Multi-morbidities are Not a Driving Factor for an Increase of COPD-Related 30-Day Readmission Risk

Background and Objective: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. COPD is expensive to treat, whereas the quality of care is difficult to evaluate due to the high prevalence of multi-morbidity among COPD patients. In the US, the Hospital Readmissions Reduction Program (HRRP) was initiated by the Centers for Medicare and Medicaid Services to penalize hospitals for excessive 30-day readmission rates for six diseases, including COPD. This study examines the difference in 30-day readmission risk between COPD patients with and without comorbidities.Methods: In this retrospective cohort study, we used Cox regression to estimate the hazard ratio of 30-day readmission rates for COPD patients who had no comorbidity and those who had one, two or three, or four or more comorbidities. We controlled for individual, hospital and geographic factors. Data came from three sources: Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID), Area Health Resources Files (AHRF) and the American Hospital Association’s (AHA’s) annual survey database for the year of 2013.Results: COPD patients with comorbidities were less likely to be readmitted within 30 days relative to patients without comorbidities (aHR from 0.84 to 0.87, p \u3c 0.05). In a stratified analysis, female patients with one comorbidity had a lower risk of 30-day readmission compared to female patients without comorbidity (aHR = 0.80, p \u3c 0.05). Patients with public insurance who had comorbidities were less likely to be readmitted within 30 days in comparison with those who had no comorbidity (aHR from 0.79 to 0.84, p \u3c 0.05).Conclusion: COPD patients with comorbidities had a lower risk of 30-day readmission compared with patients without comorbidity. Future research could use a different study design to identify the effectiveness of the HRRP

Keyword Search on RDF Graphs - A Query Graph Assembly Approach

Keyword search provides ordinary users an easy-to-use interface for querying RDF data. Given the input keywords, in this paper, we study how to assemble a query graph that is to represent user's query intention accurately and efficiently. Based on the input keywords, we first obtain the elementary query graph building blocks, such as entity/class vertices and predicate edges. Then, we formally define the query graph assembly (QGA) problem. Unfortunately, we prove theoretically that QGA is a NP-complete problem. In order to solve that, we design some heuristic lower bounds and propose a bipartite graph matching-based best-first search algorithm. The algorithm's time complexity is $O(k^{2l} \cdot l^{3l})$, where $l$ is the number of the keywords and $k$ is a tunable parameter, i.e., the maximum number of candidate entity/class vertices and predicate edges allowed to match each keyword. Although QGA is intractable, both $l$ and $k$ are small in practice. Furthermore, the algorithm's time complexity does not depend on the RDF graph size, which guarantees the good scalability of our system in large RDF graphs. Experiments on DBpedia and Freebase confirm the superiority of our system on both effectiveness and efficiency

A probable Milli-Parsec Supermassive Binary Black Hole in the Nearest Quasar Mrk 231

Supermassive binary black holes (BBHs) are unavoidable products of galaxy mergers and are expected to exist in the cores of many quasars. Great effort has been made during the past several decades to search for BBHs among quasars; however, observational evidence for BBHs remains elusive and ambiguous, which is difficult to reconcile with theoretical expectations. In this paper, we show that the distinct optical-to-UV spectrum of Mrk 231 can be well interpreted as emission from accretion flows onto a BBH, with a semimajor axis of ~590AU and an orbital period of ~1.2 year. The flat optical and UV continua are mainly emitted from a circumbinary disk and a mini-disk around the secondary black hole (BH), respectively; and the observed sharp drop off and flux deficit at wavelength lambda ~ 4000-2500 Angstrom is due to a gap (or hole) opened by the secondary BH migrating within the circumbinary disk. If confirmed by future observations, this BBH will provide a unique laboratory to study the interplay between BBHs and accretion flows onto them. Our result also demonstrates a new method to find sub-parsec scale BBHs by searching for deficits in the optical-to-UV continuum among the spectra of quasars.Comment: a typo in equation (2) and also in equation (5) of the Appendix is fixed; 9 pages, 7 figure

Associated production of the heavy charged gauge boson WH{W_{H}} and a top quark at LHC

In the context of topflavor seesaw model, we study the production of the heavy charged gauge boson ${W_{H}}$ associated with a top quark at the LHC. Focusing on the searching channel $pp\rightarrow tW_H\rightarrow t\bar{t}b \rightarrow l\nu jjbbb$, we carry out a full simulation of the signal and the relevant standard model backgrounds. The kinematical distributions of final states are presented. It is found that the backgrounds can be significantly suppressed by sets of kinematic cuts, and the signal of the heavy charged boson might be detected at the LHC with $\sqrt{s}=14$ TeV. With a integrated luminosity of \LL= 100 $fb^{-1}$, a $8.3 \sigma$ signal significance can be achieved for $m_{W_H}=1.6$ TeV.Comment: 16 pages, 6 figure