The existence of propagated sensation along the meridian proved by neuroelectrophysiology

Propagated sensation along the meridian can occur when acupoints are stimulated by acupuncture or electrical impulses. In this study, participants with notable propagated sensation along the me-ridian ...     

A Retrospective Record Review Examining Barriers to Discharge at the End of Life

End-of-life patients face barriers that prevent them from transitioning from the hospital to their preferred place of death. These barriers include a lack of trust, ineffective communication, delayed discharge planning, and difficulty accessing medications and supplies. This quality improvement study examined modifiable barriers identified within an acute care system. The study aimed to provide insight and recommendations for limiting barriers to discharge. A retrospective review of medical records was performed to evaluate for patterns and similarities. The lack of timely advanced care planning and documentation of these discussions are a factor in patients not achieving end of life preferences.     

Analysis of weekend effect on mortality by medical specialty in Helsinki University Hospital over a 14-year period

BackgroundThe weekend effect, the phenomenon of patients admitted at the weekend having a higher mortality risk, has been widely investigated and documented in both elective and emergency patients. Research on the issue is scarce in Europe, with the exception of the United Kingdom. We examined the situation in Helsinki University Hospital over a 14-year period from a specialty-specific approach.Materials and methodsWe collected the data for all patient visits for 2000–2013, selecting patients with in-hospital care in the university hospital and extracting patients that died during their hospital stay or within 30 days of discharge. These patients were categorized according to urgency of care and specialty.ResultsA total of 1,542,230 in-patients (853,268 emergency patients) met the study criteria, with 47,122 deaths in-hospital or within 30 days of discharge. Of 12 specialties, we found a statistically significant weekend effect for in-hospital mortality in 7 specialties (emergency admissions) and 4 specialties (elective admissions); for 30-day post-discharge mortality in 1 specialty (emergency admissions) and 2 specialties (elective admissions). Surgery, internal medicine, neurology, and gynecology and obstetrics were most sensitive to the weekend effect.ConclusionsThe study confirms a weekend effect for both elective and emergency admissions in most specialties. Reducing the number of weekend elective procedures may be necessary. More disease-specific research is needed to find the diagnoses most susceptible.     

用谐波小波包变换法提取GIS局部放电信号多尺度特征参数

超高频(UHF)法在GIS局部放电(PD)检测中已得到了广泛应用，UHF PD信号的特征提取对准确识别GIS内部绝缘缺陷类型和指导检修工作具有重要意义，但目前仍然缺乏有效的特征提取方法。为此，本文利用谐波小波具有严格盒形频谱的优点，提出一种提取UHF PD特征信息的谐波小波包变换(HWPT)方法，对实验室获取的4种典型放电模型产生的UHF PD信号，采用HWPT进行多尺度分解，以克服实小波包分解子带间存在频谱混叠和能量泄漏的缺陷，利用UHF PD信号在不同尺度能量和复杂度的差异，提取多尺度能量和多尺度样本熵参数作为模式识别的特征量，更加精确地描述了UHF PD信号的时频域信息。最后利用支持向量机分类识别的结果表明，该方法可以取得比实小波包更好的识别效果，多尺度能量和多尺度样本熵特征参数均能有效识别4种绝缘缺陷。     

Factors Associated With Timing of First Outpatient Visit After Newborn Hospital Discharge

ObjectiveTo determine factors associated with newborns having their first outpatient visit (FOV) beyond 3 days after postpartum hospital discharge.MethodsRetrospective cohort analysis of all newborns born at a large urban university hospital during a 1-year period, discharged home within 96 hours of birth, and with an outpatient visit with an affiliated provider within 60 days after discharge.ResultsOf 3282 newborns, 1440 (44%) had their FOV beyond 3 days after discharge. Newborns born to first-time mothers, breast-feeding, at high risk for hyperbilirubinemia, or with a pathological diagnosis were significantly (P < .05) less likely to have FOV beyond 3 days in adjusted multivariable analysis, while newborns born via Caesarian section, of older gestational age, with Medicaid insurance, or discharged on a Thursday or Friday were more likely to have FOV beyond 3 days. Discharging provider characteristics independently associated with FOV beyond 3 days included family medicine providers, providers out of residency longer, and providers practicing at the institution longer. In addition, practice of outpatient follow-up had an independent impact on timing of FOV. Having an appointment date and time recorded on the nursery record or first appointment with a home nurse decreased the odds that time to FOV was beyond 3 days of discharge.ConclusionsPhysician decisions regarding timing of outpatient visit after newborn discharge may take into account newborn medical and social characteristics, but certain patient, provider, and practice features associated with this timing may represent unrecognized barriers to care.