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"High utilizer"

Shannon Smith-Bernardin, Chris Rowe, Emily Behar, Michelle Geier, Stuart Washington, Glenn-Milo Santos, Jason Euren, Judith Martin, Alice Gleghorn, Phillip O Coffin
Extended-release naltrexone (XRNTX) is an effective treatment for alcohol use disorder (AUD). We sought to evaluate the feasibility, acceptability, and preliminary effectiveness and cost-effectiveness of XRNTX delivered as a stand-alone service to persons with severe AUD who are high utilizers of multiple urgent and emergency medical services (HUMS). Of 15 HUMS persons with severe AUD selected based on chart review, 11 agreed to participate. Participants received a mean of 4.5 injections (range 2-7). Modest benefits from XRNTX were observed in terms of patients' Urge-to-Drink Score and the costs of emergency medical services utilized...
November 8, 2017: Journal of Substance Abuse Treatment
A K Schuster, C Wolfram, B Bertram, N Pfeiffer
BACKGROUND: The prevalence of eye diseases increases in the second half of life, especially cataract, glaucoma and age-related macular degeneration. In this study we examined the influencing factors for visiting an ophthalmologist in the last 12 months. METHODS: Visits to an ophthalmologist's practice in the last 12 months and the frequency were surveyed in the German nationwide adult health survey wave 1 (DEGS1) study (baseline examination from 2008 to 2011, N = 7987, 52...
November 6, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Jennifer Abbass-Dick, Cindy-Lee Dennis
OBJECTIVE: Long-standing suboptimal breastfeeding rates suggest the design of interventions to assist parents in meeting international recommendations is warranted. Targeting both parents is necessary given research that indicates partner support for breastfeeding increases initiation, duration and exclusivity. The objective of this study was to determine maternal and paternal satisfaction with the intervention they received while participating in a co-parenting breastfeeding support trial...
October 18, 2017: Midwifery
Heather J Walter, Gina Kackloudis, Emily K Trudell, Louis Vernacchio, Jonas Bromberg, David R DeMaso, Glenn Focht
The objective of this study was to assess feasibility, utilization, perceived value, and targeted behavioral health (BH) treatment self-efficacy associated with a collaborative child and adolescent psychiatry (CAP) consultation and BH education program for pediatric primary care practitioners (PCPs). Eighty-one PCPs from 41 member practices of a statewide pediatric practice association affiliated with an academic medical center participated in a program comprising on-demand telephonic CAP consultation supported by an extensive BH learning community...
October 1, 2017: Clinical Pediatrics
G Smits, B Audic, M D Wodrich, C Corminboeuf, N Cramer
The electronic and steric properties of tailored cyclopentadienyl (Cp) ligands are powerful handles to modulate the catalytic properties of their metal complexes. This requires the individual preparation, purification and storage of each ligand/metal combination. Alternative, ideally in situ, complexation protocols would be of high utility. We disclose a new approach to access Cp metal complexes. Common metal precursors rapidly react with cyclopentadienyl carbinols via β-carbon eliminations to directly give the Cp-metal complexes...
October 1, 2017: Chemical Science
Xiong-Wen David Lou
Introducing a certain ratio of selenium into the sulfur-based cathodes is an effective strategy for enhancing the integrated battery performance. However, similar to sulfur, the selenium sulfides cathodes suffer from poor cycling stability due to the dissolution of reaction intermediate products. Herein, to exploit the advantages of SeS2 to the full and avoid its shortcomings, we have designed and synthesized a hollow mesoporous carbon@titanium nitride (HMC@TiN) host for loading 70 wt% of SeS2 as a cathode material for Li-SeS2 batteries...
October 26, 2017: Angewandte Chemie
Yijuan Li, Jingmin Fan, Jinhua Zhang, Jingfang Yang, Ru Ming Yuan, Jeng-Kuei Chang, Ming Sen Zheng, Quan Feng Dong
Because of the high theoretical capacity of 1675 mAh g-1 and high energy density of 2600 Wh kg-1, respectively, lithium-sulfur batteries are attracting intense interest. However, it remains an enormous challenge to realize high utilizations and loadings of sulfur in cathode for the practical applications of Li-S batteries. Herein, we design a quasi-2D Co@N-C composite with honeycomb architecture as multi-functional sulfur host via a simple sacrificial templates method. The cellular flake with large surface area and honeycomb architecture can encapsulate much more sulfur leading to high sulfur content (HSC) composites, and by stacking these HSC flakes, a high sulfur loading (HSL) electrode can be realized due to their high layer bulk density...
October 18, 2017: ACS Nano
Zejun Wang, Yao Fu, Zhengzhong Kang, Xiaoguo Liu, Nan Chen, Qi Wang, Yaoquan Tu, Lihua Wang, Shiping Song, Daishun Ling, Haiyun Song, Xueqian Kong, Chunhai Fan
DNA has proven of high utility to modulate the surface functionality of metal-organic frameworks (MOFs) for various biomedical applications. Nevertheless, current methods for preparing DNA-MOF nanoparticles rely on either inefficient covalent conjugation or specific modification of oligonucleotides. In this work, we report that unmodified oligonucleotides can be loaded on MOFs with high density (∼2500 strands/particle) via intrinsic, multivalent coordination between DNA backbone phosphate and unsaturated zirconium sites on MOFs...
October 26, 2017: Journal of the American Chemical Society
Xia Yang, Jiajia Lv, Zhehan Yang, Ruo Yuan, Yaqin Chai
In this work, an improved target-triggering nicking enzyme signaling amplification (NESA) strategy as signal enhancer has been fabricated to obtain a sensitive electrochemical thrombin (TB) biosensor combined with PtPd NPs decorated electroactive Co-based metal-organic frameworks (Co-MOFs/PtPdNPs) as a redox mediator. Traditionally, in the NESA strategy, only one of the output double strands DNA is available in the next cycle. However, in this work, all of the output DNA involved in the improved NESA strategies could be further employed, resulting in high utilization of output DNA, which further enhanced signal amplification and sensitivity of the biosensor...
November 7, 2017: Analytical Chemistry
Anthony J Guarascio, Laura M Brickett, Timothy J Porter, Nancy D Lee, Erin E Gorse, Jordan R Covvey
BACKGROUND: Hospitals and other facilities utilize antibiograms as tools for optimal antibiotic selection. Currently, no measures compare broad trends on the regional level, despite interest for more comprehensive data, particularly for antibiotic-resistant ESKAPE organisms. OBJECTIVE: To collect and compare regional health-care facility antibiogram data for ESKAPE organisms to form a cumulative antibiogram. METHODS: Health-care facilities were identified using the publicly accessible Pennsylvania Department of Health web site...
January 1, 2017: Journal of Pharmacy Practice
Priya Batra, Moshe Fridman, Mei Leng, Kimberly D Gregory
OBJECTIVE: To use population data to identify patient characteristics associated with a postpartum maternal emergency department visit within 90 days of discharge after birth. METHODS: This retrospective cross-sectional study analyzed linked maternal discharge and emergency department data for all live California births from 2009 to 2011. The primary outcome was at least one emergency department visit within 90 days of hospital discharge after birth. Secondary outcomes included three or more visits within 90 days ("high utilization") and inpatient readmission...
November 2017: Obstetrics and Gynecology
Lili Chan, Kinsuk Chauhan, Priti Poojary, Aparna Saha, Elizabeth Hammer, Joseph A Vassalotti, Lindsay Jubelt, Bart Ferket, Steven G Coca, Girish N Nadkarni
BACKGROUND AND OBJECTIVES: Patients on hemodialysis have high 30-day unplanned readmission rates. Using a national all-payer administrative database, we describe the epidemiology of 30-day unplanned readmissions in patients on hemodialysis, determine concordance of reasons for initial admission and readmission, and identify predictors for readmission. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective cohort study using the Nationwide Readmission Database from the year 2013 to identify index admissions and readmission in patients with ESRD on hemodialysis...
October 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
Roberta Capp, Gregory J Misky, Richard C Lindrooth, Benjamin Honigman, Heather Logan, Rose Hardy, Dong Q Nguyen, Jennifer L Wiler
Many high utilizers of the emergency department (ED) have public insurance, especially through Medicaid. We evaluated how participation in Bridges to Care (B2C)-an ED-initiated, multidisciplinary, community-based program-affected subsequent ED use, hospital admissions, and primary care use among publicly insured or Medicaid-eligible high ED utilizers. During the six months after the B2C intervention was completed, participants had significantly fewer ED visits (a reduction of 27.9 percent) and significantly more primary care visits (an increase of 114...
October 1, 2017: Health Affairs
Linnaea Schuttner, Zhenyu Zhang, Alice Kuo
BACKGROUND: Healthcare utilization is skewed to a subset of high-need, high-use patients, but optimal models of care are not known. PURPOSE: To reduce emergency room (ER) use and hospital readmissions, trainees designed an innovative model of care delivery for chronically ill, high-utilizing adult patients. METHODS: Enrolled patients (N = 65) joined an interprofessional care program (nutrition, behavioral health, pharmacy, and care coordination), located in a single ambulatory clinic with extended hours...
December 2017: Journal of Interprofessional Education & Practice (Online)
Shangping Wang, Gloria D Elliott
PURPOSE OF THE REVIEW: Over the past several decades, cryopreservation has been widely used to preserve cells during long term storage, but advances in stem cell therapies, regenerative medicine, and miniaturized cell-based diagnostics and sensors are providing new targets of opportunity for advancing preservation methodologies. The advent of microfluidics-based devices is an interesting case in which the technology has been used to improve preservation processing, but as the devices have evolved to also include cells, tissues, and simulated organs as part of the architecture, the biochip itself is a desirable target for preservation...
March 2017: Current Stem Cell Reports
Rachel Carter, Benjamin Davis, Landon Oakes, Matthew R Maschmann, Cary L Pint
The widespread use of melt infiltration has to date restricted sulfur-carbon cathode architectures to only host materials processed as bulk powders with no site control of sulfur deposits. Here, we combine structurally designed hierarchical carbon nanotube (CNT) arrays with site-selective vapor phase sulfur infiltration to produce thick electrodes with controlled sulfur loading and high areal performance. Our results illustrate the critical role structural hierarchy plays in sustaining electrical connectivity to enable high utilization of the sulfur embedded in thick electrodes with high gravimetric loading...
October 12, 2017: Nanoscale
Claire E L Smith, Alexia Alexandraki, Sarah F Cordery, Rekha Parmar, David T Bonthron, Elizabeth M A Valleley
The imprinted gene PLAGL1 is an important regulator of apoptosis and cell cycle arrest. Loss of its expression has been implicated in tumorigenesis in a range of different cancers, and overexpression during fetal development causes transient neonatal diabetes mellitus (TNDM). PLAGL1 lies within an imprinted region of chromosome 6q24, and monoallelic expression from the major, differentially methylated promoter (P1) occurs in most human tissues. However, in peripheral blood leukocytes, the active promoter (P2) is non-imprinted and drives biallelic transcription...
2017: PloS One
Chiara Damiani, Riccardo Colombo, Daniela Gaglio, Fabrizia Mastroianni, Dario Pescini, Hans Victor Westerhoff, Giancarlo Mauri, Marco Vanoni, Lilia Alberghina
Cancer cells share several metabolic traits, including aerobic production of lactate from glucose (Warburg effect), extensive glutamine utilization and impaired mitochondrial electron flow. It is still unclear how these metabolic rearrangements, which may involve different molecular events in different cells, contribute to a selective advantage for cancer cell proliferation. To ascertain which metabolic pathways are used to convert glucose and glutamine to balanced energy and biomass production, we performed systematic constraint-based simulations of a model of human central metabolism...
September 2017: PLoS Computational Biology
Matthew G Stovell, Jiun-Lin Yan, Alison Sleigh, Marius O Mada, T Adrian Carpenter, Peter J A Hutchinson, Keri L H Carpenter
Traumatic brain injury (TBI) triggers a series of complex pathophysiological processes. These include abnormalities in brain energy metabolism; consequent to reduced tissue pO2 arising from ischemia or abnormal tissue oxygen diffusion, or due to a failure of mitochondrial function. In vivo magnetic resonance spectroscopy (MRS) allows non-invasive interrogation of brain tissue metabolism in patients with acute brain injury. Nuclei with "spin," e.g., (1)H, (31)P, and (13)C, are detectable using MRS and are found in metabolites at various stages of energy metabolism, possessing unique signatures due to their chemical shift or spin-spin interactions (J-coupling)...
2017: Frontiers in Neurology
Aaron D Falchook, Stacie B Dusetzina, Fang Tian, Ramsankar Basak, Nandini Selvam, Ronald C Chen
Background: Aggressive medical care at the end of life can be harmful to patients and families, but its prevalence in use among younger cancer patients is unknown. The goal of the study was to report on the use of aggressive care and hospice services for patients younger than age 65 years. Methods: Using the HealthCore Integrated Research Database, we analyzed patients who died between 2007 and 2014 with metastatic lung (n = 12 764), colorectal (n = 5207), breast (n = 5855), pancreatic (n = 3397), or prostate (n = 1508) cancer...
September 1, 2017: Journal of the National Cancer Institute
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