379 research outputs found
Orientation of the Stripe Formed by the Two-Dimensional Electrons in Higher Landau Levels
Effect of periodic potential on the stripe phase realized in the higher
Landau levels is investigated by the Hartree-Fock approximation. The period of
the potential is chosen to be two to six times of the fundamental period of the
stripe phase. It is found that the stripe aligns perpendicularly to the
external potential in contrast to a naive expectation and hydrodynamic theory.
Charge modulation towards the Wigner crystallization along the stripe is
essential for the present unexpected new result.Comment: 5 pages, RevTex, two figures included in the tex
The Infrared Continuum Sizes of Be Star Disks
We present an analysis of the near-infrared continuum emission from the
circumstellar gas disks of Be stars using a radiative transfer code for a
parametrized version of the viscous decretion disk model. This isothermal gas
model creates predicted images that we use to estimate the HWHM emission radius
along the major axis of the projected disk and the spatially integrated flux
excess at wavelengths of 1.7, 2.1, 4.8, 9, and 18 ?m. We discuss in detail the
effect of the disk base density, inclination angle, stellar effective
temperature, and other physical parameters on the derived disk sizes and color
excesses. We calculate color excess estimates relative to the stellar V -band
flux for a sample of 130 Be stars using photometry from 2MASS and the AKARI
infrared camera all-sky survey. The color excess relations from our models make
a good match of the observed color excesses of Be stars. We also present our
results on the projected size of the disk as a function of wavelength for the
classical Be star ? Tauri, and we show that the model predictions are
consistent with interferometric observations in the H, K', and 12 \mu m bands
Provider-specific quality measurement for ERCP using natural language processing
Background and Aims
Natural language processing (NLP) is an information retrieval technique that has been shown to accurately identify quality measures for colonoscopy. There are no systematic methods by which to track adherence to quality measures for ERCP, the highest risk endoscopic procedure widely used in practice. Our aim was to demonstrate the feasibility of using NLP to measure adherence to ERCP quality indicators across individual providers.
Methods
ERCPs performed by 6 providers at a single institution from 2006 to 2014 were identified. Quality measures were defined using society guidelines and from expert opinion, and then extracted using a combination of NLP and data mining (eg, ICD9-CM codes). Validation for each quality measure was performed by manual record review. Quality measures were grouped into preprocedure (5), intraprocedure (6), and postprocedure (2). NLP was evaluated using measures of precision and accuracy.
Results
A total of 23,674 ERCPs were analyzed (average patient age, 52.9 ± 17.8 years, 14,113 were women [59.6%]). Among 13 quality measures, precision of NLP ranged from 84% to 100% with intraprocedure measures having lower precision (84% for precut sphincterotomy). Accuracy of NLP ranged from 90% to 100% with intraprocedure measures having lower accuracy (90% for pancreatic stent placement).
Conclusions
NLP in conjunction with data mining facilitates individualized tracking of ERCP providers for quality metrics without the need for manual medical record review. Incorporation of these tools across multiple centers may permit tracking of ERCP quality measures through national registries
Forty years of SNOMED: a literature review
BACKGROUND: Over a period of 40 years, SNOMED has developed from a pathology-specific nomenclature (SNOP) into a logic-based health care terminology. In spite of its long existence and continuous evolvement, it is yet unknown to what extent SNOMED is used in clinical practice, and what benefits were achieved. The aim of this paper is to investigate this by providing an overview of published studies in which a version of SNOMED was studied or applied. METHODS: This paper analyzes the use of SNOMED over time, as reflected in scientific publications, by means of Medline literature search in PubMed. The search included papers from 1966 until June 2006. For each selected paper the following characteristics were classified: version, medical domain, coding moment (during or after the care process), usage, and type of evaluation (e.g., does SNOMED work, does SNOMED help). RESULTS: 250 papers were included in this research. The number of annual publications has increased, as has the number of domains in which SNOMED is being used. Theoretical studies mainly concern comparison of SNOMED to other terminological systems and SNOMED as an illustration of a terminological systems' theory. Few studies are available on the usage of SNOMED in clinical practice, largely involving coding information and retrieval/aggregation based on SNOMED codes. CONCLUSION: The clinical application of SNOMED is broadening beyond pathology. The majority of studies concern proving the value of SNOMED in theory. Fewer studies are available on the usage of SNOMED in clinical practice. Literature gives no indication of the use of SNOMED for direct care purposes such as decision suppor
Tycho 2 stars with infrared excess in the MSX Point Source Catalogue
Stars of all evolutionary phases have been found to have excess infrared
emission due to the presence of circumstellar material. To identify such stars,
we have positionally correlated the infrared MSX point source catalogue and the
Tycho 2 optical catalogue. A near/mid infrared colour criteria has been
developed to select infrared excess stars. The search yielded 1938 excess
stars, over half (979) have never previously been detected by IRAS. The excess
stars were found to be young objects such as Herbig Ae/Be and Be stars, and
evolved objects such as OH/IR and carbon stars. A number of B type excess stars
were also discovered whose infrared colours could not be readily explained by
known catalogued objects.Comment: Added Comment: 16 pages, 9 figures, accepted for publication in MNRA
Evaluating Adults With Idiopathic Pancreatitis for Genetic Predisposition: Higher Prevalence of Abnormal Results With Use of Complete Gene Sequencing
OBJECTIVES: In adults with unexplained pancreatitis, the yield of complete gene versus select exosome sequencing on mutation detection and distinguishing clinical characteristics associated with mutations requires clarification. We sought to (1) compare frequency of mutations identified using different techniques and (2) compare clinical characteristics between adults with and without mutations.
METHODS: This is a cohort study of adults with unexplained pancreatitis who underwent genetic testing between January 2008 and December 2012. We compare probabilities of having a positive mutation with complete gene sequencing versus alternatives and describe differences in characteristics among patients with and without mutations.
RESULTS: Of the 370 patients, 67 (18%) had a genetic mutation; 24 (6%) were of high risk. Mutations were significantly more prevalent with use of complete sequencing (42%) versus other approaches (8%, P < 0.0001). Most (44/67, 66%) with a mutation had no family history. Those with high-risk mutations were more likely to have a family history of chronic pancreatitis (21% vs 4%, P = 0.002). Patients with pancreas divisum were more likely to have mutations (27% vs 14%, P = 0.0007).
CONCLUSION: Among individuals with adult-onset pancreatic disease, the probability of finding any mutation, including high risk, is significantly higher using complete gene sequencing. The impact on patients and providers requires further investigation
Lower provider volume is associated with higher failure rates for endoscopic retrograde cholangiopancreatography
BACKGROUND: Among physicians who perform endoscopic retrograde cholangiopancreatography (ERCP), the relationship between procedure volume and outcome is unknown.
OBJECTIVE: Quantify the ERCP volume-outcome relationship by measuring provider-specific failure rates, hospitalization rates, and other quality measures.
RESEARCH DESIGN: Retrospective cohort.
SUBJECTS: A total of 16,968 ERCPs performed by 130 physicians between 2001 and 2011, identified in the Indiana Network for Patient Care.
MEASURES: Physicians were classified by their average annual Indiana Network for Patient Care volume and stratified into low (<25/y) and high (≥25/y). Outcomes included failed procedures, defined as repeat ERCP, percutaneous transhepatic cholangiography or surgical exploration of the bile duct≤7 days after the index procedure, hospitalization rates, and 30-day mortality.
RESULTS: Among 15,514 index ERCPs, there were 1163 (7.5%) failures; the failure rate was higher among low (9.5%) compared with high volume (5.7%) providers (P<0.001). A second ERCP within 7 days (a subgroup of failure rate) occurred more frequently when the original ERCP was performed by a low-volume (4.1%) versus a high-volume physician (2.3%, P=0.013). Patients were more frequently hospitalized within 24 hours when the ERCP was performed by a low-volume (28.3%) versus high-volume physician (14.8%, P=0.002). Mortality within 30 days was similar (low=1.9%, high=1.9%). Among low-volume physicians and after adjusting, the odds of having a failed procedure decreased 3.3% (95% confidence interval, 1.6%-5.0%, P<0.001) with each additional ERCP performed per year.
CONCLUSIONS: Lower provider volume is associated with higher failure rate for ERCP, and greater need for postprocedure hospitalization
Thermodynamic Phase Diagram of the Quantum Hall Skyrmion System
We numerically study the interacting quantum Hall skyrmion system based on
the Chern-Simons action. By noticing that the action is invariant under global
spin rotations in the spin space with respect to the magnetic field direction,
we obtain the low-energy effective action for a many skyrmion system.
Performing extensive molecular dynamics simulations, we establish the
thermodynamic phase diagram for a many skyrmion system.Comment: 4 pages, RevTex, 2 postscript figure
Collective Modes of Soliton-Lattice States in Double-Quantum-Well Systems
In strong perpendicular magnetic fields double-quantum-well systems can
sometimes occur in unusual broken symmetry states which have interwell phase
coherence in the absence of interwell hopping. When hopping is present in such
systems and the magnetic field is tilted away from the normal to the quantum
well planes, a related soliton-lattice state can occur which has kinks in the
dependence of the relative phase between electrons in opposite layers on the
coordinate perpendicular to the in-plane component of the magnetic field. In
this article we evaluate the collective modes of this soliton-lattice state in
the generalized random-phase aproximation. We find that, in addition to the
Goldstone modes associated with the broken translational symmetry of the
soliton-lattice state, higher energy collective modes occur which are closely
related to the Goldstone modes present in the spontaneously phase-coherent
state. We study the evolution of these collective modes as a function of the
strength of the in-plane magnetic field and comment on the possibility of using
the in-plane field to generate a finite wave probe of the spontaneously
phase-coherent state.Comment: REVTEX, 37 pages (text) and 15 uuencoded postscript figure
- …