Predicting Unplanned Health Care Utilization and Cost: Comparing Patient-reported Outcomes Measurement Information System and Claims.

Objectives: There is little literature describing if and how payers are utilizing patient-reported outcomes to predict future costs. This study assessed if Patient-reported Outcomes Measurement Information System (PROMIS) domain scores, collected in routine practice at neurology clinics, improved payer predictive models for unplanned care utilization and cost.

Study Design: Retrospective cohort analysis of private Health Plan-insured patients with visits at 18 Health Plan-affiliated neurology clinics.

[Toxicity of vitamin supplements].

Half of all Dutch people take nutritional supplements, vitamins amongst others. The fact that vitamins can be toxic when taken in overdose is not common knowledge. There is no evidence that taking vitamin supplements without medical indication improves the health of people with a varied diet.

Physician satisfaction with health plans: results from a national survey.

Objectives: Physician satisfaction is associated with patient satisfaction, adherence to treatment recommendations, and quality. However, burnout is prevalent, and physician experience with health plans is likely a key contributor. We explored physician satisfaction with health plans and assessed physician and plan characteristics associated with greater satisfaction.

Photoluminescence Detection of Surface Oxidation Processes on InGaN/GaN Nanowire Arrays.

InGaN/GaN nanowire arrays (NWA) exhibit efficient photoluminescence (PL) in the green spectral range, which extends to temperatures well beyond 200 °C. Previous work has shown that their PL is effectively quenched when oxidizing gas species such as O, NO, and O abound in the ambient air. In the present work we extend our investigations to reducing gas species, in particular to alcohols and aliphatic hydrocarbons with C to C chain lengths.

Self-Test Procedures for Gas Sensors Embedded in Microreactor Systems.

Metal oxide (MOX) gas sensors sensitively respond to a wide variety of combustible, explosive and poisonous gases. However, due to the lack of a built-in self-test capability, MOX gas sensors have not yet been able to penetrate safety-critical applications. In the present work we report on gas sensing experiments performed on MOX gas sensors embedded in ceramic micro-reaction chambers.

Photoluminescence Probing of Complex HO Adsorption on InGaN/GaN Nanowires.

We demonstrate that the complex adsorption behavior of HO on InGaN/GaN nanowire arrays is directly revealed by their ambient-dependent photoluminescence properties. Under low-humidity, ambient-temperature, and low-excitation-light conditions, HO adsorbates cause a quenching of the photoluminescence. In contrast, for high humidity levels, elevated temperature, and high excitation intensity, HO adsorbates act as efficient photoluminescence enhancers.

Measuring Patient Safety: The Medicare Patient Safety Monitoring System (Past, Present, and Future).

The explicit declaration in the landmark 1999 Institute of Medicine report "To Err Is Human" that, in the United States, 44,000 to 98,000 patients die each year as a consequence of "medical errors" gave widespread validation to the magnitude of the patient safety problem and catalyzed a number of U.S. federal government programs to measure and improve the safety of the national healthcare system.

Recommendations for selecting drug-drug interactions for clinical decision support.

Purpose: Recommendations for including drug-drug interactions (DDIs) in clinical decision support (CDS) are presented.

Summary: A conference series was conducted to improve CDS for DDIs. A work group consisting of 20 experts in pharmacology, drug information, and CDS from academia, government agencies, health information vendors, and healthcare organizations was convened to address (1) the process to use for developing and maintaining a standard set of DDIs, (2) the information that should be included in a knowledge base of standard DDIs, (3) whether a list of contraindicated drug pairs can or should be established, and (4) how to more intelligently filter DDI alerts.

Reduced-intensity conditioning with fludarabine and busulfan for allogeneic hematopoietic cell transplantation in elderly or infirm patients with advanced myeloid malignancies.

We report a retrospective single-center analysis of 112 consecutive patients that underwent allogeneic hematopoietic cell transplantation (HCT) after reduced-intensity conditioning (RIC) with fludarabine (FLU) and busulfan (BU) for the treatment of acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and myeloproliferative syndrome (MPS) from 2005 to 2014. Three-year event-free survival (EFS) and overall survival (OS) were 46 and 58 %, respectively. Patients ≥60 years of age showed a similar outcome compared to younger patients (3-year OS 55 vs.

Effect of Water Vapor and Surface Morphology on the Low Temperature Response of Metal Oxide Semiconductor Gas Sensors.

In this work the low temperature response of metal oxide semiconductor gas sensors is analyzed. Important characteristics of this low-temperature response are a pronounced selectivity to acid- and base-forming gases and a large disparity of response and recovery time constants which often leads to an integrator-type of gas response. We show that this kind of sensor performance is related to the trend of semiconductor gas sensors to adsorb water vapor in multi-layer form and that this ability is sensitively influenced by the surface morphology.

Assessing the potential adoption and usefulness of concurrent, action-oriented, electronic adverse drug event triggers designed for the outpatient setting.

Background: Adverse drug event (ADE) detection is an important priority for patient safety research. Trigger tools have been developed to help identify ADEs. In previous work we developed seven concurrent, action-oriented, electronic trigger algorithms designed to prompt clinicians to address ADEs in outpatient care.

Using electronic clinical quality measure reporting for public health surveillance.

By June 2013, three fourths of office-based practicing physicians in the United States had adopted some form of electronic health record (EHR) system. With greater EHR use, more health data are linked with available patient demographic information in a format that is easily retrievable and collected at the point of care. This highlights the potential of electronic clinical quality measure (CQM) reporting data for use in monitoring population health for those receiving health care services.

Clustering patterns of comorbidities associated with in-hospital death in hospitalizations of US adults with venous thromboembolism.

Background: Venous thromboembolism (VTE) is a significant source of mortality, morbidity, disability, and impaired health-related quality of life in the world.

Objective: We aimed to evaluate the clustering patterns and associations of 29 comorbidities with in-hospital death among adult hospitalizations with a diagnosis of VTE in the United States by analyzing data from the 2009 Nationwide Inpatient Sample.

Methods: This cross-sectional study included 153,124 adult hospitalizations with a diagnosis of VTE.

Applying trigger tools to detect adverse events associated with outpatient surgery.

Objective: The objective of this study is to evaluate the performance of 5 triggers to detect adverse events (AEs) associated with outpatient surgery. Triggers use surveillance algorithms derived from clinical logic to flag cases where AEs have most likely occurred. Current efforts to detect AEs have focused primarily on the inpatient setting, despite the increase in outpatient surgery in all health care settings.

Development of trigger tools for surveillance of adverse events in ambulatory surgery.

Background: The trigger tool methodology uses clinical algorithms applied electronically to 'flag' medical records where adverse events (AEs) have most likely occurred. The authors sought to create surgical triggers to detect AEs in the ambulatory care setting.

Methods: Four consecutive steps were used to develop ambulatory surgery triggers.

Evaluation of Kromoscopy: resolution of glucose and urea.

Kromoscopy involves the transmission of a broad band of electromagnetic radiation through the sample of interest. The transmitted light is collected and divided evenly into four detector channels with complementary bandpass functions. This optical configuration provides high signal-to-noise ratios that are ideal for analytical measurements.

The surface conductivity at the diamond/aqueous electrolyte interface.

We investigate the origin of the surface conductivity of H-terminated diamond films immersed in aqueous electrolyte. We demonstrate that in contrast to the in air situation, charge transfer across the diamond interface does not govern the surface conductivity in aqueous electrolyte when a gate electrode controls the diamond/electrolyte interfacial potential. Instead, this almost ideally polarizable interface allows the capacitive charging of the surface.

Portable microsensors based on individual SnO2 nanowires.

Individual SnO(2) nanowires were integrated in suspended micromembrane-based bottom-up devices. Electrical contacts between the nanowires and the electrodes were achieved with the help of electron- and ion-beam-assisted direct-write nanolithography processes. The stability of these nanomaterials was evaluated as function of time and applied current, showing that stable and reliable devices were obtained.

Arsenic-induced APL differentiation in cerebrospinal fluid.

Although new approaches have dramatically improved, the treatment of acute promyelocytic leukemia (APL) involvement of the central nervous system (CNS) confers a bad prognosis in the disease. Here, we report a patient who was diagnosed with relapsed APL preferentially involving the CNS. Treatment with arsenic trioxide led to impressive morphological changes in CNS cellularity consistent with the induction of a differentiation syndrome.

School children's responses on a semantic differential over a 10-year span.

A semantic differential scale was administered to 208 school children when they were in the second, fourth, sixth, eighth, tenth, and twelfth grades. Their perceptions towards two concepts were measured, Education (going to school) and Work (having a job). Each semantic differential scale had 15 adjective pairs and reflected the three underlying factors of Evaluative, Potency, and Activity.

Sex and developmental differences by complexity of functions of occupational aspirations of school children across ten years.

The present longitudinal study examined the complexity of workers' functions for 65 children's occupational aspirations during a 10-yr. span beginning when the children were 7 yr. old and in Grade 2.

Double lumen port access in patients receiving allogeneic blood stem cell transplantation.

We performed a prospective trial investigating the feasibility of a double lumen port access in 26 patients with hematological malignancies or solid tumors receiving either standard conditioning (n = 9, median age 49 years (range 19-65)) or dose-reduced conditioning (n = 17, median age 56 years (range 35-66)) followed by allogeneic blood stem cell transplantation. The port system was implanted within 3 months (n = 20, range 7-91 days) before transplantation or as indicated at different time points after transplantation (n = 6, range 28-680 days). Most infusions, including the graft itself and all blood drawings, were performed via the port.