Patient-Related Characteristics Associated with Rehospitalization in Medicare Recipients with Heart Failure Receiving Telehomecare

Heart failure (HF) is the leading cause of rehospitalization in the United State. One potential way to reduce HF rehospitalizations is through the use of telehomecare, which is a remote monitoring intervention in home care settings. However, studies on telehomecare use conducted in the United States have demonstrated mixed results in reducing HF rehospitalizations. Little is known about risk factors for rehospitalization during a telehomecare episode. The aims of the study were to identify patient characteristics associated with all-cause rehospitalizations and patient characteristics associated with time-to-first rehospitalization within 60 days of the home health care episode. This is a non-experimental, cross-sectional secondary analysis of the Outcome Assessment Information Set dataset from Medicare recipients with HF provided with telehomecare. This study used multiple logistic regression, decision tree techniques and survival analysis methods. The main findings of this study were that results of a formal pain assessment and the ability to dress one\u27s lower body safely were associated with rehospitalizations. In particular, subjects who were independent in dressing their lower body had a consistently higher risk of rehospitalization than functionally dependent groups. While the logistic regression model and survival analysis presented the associations between rehospitalization and single risk factors, the decision tree techniques presented the relative contributions of and interactions between risk factors for rehospitalization as a global picture, which may provide clinicians with a visual guide to targeting those patients most likely to benefit from telehomecare, or who may need additional interventions

Visualization approaches to support healthy aging: A systematic review

Background: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored.Objective: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging.Methods: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years.Results: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one’s health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data.Conclusions: Studies we identified used visualizations to promote engagement in exercises or understandings of one’s health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making

Time Series Forecasting for Regional Development Composite Index Using Real-Time Floating Population Data

Composite development indices show an exponential movement of major economic indicators to identify and predict the overall trend of the national economy. However, the existing method of writing composite development indices is based on simple statistical methods using macroscopic data. Therefore, it presents limitations when grasping regional economic trends late. It is because the time of announcement of composite development indices is concentrated at the end of each month, quarter, and year. This study used the floating population estimated from smartphone data that can be collected in real-time to analyze how floating population patterns affect regional economic situations to compensate for these limitations. The primary purpose was to present a prompt development prediction methodology that reflects this meaningful relationship. A correlation and cross-correlation analysis was performed to exhibit a clear relationship between composite development indices and floating population value. In addition, a time series model and a multiple regression model analyses were applied to predict regional development indices. The results obtained facilitated the prompt selection of regional composite indices after choosing a model that exhibits high prediction accuracy and efficiency of the application. The selected regional development composite indices are expected to be used as a faster and more reliable prediction criterion than the existing development composite indices used to predict a specific city’s economic situation

In Vitro Studies on Therapeutic Effects of Cannabidiol in Neural Cells: Neurons, Glia, and Neural Stem Cells

(‒)-Cannabidiol (CBD) is one of the major phytocannabinoids extracted from the Cannabis genus. Its non-psychoactiveness and therapeutic potential, partly along with some anecdotal—if not scientific or clinical—evidence on the prevention and treatment of neurological diseases, have led researchers to investigate the biochemical actions of CBD on neural cells. This review summarizes the previously reported mechanistic studies of the CBD actions on primary neural cells at the in vitro cell-culture level. The neural cells are classified into neurons, microglia, astrocytes, oligodendrocytes, and neural stem cells, and the CBD effects on each cell type are described. After brief introduction on CBD and in vitro studies of CBD actions on neural cells, the neuroprotective capability of CBD on primary neurons with the suggested operating actions is discussed, followed by the reported CBD actions on glia and the CBD-induced regeneration from neural stem cells. A summary section gives a general overview of the biochemical actions of CBD on neural cells, with a future perspective. This review will provide a basic and fundamental, but crucial, insight on the mechanistic understanding of CBD actions on neural cells in the brain, at the molecular level, and the therapeutic potential of CBD in the prevention and treatment of neurological diseases, although to date, there seem to have been relatively limited research activities and reports on the cell culture-level, in vitro studies of CBD effects on primary neural cells

Clinician-targeted mobile apps in palliative care: A systematic review

Background: The availability of smartphone applications has increased rapidly including applications related to palliative care. The scope of these available apps has not been synthesized. Objective: The purpose of this study was to identify and review available palliative care-related smartphone applications for clinicians. Design: Smartphone application platform stores, for example, App Store iOS, Google Play Store, Windows App-Microsoft Store, and Blackberry World App store were searched (December 2016) using relevant key words. Results: Forty-six palliative care applications targeting clinicians were identified, including clinical guidelines (n = 17), advance care planning (n = 9), training materials in palliative care (n = 7), and pharmaceutical tools (n = 7), and platforms for distributing current palliative care news, articles, and opinions (n = 6). The majority of the applications were free and available in English. The most common platforms were Android and iOS. Conclusions: The number of palliative care apps targeting clinicians has increased dramatically for the past five years. However, many apps did not report adequate information to judge the evidence upon which the apps were based

Visualization approaches to support healthy aging: A systematic review

Background: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored. Objective: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging. Methods: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years. Results: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one’s health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data. Conclusions: Studies we identified used visualizations to promote engagement in exercises or understandings of one’s health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making

Endoscopic Ultrasound-Guided Pancreatic Interstitial Laser Ablation Using a Cylindrical Laser Diffuser: A Long-Term Follow-Up Study

Background and Aims: Local ablative treatment is another option for improving outcomes and has been evaluated for locally advanced pancreatic cancer. We previously suggested endoscopic ultrasound (EUS)-guided interstitial laser ablation using a cylindrical laser diffuser (CILA) might be a feasible therapeutic option based on experiments performed on pancreatic cancer cell lines and porcine model with a short follow-up (3 days). The aim of this study was to investigate the safety of EUS-CILA performed using optimal settings in porcine pancreas with a long-term follow-up (2 weeks). Methods: EUS-CILA (laser energy of 450 J; 5 W for 90 s) was applied to normal pancreatic tissue in porcine (n = 5) under EUS guidance. Animals were observed clinically for 2 weeks after EUS-CILA to evaluate complications. Computed tomography and laboratory tests were carried out to evaluate safety. Two weeks after EUS-CILA, all pigs were sacrificed, and histopathological safety and efficacy evaluations were conducted. Results: EUS-CILA was technically successful in all five cases. No major complications occurred during the follow-up period. Body weight of porcine did not change during the study period without any significant change in feed intake. Animals remained in excellent condition throughout the experimental period, and laboratory tests and computed tomography (CT) scans provided no evidence of a major complication. Histopathological evaluation showed complete ablation in the ablated area with clear delineation of surrounding normal pancreatic tissue. Mean ablated volume was 55.5 mm2 × 29.0 mm and mean ablated areas in the pancreatic sections of the five pigs were not significantly different (p = 0.368). Conclusions: In conclusion, our experimental study suggests that EUS-CILA is safe and has the potential to be an effective local treatment modality. No major morbidity or mortality occurred during the study period. Further evaluations are warranted before clinical application