Effect of time and day of admission on hospital care quality for patients with chronic obstructive pulmonary disease exacerbation in England and Wales: single cohort study

OBJECTIVE: To evaluate if observed increased weekend mortality was associated with poorer quality of care for patients admitted to hospital with chronic obstructive pulmonary disease (COPD) exacerbation. DESIGN: Prospective case ascertainment cohort study. SETTING: 199 acute hospitals in England and Wales, UK. PARTICIPANTS: Consecutive COPD admissions, excluding subsequent readmissions, from 1 February to 30 April 2014 of whom 13 414 cases were entered into the study. MAIN OUTCOMES: Process of care mapped to the National Institute for Health and Care Excellence clinical quality standards, access to specialist respiratory teams and facilities, mortality and length of stay, related to time and day of the week of admission. RESULTS: Mortality was higher for weekend admissions (unadjusted OR 1.20, 95% CI 1.00 to 1.43), and for case-mix adjusted weekend mortality when calculated for admissions Friday morning through to Monday night (adjusted OR 1.19, 95% CI 1.00 to 1.43). Median time to death was 6 days. Some clinical processes were poorer on Mondays and during normal working hours but not weekends or out of hours. Specialist respiratory care was less available and less prompt for Friday and Saturday admissions. Admission to a specialist ward or high dependency unit was less likely on a Saturday or Sunday. CONCLUSIONS: Increased mortality observed in weekend admissions is not easily explained by deficiencies in early clinical guideline care. Further study of out-of-hospital factors, specialty care and deaths later in the admission are required if effective interventions are to be made to reduce variation by day of the week of admission

Studies of the decays D^0 \rightarrow K_S^0K^-\pi^+ and D^0 \rightarrow K_S^0K^+\pi^-

The first measurements of the coherence factor R_{K_S^0K\pi} and the average strong--phase difference \delta^{K_S^0K\pi} in D^0 \to K_S^0 K^\mp\pi^\pm decays are reported. These parameters can be used to improve the determination of the unitary triangle angle \gamma\ in B^- \rightarrow $\widetilde{D}K^-$ decays, where $\widetilde{D}$ is either a D^0 or a D^0-bar meson decaying to the same final state, and also in studies of charm mixing. The measurements of the coherence factor and strong-phase difference are made using quantum-correlated, fully-reconstructed D^0D^0-bar pairs produced in e^+e^- collisions at the \psi(3770) resonance. The measured values are R_{K_S^0K\pi} = 0.70 \pm 0.08 and \delta^{K_S^0K\pi} = (0.1 \pm 15.7)$^\circ$ for an unrestricted kinematic region and R_{K*K} = 0.94 \pm 0.12 and \delta^{K*K} = (-16.6 \pm 18.4)$^\circ$ for a region where the combined K_S^0 \pi^\pm invariant mass is within 100 MeV/c^2 of the K^{*}(892)^\pm mass. These results indicate a significant level of coherence in the decay. In addition, isobar models are presented for the two decays, which show the dominance of the K^*(892)^\pm resonance. The branching ratio {B}(D^0 \rightarrow K_S^0K^+\pi^-)/{B}(D^0 \rightarrow K_S^0K^-\pi^+) is determined to be 0.592 \pm 0.044 (stat.) \pm 0.018 (syst.), which is more precise than previous measurements.Comment: 38 pages. Version 3 updated to include the erratum information. Errors corrected in Eqs (25), (26), 28). Fit results updated accordingly, and external inputs updated to latest best known values. Typo corrected in Eq(3)- no other consequence

Updated Measurement of the Strong Phase in D0 --> K+pi- Decay Using Quantum Correlations in e+e- --> D0 D0bar at CLEO

We analyze a sample of 3 million quantum-correlated D0 D0bar pairs from 818 pb^-1 of e+e- collision data collected with the CLEO-c detector at E_cm = 3.77 GeV, to give an updated measurement of \cos\delta and a first determination of \sin\delta, where \delta is the relative strong phase between doubly Cabibbo-suppressed D0 --> K+pi- and Cabibbo-favored D0bar --> K+pi- decay amplitudes. With no inputs from other experiments, we find \cos\delta = 0.81 +0.22+0.07 -0.18-0.05, \sin\delta = -0.01 +- 0.41 +- 0.04, and |\delta| = 10 +28+13 -53-0 degrees. By including external measurements of mixing parameters, we find alternative values of \cos\delta = 1.15 +0.19+0.00 -0.17-0.08, \sin\delta = 0.56 +0.32+0.21 -0.31-0.20, and \delta = (18 +11-17) degrees. Our results can be used to improve the world average uncertainty on the mixing parameter y by approximately 10%.Comment: Minor revisions, version accepted by PR

Higher-order multipole amplitudes in charmonium radiative transitions

Using 24 million $\psi' \equiv \psi(2S)$ decays in CLEO-c, we have searched for higher multipole admixtures in electric-dipole-dominated radiative transitions in charmonia. We find good agreement between our data and theoretical predictions for magnetic quadrupole (M2) amplitudes in the transitions $\psi' \to \gamma \chi_{c1,2}$ and $\chi_{c1,2} \to \gamma J/\psi$, in striking contrast to some previous measurements. Let $b_2^J$ and $a_2^J$ denote the normalized M2 amplitudes in the respective aforementioned decays, where the superscript $J$ refers to the angular momentum of the $\chi_{cJ}$. By performing unbinned maximum likelihood fits to full five-parameter angular distributions, we determine the ratios $a_2^{J=1}/a_2^{J=2} = 0.67^{+0.19}_{-0.13}$ and $a_2^{J=1}/b_2^{J=1} = -2.27^{+0.57}_{-0.99}$, where the theoretical predictions are independent of the charmed quark magnetic moment and are $a_2^{J=1}/a_2^{J=2} = 0.676 \pm 0.071$ and $a_2^{J=1}/b_2^{J=1} = -2.27 \pm 0.16$.Comment: 32 pages, 7 figures, acceptance updat

Observation of the Dalitz Decay Ds∗+→Ds+e+e−D_{s}^{*+} \to D_{s}^{+} e^{+} e^{-}

Using 586 $\textrm{pb}^{-1}$ of $e^{+}e^{-}$ collision data acquired at $\sqrt{s}=4.170$ GeV with the CLEO-c detector at the Cornell Electron Storage Ring, we report the first observation of $D_{s}^{*+} \to D_{s}^{+} e^{+} e^{-}$ with a significance of $5.3 \sigma$. The ratio of branching fractions \calB(D_{s}^{*+} \to D_{s}^{+} e^{+} e^{-}) / \calB(D_{s}^{*+} \to D_{s}^{+} \gamma) is measured to be $[ 0.72^{+0.15}_{-0.13} (\textrm{stat}) \pm 0.10 (\textrm{syst})]$, which is consistent with theoretical expectations

Dalitz Plot Analysis of Ds to K+K-pi+

We perform a Dalitz plot analysis of the decay Ds to K+K-pi+ with the CLEO-c data set of 586/pb of e+e- collisions accumulated at sqrt(s) = 4.17 GeV. This corresponds to about 0.57 million D_s+D_s(*)- pairs from which we select 14400 candidates with a background of roughly 15%. In contrast to previous measurements we find good agreement with our data only by including an additional f_0(1370)pi+ contribution. We measure the magnitude, phase, and fit fraction of K*(892) K+, phi(1020)pi+, K0*(1430)K+, f_0(980)pi+, f_0(1710)pi+, and f_0(1370)pi+ contributions and limit the possible contributions of other KK and Kpi resonances that could appear in this decay.Comment: 21 Pages,available through http://www.lns.cornell.edu/public/CLNS/, submitted to PR

Branching fractions for Y(3S) -> pi^0 h_b and psi(2S) -> pi^0 h_c

Using e^+e^- collision data corresponding to 5.88M Y(3S) [25.9M psi(2S)] decays and acquired by the CLEO III [CLEO-c] detectors operating at CESR, we study the single-pion transitions from Y(3S) [psi(2S)] to the respective spin-singlet states h_{b[c]}. Utilizing only the momentum of suitably selected transition-pi^0 candidates, we obtain the upper limit B(Y(3S) -> pi^0 h_b) < 1.2\times 10^{-3} at 90% confidence level, and measure B(psi(2S) -> pi^0 h_c) = (9.0+-1.5+-1.3)\times 10^{-4}. Signal sensitivities are enhanced by excluding very asymmetric pi^0 -> gamma gamma candidates.Comment: 12 pages 4 figures, version published in Physical Review

Search for D0 to p e- and D0 to pbar e+

Using data recorded by CLEO-c detector at CESR, we search for simultaneous baryon and lepton number violating decays of the D^0 meson, specifically, D^0 --> p-bar e^+, D^0-bar --> p-bar e^+, D^0 --> p e^- and D^0-bar --> p e^-. We set the following branching fraction upper limits: D^0 --> p-bar e^+ (D^0-bar --> p-bar e^+) p e^- (D^0-bar --> p e^-) < 1.2 * 10^{-5}, both at 90% confidence level.Comment: 10 pages, available through http://www.lns.cornell.edu/public/CLNS/, submitted to PRD. Comments: changed abstract, added reference for section 1, vertical axis in Fig.5 changed (starts from 1.5 rather than 2.0), fixed typo

Search for rare and forbidden decays of charm and charmed-strange mesons to final states h^+- e^-+ e^+

We have searched for flavor-changing neutral current decays and lepton-number-violating decays of D^+ and D^+_s mesons to final states of the form h^+- e^-+ e^+, where h is either \pi or K. We use the complete samples of CLEO-c open-charm data, corresponding to integrated luminosities of 818 pb^-1 at the center-of-mass energy E_CM = 3.774 GeV containing 2.4 x 10^6 D^+D^- pairs and 602 pb^-1 at E_CM = 4.170 GeV containing 0.6 x 10^6 D^*+-_s D^-+_s pairs. No signal is observed in any channel, and we obtain 90% confidence level upper limits on branching fractions B(D^+ --> \pi^+ e^+ e^-) < 5.9 x 10^-6, B(D^+ --> \pi^- e^+ e^+) K^+ e^+ e^-) < 3.0 x 10^-6, B(D^+ --> K^- e^+ e^+) \pi^+ e^+ e^-) < 2.2 x 10^-5, B(D^+_s --> \pi^- e^+ e^+) K^+ e^+ e^-) < 5.2 x 10^-5, and B(D^+_s --> K^- e^+ e^+) < 1.7 x 10^-5.Comment: 9 pages, available through http://www.lns.cornell.edu/public/CLNS