Differences in results and related factors between hospital-at-home modalities in Catalonia: a cross-sectional study

This is the final version. Available on open access from MDPI via the DOI in this record. Hospital-at-home (HaH) is a healthcare modality that provides active treatment by healthcare staff in the patient's home for a condition that would otherwise require hospitalization. The aims were to describe the characteristics of different types of hospital-at-home (HaH), assess their results, and examine which factors could be related to these results. A cross-sectional study based on data from all 2014 HaH contacts from Catalonia was designed. The following HaH modalities were considered-admission avoidance (n = 7,214; 75.1%) and early assisted discharge (n = 2,387; 24.9%). The main outcome indicators were readmission, mortality, and length of stay (days). Multivariable models were fitted to assess the association between explanatory factors and outcomes. Hospital admission avoidance is a scheme in which, instead of being admitted to acute care hospitals, patients are directly treated in their own homes. Early assisted discharge is a scheme in which hospital in-care patients continue their treatment at home. In the hospital avoidance modality, there were 8.3% readmissions, 0.9% mortality, and a mean length of stay (SD) of 9.6 (10.6) days. In the early assisted discharge modality, these figures were 7.9%, 0.5%, and 9.8 (11.1), respectively. In both modalities, readmission and mean length of stay were related to comorbidity and type of hospital, and mortality with age. The results of HaH in Catalonia are similar to those observed in other contexts. The factors related to these results identified might help to improve the effectiveness and efficiency of the different HaH modalities

Auditory but Not Audiovisual Cues Lead to Higher Neural Sensitivity to the Statistical Regularities of an Unfamiliar Musical Style

It is still a matter of debate whether visual aids improve learning of music. In a multisession study, we investigated the neural signatures of novel music sequence learning with or without aids (auditory-only: AO, audiovisual: AV). During three training sessions on 3 separate days, participants (nonmusicians) reproduced (note by note on a keyboard) melodic sequences generated by an artificial musical grammar. The AV group (n = 20) had each note color-coded on screen, whereas the AO group (n = 20) had no color indication. We evaluated learning of the statistical regularities of the novel music grammar before and after training by presenting melodies ending on correct or incorrect notes and by asking participants to judge the correctness and surprisal of the final note, while EEG was recorded. We found that participants successfully learned the new grammar. Although the AV group, as compared to the AO group, reproduced longer sequences during training, there was no significant difference in learning between groups. At the neural level, after training, the AO group showed a larger N100 response to lowprobability compared to high-probability notes, suggesting an increased neural sensitivity to statistical properties of the grammar; this effect was not observed in the AV group. Our findings indicate that visual aids might improve sequence reproduction while not necessarily promoting better learning, indicating a potential dissociation between sequence reproduction and learning. We suggest that the difficulty induced by auditory-only input during music training might enhance cognitive engagement, thereby improving neural sensitivity to the underlying statistical properties of the learned material

The German Music@Home: Validation of a questionnaire measuring at home musical exposure and interaction of young children.

The present study introduces the German version of the original version of the Music@Home questionnaire developed in the UK, which systematically evaluates musical engagement in the home environment of young children. Two versions are available, an Infant version for children aged three to 23 months and a Preschool version for children aged two to five and a half years. For the present study, the original Music@Home questionnaire was translated from English into German and 656 caregivers completed the questionnaire online. A confirmatory factor analysis showed moderate to high fit indices for both versions, confirming the factor structure of the original questionnaire. Also, the reliability coefficients for the subscales (Parental beliefs, Child engagement with music, Parent initiation of singing, Parent initiation of music-making for the Infant version and Parental beliefs, Child engagement with music, Parent initiation of music behavior and Breadth of musical exposure for the Preschool version) ranged from moderate to high fits. Furthermore, the test-retest analysis (N = 392) revealed high correlations for the general factor and all subscales confirming their internal reliability. Additionally, we included language questionnaires for children of two and three years of age. Results showed that higher scores on the Music@Home questionnaire were moderately associated with better language skills in two-year-olds (N = 118). In sum, the study presents the validated German Music@Home questionnaire, which shows good psychometric properties. The two versions of the questionnaire are available for use in order to assess home musical engagement of young children, which could be of interest in many areas of developmental research

Urban space under negotiation: Reactivation of underused spaces as a tool for urban transformation

UrbanismArchitectur

Case Report: Schwannom im Bereich der Oberlippe und des Nasenstegs

Einleitung: Schwannome sind seltene, langsam wachsende, gutartige Tumoren der Zellen peripheren Nerven, die eine Differenzierung entsprechend Schwannscher Zellen aufweisen. Sie kommen intrakraniell(Akustikusneurinom)aber auch extrakraniell vor. Die extrakraniellen Schwannome sind am häufigsten in der Kopf-Hals-Region nachzuweisen.Methoden: In dieser Arbeit stellen wir den bemerkenswerten Fall einer 52-jähriger Patient mit einer indolenten Raumforderung der Columella bds. bis in die Oberlippe ziehend. Klinisch zeigte sich eine ballonierende Raumforderung ca. 3x4cm, indolent, wenig verschieblich und derb. Im CT NNH wurde eine glatt berandete, homogene Weichgewebsvermehrung am knorpeligen Anteil des Nasenseptums bis zur Oberlippe reichend. Unsere Therapie beinhaltete ein Teilablatio nasi bds. mit Entfernung der Colummella nasi sowie des vorderen Anteils des Septums und der Oberlippe. Die Rekonstruktion erfolgte mittels zweier Nasolabiallappen bds.Schlussfolgerung: Im Kontext unseres Fallberichtes diskutieren wir die klinischen und therapeutischen Merkmalen dieser seltener Entität.Der Erstautor gibt keinen Interessenkonflikt an

Characteristic ratio of poly(tetrahydrofurfuryl acrylate) and poly(2-ethylbutyl acrylate)

The synthesis, characteristic ratio Cx and glass transition temperature (Tg) of poly(tetrahydrofurfuryl acrylate) (PTHFA) and of poly(2-ethylbutyl acrylate) (P2EBA) are reported. P2EBA has slightly lower flexibility (Cx = 9.2) than PTHFA (Cx = 8.6), mainly because of the higher bulkiness of its side group and the closer proximity to the main chain. The Cx results compared with the corresponding polymethacrylates show an increase in flexibility due to the absence of the α-methyl group. Comparison with poly(methyl acrylate) clearly shows the influence of the bulkiness of the side group on the chain flexibility. The lower Tg of P2EBA than that of PTHFA may be explained by the higher flexibility of the 2-ethylbutyl side group. © 1997 John Wiley & Sons, Inc

lmmunohistochemical expression of the p53, mdm2, p21/Waf-1, Rb, p16, Ki67, Cyclin DI, Cyclin A and Cyclin B1 proteins and apoptotic index in T-cell lymphomas

Fifty-seven cases of T-cell lymphomas (TCL) including 5 lymphoblastic (T-LBL) and 52 peripheral TCL (PTCL) were analyzed by immunohistochemistry for the expression of p53, mdm2, p21, Rb, cyclin DI, cyclin A, cyclin B1, and Ki67IMIB1 proteins and 39/52 PTCL were also analyzed for the expression of p16 protein and for the presence of apoptotic cells by the TUNEL method. The aim was to search for abnormal immunoprofiles of p53 and Rb growth control pathways and to determine the proliferative activity and the apoptotic index of TCL. Abnormal overexpression of p53, p21 and mdm2, in comparison to normal lymph nodes, was found in 12/57,10/57 and 2/57 cases of TCL, respectively. Abnormal loss of Rb and p16 expression was found in 1/57 and 2/39 cases, respectively, whereas abnormal overexpression of cyclin D1 was not detected in any of the 57 cases. Our data revealed entity-related p53/p21/mdm2 phenotypes. Indeed, most nodal and cutaneous CD30+ anaplastic large cell lymphomas (ALCL) showed concomitant overexpression of p53 and p21 proteins (718 cases), and mdm2 was overexpressed in 2 p53-positive nodal ALCL. In contrast, overexpression of p53 was found in 3/17 cases of nodal peripheral TCL unspecified (PTCL-UC) and 217 non- ALCL cutaneous pleomorphic TCL. Overexpression of p21 protein was detected in 213 p53-positive PTCLUC and in 112 p53-positive non-ALCL cutaneous pleomorphic TCL. Finally, al1 the remaining 25 cases of TCL did not show p53 and p21 overexpression. Overali, the p53+/p21+ phenotype in 10157 TCL suggests wildtype p53 capable of inducing p21 expression. The highest apoptotic index (Al) was found in ALCL and a positive correlation between apoptotic index and Ki67 index (p<0.001) was detected. Ki67, cyclin A and cyclin B1 expression was found in al1 57 TCL and on the basis of the combined use of these 3 variables, 3 groups of proliferative activity,.could be determined: a) high in ALCL and T-LBL, b) low in mycosis fungoides (MF) and γδ hepatosplenic TCL, and c) intermediate in the remaining TCL entities. The proliferative activity in the 12 p53 overexpressing cases was higher in comparison to the 45 p53-negative cases. Ki67 expresion in more than 25% of tumour cells showed significant correlation with p53 overexpression (p<0.001). Rb expression tended to be parallel to Ki67, cyclin A and cyclin B1 expression in al1 but one case of nodal PTCL-UC which displayed loss of RB expression. Interestingly, this case was p53-negative, whereas the p53-positive cases were Rb-positive. These findings suggest that different pathogenetic routes may function in some TCL, involving either the p53 or, less frequently, the Rb pathways