BackgroundRoom transfers are suspected to promote the development of delirium in hospitalized elderly patients, but no studies have systematically examined the relationship between room transfers and delirium incidence. We used a case–control study to determine if the number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients, controlling for baseline risk factors.MethodsWe included patients 70 years of age or older who were admitted to the internal medicine or geriatric medicine services at St. Michael’s Hospital between October 2009 and September 2010 for more than 24 h. The cases consisted of patients who developed delirium during the first week of hospital stay. The controls consisted of patients who did not develop delirium during the first week of hospital stay. Patients with evidence of delirium at admission were excluded from the analysis. A multivariable logistic regression model was used to determine the relationship between room transfers and delirium development within the first week of hospital stay.Results994 patients were included in the study, of which 126 developed delirium during the first week of hospital stay. Using a multivariable logistic regression model which controlled for age, gender, cognitive impairment, vision impairment, dehydration, and severe illness, room transfers per patient days were associated with delirium incidence (OR: 9.69, 95 % CI (6.20 to15.16), P < 0.0001).ConclusionsAn increased number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients. This is an exploratory analysis and needs confirmation with larger studies.

Introduction of the ACR Appropriateness Criteria resulted in an increase in the rate of performance of appropriate MRI examinations and a decrease in the rate of performance of inappropriate MRI examinations. ACR Appropriateness Criteria were applicable to approximately 50% of MRI requests.

Mathematical models of quantum mechanics can be studied and distinguished using nonlocal games. We discuss a class of nonlocal games called synchronous linear constraint system (syncLCS) games. We unify two algebraic approaches to studying syncLCS games and relate these games to nonlocal games played on graphs, known as graph isomorphism games. In more detail, syncLCS games are nonlocal games that verify whether or not two players share a solution to a given system of equations. Two algebraic objects associated with these games encode information about the existence of perfect strategies. They are called the game algebra and the solution group. Here, we show that these objects are essentially the same, i.e., the game algebra is a suitable quotient of the group algebra of the solution group. We also demonstrate that syncLCS games are equivalent to graph isomorphism games on a pair of graphs parameterized by the linear system.

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For operations that involve multiple possible surgical sites, site marking should be carried out by individuals who are knowledgeable about the patient and the proposed procedure. For operations in which there is no uncertainty about the intended site, interventions other than site marking could be implemented to ensure patient-surgeon interactions on the day of surgery. Surgical site marking procedures should respect patient dignity and privacy.