31,230 research outputs found
Reducing inappropriate antibiotics prescribing: The role of online commentary on physical examination findings
Objective: This study investigates the relationship of ‘online commentary’(contemporaneous physician comments about physical examination [PE] findings) with (i) parent questioning of the treatment recommendation and (ii) inappropriate antibiotic prescribing. Methods: A nested cross-sectional study of 522 encounters motivated by upper respiratory symptoms in 27 California pediatric practices (38 pediatricians). Physicians completed a post-visit survey regarding physical examination findings, diagnosis, treatment, and whether they perceived the parent as expecting an antibiotic. Taped encounters were coded for ‘problem’ online commentary (PE findings discussed as significant or clearly abnormal) and ‘no problem’ online commentary (PE findings discussed reassuringly as normal or insignificant). Results: Online commentary during the PE occurred in 73% of visits with viral diagnoses (n = 261). Compared to similar cases with ‘no problem’ online commentary, ‘problem’ comments were associated with a 13% greater probability of parents uestioning a non-antibiotic treatment plan (95% CI 0-26%, p = .05,) and a 27% (95% CI: 2-52%, p < .05) greater probability of an inappropriate antibiotic prescription. Conclusion: With viral illnesses, problematic online comments are associated with more pediatrician-parent conflict over non-antibiotic treatment recommendations. This may increase inappropriate antibiotic prescribing. Practice implications: In viral cases, physicians should consider avoiding the use of problematic online commentary
Classification and analysis of emission-line galaxies using mean field independent component analysis
We present an analysis of the optical spectra of narrow emission-line
galaxies, based on mean field independent component analysis (MFICA). Samples
of galaxies were drawn from the Sloan Digital Sky Survey (SDSS) and used to
generate compact sets of `continuum' and `emission-line' component spectra.
These components can be linearly combined to reconstruct the observed spectra
of a wider sample of galaxies. Only 10 components - five continuum and five
emission line - are required to produce accurate reconstructions of essentially
all narrow emission-line galaxies; the median absolute deviations of the
reconstructed emission-line fluxes, given the signal-to-noise ratio (S/N) of
the observed spectra, are 1.2-1.8 sigma for the strong lines. After applying
the MFICA components to a large sample of SDSS galaxies we identify the regions
of parameter space that correspond to pure star formation and pure active
galactic nucleus (AGN) emission-line spectra, and produce high S/N
reconstructions of these spectra.
The physical properties of the pure star formation and pure AGN spectra are
investigated by means of a series of photoionization models, exploiting the
faint emission lines that can be measured in the reconstructions. We are able
to recreate the emission line strengths of the most extreme AGN case by
assuming the central engine illuminates a large number of individual clouds
with radial distance and density distributions, f(r) ~ r^gamma and g(n) ~
n^beta, respectively. The best fit is obtained with gamma = -0.75 and beta =
-1.4. From the reconstructed star formation spectra we are able to estimate the
starburst ages. These preliminary investigations serve to demonstrate the
success of the MFICA-based technique in identifying distinct emission sources,
and its potential as a tool for the detailed analysis of the physical
properties of galaxies in large-scale surveys.Comment: MNRAS accepted. 29 pages, 24 figures, 3 table
Interpreting the Ionization Sequence in AGN Emission-Line Spectra
We investigate the physical cause of the great range in the ionization level
seen in the spectra of narrow lined active galactic nuclei (AGN). Mean field
independent component analysis identifies examples of individual SDSS galaxies
whose spectra are not dominated by emission due to star formation (SF), which
we designate as AGN. We assembled high S/N ratio composite spectra of a
sequence of these AGN defined by the ionization level of their narrow-line
regions (NLR), extending down to very low-ionization cases. We used a local
optimally emitting cloud (LOC) model to fit emission-line ratios in this AGN
sequence. These included the weak lines that can be measured only in the
co-added spectra, providing consistency checks on strong line diagnostics.
After integrating over a wide range of radii and densities our models indicate
that the radial extent of the NLR is the major parameter in determining the
position of high to moderate ionization AGN along our sequence, providing a
physical interpretation for their systematic variation. Higher ionization AGN
contain optimally emitting clouds that are more concentrated towards the
central continuum source than in lower ionization AGN. Our LOC models indicate
that for the objects that lie on our AGN sequence, the ionizing luminosity is
anticorrelated with the NLR ionization level, and hence anticorrelated with the
radial concentration and physical extent of the NLR. A possible interpretation
that deserves further exploration is that the ionization sequence might be an
age sequence where low ionization objects are older and have systematically
cleared out their central regions by radiation pressure. We consider that our
AGN sequence instead represents a mixing curve of SF and AGN spectra, but argue
that while many galaxies do have this type of composite spectra, our AGN
sequence appears to be a special set of objects with negligible SF excitation.Comment: 57 pages; 18 figures, accepted by MNRA
Highly Collimated Jets and Wide-Angle Outflows in HH46/47: New Evidence from Spitzer IR Images
We present new details of the structure and morphology of the jets and
outflows in HH46/47 as seen in Spitzer infrared images from IRAC and MIPS,
reprocessed using the ``HiRes'' deconvolution technique. HiRes improves the
visualization of spatial morphology by enhancing resolution (to sub-arcsec
levels in IRAC bands) and removing the contaminating side lobes from bright
sources. In addition to sharper views of previously reported bow shocks, we
have detected: (i) the sharply-delineated cavity walls of the wide-angle
biconical outflow, seen in scattered light on both sides of the protostar, (ii)
several very narrow jet features at distances 400 AU to 0.1 pc from the star,
and, (iii) compact emissions at MIPS 24 micron coincident with the jet heads,
tracing the hottest atomic/ionic gas in the bow shocks.Comment: 11 pages, 4 Figures, Accepted for publication in ApJ(Letters
Community Structure in Time-Dependent, Multiscale, and Multiplex Networks
Network science is an interdisciplinary endeavor, with methods and
applications drawn from across the natural, social, and information sciences. A
prominent problem in network science is the algorithmic detection of
tightly-connected groups of nodes known as communities. We developed a
generalized framework of network quality functions that allowed us to study the
community structure of arbitrary multislice networks, which are combinations of
individual networks coupled through links that connect each node in one network
slice to itself in other slices. This framework allows one to study community
structure in a very general setting encompassing networks that evolve over
time, have multiple types of links (multiplexity), and have multiple scales.Comment: 31 pages, 3 figures, 1 table. Includes main text and supporting
material. This is the accepted version of the manuscript (the definitive
version appeared in Science), with typographical corrections included her
Interpreting the Ionization Sequence in Star-Forming Galaxy Emission-Line Spectra
High ionization star forming (SF) galaxies are easily identified with strong
emission line techniques such as the BPT diagram, and form an obvious
ionization sequence on such diagrams. We use a locally optimally emitting cloud
model to fit emission line ratios that constrain the excitation mechanism,
spectral energy distribution, abundances and physical conditions along the
star-formation ionization sequence. Our analysis takes advantage of the
identification of a sample of pure star-forming galaxies, to define the
ionization sequence, via mean field independent component analysis. Previous
work has suggested that the major parameter controlling the ionization level in
SF galaxies is the metallicity. Here we show that the observed SF- sequence
could alternatively be interpreted primarily as a sequence in the distribution
of the ionizing flux incident on gas spread throughout a galaxy. Metallicity
variations remain necessary to model the SF-sequence, however, our best models
indicate that galaxies with the highest and lowest observed ionization levels
(outside the range -0.37 < log [O III]/H\b{eta} < -0.09) require the variation
of an additional physical parameter other than metallicity, which we determine
to be the distribution of ionizing flux in the galaxy.Comment: 41 pages, 17 figures, 9 tables, accepted to MNRA
Leech Parasitism of the Gulf Coast Box Turtle, Terrapene carolina major (Testudines:Emydidae) in Mississippi, USA
Ten leeches were collected from a Gulf Coast box turtle, Terrapene carolina major, found crossing a road in Gulfport, Harrison County, Mississippi, USA. Eight of the leeches were identified as Placobdella multilineata and 2 were identified as Helobdella europaea. This represents the second vouchered report of leeches from a box turtle. Helobdella europaea is reported for the first time associated with a turtle and for the second time from the New World
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