Assessment of Heart Failure Patients' Interest in Mobile Health Apps for Self-Care: Survey Study.

BackgroundHeart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders.ObjectiveThe objective of this study was to ascertain heart failure patients' interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app.MethodsIn the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board-approved questionnaires. The survey measured patients' interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients' health-related quality of life through patient-reported outcomes.ResultsParticipants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (P<.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (P<.05).ConclusionsThe majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology

Learning Disentangled Prompts for Compositional Image Synthesis

We study domain-adaptive image synthesis, the problem of teaching pretrained image generative models a new style or concept from as few as one image to synthesize novel images, to better understand the compositional image synthesis. We present a framework that leverages a pretrained class-conditional generation model and visual prompt tuning. Specifically, we propose a novel source class distilled visual prompt that learns disentangled prompts of semantic (e.g., class) and domain (e.g., style) from a few images. Learned domain prompt is then used to synthesize images of any classes in the style of target domain. We conduct studies on various target domains with the number of images ranging from one to a few to many, and show qualitative results which show the compositional generalization of our method. Moreover, we show that our method can help improve zero-shot domain adaptation classification accuracy.Comment: tech repor

Jede Art Vervielfältigung vorbehalten [Material gráfico]

Contenido parcial: II. Umilu ; III. Arce ; IV. Álamo negro ; VI. Abedul blanco ; VII. Fresno ; VIII. Castaño de Indias ; IX. Olivo ; X. Pino ; XII. Alerce ; XIV. Plátano ; XVI. Abedul blanco ; XVII. Manzano ; XIX. Haya ; XXI. Cerezo ; XXII. Ciruelo ; XXIV. Castaño ; XXVV. AcaciaTit. de las láminas tomados del verso de las mismasFechas deducidas de la actividad del editorLáminas murales de cartulina con refuerzos metálico

An Empirical Assessment of A-Share IPO Under-Pricing in China

This paper investigates the under-pricing and long-run performance of 230 A-share IPOs issued in the Chinese markets using comparable firm multiples. We find that A-share IPOs are severely under-valued by issuers and underwriters at the offer, but over-valued by investors on the listing day. Both contribute to the severe under-pricing of IPOs in China. Our findings are robust across stock exchanges, classification of firms, criteria for choosing matching firms; absence of CSRC regulation and B-share market prices, respectively. The results also show that those over-valued IPOs by investors on the listing day under-perform those under-valued IPOs in the long-run

New and Improved Diagnostics for Detection of Drug-Resistant Pulmonary Tuberculosis.

PURPOSE OF REVIEW: Tuberculosis (TB) remains a global emergency and continues to kill 1.7 million people globally each year. Drug-resistant TB is now well established throughout the world and most TB patients are not being screened for drug resistance due to lack of laboratory resources and rapid accurate point-of-care tests. Accurate and rapid diagnosis of TB and drug-resistant TB is of paramount importance in establishing appropriate clinical management and infection control measures. During the past decade, there have been significant advances in diagnostic technologies for TB and drug-resistant TB. The purpose of this article is to review the current data, recommendations and evidence base for these tests. RECENT FINDINGS: Second-line drug susceptibility testing (DST) is complex and expensive. Automated liquid culture systems and molecular line probe assays are recommended by the WHO as the current 'gold standard' for first-line DST. Liquid culture DST for aminoglycosides, polypeptides and fluoroquinolones has been shown to have relatively good reliability and reproducibility for diagnosis of extensively drug-resistant TB; however, DST for other second-line drugs (ethionamide, prothionamide, cycloserine, terizidone, para-aminosalicylic acid, clofazimine, amoxicillin-clavulanate, clarithromycin, linezolid) is not recommended. Automated liquid culture systems are currently recommended by the WHO as the 'gold standard' for second-line DST. SUMMARY: In this review, we describe the phenotypic and genotypic methods currently available for the diagnosis of TB and drug-resistant forms of Mycobacterium tuberculosis and discuss future prospects for TB diagnostics. Current technologies for the detection of drug resistant M. tuberculosis vary greatly in terms of turnaround time, cost and complexity. Ultimately, the 'holy grail' diagnostic for TB must fulfil all technical specifications for a good point-of-care test, screen for drug resistance concurrently and be adaptable to the various health system levels and to countries with diverse economic status and TB burden. © 2011 Lippincott Williams & Wilkins, Inc

The assessment of the near infrared identification of Carbon stars. I. The Local Group galaxies WLM, IC 10 and NGC 6822

{The selection of AGB C and M stars from NIR colours has been done in recent years using adjustable criteria that are in needs of standardization if one wants to compare, in a coherent manner, properties of various populations.} We intend to assess the NIR colour technique to identify C and M stars. We compare the NIR colours of several C stars previously identified from spectroscopy or narrow band techniques in WLM, IC 10 and NGC 6822. We demonstrate that very few M stars have $(J-K)_0 > 1.4$ but a non negligible number of C stars are bluer than this limit. Thus, counts of M and C stars based on such limit do not produce pure samples. C/M ratios determined from NIR colours must be regarded as underestimates mainly because the M numbers include many warm C stars and also K stars if no blue limit is considered.Comment: A&A accepted 18.07.200

Application of Social Network Analysis to Health Care Sectors

Objectives: This study aimed to examine the feasibility of social network analysis as a valuable research tool for indicating a change in research topics in health care and medicine. Methods: Papers used in the analysis were collected from the PubMed database at the National Library of Medicine. After limiting the search to papers affiliated with the National Institutes of Health, 27,125 papers were selected for the analysis. From these papers, the top 100 non-duplicate and most studied Medical Subject Heading terms were extracted. NetMiner V.3 was used for analysis. Weighted degree centrality was applied to the analysis to compare the trends in the change of research topics. Changes in the core keywords were observed for the entire group and in three-year intervals. Results: The core keyword with the highest centrality value was “Risk Factor, ” followed b

Near-infrared properties of asymptotic giant branch stars in nearby dwarf elliptical Galaxy NGC 205

We investigated the distribution of resolved asymptotic giant branch (AGB) stars over a much larger area than covered by previous near-infrared studies in the nearby dwarf elliptical galaxy NGC 205. Using data obtained with the WIRCam near-infrared imager of the CFHT, we selected the AGB stars in the JHKs color-magnitude diagrams, and separated the C stars from M-giant stars in the JHKs color-color diagram. We identified 1,550 C stars in NGC 205 with a mean absolute magnitude of M_Ks = -7.49 \pm 0.54, and colors of (J - Ks) = 1.81 \pm 0.41 and (H - Ks) = 0.76 \pm 0.24. The ratio of C stars to M-giant stars was estimated to be 0.15 \pm 0.01 in NGC 205, and the local C/M ratios for the southern region are somewhat lower than those for the northern region. The (J - Ks) color distributions of AGB stars contain the main peak of the M-giant stars and the red tail of the C stars. A comparison of the theoretical isochrone models with the observed color distribution indicates that most of the bright M-giant stars in NGC 205 were formed at log(t_yr) \sim 9.0-9.7. The logarithmic slope of the M_Ks luminosity function for M-giant stars was estimated to be 0.84 \pm 0.01, which is comparable with dwarf elliptical galaxies NGC 147 and NGC 185. Furthermore, we found that the logarithmic slopes of the M_Ks luminosity function for C and M-giant stars are different to places, implying a different star formation history within NGC 205. The bolometric luminosity function for M-giant stars extends to M_bol = -6.0 mag, and that for C stars spans -5.6 < M_bol < -3.0. The bolometric luminosity function of C stars is unlikely to be a Gaussian distribution and the mean bolometric magnitude of C stars is estimated to be M_bol = -4.24 \pm 0.55, which is consistent with our results for dwarf elliptical galaxies NGC 147 and NGC 185.Comment: 11 pages, 11 figures, accepted for publication in A&

Optical chemosensors and reagents to detect explosives

[EN] This critical review is focused on examples reported from 1947 to 2010 related to the design of chromo-fluorogenic chemosensors and reagents for explosives (141 references). © 2012 The Royal Society of Chemistry.Financial support from the Spanish Government (project MAT2009-14564-C04) and the Generalitat Valencia (project PROMETEO/2009/016) is gratefully acknowledged. Y.S. is grateful to the Spanish Ministry of Science and Innovation for her grant.Salinas Soler, Y.; Martínez Mañez, R.; Marcos Martínez, MD.; Sancenón Galarza, F.; Costero Nieto, AM.; Parra Álvarez, M.; Gil Grau, S. (2012). Optical chemosensors and reagents to detect explosives. Chemical Society Reviews. 41(3):1261-1296. https://doi.org/10.1039/c1cs15173hS12611296413Furton, K. (2001). The scientific foundation and efficacy of the use of canines as chemical detectors for explosives. Talanta, 54(3), 487-500. doi:10.1016/s0039-9140(00)00546-4H�kansson, K., Coorey, R. V., Zubarev, R. A., Talrose, V. L., & H�kansson, P. (2000). Low-mass ions observed in plasma desorption mass spectrometry of high explosives. Journal of Mass Spectrometry, 35(3), 337-346. doi:10.1002/(sici)1096-9888(200003)35:33.0.co;2-7Walsh, M. (2001). Determination of nitroaromatic, nitramine, and nitrate ester explosives in soil by gas chromatography and an electron capture detector. Talanta, 54(3), 427-438. doi:10.1016/s0039-9140(00)00541-5Sylvia, J. M., Janni, J. A., Klein, J. D., & Spencer, K. M. (2000). Surface-Enhanced Raman Detection of 2,4-Dinitrotoluene Impurity Vapor as a Marker To Locate Landmines. Analytical Chemistry, 72(23), 5834-5840. doi:10.1021/ac0006573Yinon, J. (1982). Mass spectrometry of explosives: Nitro compounds, nitrate esters, and nitramines. Mass Spectrometry Reviews, 1(3), 257-307. doi:10.1002/mas.1280010304Mathurin, J. C., Faye, T., Brunot, A., Tabet, J. C., Wells, G., & Fuché, C. (2000). High-Pressure Ion Source Combined with an In-Axis Ion Trap Mass Spectrometer. 1. Instrumentation and Applications. Analytical Chemistry, 72(20), 5055-5062. doi:10.1021/ac000171mHallowell, S. (2001). Screening people for illicit substances: a survey of current portal technology. Talanta, 54(3), 447-458. doi:10.1016/s0039-9140(00)00543-9Vourvopoulos, G. (2001). Pulsed fast/thermal neutron analysis: a technique for explosives detection. Talanta, 54(3), 459-468. doi:10.1016/s0039-9140(00)00544-0Krausa, M., & Schorb, K. (1999). Trace detection of 2,4,6-trinitrotoluene in the gaseous phase by cyclic voltammetry. Journal of Electroanalytical Chemistry, 461(1-2), 10-13. doi:10.1016/s0022-0728(98)00162-4Steinfeld, J. I., & Wormhoudt, J. (1998). EXPLOSIVES DETECTION: A Challenge for Physical Chemistry. Annual Review of Physical Chemistry, 49(1), 203-232. doi:10.1146/annurev.physchem.49.1.203Moore, D. S. (2004). Instrumentation for trace detection of high explosives. Review of Scientific Instruments, 75(8), 2499-2512. doi:10.1063/1.1771493Martínez-Máñez, R., Sancenón, F., Hecht, M., Biyikal, M., & Rurack, K. (2010). Nanoscopic optical sensors based on functional supramolecular hybrid materials. Analytical and Bioanalytical Chemistry, 399(1), 55-74. doi:10.1007/s00216-010-4198-2Moragues, M. E., Martínez-Máñez, R., & Sancenón, F. (2011). Chromogenic and fluorogenic chemosensors and reagents for anions. A comprehensive review of the year 2009. Chemical Society Reviews, 40(5), 2593. doi:10.1039/c0cs00015aMartínez-Máñez, R., & Sancenón, F. (2005). New Advances in Fluorogenic Anion Chemosensors. Journal of Fluorescence, 15(3), 267-285. doi:10.1007/s10895-005-2626-zXu, Z., Chen, X., Kim, H. N., & Yoon, J. (2010). Sensors for the optical detection ofcyanide ion. Chem. Soc. Rev., 39(1), 127-137. doi:10.1039/b907368jNolan, E. M., & Lippard, S. J. (2008). Tools and Tactics for the Optical Detection of Mercuric Ion. Chemical Reviews, 108(9), 3443-3480. doi:10.1021/cr068000qPallavicini, P., Diaz-Fernandez, Y. A., & Pasotti, L. (2009). Micelles as nanosized containers for the self-assembly of multicomponent fluorescent sensors. Coordination Chemistry Reviews, 253(17-18), 2226-2240. doi:10.1016/j.ccr.2008.11.010Que, E. L., & Chang, C. J. (2010). Responsive magnetic resonance imaging contrast agents as chemical sensors for metals in biology and medicine. Chem. Soc. Rev., 39(1), 51-60. doi:10.1039/b914348nMohr, G. J. (2004). Tailoring the sensitivity and spectral properties of a chromoreactand for the detection of amines and alcohols. Analytica Chimica Acta, 508(2), 233-237. doi:10.1016/j.aca.2003.12.005Martínez-Máñez, R., & Sancenón, F. (2003). Fluorogenic and Chromogenic Chemosensors and Reagents for Anions. Chemical Reviews, 103(11), 4419-4476. doi:10.1021/cr010421eJ. P. Agrawal and R. D.Hodgson, Organic Chemistry of Explosives, John Wiley & Sons, Chichester, 2007, ISBN-13, 978, 0-470-02967-1, HBCumming, C. J., Aker, C., Fisher, M., Fok, M., la Grone, M. J., Reust, D., … Williams, V. (2001). Using novel fluorescent polymers as sensory materials for above-ground sensing of chemical signature compounds emanating from buried landmines. IEEE Transactions on Geoscience and Remote Sensing, 39(6), 1119-1128. doi:10.1109/36.927423Toal, S. J., & Trogler, W. C. (2006). Polymer sensors for nitroaromatic explosives detection. Journal of Materials Chemistry, 16(28), 2871. doi:10.1039/b517953jMcQuade, D. T., Pullen, A. E., & Swager, T. M. (2000). Conjugated Polymer-Based Chemical Sensors. Chemical Reviews, 100(7), 2537-2574. doi:10.1021/cr9801014Zhou, Q., & Swager, T. M. (1995). Method for enhancing the sensitivity of fluorescent chemosensors: energy migration in conjugated polymers. Journal of the American Chemical Society, 117(26), 7017-7018. doi:10.1021/ja00131a031Yang, J.-S., & Swager, T. M. (1998). Porous Shape Persistent Fluorescent Polymer Films:  An Approach to TNT Sensory Materials. Journal of the American Chemical Society, 120(21), 5321-5322. doi:10.1021/ja9742996Yang, J.-S., & Swager, T. M. (1998). Fluorescent Porous Polymer Films as TNT Chemosensors:  Electronic and Structural Effects. Journal of the American Chemical Society, 120(46), 11864-11873. doi:10.1021/ja982293qYamaguchi, S., & Swager, T. M. (2001). Oxidative Cyclization of Bis(biaryl)acetylenes:  Synthesis and Photophysics of Dibenzo[g,p]chrysene-Based Fluorescent Polymers. Journal of the American Chemical Society, 123(48), 12087-12088. doi:10.1021/ja016692oZahn, S., & Swager, T. M. (2002). Three-Dimensional Electronic Delocalization in Chiral Conjugated Polymers. Angewandte Chemie International Edition, 41(22), 4225-4230. doi:10.1002/1521-3773(20021115)41:223.0.co;2-3Amara, J. P., & Swager, T. M. (2005). Synthesis and Properties of Poly(phenylene ethynylene)s with Pendant Hexafluoro-2-propanol Groups. Macromolecules, 38(22), 9091-9094. doi:10.1021/ma051562bZhao, D., & Swager, T. M. (2005). Sensory Responses in Solution vs Solid State:  A Fluorescence Quenching Study of Poly(iptycenebutadiynylene)s. Macromolecules, 38(22), 9377-9384. doi:10.1021/ma051584yThomas III, S. W., Amara, J. P., Bjork, R. E., & Swager, T. M. (2005). Amplifying fluorescent polymer sensors for the explosives taggant 2,3-dimethyl-2,3-dinitrobutane (DMNB). Chemical Communications, (36), 4572. doi:10.1039/b508408cNarayanan, A., Varnavski, O. P., Swager, T. M., & Goodson, T. (2008). Multiphoton Fluorescence Quenching of Conjugated Polymers for TNT Detection. The Journal of Physical Chemistry C, 112(4), 881-884. doi:10.1021/jp709662wChen, S., Zhang, Q., Zhang, J., Gu, J., & Zhang, L. (2010). Synthesis of two conjugated polymers as TNT chemosensor materials. Sensors and Actuators B: Chemical, 149(1), 155-160. doi:10.1016/j.snb.2010.06.007Long, Y., Chen, H., Yang, Y., Wang, H., Yang, Y., Li, N., … Liu, F. (2009). Electrospun Nanofibrous Film Doped with a Conjugated Polymer for DNT Fluorescence Sensor. Macromolecules, 42(17), 6501-6509. doi:10.1021/ma900756wChang, C.-P., Chao, C.-Y., Huang, J. H., Li, A.-K., Hsu, C.-S., Lin, M.-S., … Su, A.-C. (2004). Fluorescent conjugated polymer films as TNT chemosensors. Synthetic Metals, 144(3), 297-301. doi:10.1016/j.synthmet.2004.04.003Levitsky, I. A., Euler, W. B., Tokranova, N., & Rose, A. (2007). Fluorescent polymer-porous silicon microcavity devices for explosive detection. Applied Physics Letters, 90(4), 041904. doi:10.1063/1.2432247Chen, L., McBranch, D., Wang, R., & Whitten, D. (2000). Surfactant-induced modification of quenching of conjugated polymer fluorescence by electron acceptors: applications for chemical sensing. Chemical Physics Letters, 330(1-2), 27-33. doi:10.1016/s0009-2614(00)00970-2Rose, A., Zhu, Z., Madigan, C. F., Swager, T. M., & Bulović, V. (2005). Sensitivity gains in chemosensing by lasing action in organic polymers. Nature, 434(7035), 876-879. doi:10.1038/nature03438Tamao, K., Uchida, M., Izumizawa, T., Furukawa, K., & Yamaguchi, S. (1996). Silole Derivatives as Efficient Electron Transporting Materials. Journal of the American Chemical Society, 118(47), 11974-11975. doi:10.1021/ja962829cSohn, H., Huddleston, R. R., Powell, D. R., West, R., Oka, K., & Yonghua, X. (1999). An Electroluminescent Polysilole and Some Dichlorooligosiloles. Journal of the American Chemical Society, 121(12), 2935-2936. doi:10.1021/ja983350iOhshita, J., & Kunai, A. (1998). Polymers with alternating organosilicon and π-conjugated units. Acta Polymerica, 49(8), 379-403. doi:10.1002/(sici)1521-4044(199808)49:83.0.co;2-zToal, S. J., Magde, D., & Trogler, W. C. (2005). Luminescent oligo(tetraphenyl)silole nanoparticles as chemical sensors for aqueous TNT. Chemical Communications, (43), 5465. doi:10.1039/b509404fSohn, H., Sailor, M. J., Magde, D., & Trogler, W. C. (2003). Detection of Nitroaromatic Explosives Based on Photoluminescent Polymers Containing Metalloles. Journal of the American Chemical Society, 125(13), 3821-3830. doi:10.1021/ja021214eSanchez, J. C., DiPasquale, A. G., Rheingold, A. L., & Trogler, W. C. (2007). Synthesis, Luminescence Properties, and Explosives Sensing with 1,1-Tetraphenylsilole- and 1,1-Silafluorene-vinylene Polymers. Chemistry of Materials, 19(26), 6459-6470. doi:10.1021/cm702299gSanchez, J. C., Urbas, S. A., Toal, S. J., DiPasquale, A. G., Rheingold, A. L., & Trogler, W. C. (2008). Catalytic Hydrosilylation Routes to Divinylbenzene Bridged Silole and Silafluorene Polymers. Applications to Surface Imaging of Explosive Particulates. Macromolecules, 41(4), 1237-1245. doi:10.1021/ma702274cSanchez, J. C., & Trogler, W. C. (2008). Efficient blue-emitting silafluorene–fluorene-conjugated copolymers: selective turn-off/turn-on detection of explosives. Journal of Materials Chemistry, 18(26), 3143. doi:10.1039/b802623hLiu, J., Zhong, Y., Lam, J. W. Y., Lu, P., Hong, Y., Yu, Y., … Tang, B. Z. (2010). Hyperbranched Conjugated Polysiloles: Synthesis, Structure, Aggregation-Enhanced Emission, Multicolor Fluorescent Photopatterning, and Superamplified Detection of Explosives. Macromolecules, 43(11), 4921-4936. doi:10.1021/ma902432mLu, P., Lam, J. W. Y., Liu, J., Jim, C. K. W., Yuan, W., Xie, N., … Tang, B. Z. (2010). Aggregation-Induced Emission in a Hyperbranched Poly(silylenevinylene) and Superamplification in Its Emission Quenching by Explosives. Macromolecular Rapid Communications, 31(9-10), 834-839. doi:10.1002/marc.200900794Liu, Y., Mills, R. C., Boncella, J. M., & Schanze, K. S. (2001). Fluorescent Polyacetylene Thin Film Sensor for Nitroaromatics. Langmuir, 17(24), 7452-7455. doi:10.1021/la010696pToy, L. G., Nagai, K., Freeman, B. D., Pinnau, I., He, Z., Masuda, T., … Yampolskii, Y. P. (2000). Pure-Gas and Vapor Permeation and Sorption Properties of Poly[1-phenyl-2-[p-(trimethylsilyl)phenyl]acetylene] (PTMSDPA). Macromolecules, 33(7), 2516-2524. doi:10.1021/ma991566eSaxena, A., Fujiki, M., Rai, R., & Kwak, G. (2005). Fluoroalkylated Polysilane Film as a Chemosensor for Explosive Nitroaromatic Compounds. Chemistry of Materials, 17(8), 2181-2185. doi:10.1021/cm048319wSaxena, A., Rai, R., Kim, S.-Y., Fujiki, M., Naito, M., Okoshi, K., & Kwak, G. (2006). Weak noncovalent Si···FC interactions stabilized fluoroalkylated rod-like polysilanes as ultrasensitive chemosensors. Journal of Polymer Science Part A: Polymer Chemistry, 44(17), 5060-5075. doi:10.1002/pola.21607Toal, S. J., Sanchez, J. C., Dugan, R. E., & Trogler, W. C. (2007). Visual Detection of Trace Nitroaromatic Explosive Residue Using Photoluminescent Metallole-Containing Polymers. Journal of Forensic Sciences, 52(1), 79-83. doi:10.1111/j.1556-4029.2006.00332.xStringer, R. C., Gangopadhyay, S., & Grant, S. A. (2010). Detection of Nitroaromatic Explosives Using a Fluorescent-Labeled Imprinted Polymer. Analytical Chemistry, 82(10), 4015-4019. doi:10.1021/ac902838cLi, J., Kendig, C. E., & Nesterov, E. E. (2007). Chemosensory Performance of Molecularly Imprinted Fluorescent Conjugated Polymer Materials. Journal of the American Chemical Society, 129(51), 15911-15918. doi:10.1021/ja0748027Bunte, G., Hürttlen, J., Pontius, H., Hartlieb, K., & Krause, H. (2007). Gas phase detection of explosives such as 2,4,6-trinitrotoluene by molecularly imprinted polymers. Analytica Chimica Acta, 591(1), 49-56. doi:10.1016/j.aca.2007.02.014Zhang, X., & Jenekhe, S. A. (2000). Electroluminescence of Multicomponent Conjugated Polymers. 1. Roles of Polymer/Polymer Interfaces in Emission Enhancement and Voltage-Tunable Multicolor Emission in Semiconducting Polymer/Polymer Heterojunctions. Macromolecules, 33(6), 2069-2082. doi:10.1021/ma991913kHou, S., Ding, M., & Gao, L. (2003). Synthesis and Properties of Polyquinolines and Polyanthrazolines Containing Pyrrole Units in the Main Chain. Macromolecules, 36(11), 3826-3832. doi:10.1021/ma025768dKim, T. H., Kim, H. J., Kwak, C. G., Park, W. H., & Lee, T. S. (2006). Aromatic oxadiazole-based conjugated polymers with excited-state intramolecular proton transfer: Their synthesis and sensing ability for explosive nitroaromatic compounds. Journal of Polymer Science Part A: Polymer Chemistry, 44(6), 2059-2068. doi:10.1002/pola.21319Nie, H., Zhao, Y., Zhang, M., Ma, Y., Baumgarten, M., & Müllen, K. (2011). Detection of TNT explosives with a new fluorescent conjugated polycarbazole polymer. Chem. Commun., 47(4), 1234-1236. doi:10.1039/c0cc03659eQin, A., Lam, J. W. Y., Tang, L., Jim, C. K. W., Zhao, H., Sun, J., & Tang, B. Z. (2009). Polytriazoles with Aggregation-Induced Emission Characteristics: Synthesis by Click Polymerization and Application as Explosive Chemosensors. Macromolecules, 42(5), 1421-1424. doi:10.1021/ma8024706Kumar, A., Pandey, M. K., Anandakathir, R., Mosurkal, R., Parmar, V. S., Watterson, A. C., & Kumar, J. (2010). Sensory response of pegylated and siloxanated 4,8-dimethylcoumarins: A fluorescence quenching study by nitro aromatics. Sensors and Actuators B: Chemical, 147(1), 105-110. doi:10.1016/j.snb.2010.02.004Nguyen, H. H., Li, X., Wang, N., Wang, Z. Y., Ma, J., Bock, W. J., & Ma, D. (2009). Fiber-Optic Detection of Explosives Using Readily Available Fluorescent Polymers. Macromolecules, 42(4), 921-926. doi:10.1021/ma802460qAlbert, K. J., & Walt, D. R. (2000). High-Speed Fluorescence Detection of Explosives-like Vapors. Analytical Chemistry, 72(9), 1947-1955. doi:10.1021/ac991397wGao, D., Wang, Z., Liu, B., Ni, L., Wu, M., & Zhang, Z. (2008). Resonance Energy Transfer-Amplifying Fluorescence Quenching at the Surface of Silica Nanoparticles toward Ultrasensitive Detection of TNT. Analytical Chemistry, 80(22), 8545-8553. doi:10.1021/ac8014356Fang, Q., Geng, J., Liu, B., Gao, D., Li, F., Wang, Z., … Zhang, Z. (2009). Inverted Opal Fluorescent Film Chemosensor for the Detection of Explosive Nitroaromatic Vapors through Fluorescence Resonance Energy Transfer. Chemistry - A European Journal, 15(43), 11507-11514. doi:10.1002/chem.200901488Geng, J., Liu, P., Liu, B., Guan, G., Zhang, Z., & Han, M.-Y. (2010). A Reversible Dual-Response Fluorescence Switch for the Detection of Multiple Analytes. Chemistry - A European Journal, 16(12), 3720-3727. doi:10.1002/chem.200902721Yang, J., Aschemeyer, S., Martinez, H. P., & Trogler, W. C. (2010). Hollow silica nanospheres containing a silafluorene–fluorene conjugated polymer for aqueous TNT and RDX detection. Chemical Communications, 46(36), 6804. doi:10.1039/c0cc01906bFeng, J., Li, Y., & Yang, M. (2010). Conjugated polymer-grafted silica nanoparticles for the sensitive detection of TNT. Sensors and Actuators B: Chemical, 145(1), 438-443. doi:10.1016/j.snb.2009.12.056Tao, S., Shi, Z., Li, G., & Li, P. (2006). Hierarchically Structured Nanocomposite Films as Highly Sensitive Chemosensory Materials for TNT Detection. ChemPhysChem, 7(9), 1902-1905. doi:10.1002/cphc.200600185Tao, S., Yin, J., & Li, G. (2008). High-performance TNT chemosensory materials based on nanocomposites with bimodal porous structures. Journal of Materials Chemistry, 18(40), 4872. doi:10.1039/b802486cTao, S., Li, G., & Zhu, H. (2006). Metalloporphyrins as sensing elements for the rapid detection of trace TNT vapor. Journal of Materials Chemistry, 16(46), 4521. doi:10.1039/b606061gTao, S., & Li, G. (2007). Porphyrin-doped mesoporous silica films for rapid TNT detection. Colloid and Polymer Science, 285(7), 721-728. doi:10.1007/s00396-007-1643-7Yildirim, A., Budunoglu, H., Deniz, H., O. Guler, M., & Bayindir, M. (2010). Template-Free Synthesis of Organically Modified Silica Mesoporous Thin Films for TNT Sensing. ACS Applied Materials & Interfaces, 2(10), 2892-2897. doi:10.1021/am100568cLi, H., Wang, J., Pan, Z., Cui, L., Xu, L., Wang, R., … Jiang, L. (2011). Amplifying fluorescence sensing based on inverse opal photonic crystal toward trace TNT detection. J. Mater. Chem., 21(6), 1730-1735. doi:10.1039/c0jm02554bTao, S., Li, G., & Yin, J. (2007). Fluorescent nanofibrous membranes for trace detection of TNT vapor. Journal of Materials Chemistry, 17(26), 2730. doi:10.1039/b618122hNaddo, T., Che, Y., Zhang, W., Balakrishnan, K., Yang, X., Yen, M., … Zang, L. (2007). Detection of Explosives with a Fluorescent Nanofibril Film. Journal of the American Chemical Society, 129(22), 6978-6979. doi:10.1021/ja070747qContent, S., Trogler, W. C., & Sailor, M. J. (2000). Detection of Nitrobenzene, DNT, and TNT Vapors by Quenching of Porous Silicon Photoluminescence. Chemistry - A European Journal, 6(12), 2205-2213. doi:10.1002/1521-3765(20000616)6:123.0.co;2-aKang, J., Ding, L., Lü, F., Zhang, S., & Fang, Y. (2006). Dansyl-based fluorescent film sensor for nitroaromatics in aqueous solution. Journal of Physics D: Applied Physics, 39(23), 5097-5102. doi:10.1088/0022-3727/39/23/030Zhang, S., Lü, F., Gao, L., Ding, L., & Fang, Y. (2007). Fluorescent Sensors for Nitroaromatic Compounds Based on Monolayer Assembly of Polycyclic Aromatics. Langmuir, 23(3), 1584-1590. doi:10.1021/la062773sHe, G., Zhang, G., Lü, F., & Fang, Y. (2009). Fluorescent Film Sensor for Vapor-Phase Nitroaromatic Explosives via Monolayer Assembly of Oligo(diphenylsilane) on Glass Plate Surfaces. Chemistry of Materials, 21(8), 1494-1499. doi:10.1021/cm900013fGoodpaster, J. V., & McGuffin, V. L. (2001). Fluorescence Quenching as an Indirect Detection Method for Nitrated Explosives. Analytical Chemistry, 73(9), 2004-2011. doi:10.1021/ac001347nHughes, A. D., Glenn, I. C., Patrick, A. D., Ellington, A., & Anslyn, E. V. (2008). A Pattern Recognition Based Fluorescence Quenching Assay for the Detection and Identification of Nitrated Explosive Analytes. Chemistry - A European Journal, 14(6), 1822-1827. doi:10.1002/chem.200701546Malashikhin, S., & Finney, N. S. (2008). Fluorescent Signaling Based on Sulfoxide Profluorophores: Application to the Visual Detection of the Explosive TATP. Journal of the American Chemical Society, 130(39), 12846-12847. doi:10.1021/ja802989vFocsaneanu, K.-S., & Scaiano, J. C. (2005). Potential analytical applications of differential fluorescence quenching: pyrene monomer and excimer emissions as sensors for electron deficient molecules. Photochemical & Photobiological Sciences, 4(10), 817. doi:10.1039/b505249aLee, Y. H., Liu, H., Lee, J. Y., Kim, S. H., Kim, S. K., Sessler, J. L., … Kim, J. S. (2010). Dipyrenylcalix[4]arene-A Fluorescence-Based Chemosensor for Trinitroaromatic Explosives. Chemistry - A European Journal, 16(20), 5895-5901. doi:10.1002/chem.200903439Jian, C., & Seitz, W. R. (1990). Membrane for in situ optical detection of organic nitro compounds based on fluorescence quenching. Analytica Chimica Acta, 237, 265-271. doi:10.1016/s0003-2670(00)83928-8Vijayakumar, C., Tobin, G., Schmitt, W., Kim, M.-J., & Takeuchi, M. (2010). Detection of explosive vapors with a charge transfer molecule: self-assembly assisted morphology tuning and enhancement in sensing efficiency. Chemical Communications, 46(6), 874. doi:10.1039/b921520dZyryanov, G. V., Palacios, M. A., & Anzenbacher, P. (2008). Simple Molecule-Based Fluorescent Sensors for Vapor Detection of TNT. Organic Letters, 10(17), 3681-3684. doi:10.1021/ol801030uCavaye, H., Shaw, P. E., Wang, X., Burn, P. L., Lo, S.-C., & Meredith, P. (2010). Effect of Dimensionality in Dendrimeric and Polymeric Fluorescent Materials for Detecting Explosives. Macromolecules, 43(24), 10253-10261. doi:10.1021/ma102369qPonnu, A., & Anslyn, E. V. (2010). A fluorescence-based cyclodextrin sensor to detect nitroaromatic explosives. Supramolecular Chemistry, 22(1), 65-71. doi:10.1080/10610270903378032Zhang, C., Che, Y., Yang, X., Bunes, B. R., & Zang, L. (2010). Organic nanofibrils based on linear carbazole trimer for explosive sensing. Chemical Communications, 46(30), 5560. doi:10.1039/c0cc01258kLi, Z., Dong, Y. Q., Lam, J. W. Y., Sun, J., Qin, A., Häußler, M., … Tang, B. Z. (2009). Functionalized Siloles: Versatile Synthesis, Aggregation-Induced Emission, and Sensory and Device Applications. Advanced Functional Materials, 19(6), 905-917. doi:10.1002/adfm.20

Understanding the implementation of evidence-based care: A structural network approach

<p>Abstract</p> <p>Background</p> <p>Recent study of complex networks has yielded many new insights into phenomenon such as social networks, the internet, and sexually transmitted infections. The purpose of this analysis is to examine the properties of a network created by the 'co-care' of patients within one region of the Veterans Health Affairs.</p> <p>Methods</p> <p>Data were obtained for all outpatient visits from 1 October 2006 to 30 September 2008 within one large Veterans Integrated Service Network. Types of physician within each clinic were nodes connected by shared patients, with a weighted link representing the number of shared patients between each connected pair. Network metrics calculated included edge weights, node degree, node strength, node coreness, and node betweenness. Log-log plots were used to examine the distribution of these metrics. Sizes of k-core networks were also computed under multiple conditions of node removal.</p> <p>Results</p> <p>There were 4,310,465 encounters by 266,710 shared patients between 722 provider types (nodes) across 41 stations or clinics resulting in 34,390 edges. The number of other nodes to which primary care provider nodes have a connection (172.7) is 42% greater than that of general surgeons and two and one-half times as high as cardiology. The log-log plot of the edge weight distribution appears to be linear in nature, revealing a 'scale-free' characteristic of the network, while the distributions of node degree and node strength are less so. The analysis of the k-core network sizes under increasing removal of primary care nodes shows that about 10 most connected primary care nodes play a critical role in keeping the <it>k</it>-core networks connected, because their removal disintegrates the highest <it>k</it>-core network.</p> <p>Conclusions</p> <p>Delivery of healthcare in a large healthcare system such as that of the US Department of Veterans Affairs (VA) can be represented as a complex network. This network consists of highly connected provider nodes that serve as 'hubs' within the network, and demonstrates some 'scale-free' properties. By using currently available tools to explore its topology, we can explore how the underlying connectivity of such a system affects the behavior of providers, and perhaps leverage that understanding to improve quality and outcomes of care.</p