Notes

Health benefits of first and second extraction drum-dried uneven or dimpled skin olive pomace.
Secondary measures included the daily number of telemetry downgrades and total number of patients on telemetry. Diagnosis-related group and case mix index were also noted.

Patient average days on telemetry changed from 7.20 days preintervention to 3.51 days post intervention (P < .0001). The number of patients on telemetry with a diagnosis meeting AHA guidelines for telemetry increased.

The stated intervention resulted in more effective use of telemetry, evidenced by fewer patient days on telemetry and increased numbers of patients on telemetry meeting AHA guidelines for telemetry.
The stated intervention resulted in more effective use of telemetry, evidenced by fewer patient days on telemetry and increased numbers of patients on telemetry meeting AHA guidelines for telemetry.
Optimizing care for patients with advanced kidney disease requires close collaboration between primary care physicians (PCPs) and nephrologists. Factors associated with PCP referral to nephrology were assessed in patients with estimated glomerular filtration rates (eGFRs) less than 30 mL/min/1.73 m2.

Electronic health record review at an integrated health care network.

Factors associated with referral status were identified using Fisher's exact tests, t tests, and multivariable logistic regression.

Of 133,913 patients regularly seeing PCPs between October 2017 and September 2019, 1119 had a final eGFR less than 30 mL/min/1.73 m2 and were not on renal replacement therapy. Care was provided by 185 PCPs (61 practices). Analyses were restricted to the 97.1% (n = 1087) of patients who were African American or European American. Of these, 54.6% had not been referred to nephrology. Nonreferred patients had higher numbers of PCP visits (P = .004). In contrast, referred patients were younger, were more often Aare should be rapidly addressed to meet targets in the 2019 Executive Order on Advancing American Kidney Health.Elderly, homebound individuals comprise a vulnerable segment of society who have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic through a myriad of unique challenges. There is a significant amount of fear of acquiring COVID-19 by seeking health care services, which has adversely affected patients by worsening fixable situations. Another challenge is the decrease in diagnostic support for evaluating patients compared with a pre-COVID-19 world. Agencies providing at-home phlebotomy, portable radiology, and support services have had to limit their home visits due to an inability to access personal protective equipment. This loss of diagnostic and therapeutic support has had an emotional toll on patients and their caregivers. COVID-19 has had a tremendous impact on the health and finances of home health aides and their patients. Loss of long-term home health aides has adversely affected younger patients with ailments like Down syndrome as well as older patients with dementia. COVID-19 has also increased pressure on end-of-life decision making. Patients and their families are increasingly opting for palliative care and hospice programming to avoid separation. Families are being forced to consider advance directives under an increased emotional strain as patients become "persons under investigation" for COVID-19. Technology has allowed for the provision of services through telehealth, and changes to policy by CMS have aided widespread implementation of telemedicine. We anticipate continuing to be nimble in the face of challenge and to provide timely and meaningful care for those who depend on our efforts.One in 5 Americans utilizes federally qualified health center (FQHC) services for their primary care, preventive, and community health needs. Medicaid and FQHC programs have been partners at the forefront of addressing population health needs for more than 50 years. Although testing and contact tracing during the coronavirus disease 2019 (COVID-19) crisis are helping rural FQHC patients, there are other vital Medicaid services that are both available right now and ripe for enhancement to ensure the accessibility of services during and after the COVID-19 emergency. A primary example is nonemergency medical transportation (NEMT). Community health centers must focus on NEMT use to ensure access to care for rural patients as states reopen. check details This commentary defines NEMT and ways that FQHCs can enhance it as a Medicaid benefit as states reopen amid COVID-19.
Inappropriate use of telemetry monitoring is associated with alarm fatigue, an increase in health care expenditures, and the potential for patient harm from interventions in clinically inconsequential arrhythmias. We explored adherence to current guidelines for appropriateness of (1) initial telemetry assignment and (2) duration of the assignment.

Retrospective study.

After institutional review board approval, 695 consecutive adult patients (≥ 18 years) who were admitted with any diagnosis to general medical floors and assigned telemetry at the time of admission over 3 months were enrolled. Patients on surgical service and transferred from critical care were excluded. Data were collected from electronic health records (EHRs).

We observed that 155 of 695 (22.3%) patients had been inappropriately assigned telemetry at the time of initial assignment. Of the 540 patients appropriately assigned telemetry, 56.3% of patients had longer than the recommended duration of telemetry monitoring with a median (interquartile range) of 3 (2-4) nonindicated days per patient. The annualized additional cost of telemetry monitoring due to the inefficient utilization was found to be more than $500,000 per year.

Our data further support the need for frequent reassessment of telemetry indication, which can be facilitated by the utilization of EHR-based automated monitoring.
Our data further support the need for frequent reassessment of telemetry indication, which can be facilitated by the utilization of EHR-based automated monitoring.To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a health care thought leader. The November issue features a conversation with William H. Shrank, MD, MSHS, chief medical officer of Humana.We explore the relationship between symmetrization and entanglement through measurements on few-particle systems in a multiwell potential. In particular, considering two or three trapped atoms, we measure and distinguish correlations arising from two different physical origins antisymmetrization of the fermionic wave function and interaction between particles. We quantify this through the entanglement negativity of states, and the introduction of an antisymmetric negativity, which allows us to understand the role that symmetrization plays in the measured entanglement properties. We apply this concept both to pure theoretical states and to experimentally reconstructed density matrices of two or three mobile particles in an array of optical tweezers.The eigenstate entanglement entropy is a powerful tool to distinguish integrable from generic quantum-chaotic models. In integrable models, the average eigenstate entanglement entropy (over all Hamiltonian eigenstates) has a volume-law coefficient that generally depends on the subsystem fraction. In contrast, it is maximal (subsystem fraction independent) in quantum-chaotic models. Using random matrix theory for quadratic Hamiltonians, we obtain a closed-form expression for the average eigenstate entanglement entropy as a function of the subsystem fraction. We test it against numerical results for the quadratic Sachdev-Ye-Kitaev model and show that it describes the results for the power-law random banded matrix model (in the delocalized regime). We show that localization in quasimomentum space produces (small) deviations from our analytic predictions.I discuss the two-flavor Schwinger model both without and with fermion masses. I argue that the phenomenon of "conformal coalescence," in unparticle physics in which linear combinations of short-distance operators can disappear from the long-distance theory, makes it easy to understand some puzzling features of the model with small fermion masses. In particular, I argue that for an average fermion mass m_f and a mass difference δm, so long as both are small compared to the dynamical gauge boson mass m=esqrt[2/π], isospin-breaking effects in the low-energy theory are exponentially suppressed by powers of exp[-(m/m_f)^2/3] even if δm≈m_f. In the low-energy theory, this looks like exponential fine-tuning, but it is done automatically by conformal coalescence.The Vicsek model of self-propelled particles is known in three different phases a polar ordered homogeneous phase, also called the Toner-Tu phase, a phase of polar ordered regularly arranged high density bands with surrounding low density regions without polar order, and a homogeneous phase without polar order. Here, we show that the standard Vicsek model has a fourth phase for large system sizes a polar ordered cross sea phase. We demonstrate that the cross sea phase is not just a superposition of two waves, but it is an independent complex pattern with an inherently selected crossing angle.Electrical double layers (EDLs) play a significant role in a broad range of physical phenomena related to colloidal stability, diffuse-charge dynamics, electrokinetics, and energy storage applications. Recently, it has been suggested that for large ion sizes or multivalent electrolytes, ions can arrange in a layered structure inside the EDLs. However, the widely used Poisson-Boltzmann models for EDLs are unable to capture the details of ion concentration oscillations and the effect of electrolyte valence on such oscillations. Here, by treating a pair of ions as hard spheres below the distance of closest approach and as point charges otherwise, we are able to predict ionic layering without any additional parameters or boundary conditions while still being compatible with the Poisson-Boltzmann framework. Depending on the combination of ion valence, size, and concentration, our model reveals a structured EDL with spatially oscillating ion concentrations. We report the dependence of critical ion concentration, i.e., the ion concentration above which the oscillations are observed, on the counter-ion valence and the ion size. More importantly, our model displays quantitative agreement with the results of computationally intensive models of the EDL. Finally, we analyze the nonequilibrium problem of EDL charging and demonstrate that ionic layering increases the total charge storage capacity and the charging timescale.It is well known that the acoustic properties of fluid are characterized by mass density and bulk modulus. Metafluids, the fluid metamaterials, generalize the natural fluid, which can accommodate extreme and/or negative values of these two parameters. Here, we further show that the metafluids, composed of periodic thin-walled hollow cylinders immersed in fluid, can provide not only the designable effective mass density and bulk modulus, but also a completely new effective parameter, which appears in the wave velocities as a role similar to the shear modulus of solid. The new effective parameter, describing the response of the fluid to the quadrupolar component of waves, is obtained by generalizing the effective medium theory (EMT) to include the second-order effects, which is vanishing and neglected in the conventional EMT, but giant here in the metafluids with built-in quadrupolar resonances. With the discovery of the metafluids of shearlike moduli, our Letter extends the concept of metafluids and will have a great significance in the field of metamaterials.
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