929 research outputs found
Use of cumulative mortality data in patients with acute myocardial infarction for early detection of variation in clinical practice: observational study
OBJECTIVES: Use of cumulative mortality adjusted for
case mix in patients with acute myocardial infarction
for early detection of variation in clinical practice.
DESIGN: Observational study.
SETTING: 20 hospitals across the former Yorkshire
region.
PARTICIPANTS: All 2153 consecutive patients with
confirmed acute myocardial infarction identified
during three months.
MAIN OUTCOME MEASURES: Variable lifeadjusted
displays showing cumulative differences between
observed and expected mortality of patients; expected
mortality calculated from risk model based on
admission characteristics of age, heart rate, and
systolic blood pressure.
RESULTS: The performance of two individual hospitals
over three months was examined as an example. One,
the smallest district hospital in the region, had a series
of 30 consecutive patients but had five more deaths
than predicted. The variable lifeadjusted display
showed minimal variation from that predicted for the
first 15 patients followed by a run of unexpectedly
high mortality. The second example was the main
tertiary referral centre for the region, which admitted
188 consecutive patients. The display showed a period
of apparently poor performance followed by
substantial improvement, where the plot rose steadily
from a cumulative net lives saved of - 4 to 7. These
variations in patient outcome are unlikely to have
been revealed during conventional audit practice.
CONCLUSIONS: Variable lifeadjusted display has been
integrated into surgical care as a graphical display of
riskadjusted survival for individual surgeons or centres.
In combination with a simple risk model, it may have a
role in monitoring performance and outcome in
patients with acute myocardial infarction
Diffusive limits on the Penrose tiling
In this paper random walks on the Penrose lattice are investigated. Heat
kernel estimates and the invariance principle are shown
The use of admissions simulation to stabilize ancillary workloads
As part of the planning of a new hospital, an analysis was per formed to determine the number of procedures that would be performed in each of nineteen ancillary departments on a day of the week basis. Because the planned occupancy was not the maximum possible, attempts were made using simulation to smooth the daily ancillary loads by varying the admission day of elective, urgent inpatient and outpatient loads. The methodology, sample outputs, and main conclusions are presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69095/2/10.1177_003754978404300203.pd
An alternative approach to the construction of Schur-Weyl transform
We propose an alternative approach for the construction of the unitary matrix
which performs generalized unitary rotations of the system consisting of
independent identical subsystems (for example spin system). This matrix, when
applied to the system, results in a change of degrees of freedom, uncovering
the information hidden in non-local degrees of freedom. This information can be
used, inter alia, to study the structure of entangled states, their
classification and may be useful for construction of quantum algorithms.Comment: 6 page
The caloric and sugar content of beverages purchased at different store-types changed after the sugary drinks taxation in Mexico
Background: Following the 2014 sugary drinks tax implementation in Mexico, promising reduction in the volume of purchases of taxed beverages were observed overall and at different store-types. However, the tax's effects on purchasing patterns of calories and sugar remain unclear. Methods: Using longitudinal data from Mexican households (n = 7038), we examined changes in volume, calories and total sugar of packaged beverages purchased from 2012 to 2016 overall and by store-type. We used fixed effects models to estimate means for volume, calories, and sugar of households. To address the potential selectivity from households shopping at different stores, we calculated inverse probability weights to model the purchases changes over time by store-type. Results: For taxed beverages, the volume of purchases declined by-49 ml and-30 ml in the first year and second year post tax (2014 and 2015, respectively), while purchases leveled off in the third year of the tax (2016). Calories and sugar from taxed beverage purchases decreased over time, with the majority of the declines occurring in the first two years post-tax implementation. The volume of untaxed beverage purchases increased, whereas changes in calories and total sugar of untaxed beverages were minimal. Store level purchases of taxed beverages significantly decreased in the first two years post taxation (2014 and to 2015) only in supermarkets and traditional stores. The steepest declines in purchases of taxed beverages in 2014 were observed at supermarkets (-40 ml or-45%). The volume of purchases of untaxed beverages increased over time in almost all store-types, while calories and sugar minimally decreased over time. Conclusion: Although the Mexican tax on SSBs has lowered the purchases of sugary drinks 3 years after the tax implementation, the tax should be strengthened and store-specific interventions should be implemented to further reduce SSBs purchases in the Mexican population
Constraints on food choices of women in the UK with lower educational attainment
Constraints on food choices of women in the UK with lower educational attainmen
Photoionization of ultracold and Bose-Einstein condensed Rb atoms
Photoionization of a cold atomic sample offers intriguing possibilities to
observe collective effects at extremely low temperatures. Irradiation of a
rubidium condensate and of cold rubidium atoms within a magneto-optical trap
with laser pulses ionizing through 1-photon and 2-photon absorption processes
has been performed. Losses and modifications in the density profile of the
remaining trapped cold cloud or the remaining condensate sample have been
examined as function of the ionizing laser parameters. Ionization
cross-sections were measured for atoms in a MOT, while in magnetic traps losses
larger than those expected for ionization process were measured.Comment: 9 pages, 7 figure
The β3-integrin endothelial adhesome regulates microtubule-dependent cell migration
Integrin β3 is seen as a key anti-angiogenic target for cancer treatment due to its expression on neovasculature, but the role it plays in the process is complex; whether it is pro- or anti-angiogenic depends on the context in which it is expressed. To understand precisely β3's role in regulating integrin adhesion complexes in endothelial cells, we characterised, by mass spectrometry, the β3-dependent adhesome. We show that depletion of β3-integrin in this cell type leads to changes in microtubule behaviour that control cell migration. β3-integrin regulates microtubule stability in endothelial cells through Rcc2/Anxa2-driven control of active Rac1 localisation. Our findings reveal that angiogenic processes, both in vitro and in vivo, are more sensitive to microtubule targeting agents when β3-integrin levels are reduced
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Standard reference sequences for submission of HLA genotyping for the 18th International HLA and Immunogenetics Workshop
The International human leukocyte antigen (HLA) and Immunogenetics Workshops (IHIWs) have fostered international collaborations of researchers and experts in the fields of HLA, histocompatibility and immunology. These IHIW collaborations have comprised many projects focused on achieving a variety of specific goals. The international and collaborative nature of these projects necessitates the collection and analysis of complex data generated in multiple laboratories, often using multiple methods of acquisition. Collection and storage of these data in a consistent way adds value to IHIW projects, which can be extended to future work. DNA-based genotyping data, especially HLA genotyping data, can be transmitted in the form of a Histoimmunogenetics Markup Language (HML) document. HML facilitates clear communication of a genotype and supporting metadata, such as, sequencing platform, laboratory assays, consensus sequence, and interpretation. Sequence information can be reported relative to known reference sequences, which add meaning and context to genotypes. Selecting the correct reference sequence for a given allele sequence is nuanced, and guidelines have emerged through collaborative community efforts such as Data Standards Hackathons. Here, we describe the guidelines established for the selection of reference sequences to be used in transmission of HLA (and MICA/MICB) genotyping data for the 18th IHIW.Transplantation and autoimmunit
Chaos in a double driven dissipative nonlinear oscillator
We propose an anharmonic oscillator driven by two periodic forces of
different frequencies as a new time-dependent model for investigating quantum
dissipative chaos. Our analysis is done in the frame of statistical ensemble of
quantum trajectories in quantum state diffusion approach. Quantum dynamical
manifestation of chaotic behavior, including the emergence of chaos, properties
of strange attractors, and quantum entanglement are studied by numerical
simulation of ensemble averaged Wigner function and von Neumann entropy.Comment: 9 pages, 18 figure
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