OBJECTIVEA report from the Canadian Institute for Health Information found unplanned hospital readmissions (UHR) common, costly, and potentially avoidable, estimating a $1.8 billion cost to the Canadian healthcare system associated with inpatient readmissions within 30 days of discharge for the studied period (11 months). The first step towards addressing this costly problem is enabling early detection of patients at risk through detecting UHR risk factors.METHODOLOGYWe utilized Machine Learning and explainability tools to examine risk factors for UHR within 30 days of discharge, utilizing data from Nova Scotian (Canada) healthcare institutions (2015-2022). To the best of our knowledge, our research constitutes the most comprehensive study on UHR risk factors for the province.RESULTSWe found that predicting UHR solely from healthcare data has limitations, as discharge information often falls short of accurately predicting readmission occurrences. However, despite this inherent limitation, integrating explainability tools offers insights into the underlying factors contributing to readmission risk, empowering medical personnel with information to improve patient care and outcomes. As part of this work, we identify and report risk factors for UHR and build a guideline to support medical personnel's decision-making regarding targeted post-discharge follow-ups. We found that conditions such as heart failure and Chronic Obstructive Pulmonary Disease (COPD) are associated with a higher likelihood of readmission. Patients admitted for procedures related to childbirth have a lower probability of readmission. We studied the impact of the admission type, patient characteristics, and patient stay characteristics on UHR. For example, we found that new and elective admission patients are less likely to be readmitted, while patients who received a transfusion are more likely to be readmitted.CONCLUSIONSWe validated the risk factors and the guidelines using real-world data. Our results suggested that our proposal correctly identifies risk factors and effectively produces valuable guidelines for medical personnel. The guideline evaluation suggests we can screen half the patients while capturing more than 72% of the readmission episodes. Our study contributes insights into the challenge of identifying risk factors for UHR while providing a practical guideline for healthcare professionals to identify factors influencing patient readmission, particularly within Nova Scotia.

2025-05-01·American Journal of Public Health

Exploring Indigenous Health and Employment: Methods to Capture Diversity and Intersecting Factors

作者: Gunn, Virginia ; O’Campo, Patricia ; Muntaner, Carles

2025-05-01·Neuroscience

Social behavior in South American electric fishes: Linking neuroendocrine regulation, signal plasticity, and reproductive strategies

Review

作者: Quintana, Laura ; Salazar, Vielka

Cross-species analysis can provide valuable insights into the neural and hormonal mechanisms underlying behavior. South American weakly electric fishes (order Gymnotiformes) are ideal models due to their well-characterized electric signals, which convey important social information. These signals are quantifiable and traceable to specific brain and peripheral substrates. This review focuses on social electric signaling in two nocturnal gymnotiform species found syntopically in Uruguay: Gymnotus omarorum and Brachyhypopomus gauderio. We examine the influence of sex, social context, and neuromodulators on signal flexibility across day/night and seasonal cycles. Common features include a nocturnal increase in basal electric rate mediated by melatonin, enhancing awareness and social engagement; androgen-mediated seasonal protection of electric signals against high summer temperatures; and the production of social electric signals, such as chirps and interruptions, during social interactions, modulated by vasotocinergic and serotonergic systems. Key differences lie in neuromodulator involvement and signal plasticity: B. gauderio exhibits greater signal flexibility, with sex- and context-dependent waveform changes and a broader repertoire of transient social signals used in dyadic interactions, supported by distinct neural mechanisms. These differences likely reflect species-specific reproductive strategies and their associated costs, such as predation pressure. This review underscores the value of studying electric behavior to understand the integration of internal states with environmental and social cues, offering insights into mechanisms underlying behavioral responses to natural challenges.

100 项与 University College of Cape Breton 相关的药物交易

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100 项与 University College of Cape Breton 相关的转化医学

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