Developing useful early warning and prognostic scores for COVID-19

Abstract Early recognition of high-risk or deteriorating patients with COVID-19 allows timely treatment escalation and optimises allocation of scarce resources across overstretched healthcare systems. Since the late 1990s, physiological scoring systems have been used in hospital settings to provide an objective signal of clinical deterioration prompting urgent clinical review. Several early warning scores (EWS) accurately predict the need for intensive care unit admission and survival in hospitalised patients with sepsis and other acute illnesses, and their routine use is now recommended in secondary care settings in high and low income countries alike. However, there are widespread concerns that existing EWS, which place a premium on the cardiovascular instability seen in severe sepsis, may fail to identify the deteriorating COVID-19 patient. Dozens of research groups have now assessed the predictive value of existing EWS in hospitalised adults with COVID-19, and used sophisticated statistical methods to develop novel early warning and prognostic scores incorporating vital signs, laboratory tests and imaging results. However, many of these novel scores are at high risk of bias and few have been adopted in routine clinical practice. In this education and learning article, we will discuss key pitfalls of existing prognostic and EWS in hospitalised adults with COVID-19; outline promising novel scores for this patient group; and describe the ideal properties of scoring systems suitable for use in low and middle income settings

Brighter prospects? Assessing the franchise advantage using census data

This paper uses Census micro data to examine how starting a business as a franchise rather than an independent business affects its survival and growth prospects. We assess factors that influence the decision to become a franchisee and use various empirical approaches to correct for selection bias in our performance analyses. We find that franchised businesses on average exhibit higher survival rates than independent businesses, but importantly, the difference is small compared to claims in the trade press. The effect is also short lived: conditional on surviving a year or two, we no longer find survival (or growth) differences. We then explore two potential sources for this small survival advantage, namely franchisors’ screening process and the benefits arising from the brand and business know-how provided by franchisors. We find evidence that both of the sources contribute to the franchising advantage

Monitoring the CMS strip tracker readout system

The CMS Silicon Strip Tracker at the LHC comprises a sensitive area of approximately 200 m2 and 10 million readout channels. Its data acquisition system is based around a custom analogue front-end chip. Both the control and the readout of the front-end electronics are performed by off-detector VME boards in the counting room, which digitise the raw event data and perform zero-suppression and formatting. The data acquisition system uses the CMS online software framework to configure, control and monitor the hardware components and steer the data acquisition. The first data analysis is performed online within the official CMS reconstruction framework, which provides many services, such as distributed analysis, access to geometry and conditions data, and a Data Quality Monitoring tool based on the online physics reconstruction. The data acquisition monitoring of the Strip Tracker uses both the data acquisition and the reconstruction software frameworks in order to provide real-time feedback to shifters on the operational state of the detector, archiving for later analysis and possibly trigger automatic recovery actions in case of errors. Here we review the proposed architecture of the monitoring system and we describe its software components, which are already in place, the various monitoring streams available, and our experiences of operating and monitoring a large-scale system

String Theory and Cosmology

We discuss the main cosmological implications of considering string-loop effects and a potential for the dilaton in the lowest order string effective action. Our framework is based on the effective model arising from regarding homogeneous and isotropic dilaton, metric and Yang-Mills field configurations. The issues of inflation, entropy crisis and the Polonyi problem as well as the problem of the cosmological constant are discussed.Comment: 7 pages, plain Tex, no figure

Cosmological Constraints on Late-time Entropy Production

We investigate cosmological effects concerning the late-time entropy production due to the decay of non-relativistic massive particles. The thermalization process of neutrinos after the entropy production is properly solved by using the Boltzmann equation. If a large entropy production takes place at late time t$\simeq$ 1 sec, it is found that a large fraction of neutrinos cannot be thermalized. This fact loosens the tight constraint on the reheating temperature T_R from the big bang nucleosynthesis and T_R could be as low as 0.5 MeV. The influence on the large scale structure formation and cosmic microwave background anisotropies is also discussed.Comment: 4 pages, using RevTeX and five postscript figures, comments added, to appear in Phys. Rev. Let

Data acquisition software for the CMS strip tracker

The CMS silicon strip tracker, providing a sensitive area of approximately 200 m2 and comprising 10 million readout channels, has recently been completed at the tracker integration facility at CERN. The strip tracker community is currently working to develop and integrate the online and offline software frameworks, known as XDAQ and CMSSW respectively, for the purposes of data acquisition and detector commissioning and monitoring. Recent developments have seen the integration of many new services and tools within the online data acquisition system, such as event building, online distributed analysis, an online monitoring framework, and data storage management. We review the various software components that comprise the strip tracker data acquisition system, the software architectures used for stand-alone and global data-taking modes. Our experiences in commissioning and operating one of the largest ever silicon micro-strip tracking systems are also reviewed

Increasing the Quantity of Silver in Zinc-Based Glass Polyalkenoate Cement: is There an Improvement in Antibacterial Efficacy?

Bone cements should have the ability to chemically bond to both bone and surgical metals, exhibit no chemical or thermal necrosis, and have no significant shrinkage or exotherm upon setting. Taking these properties into consideration, glass polyalkenoate cements (GPCs) have potential as bone cements. GPCs are formed by the reaction between an ion-leachable glass and an aqueous solution of polyacrylic acid (PAA) [1] and have proven antibacterial and cariostatic properties [2], which are related to their ability to release beneficial amounts of ions over time [3, 4]. The GPCs can be formulated to release ions that can have a therapeutic benefit in a chosen application such as fluoride release in dental applications [5], which assists in the prevention of secondary caries [6]. Recently, GPCs have been formulated with zinc (Zn) replacing Al; a more biologically acceptable ion [7]. The authors have previously shown that GPCs based on a glass phase containing both Zn and silver (Ag) have the ability to release ions which are antibacterial against both Staphylococcus aureus (Oxford strain) [8] and Pseudomonas aeruginosa (a clinical isolate) [9, 10] in vitro and methicillin-resistant S. aureus (MRSA) both in vitro and in vivo [11]. The authors have also shown that their cements have the ability to inhibit proliferation of a biofilm of P. aeruginosa (PA01) [9]. The objective of the study reported herein is to build on the authors previous publications in order to determine if increases in Ag content of the glass phase of these cements will result in a concomitant increase in antibacterial efficacy of the resultant Ag-Zn GPCs formulated from them. © 2012 IEEE

Structures for Knowledge Co-creation Between Organisations and the Public

A definitive version of this conference paper is available in the ACM Digital Library http://dx.doi.org/10.1145/2556420.2558854© ACM 2014Social computing technologies are emerging to support innovative new relationships between organisations and the public. Inspired by concepts such as collective intelligence and crowdsourcing, diverse organisations are exploring new ways to increase engagement with the public, collect localised knowledge, or leverage human cognition and creativity. The COP2014 workshop will assimilate the craft understanding and experimentation underpinning innovations in relationships between public and professional realms. We aim to provide an opportunity for discussion and to build understanding of the principles of making these sociotechnical systems work, and discuss possible designs and opportunities that may be valuable and remain underexplored. As a tangible outcome, our main goal will be to co-author a paper discussing our positions on current systems and future visions, for submission to Communications of the ACM. We welcome participation from interested organisations, alongside those conducting research in this area. Topics of interest include: How can systems be designed for participation that is beneficial to individuals and organisations? How do we draw boundaries between ‘official’ and externally-generated knowledge? How can professional activities connect with the just-in-time, emergent nature of amateur interactions?RCUK Horizon Hu

Lorentz Invariance and the Cosmological Constant

Non-trivial solutions in string field theory may lead to the spontaneous breaking of Lorentz invariance and to new tensor-matter interactions. It is argued that requiring the contribution of the vacuum expectation values of Lorentz tensors to account for the vacuum energy up to the level that $\Omega_{0}^{\Lambda} = 0.5$ implies the new interactions range is $\lambda \sim 10^{-4} m$. These conjectured violations of the Lorentz symmetry are consistent with the most stringent experimental limits.Comment: 13 pages, plain Latex. This essay was selected for an honorable mention in the 1997 Gravity Research Foundation essay competio

Supersymmetry Breaking in the Early Universe

Supersymmetry breaking in the early universe induces scalar soft potentials with curvature of order the Hubble constant. This has a dramatic effect on the coherent production of scalar fields along flat directions. For the moduli problem it generically gives a concrete realization of the problem by determining the field value subsequent to inflation. However it might suggest a solution if the minimum of the induced potential coincides with the true minimum. The induced Hubble scale mass also has important implications for the Affleck-Dine mechanism of baryogenesis. This mechanism requires large squark or slepton expectation values to develop along flat directions in the early universe. This is generally not the case if the induced mass squared is positive, but does occur if it is negative. The resulting baryon to entropy ratio depends mainly on the dimension of the nonrenormalizable operator in the superpotential which stabilizes the flat direction, and the reheat temperature after inflation. Unlike the original scenario, it is possible to obtain an acceptable baryon asymmetry without subsequent entropy releases.Comment: 11 pages, requires phyzz