Nuclear matter incompressibility coefficient in relativistic and nonrelativistic microscopic models

We systematically analyze the recent claim that nonrelativistic and relativistic mean field (RMF) based random phase approximation (RPA) calculations for the centroid energy E_0 of the isoscalar giant monopole resonance yield for the nuclear matter incompressibility coefficient, K_{nm}, values which differ by about 20%. For an appropriate comparison with the RMF based RPA calculations, we obtain the parameters for the Skyrme force used in the nonrelativistic model by adopting the same procedure as employed in the determination of the NL3 parameter set of an effective Lagrangian used in the RMF model. Our investigation suggest that the discrepancy between the values of K_{nm} predicted by the relativistic and nonrelativistic models is significantly less than 20%.Comment: Revtex file (13 pages), appearing in PRC-Rapid Com

MO analysis of the high statistics Belle results on γγ→π+π−,π0π0\gamma\gamma\to \pi^+\pi^-,\pi^0\pi^0 with chiral constraints

We reconsider Muskhelishvili-Omn\`es (MO) dispersive representations of photon-photon scattering to two pions, motivated by the very high statistics results recently released by the Belle collaboration for charged as well as neutral pion pairs and also by recent progress in the determination of the low-energy $\pi\pi$ scattering amplitude. Applicability of this formalism is extended beyond 1 GeV by taking into account inelasticity due to $K\bar{K}$ . A modified MO representation is derived which has the advantage that all polynomial ambiguities are collected into the subtraction constants and have simple relations to pion polarizabilities. It is obtained by treating differently the exactly known QED Born term and the other components of the left-hand cut. These components are approximated by a sum over resonances. All resonances up to spin two and masses up to $\simeq1.3$ GeV are included. The tensor contributions to the left-hand cut are found to be numerically important. We perform fits to the data imposing chiral constraints, in particular, using a model independent sum rule result on the $p^6$ chiral coupling $c_{34}$. Such theoretical constraints are necessary because the experimental errors are dominantly systematic. Results on further $p^6$ couplings and pion dipole and quadrupole polarizabilities are then derived from the fit. The relevance of the new data for distinguishing between two possible scenarios of isospin breaking in the $f_0(980)$ region is discussed.Comment: 44 pages, 12 figure

Determinants of Spirometry Use and Accuracy of COPD Diagnosis in Primary Care

BACKGROUND: It is unclear if primary care physicians are following guidelines or using other patient characteristics and factors to determine when to perform spirometry in patients at risk for COPD. It is also unclear to what degree a diagnosis of COPD is accurately reflected by spirometry results. OBJECTIVES: To examine characteristics associated with use of spirometry in primary care for patients with increased risk for COPD and to determine the accuracy of COPD diagnosis in patients with spirometry. DESIGN: Retrospective cohort study. SUBJECTS: A cohort that met the following criteria was identified: ≥35 years of age; ≥ 2 primary care visits in internal medicine clinic in 2007; at least one respiratory or smoking cessation medication, or diagnosis of COPD or shortness of breath or dyspnea in 2007. MAIN MEASURES: Medical records of all primary care physician visits prior to the time of inclusion in 2007 were reviewed. Data on patient demographics, co-morbidities, respiratory medication use, presence of symptoms, history of tobacco use, and pulmonary function tests were extracted. KEY RESULTS: A total 1052 patients were identified. Dyspnea on exertion (Adjusted odds ratio (AOR) 1.52 [95% CI 1.06-2.18]) and chronic cough (AOR 1.71 [1.07-2.72]) were the only chronic symptoms associated with use of spirometry. Current (AOR 1.54 [0.99-2.40]) or past smoking (AOR 1.09 [0.72-1.65]) status were not associated with use of spirometry. Of the 159 patients with a diagnosis of COPD, 93 (58.5%) met GOLD criteria and 81(50.9%) met lower limit of normal (LLN) criteria for COPD. CONCLUSION: Clinicians use spirometry more often among patients with symptoms suggestive of COPD but not more often among patients with current or past tobacco use. For patients who had a spirometry and a diagnosis of COPD, primary care physicians were accurate in their diagnosis only half of the time

Impact of sleep telementorship in primary care: Sleep va-echo (veterans affairs-extension for community healthcare outcomes)

Sleep VA-ECHO (Veterans Affairs–Extension for Community Healthcare Outcomes) is a national telementorship program intended to improve knowledge about sleep disorders among non-specialty providers. The project goal was to describe the characteristics of Sleep VA-ECHO participants from primary care and their use of program-obtained knowledge in practice. Sleep VA-ECHO consisted of 10 voluntary, 75-min teleconference sessions combining didactics and case discussion. Out of 86 participants, 21 self-identified as primary care team members and completed a program evaluation. Participants self-reported their application of knowledge gained, including changes to practice as a result of program participation. These 21 participants represented 18 sites in 11 states and attended a median of 5.0 sessions. They included physicians (29%), nurse practitioners (24%), and registered nurses (24%). Nearly all participants (95%) reported using acquired knowledge to care for their own patients at least once a month; 67% shared knowledge with colleagues at least once a month. Eighty-five percent reported improved quality of sleep care for their patients, and 76% reported an expanded clinical skillset. The greatest self-reported change in practice occurred in patient education about sleep disorders (95%) and non-pharmacologic management of insomnia (81%). © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

How the dual process model of human cognition can inform efforts to de-implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution

Analysis and support of clinical decision makin