing to systematically investigate between-study differences. Restrictions due to privacy or proprietary data as well as more practical concerns can make it hard to share neuroimaging datasets, such that analyzing all data in a common location might be impractical or impossible. Meta-analytic methods provide a way to overcome this issue, by combining aggregated quantities like model parameters or risk ratios. Most meta-analytic tools focus on parametric statistical models, and methods for meta-analyzing semi-parametric models like generalized additive models have not been well developed. Parametric models are often not appropriate in neuroimaging, where for instance age-brain relationships may take forms that are difficult to accurately describe using such models. In this paper we introduce meta-GAM, a method for meta-analysis of generalized additive models which does not require individual participant data, and hence is suitable for increasing statistical power while upholding privacy and other regulatory concerns. We extend previous works by enabling the analysis of multiple model terms as well as multivariate smooth functions. In addition, we show how meta-analytic p-values can be computed for smooth terms. The proposed methods are shown to perform well in simulation experiments, and are demonstrated in a real data analysis on hippocampal volume and self-reported sleep quality data from the Lifebrain consortium. We argue that application of meta-GAM is especially beneficial in lifespan neuroscience and imaging genetics. The methods are implemented in an accompanying R package metagam, which is also demonstrated
Intake of silica nanoparticles by giant lipid vesicles: influence of particle size and thermodynamic membrane state
The uptake of nanoparticles into cells often involves their engulfment by the plasma membrane and a fission of the latter. Understanding the physical mechanisms underlying these uptake processes may be achieved by the investigation of simple model systems that can be compared to theoretical models. Here, we present experiments on a massive uptake of silica nanoparticles by giant unilamellar lipid vesicles (GUVs). We find that this uptake process depends on the size of the particles as well as on the thermodynamic state of the lipid membrane. Our findings are discussed in the light of several theoretical models and indicate that these models have to be extended in order to capture the interaction between nanomaterials and biological membranes correctly
Intake of silica nanoparticles by giant lipid vesicles: influence of particle size and thermodynamic membrane state
The uptake of nanoparticles into cells often involves their engulfment by the plasma membrane and a fission of the latter. Understanding the physical mechanisms underlying these uptake processes may be achieved by the investigation of simple model systems that can be compared to theoretical models. Here, we present experiments on a massive uptake of silica nanoparticles by giant unilamellar lipid vesicles (GUVs). We find that this uptake process depends on the size of the particles as well as on the thermodynamic state of the lipid membrane. Our findings are discussed in the light of several theoretical models and indicate that these models have to be extended in order to capture the interaction between nanomaterials and biological membranes correctly
A novel tool for in vitro correlation of cell adhesion behavior and local shear flow [Abstract]
Personal identity (de)formation among lifestyle travellers: A double-edged sword?
This article explores the personal identity work of lifestyle travellers â individuals for whom extended leisure travel is a preferred lifestyle that they return to repeatedly. Qualitative findings from in-depth semi-structured interviews with lifestyle travellers in northern India and southern Thailand are interpreted in light of theories on identity formation in late modernity that position identity as problematic. It is suggested that extended leisure travel can provide exposure to varied cultural praxes that may contribute to a sense of social saturation. Whilst a minority of the respondents embraced a saturation of personal identity in the subjective formation of a cosmopolitan cultural identity, several of the respondents were paradoxically left with more identity questions than answers as the result of their travels
Lifestyle travellers: Backpacking as a way of life
Scholarship on backpackers speculates some individuals may extend backpacking to a way of life. This article empirically explores this proposition using lifestyle consumption as its framing concept and conceptualises individuals who style their lives around the enduring
practice of backpacking as âlifestyle travellersâ. Ethnographic interviews with lifestyle travellers in India and Thailand offer an emic account of the practices, ideologies and social identity that characterise lifestyle travel as a distinctive subtype within backpacking.
Departing from the drifter construct, which (re)constitutes this identity as socially deviant, the concept of lifestyle allows for a contemporary appraisal of these individualsâ patterns of meaningful consumption and wider insights into how ongoing mobility can lead to different ways of understanding identities and relating to place.
Keywords: lifestyle consumption; backpacker; mobility; drifter; identit
Individual variations in 'brain age' relate to early-life factors more than to longitudinal brain change
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