The Effect of an Automated Mobile Patient Engagement Application on Emergency Department Revisits: Prospective Observational Study.

Background: Revisits within 30 days to an emergency department (ED), observation care unit, or inpatient setting following patient discharge continue to be a challenge, especially in urban settings. In addition to the consequences for the patient, these revisits have a negative impact on a health system's finances in a value-based care or global budget environment. LifeBridge Health, a community health system in Maryland, United States, implemented an automated mobile patient engagement application as part of our enterprise-wide digital health strategy to improve patient engagement and reduce revisits to the ED.

Polymerization of Allenes by Using an Iron(II) β-Diketiminate Pre-Catalyst to Generate High M Polymers.

Herein, we report an iron(II)-catalyzed polymerization of arylallenes. This reaction proceeds rapidly at room temperature in the presence of a hydride co-catalyst to generate polymers of weight up to M =189 000 Da. We have determined the polymer structure and chain length for a range of monomers through a combination of NMR, differential scanning calorimetry (DSC) and gel permeation chromatography (GPC) analysis.

Stratifying Deterioration Risk by Acuity at Admission Offers Triage Insights for Coronavirus Disease 2019 Patients.

Objectives: Triaging patients at admission to determine subsequent deterioration risk can be difficult. This is especially true of coronavirus disease 2019 patients, some of whom experience significant physiologic deterioration due to dysregulated immune response following admission. A well-established acuity measure, the Rothman Index, is evaluated for stratification of patients at admission into high or low risk of subsequent deterioration.

Improving Awareness of LGBTQ Patient Preferences Among Radiology Staff Members.

Background: Our health system set out to improve services to patients from the LGBTQ community as a step towards decreasing disparities in care.

Materials And Methods: A pilot education intervention targeting staff knowledge and skills regarding terminology with regards to gender fluidity and sexual orientation was designed and implemented.

Results: 81 staff members participated and we found improvements in knowledge but there remain uncertainties that can be addressed in future training sessions.

Building a Toolbox for the Analysis and Prediction of Ligand and Catalyst Effects in Organometallic Catalysis.

Computers have become closely involved with most aspects of modern life, and these developments are tracked in the chemical sciences. Recent years have seen the integration of computing across chemical research, made possible by investment in equipment, software development, improved networking between researchers, and rapid growth in the application of predictive approaches to chemistry, but also a change of attitude rooted in the successes of computational chemistry-it is now entirely possible to complete research projects where computation and synthesis are cooperative and integrated, and work in synergy to achieve better insights and improved results. It remains our ambition to put computational prediction before experiment, and we have been working toward developing the key ingredients and workflows to achieve this.

Iron Catalyzed Double Bond Isomerization: Evidence for an Fe /Fe Catalytic Cycle.

Iron-catalyzed isomerization of alkenes is reported using an iron(II) β-diketiminate pre-catalyst. The reaction proceeds with a catalytic amount of a hydride source, such as pinacol borane (HBpin) or ammonia borane (H N⋅BH ). Reactivity with both allyl arenes and aliphatic alkenes has been studied.

Baby's first bath: Changes in skin barrier function after bathing full-term newborns with water vs liquid baby cleanser.

Background: The impact of the newborn's first bath, whether given with water alone or water with skin cleansing products, on skin barrier function is unknown.

Methods: We evaluated skin barrier function, measured by skin surface pH (primary outcome), transepidermal water loss (TEWL), and hydration of the stratum corneum (SCH) in 100 newborns before and after their first bath, randomizing this cohort to bathing with water alone or with water and a liquid baby cleanser. Two consecutive measurements of each parameter were obtained at two anatomic locations, the volar forearm, and below the sternum.

On the Basicity of Carboranylphosphines.

Three new carboranylphosphines, [1-(1'--1',7'-CBH)-7-PPh--1,7-CBH], [1-(1'-7'-PPh--1',7'-CBH)-7-PPh--1,7-CBH], and [1-{PPh-(1'--1',2'-CBH)}--1,2-CBH], have been prepared, and from a combination of these and literature compounds, eight new carboranylphosphine selenides were subsequently synthesized. The relative basicities of the carboranylphosphines were established by (i) measurement of the NMR coupling constant of the selenide and (ii) calculation of the proton affinity of the phosphine, in an attempt to establish which of several factors are the most important in controlling the basicity. It is found that the basicity of the carboranylphosphines is significantly influenced by the nature of other substituents on the P atom, the nature of the carborane cage vertex (C or B) to which the P atom is attached, and the charge on the carboranylphosphine.

Trends in Hospital Performance on the Medicare National Outpatient Imaging Metrics: A 5-Year Longitudinal Cohort Analysis.

Purpose: Medicare established its Hospital Outpatient Quality Reporting Program (HOQRP) to promote and incentivize quality care and appropriate utilization in the hospital outpatient setting. The program includes "imaging efficiency" metrics evaluating appropriate utilization of imaging examinations. Our purpose was to evaluate the longitudinal performance of the nation's hospitals on the HOQPR's imaging efficiency metrics.

Computational Ligand Descriptors for Catalyst Design.

Ligands, especially phosphines and carbenes, can play a key role in modifying and controlling homogeneous organometallic catalysts, and they often provide a convenient approach to fine-tuning the performance of known catalysts. The measurable outcomes of such catalyst modifications (yields, rates, selectivity) can be set into context by establishing their relationship to steric and electronic descriptors of ligand properties, and such models can guide the discovery, optimization, and design of catalysts. In this review we present a survey of calculated ligand descriptors, with a particular focus on homogeneous organometallic catalysis.

Asymmetric and Geometry-Selective α-Alkenylation of α-Amino Acids.

Both E- and Z-N'-alkenyl urea derivatives of imidazolidinones may be formed selectively from enantiopure α-amino acids. Generation of their enolate derivatives in the presence of K and [18]crown-6 induces intramolecular migration of the alkenyl group from N' to Cα with retention of double bond geometry. DFT calculations indicate a partially concerted substitution mechanism.

ACR Appropriateness Criteria Sinusitis-Child.

Sinusitis is common in children that usually resolves spontaneously. Imaging is not part of the standard of care for initial diagnosis, however may be necessary in cases with persistent or chronic sinusitis to guide surgical intervention, or to rule out intracranial and vascular complications of sinusitis. Computed tomography (CT) and magnetic resonance imaging (MRI) are the leading imaging modalities.

Engaging Patients: Models for Patient- and Family-centered Care in Radiology.

This article examines how radiologists can meet the objectives of patient- and family-centered care set forth by the National Committee for Quality Assurance (NCQA) program for primary care providers. The breadth of initiatives in radiology that can be mapped to the NCQA objectives is impressive and invites the idea of creating a similar program in radiology. RSNA, 2018.

International Society for the Study of Vascular Anomalies Classification of Soft Tissue Vascular Anomalies: Survey-Based Assessment of Musculoskeletal Radiologists' Use in Clinical Practice.

Aim: There is controversy regarding the diagnosis and classification of vascular anomalies (VA). As torso and extremities are the second most common body part for presentation of VAs, musculoskeletal (MSK) radiologists play a central role in VA classification. The purpose of this study was to evaluate the awareness and clinical use of the International Society for the Study of Vascular Anomalies (ISSVA) classification by MSK radiologists.

Understanding and Applying the Concept of Value Creation in Radiology.

The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer.

The Randomized, Controlled Trial of Late Surfactant: Effects on Respiratory Outcomes at 1-Year Corrected Age.

Objective: To determine the effects of late surfactant on respiratory outcomes determined at 1-year corrected age in the Trial of Late Surfactant (TOLSURF), which randomized newborns of extremely low gestational age (≤28 weeks' gestational age) ventilated at 7-14 days to late surfactant and inhaled nitric oxide vs inhaled nitric oxide-alone (control).

Study Design: Caregivers were surveyed in a double-blinded manner at 3, 6, 9, and 12 months' corrected age to collect information on respiratory resource use (infant medication use, home support, and hospitalization). Infants were classified for composite outcomes of pulmonary morbidity (no PM, determined in infants with no reported respiratory resource use) and persistent PM (determined in infants with any resource use in ≥3 surveys).

Report of the ACR's Economics Committee on Value-Based Payment Models.

A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services.