393 research outputs found
An Analysis of the NYPD\u27s Stop-and-Frisk Policy in the Context of Claims of Racial Bias
Recent studies by police departments and researchers confirm that police stop racial and ethnic minority citizens more often than whites, relative to their proportions in the population. However, it has been argued stop rates more accurately reflect rates of crimes committed by each ethnic group, or that stop rates reflect elevated rates in specific social areas such as neighborhoods or precincts. Most of the research on stop rates and police-citizen interactions has focused on traffic stops, and analyses of pedestrian stops are rare. In this paper, we analyze data from 175,000 pedestrian stops by the New York Police Department over a fifteen-month period. We disaggregate stops by police precinct, and compare stop rates by racial and ethnic group controlling for previous race-specific arrest rates. We use hierarchical multilevel models to adjust for precinct-level variability, thus directly addressing the question of geographic heterogeneity that arises in the analysis of pedestrian stops. We find that persons of African and Hispanic descent were stopped more frequently than whites, even after controlling for precinct variability and race-specific estimates of crime participation
Feedback GAP : study protocol for a cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care
Peer reviewedPublisher PD
Evaluation of the vaginal flora in pregnant women receiving opioid maintenance therapy: a matched case-control study
Dataset supporting the conclusions of this article. (XLS 2634 kb
The mass and density of the dwarf planet (225088) 2007 OR10
The satellite of (225088) 2007 OR10 was discovered on archival Hubble Space
Telescope images and along with new observations with the WFC3 camera in late
2017 we have been able to determine the orbit. The orbit's notable
eccentricity, e0.3, may be a consequence of an intrinsically eccentric
orbit and slow tidal evolution, but may also be caused by the Kozai mechanism.
Dynamical considerations also suggest that the moon is small, D 100
km. Based on the newly determined system mass of 1.75x10 kg, 2007 OR10
is the fifth most massive dwarf planet after Eris, Pluto, Haumea and Makemake.
The newly determined orbit has also been considered as an additional option in
our radiometric analysis, provided that the moon orbits in the equatorial plane
of the primary. Assuming a spherical shape for the primary this approach
provides a size of 123050 km, with a slight dependence on the satellite
orbit orientation and primary rotation rate chosen, and a bulk density of
1.750.07 g cm for the primary. A previous size estimate that
assumed an equator-on configuration (1535 km) would provide a
density of 0.92 g cm, unexpectedly low for a 1000
km-sized dwarf planet.Comment: Accepted for publication in Icaru
The orbital period of Nova V2540 Ophiuchi (2002)
We present the results of 26 nights of CCD photometry of the nova V2540 Oph
(2002) from 2003 and 2004. We find a period of 0.284781 +/- 0.000006 d (6.8347
+/- 0.0001 h) in the data. Since this period was present in the light curves
taken in both years, with no apparent change in its value or amplitude, we
interpret it as the orbital period of the nova binary system. The mass-period
relation for cataclysmic variables yields a secondary mass of about 0.75 +/-
0.04 Msun. From maximum magnitude - rate of decline relation, we estimate a
maximum absolute visual magnitude of M(V)=-6.2 +/- 0.4 mag. This value leads to
an uncorrected distance modulus of (m-M) = 14.7 +/- 0.7. By using the
interstellar reddening for the location of V2540 Oph, we find a rough estimate
for the distance of 5.2 +/- 0.8 kpc. We propose that V2540 Oph is either: 1) a
high inclination cataclysmic variable showing a reflection effect of the
secondary star, or having a spiral structure in the accretion disc, 2) a high
inclination intermediate polar system, or less likely 3) a polar.Comment: 8 pages, 7 figures, accepted by PAS
Enhancing breast milk production with Domperidone in mothers of preterm neonates (EMPOWER trial)
BACKGROUND: The use of mother’s own breast milk during initial hospitalization has a positive impact not only in reducing potential serious neonatal morbidities but also contribute to improvements in neurodevelopmental outcomes. Mothers of very preterm infants struggle to maintain a supply of breast milk during their infants’ prolonged hospitalization. Galactogogues are medications that induce lactation by exerting its effects through oxytocin or prolactin enhancement. Domperidone is a potent dopamine D(2) receptor antagonist which stimulates the release of prolactin. Small trials have established its ability in enhancing breast milk production. EMPOWER was designed to determine the safety and efficacy of domperidone in mothers experiencing an inadequate milk supply. METHODS/DESIGN: EMPOWER is a multicenter, double masked, randomized controlled phase-II trial to evaluate the safety and effectiveness of domperidone in those mothers identified as having difficulty in breast milk production. Eligible mothers will be randomized to one of two allocated groups: Group A: domperidone 10 mg orally three times daily for 28 days; and Group B: identical placebo 10 mg orally three times daily for 14 days followed by domperidone 10 mg orally three times daily for 14 days. The primary outcome will be determined at the completion of the first 2-week period; the second 2-week period will facilitate answering the secondary questions regarding timing and duration of treatment. To detect an estimated 30% change between the two groups (from 40% to 28%, corresponding to an odds ratio of 0.6), a total sample size of 488 mothers would be required at 80% power and alpha = 0.05. To account for a 15% dropout, this number is increased to 560 (280 per group). The duration of the trial is expected to be 36–40 months. DISCUSSION: The use of a galactogogue often becomes the measure of choice for mothers in the presence of insufficient breast milk production, particularly when the other techniques are unsuccessful. EMPOWER is designed to provide valuable information in guiding the practices for this high-risk group of infants and mothers. The results of this trial will also inform both mothers and clinicians about the choices available to increase and maintain sufficient breast milk. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT0151222
Trigger and Timing Distributions using the TTC-PON and GBT Bridge Connection in ALICE for the LHC Run 3 Upgrade
The ALICE experiment at CERN is preparing for a major upgrade for the third
phase of data taking run (Run 3), when the high luminosity phase of the Large
Hadron Collider (LHC) starts. The increase in the beam luminosity will result
in high interaction rate causing the data acquisition rate to exceed 3 TB/sec.
In order to acquire data for all the events and to handle the increased data
rate, a transition in the readout electronics architecture from the triggered
to the trigger-less acquisition mode is required. In this new architecture, a
dedicated electronics block called the Common Readout Unit (CRU) is defined to
act as a nodal communication point for detector data aggregation and as a
distribution point for timing, trigger and control (TTC) information. TTC
information in the upgraded triggerless readout architecture uses two
asynchronous high-speed serial links connections: the TTC-PON and the GBT. We
have carried out a study to evaluate the quality of the embedded timing signals
forwarded by the CRU to the connected electronics using the TTC-PON and GBT
bridge connection. We have used four performance metrics to characterize the
communication bridge: (a)the latency added by the firmware logic, (b)the jitter
cleaning effect of the PLL on the timing signal, (c)BER analysis for
quantitative measurement of signal quality, and (d)the effect of optical
transceivers parameter settings on the signal strength. Reliability study of
the bridge connection in maintaining the phase consistency of timing signals is
conducted by performing multiple iterations of power on/off cycle, firmware
upgrade and reset assertion/de-assertion cycle (PFR cycle). The test results
are presented and discussed concerning the performance of the TTC-PON and GBT
bridge communication chain using the CRU prototype and its compliance with the
ALICE timing requirements
Expanding Paramedicine in the Community (EPIC): study protocol for a randomized controlled trial.
BackgroundThe incidence of chronic diseases, including diabetes mellitus (DM), heart failure (HF) and chronic obstructive pulmonary disease (COPD) is on the rise. The existing health care system must evolve to meet the growing needs of patients with these chronic diseases and reduce the strain on both acute care and hospital-based health care resources. Paramedics are an allied health care resource consisting of highly-trained practitioners who are comfortable working independently and in collaboration with other resources in the out-of-hospital setting. Expanding the paramedic's scope of practice to include community-based care may decrease the utilization of acute care and hospital-based health care resources by patients with chronic disease.Methods/designThis will be a pragmatic, randomized controlled trial comparing a community paramedic intervention to standard of care for patients with one of three chronic diseases. The objective of the trial is to determine whether community paramedics conducting regular home visits, including health assessments and evidence-based treatments, in partnership with primary care physicians and other community based resources, will decrease the rate of hospitalization and emergency department use for patients with DM, HF and COPD. The primary outcome measure will be the rate of hospitalization at one year. Secondary outcomes will include measures of health system utilization, overall health status, and cost-effectiveness of the intervention over the same time period. Outcome measures will be assessed using both Poisson regression and negative binomial regression analyses to assess the primary outcome.DiscussionThe results of this study will be used to inform decisions around the implementation of community paramedic programs. If successful in preventing hospitalizations, it has the ability to be scaled up to other regions, both nationally and internationally. The methods described in this paper will serve as a basis for future work related to this study.Trial registrationClinicalTrials.gov: NCT02034045. Date: 9 January 2014
Comparison of emergency department time performance between a Canadian and an Australian academic tertiary hospital
Objective To compare performance and factors predicting failure to reach Ontario and Australian government time targets between a Canadian (Sunnybrook Hospital) and an Australian (Austin Health) academic tertiary-level hospitals in 2012, and to assess for change of factors and performance in 2016 between the same hospitals. Methods This was a retrospective, observational study of patient administrative data in two calendar years. The main outcome measure was reaching Ontario and Australian ED time targets for admissions, high and low urgency discharges. Secondary outcomes were factors predicting failure to reach these targets. Results Between 2012 and 2016, Sunnybrook and Austin experienced increased patient volume of 10.2% and 19.2%, respectively. Bed capacity decreased at Sunnybrook (-10.8%) but increased at the Austin (+30.3%). For both years, Austin failed to achieve the Australian time target, but succeeded for all Ontario targets except for low urgency discharges. Sunnybrook failed all targets irrespective of year. The top factors for failing Ontario ED length-of-stay targets for both hospitals in 2012 and 2016 were bed request greater than 6 h, access block greater than 1 h, use of cross-sectional imaging, consultation and waiting for the emergency physician greater than 2 h. Conclusion Austin outperformed Sunnybrook for Ontario and Australian government time targets. Both hospitals failed the Australian targets. Factors predicting failure to achieve targets were different between hospitals, but were mainly clinical resources. Sunnybrook focussed on increasing human resources. Austin focussed on increasing human resources, observation unit and hospital beds. Intrinsic hospital characteristics and infrastructure influenced target success.Peer reviewe
Emergency department length of stay for patients requiring mechanical ventilation: a prospective observational study
BACKGROUND: Recommendations for acceptable emergency department (ED) length of stay (LOS) vary internationally with ≤ 8 h generally considered acceptable. Protracted ED LOS may place critically ill patients requiring mechanical ventilation at increased risk of adverse events as most EDs are not resourced for longitudinal delivery of critical care. Our objective was to quantify the ED LOS for mechanically ventilated patients (invasive and/or non-invasive ventilation [NIV]) and to explore patient and system level predictors of prolonged ED LOS. Additionally, we aimed to describe delivery and monitoring of ventilation in the ED. METHODS: Prospective observational study of ED LOS for all patients receiving mechanical ventilation at four metropolitan EDs in Toronto, Canada over two six-month periods in 2009 and 2010. RESULTS: We identified 618 mechanically ventilated patients which represented 0.5% (95% CI 0.4%–0.5%) of all ED visits. Of these, 484 (78.3%) received invasive ventilation, 118 (19.1%) received NIV; 16 received both during the ED stay. Median Kaplan-Meier estimated duration of ED stay for all patients was 6.4 h (IQR 2.8–14.6). Patients with trauma diagnoses had a shorter median (IQR) LOS, 2.5 h (1.3–5.1), compared to ventilated patients with non-trauma diagnoses, 8.5 h (3.3–14.0) (p <0.001). Patients requiring NIV had a longer ED stay (16.6 h, 8.2–27.9) compared to those receiving invasive ventilation exclusively (4.6 h, 2.2–11.1) and patients receiving both (15.4 h, 6.4–32.6) (p <0.001). Longer ED LOS was associated with ED site and lower priority triage scores. Shorter ED LOS was associated with intubation at another ED prior to transfer. CONCLUSIONS: While patients requiring mechanical ventilation represent a small proportion of overall ED visits these critically ill patients frequently experienced prolonged ED stay especially those treated with NIV, assigned lower priority triage scores at ED presentation, and non-trauma patients
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