What impact did a Paediatric Early Warning system have on emergency admissions to the paediatric intensive care unit? An observational cohort study

Summary The ideology underpinning Paediatric Early Warning systems (PEWs) is that earlier recognition of deteriorating in-patients would improve clinical outcomes. Objective To explore how the introduction of PEWs at a tertiary children's hospital affects emergency admissions to the Paediatric Intensive Care Unit (PICU) and the impact on service delivery. To compare ‘in-house’ emergency admissions to PICU with ‘external’ admissions transferred from District General Hospitals (without PEWs). Method A before-and-after observational study August 2005–July 2006 (pre), August 2006–July 2007 (post) implementation of PEWs at the tertiary children's hospital. Results The median Paediatric Index of Mortality (PIM2) reduced; 0.44 vs 0.60 (p < 0.001). Fewer admissions required invasive ventilation 62.7% vs 75.2% (p = 0.015) for a shorter median duration; four to two days. The median length of PICU stay reduced; five to three days (p = 0.002). There was a non-significant reduction in mortality (p = 0.47). There was no comparable improvement in outcome seen in external emergency admissions to PICU. A 39% reduction in emergency admission total beds days reduced cancellation of major elective surgical cases and refusal of external PICU referrals. Conclusions Following introduction of PEWs at a tertiary children's hospital PIM2 was reduced, patients required less PICU interventions and had a shorter length of stay. PICU service delivery improved

Could the Pioneer anomaly have a gravitational origin?

If the Pioneer anomaly has a gravitational origin, it would, according to the equivalence principle, distort the motions of the planets in the Solar System. Since no anomalous motion of the planets has been detected, it is generally believed that the Pioneer anomaly can not originate from a gravitational source in the Solar System. However, this conclusion becomes less obvious when considering models that either imply modifications to gravity at long range or gravitational sources localized to the outer Solar System, given the uncertainty in the orbital parameters of the outer planets. Following the general assumption that the Pioneer spacecraft move geodesically in a spherically symmetric spacetime metric, we derive the metric disturbance that is needed in order to account for the Pioneer anomaly. We then analyze the residual effects on the astronomical observables of the three outer planets that would arise from this metric disturbance, given an arbitrary metric theory of gravity. Providing a method for comparing the computed residuals with actual residuals, our results imply that the presence of a perturbation to the gravitational field necessary to induce the Pioneer anomaly is in conflict with available data for the planets Uranus and Pluto, but not for Neptune. We therefore conclude that the motion of the Pioneer spacecraft must be non-geodesic. Since our results are model independent within the class of metric theories of gravity, they can be applied to rule out any model of the Pioneer anomaly that implies that the Pioneer spacecraft move geodesically in a perturbed spacetime metric, regardless of the origin of this metric disturbance.Comment: 16 pages, 6 figures. Rev. 3: Major revision. Accepted for publication in Phys. Rev. D. Rev. 4: Added two reference

Wide-angle elastic scattering and color randomization

Baryon-baryon elastic scattering is considered in the independent scattering (Landshoff) mechanism. It is suggested that for scattering at moderate energies, direct and interchange quark channels contribute with equal color coefficients because the quark color is randomized by soft gluon exchange during the hadronization stage. With this assumption, it is shown that the ratio of cross sections $R_{\overline{p} p/ p p}$ at CM angle $\theta = 90^0$ decreases from a high energy value of R_{\pbar p / pp} \approx 1/2.7, down to R_{\pbar p / pp} \approx 1/28, compatible with experimental data at moderate energies. This sizable fall in the ratio seems to be characteristic of the Landshoff mechanism, in which changes at the quark level have a strong effect precisely because the hadronic process occurs via multiple quark scatterings. The effect of color randomization on the angular distribution of proton-proton elastic scattering and the cross section ratio $R_{np/pp}$ is also discussed.Comment: 18 pages, latex2e, 4 uuencoded figures, include

Gravitational collapse in asymptotically Anti-de Sitter/de Sitter backgrounds

We study here the gravitational collapse of a matter cloud with a non-vanishing tangential pressure in the presence of a non-zero cosmological term. Conditions for bounce and singularity formation are derived for the model. It is also shown that when the tangential pressures vanish, the bounce and singularity conditions reduce to that of the dust case studied earlier. The collapsing interior is matched with an exterior which is asymptotically de Sitter or anti de Sitter, depending on the sign of cosmological constant. The junction conditions for matching the cloud to exterior are specified. The effect of the cosmological term on apparent horizons is studied in some detail, and the nature of central singularity is analyzed. We also discuss here the visibility of the singularity and implications for the cosmic censorship conjecture.Comment: 11 pages, 1 figure, Revtex

Exactly Solvable Hydrogen-like Potentials and Factorization Method

A set of factorization energies is introduced, giving rise to a generalization of the Schr\"{o}dinger (or Infeld and Hull) factorization for the radial hydrogen-like Hamiltonian. An algebraic intertwining technique involving such factorization energies leads to derive $n$-parametric families of potentials in general almost-isospectral to the hydrogen-like radial Hamiltonians. The construction of SUSY partner Hamiltonians with ground state energies greater than the corresponding ground state energy of the initial Hamiltonian is also explicitly performed.Comment: LaTex file, 21 pages, 2 PostScript figures and some references added. To be published in J. Phys. A: Math. Gen. (1998

Orbital dependent nucleonic pairing in the lightest known isotopes of tin

By studying the 109Xe-->105Te-->101Sn superallowed alpha-decay chain, we observe low-lying states in 101Sn, the one-neutron system outside doubly magic 100Sn. We find that the spins of the ground state (J = 7=2) and first excited state (J = 5=2) in 101Sn are reversed with respect to the traditional level ordering postulated for 103Sn and the heavier tin isotopes. Through simple arguments and state-of-the-art shell model calculations we explain this unexpected switch in terms of a transition from the single-particle regime to the collective mode in which orbital-dependent pairing correlations, dominate.Comment: 5 pages 3 figure

Exploring the vicinity of the Bogomol'nyi-Prasad-Sommerfield bound

We investigate systems of real scalar fields in bidimensional spacetime, dealing with potentials that are small modifications of potentials that admit supersymmetric extensions. The modifications are controlled by a real parameter, which allows implementing a perturbation procedure when such parameter is small. The approach allows obtaining the energy and topological charge in closed forms, up to first order in the parameter. We illustrate the procedure with some examples. In particular, we show how to remove the degeneracy in energy for the one-field and the two-field solutions that appear in a model of two real scalar fields.Comment: Revtex, 9 pages, To be published in J. Phys.

On the equivalence principle and gravitational and inertial mass relation of classical charged particles

We show that the locally constant force necessary to get a stable hyperbolic motion regime for classical charged point particles, actually, is a combination of an applied external force and of the electromagnetic radiation reaction force. It implies, as the strong Equivalence Principle is valid, that the passive gravitational mass of a charged point particle should be slight greater than its inertial mass. An interesting new feature that emerges from the unexpected behavior of the gravitational and inertial mass relation, for classical charged particles, at very strong gravitational field, is the existence of a critical, particle dependent, gravitational field value that signs the validity domain of the strong Equivalence Principle. For electron and proton, these critical field values are $g_{c}\simeq 4.8\times 10^{31}m/s^{2}$ and $g_{c}\simeq 8.8\times 10^{34}m/s^{2}$, respectively

The supersymmetric modified Poschl-Teller and delta-well potentials

New supersymmetric partners of the modified Poschl-Teller and the Dirac's delta well potentials are constructed in closed form. The resulting one-parametric potentials are shown to be interrelated by a limiting process. The range of values of the parameters for which these potentials are free of singularities is exactly determined. The construction of higher order supersymmetric partner potentials is also investigated.Comment: 20 pages, LaTeX file, 4 eps figure

On the K^+D Interaction at Low Energies

The Kd reactions are considered in the impulse approximation with NN final-state interactions (NN FSI) taken into account. The realistic parameters for the KN phase shifts are used. The "quasi-elastic" energy region, in which the elementary KN interaction is predominantly elastic, is considered. The theoretical predictions are compared with the data on the K^+d->K^+pn, K^+d->K^0pp, K^+d->K^+d and K^+d total cross sections. The NN FSI effect in the reaction K^+d->K^+pn has been found to be large. The predictions for the Kd cross sections are also given for slow kaons, produced from phi(1020) decays, as the functions of the isoscalar KN scattering length a_0. These predictions can be used to extract the value of a_0 from the data.Comment: 22 pages, 5 figure