413 research outputs found
Use of cumulative mortality data in patients with acute myocardial infarction for early detection of variation in clinical practice: observational study
OBJECTIVES: Use of cumulative mortality adjusted for
case mix in patients with acute myocardial infarction
for early detection of variation in clinical practice.
DESIGN: Observational study.
SETTING: 20 hospitals across the former Yorkshire
region.
PARTICIPANTS: All 2153 consecutive patients with
confirmed acute myocardial infarction identified
during three months.
MAIN OUTCOME MEASURES: Variable lifeÂadjusted
displays showing cumulative differences between
observed and expected mortality of patients; expected
mortality calculated from risk model based on
admission characteristics of age, heart rate, and
systolic blood pressure.
RESULTS: The performance of two individual hospitals
over three months was examined as an example. One,
the smallest district hospital in the region, had a series
of 30 consecutive patients but had five more deaths
than predicted. The variable lifeÂadjusted display
showed minimal variation from that predicted for the
first 15 patients followed by a run of unexpectedly
high mortality. The second example was the main
tertiary referral centre for the region, which admitted
188 consecutive patients. The display showed a period
of apparently poor performance followed by
substantial improvement, where the plot rose steadily
from a cumulative net lives saved of - 4 to 7. These
variations in patient outcome are unlikely to have
been revealed during conventional audit practice.
CONCLUSIONS: Variable lifeÂadjusted display has been
integrated into surgical care as a graphical display of
riskÂadjusted survival for individual surgeons or centres.
In combination with a simple risk model, it may have a
role in monitoring performance and outcome in
patients with acute myocardial infarction
Measurement of serum haptoglobin as an indicator of the efficacy of malaria intervention trials
Serum haptoglobin levels were measured by an enzyme-linked immunosorbent assay in Gambian children who participated in 3 malaria intervention trials with untreated or impregnated bed nets. In one study, in which a significant effect on clinical malaria was observed, the mean serum haptoglobin level was significantly higher in the intervention than in the control group. In the other 2 studies, in which no significant protection was observed, mean haptoglobin levels were similar in intervention and control groups. Measurement of serum haptoglobin may provide a useful indirect measure of the effectiveness of malaria control programme
Estimating the potential public health impact of seasonal malaria chemoprevention in African children
Seasonal malaria chemoprevention, previously known as intermittent preventive treatment in children, is highly effective in areas with a short malaria transmission season. Here we assess seasonality in malaria incidence data and define a predictor of seasonality based on rainfall. We then use spatial rainfall, malaria endemicity and population data to identify areas likely to have highly seasonal malaria incidence, and estimate the population at risk and malaria burden in areas where seasonal malaria chemoprevention would be appropriate. We estimate that in areas suitable for seasonal malaria chemoprevention, there are 39 million children under 5 years of age, who experience 33.7 million malaria episodes and 152,000 childhood deaths from malaria each year. The majority of this burden occurs in the Sahelian or sub-Sahelian regions of Africa. Our data suggest that seasonal malaria chemoprevention has the potential to avert several million malaria cases and tens of thousands of childhood deaths each year if successfully delivered to the populations at risk
The response to iron supplementation of pregnant women with the haemoglobin genotype AA or AS
The influence of haemoglobin genotype on the response to iron supplementation was studied in a randomized, double blind, placebo-controlled trial involving 497 multigravid pregnant women from a rural area of The Gambia. Women were randomly allocated to receive either oral iron (60mg elemental iron per day) or placebo. At 36 weeks of pregnancy, women who had received oral iron during pregnancy had higher mean haemoglobin, packed cell volume, plasma iron and ferritin levels than did women who received placebo. Iron supplementation of pregnant women with the AA haemoglobin genotype also resulted in increases in the packed cell volume (PCV) and haemoglobin level measured after delivery, and in the birth weight of the infant. However, in AS women PCV and haemoglobin level at delivery were lower in the supplemented group and supplementation was also associated with reduced birth weights. In malaria endemic areas, pregnant women with the haemoglobin genotype AS may not benefit from iron supplementation during pregnanc
Fast Neutron Detection with 6Li-loaded Liquid Scintillator
We report on the development of a fast neutron detector using a liquid
scintillator doped with enriched Li-6. The lithium was introduced in the form
of an aqueous LiCl micro-emulsion with a di-isopropylnaphthalene-based liquid
scintillator. A Li-6 concentration of 0.15 % by weight was obtained. A 125 mL
glass cell was filled with the scintillator and irradiated with fission-source
neutrons. Fast neutrons may produce recoil protons in the scintillator, and
those neutrons that thermalize within the detector volume can be captured on
the Li-6. The energy of the neutron may be determined by the light output from
recoiling protons, and the capture of the delayed thermal neutron reduces
background events. In this paper, we discuss the development of this 6Li-loaded
liquid scintillator, demonstrate the operation of it in a detector, and compare
its efficiency and capture lifetime with Monte Carlo simulations. Data from a
boron-loaded plastic scintillator were acquired for comparison. We also present
a pulse-shape discrimination method for differentiating between electronic and
nuclear recoil events based on the Matusita distance between a normalized
observed waveform and nuclear and electronic recoil template waveforms. The
details of the measurements are discussed along with specifics of the data
analysis and its comparison with the Monte Carlo simulation
Search for displaced vertices arising from decays of new heavy particles in 7 TeV pp collisions at ATLAS
We present the results of a search for new, heavy particles that decay at a
significant distance from their production point into a final state containing
charged hadrons in association with a high-momentum muon. The search is
conducted in a pp-collision data sample with a center-of-mass energy of 7 TeV
and an integrated luminosity of 33 pb^-1 collected in 2010 by the ATLAS
detector operating at the Large Hadron Collider. Production of such particles
is expected in various scenarios of physics beyond the standard model. We
observe no signal and place limits on the production cross-section of
supersymmetric particles in an R-parity-violating scenario as a function of the
neutralino lifetime. Limits are presented for different squark and neutralino
masses, enabling extension of the limits to a variety of other models.Comment: 8 pages plus author list (20 pages total), 8 figures, 1 table, final
version to appear in Physics Letters
Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment
This paper describes an analysis of the angular distribution of W->enu and
W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with
the ATLAS detector at the LHC in 2010, corresponding to an integrated
luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and
the missing transverse energy, the W decay angular distribution projected onto
the transverse plane is obtained and analysed in terms of helicity fractions
f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV
and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw
> 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour,
are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017
+/- 0.030, where the first uncertainties are statistical, and the second
include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables,
revised author list, matches European Journal of Physics C versio
- âŠ