2,123 research outputs found
How good are we at determining risk? Quantifying the accuracy of clinician determined risk for VTE prophylaxis
Objectives:
Create and validate a simple tool for concurrent audits of risk stratification, compliance and documentation
Evaluate accuracy of clinician risk stratification and prophylatic ordering practice compared with a standardized Caprini RAM across different assigned risk categories
Provide recommendations for EPIC VTE Prophylaxis CDS Developmenthttps://jdc.jefferson.edu/patientsafetyposters/1050/thumbnail.jp
Quantifying Patient Reported and Documented Compliance with Adjuncts to Venous Thromboembolism Prophylaxis
Objectives:
1. Measure patient compliance with pharmacologic, mechanical and ambulatory prophylactic measures.
2. Evaluate for agreement between nursing documentation and patient reported compliance with mechanical and ambulatory prophylactic measures.https://jdc.jefferson.edu/patientsafetyposters/1042/thumbnail.jp
Minding impacting events in a model of stochastic variance
We introduce a generalisation of the well-known ARCH process, widely used for
generating uncorrelated stochastic time series with long-term non-Gaussian
distributions and long-lasting correlations in the (instantaneous) standard
deviation exhibiting a clustering profile. Specifically, inspired by the fact
that in a variety of systems impacting events are hardly forgot, we split the
process into two different regimes: a first one for regular periods where the
average volatility of the fluctuations within a certain period of time is below
a certain threshold and another one when the local standard deviation
outnumbers it. In the former situation we use standard rules for
heteroscedastic processes whereas in the latter case the system starts
recalling past values that surpassed the threshold. Our results show that for
appropriate parameter values the model is able to provide fat tailed
probability density functions and strong persistence of the instantaneous
variance characterised by large values of the Hurst exponent is greater than
0.8, which are ubiquitous features in complex systems.Comment: 18 pages, 5 figures, 1 table. To published in PLoS on
Comprehensive Analysis of Market Conditions in the Foreign Exchange Market: Fluctuation Scaling and Variance-Covariance Matrix
We investigate quotation and transaction activities in the foreign exchange
market for every week during the period of June 2007 to December 2010. A
scaling relationship between the mean values of number of quotations (or number
of transactions) for various currency pairs and the corresponding standard
deviations holds for a majority of the weeks. However, the scaling breaks in
some time intervals, which is related to the emergence of market shocks. There
is a monotonous relationship between values of scaling indices and global
averages of currency pair cross-correlations when both quantities are observed
for various window lengths .Comment: 13 pages, 10 figure
A Large Scale Double Beta and Dark Matter Experiment: GENIUS
The recent results from the HEIDELBERG-MOSCOW experiment have demonstrated
the large potential of double beta decay to search for new physics beyond the
Standard Model. To increase by a major step the present sensitivity for double
beta decay and dark matter search much bigger source strengths and much lower
backgrounds are needed than used in experiments under operation at present or
under construction. We present here a study of a project proposed recently,
which would operate one ton of 'naked' enriched GErmanium-detectors in liquid
NItrogen as shielding in an Underground Setup (GENIUS). It improves the
sensitivity to neutrino masses to 0.01 eV. A ten ton version would probe
neutrino masses even down to 10^-3 eV. The first version would allow to test
the atmospheric neutrino problem, the second at least part of the solar
neutrino problem. Both versions would allow in addition significant
contributions to testing several classes of GUT models. These are especially
tests of R-parity breaking supersymmetry models, leptoquark masses and
mechanism and right-handed W-boson masses comparable to LHC. The second issue
of the experiment is the search for dark matter in the universe. The entire
MSSM parameter space for prediction of neutralinos as dark matter particles
could be covered already in a first step of the full experiment - with the same
purity requirements but using only 100 kg of 76Ge or even of natural Ge -
making the experiment competitive to LHC in the search for supersymmetry.
The layout of the proposed experiment is discussed and the shielding and
purity requirements are studied using GEANT Monte Carlo simulations. As a
demonstration of the feasibility of the experiment first results of operating a
'naked' Ge detector in liquid nitrogen are presented.Comment: 22 pages, 12 figures, see also
http://pluto.mpi-hd.mpg.de/~betalit/genius.htm
Invasion speeds for structured populations in fluctuating environments
We live in a time where climate models predict future increases in
environmental variability and biological invasions are becoming increasingly
frequent. A key to developing effective responses to biological invasions in
increasingly variable environments will be estimates of their rates of spatial
spread and the associated uncertainty of these estimates. Using stochastic,
stage-structured, integro-difference equation models, we show analytically that
invasion speeds are asymptotically normally distributed with a variance that
decreases in time. We apply our methods to a simple juvenile-adult model with
stochastic variation in reproduction and an illustrative example with published
data for the perennial herb, \emph{Calathea ovandensis}. These examples
buttressed by additional analysis reveal that increased variability in vital
rates simultaneously slow down invasions yet generate greater uncertainty about
rates of spatial spread. Moreover, while temporal autocorrelations in vital
rates inflate variability in invasion speeds, the effect of these
autocorrelations on the average invasion speed can be positive or negative
depending on life history traits and how well vital rates ``remember'' the
past
Molecular monitoring of Plasmodium falciparum resistance to artemisinin in Tanzania
Artemisinin-based combination therapies (ACTs) are recommended for use against uncomplicated malaria in areas of multi-drug resistant malaria, such as sub-Saharan Africa. However, their long-term usefulness in these high transmission areas remains unclear. It has been suggested that documentation of the S769N PfATPase6 mutations may indicate an emergence of artemisinin resistance of Plasmodium falciparum in the field. The present study assessed PfATPase6 mutations (S769N and A623E) in 615 asymptomatic P. falciparum infections in Tanzania but no mutant genotype was detected. This observation suggests that resistance to artemisinin has not yet been selected in Tanzania, supporting the Ministry of Health's decision to adopt artemether+lumefantrine as first-line malaria treatment. The findings recommend further studies to assess PfATPase6 mutations in sentinel sites and verify their usefulness in monitoring emergency of ACT resistance
Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US national institutes of health-funded trials
Background The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. Methods and Findings We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972–2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges’ g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. Conclusion The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression
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