547 research outputs found
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting
Background Experts suggest that formulary alerts at the time of medication order entry are the most effective form of clinical decision support to automate formulary management. Objective Our objectives were to quantify the frequency of inappropriate nonformulary medication (NFM) alert overrides in the inpatient setting and provide insight on how the design of formulary alerts could be improved. Methods Alert overrides of the top 11 (nâ=â206) most-utilized and highest-costing NFMs, from January 1 to December 31, 2012, were randomly selected for appropriateness evaluation. Using an empirically developed appropriateness algorithm, appropriateness of NFM alert overrides was assessed by 2 pharmacists via chart review. Appropriateness agreement of overrides was assessed with a Cohenâs kappa. We also assessed which types of NFMs were most likely to be inappropriately overridden, the override reasons that were disproportionately provided in the inappropriate overrides, and the specific reasons the overrides were considered inappropriate. Results Approximately 17.2% (nâ=â35.4/206) of NFM alerts were inappropriately overridden. Non-oral NFM alerts were more likely to be inappropriately overridden compared to orals. Alerts overridden with âblankâ reasons were more likely to be inappropriate. The failure to first try a formulary alternative was the most common reason for alerts being overridden inappropriately. Conclusion Approximately 1 in 5 NFM alert overrides are overridden inappropriately. Future research should evaluate the impact of mandating a valid override reason and adding a list of formulary alternatives to each NFM alert; we speculate these NFM alert features may decrease the frequency of inappropriate overrides
Conservative Constraints on Dark Matter from the Fermi-LAT Isotropic Diffuse Gamma-Ray Background Spectrum
We examine the constraints on final state radiation from Weakly Interacting
Massive Particle (WIMP) dark matter candidates annihilating into various
standard model final states, as imposed by the measurement of the isotropic
diffuse gamma-ray background by the Large Area Telescope aboard the Fermi
Gamma-Ray Space Telescope. The expected isotropic diffuse signal from dark
matter annihilation has contributions from the local Milky Way (MW) as well as
from extragalactic dark matter. The signal from the MW is very insensitive to
the adopted dark matter profile of the halos, and dominates the signal from
extragalactic halos, which is sensitive to the low mass cut-off of the halo
mass function. We adopt a conservative model for both the low halo mass
survival cut-off and the substructure boost factor of the Galactic and
extragalactic components, and only consider the primary final state radiation.
This provides robust constraints which reach the thermal production
cross-section for low mass WIMPs annihilating into hadronic modes. We also
reanalyze limits from HESS observations of the Galactic Ridge region using a
conservative model for the dark matter halo profile. When combined with the
HESS constraint, the isotropic diffuse spectrum rules out all interpretations
of the PAMELA positron excess based on dark matter annihilation into two lepton
final states. Annihilation into four leptons through new intermediate states,
although constrained by the data, is not excluded.Comment: 11 pages, 5 figures. v3: minor revisions, matches version to appear
in JCA
Generalizations of entanglement based on coherent states and convex sets
Unentangled pure states on a bipartite system are exactly the coherent states
with respect to the group of local transformations. What aspects of the study
of entanglement are applicable to generalized coherent states? Conversely, what
can be learned about entanglement from the well-studied theory of coherent
states? With these questions in mind, we characterize unentangled pure states
as extremal states when considered as linear functionals on the local Lie
algebra. As a result, a relativized notion of purity emerges, showing that
there is a close relationship between purity, coherence and (non-)entanglement.
To a large extent, these concepts can be defined and studied in the even more
general setting of convex cones of states. Based on the idea that entanglement
is relative, we suggest considering these notions in the context of partially
ordered families of Lie algebras or convex cones, such as those that arise
naturally for multipartite systems. The study of entanglement includes notions
of local operations and, for information-theoretic purposes, entanglement
measures and ways of scaling systems to enable asymptotic developments. We
propose ways in which these may be generalized to the Lie-algebraic setting,
and to a lesser extent to the convex-cones setting. One of our original
motivations for this program is to understand the role of entanglement-like
concepts in condensed matter. We discuss how our work provides tools for
analyzing the correlations involved in quantum phase transitions and other
aspects of condensed-matter systems.Comment: 37 page
Recent advances in alcohol-related liver disease (ALD): summary of a Gut roundtable meeting
Alcohol-related liver disease (ALD), which includes a range of disorders of different severity and is
one of the most prevalent types of liver disease worldwide, has recently regained increased
attention. Among other reasons, the realisation that any alcohol intake, regardless of type of
beverage represents a health risk, and the new therapeutic strategies tested in recently published or
undergoing clinical trials spur scientific interest in this area.
In April 2019, Gut convened a round table panel of experts during the European Association for the
Study of the Liver (EASL) International Liver Congress (ILC) in Vienna to discuss critical and up-to-date
issues and clinical trial data regarding ALD, its epidemiology, diagnosis, management,
pathomechanisms, possible future treatments and prevention. This paper summarises the discussion
and its conclusions
Location-Aware Quality of Service Measurements for Service-Level Agreements
We add specifications of location-aware measurements to performance models in a compositional fashion, promoting precision in performance measurement design. Using immediate actions to send control signals between measurement components we are able to obtain more accurate measurements from our stochastic models without disturbing their structure. A software tool processes both the model and the measurement specifications to give response time distributions and quantiles, an essential calculation in determining satisfaction of service-level agreements (SLAs)
D* Production in Deep Inelastic Scattering at HERA
This paper presents measurements of D^{*\pm} production in deep inelastic
scattering from collisions between 27.5 GeV positrons and 820 GeV protons. The
data have been taken with the ZEUS detector at HERA. The decay channel
(+ c.c.) has been used in the study. The
cross section for inclusive D^{*\pm} production with
and is 5.3 \pms 1.0 \pms 0.8 nb in the kinematic region
{ GeV and }. Differential cross
sections as functions of p_T(D^{*\pm}), and are
compared with next-to-leading order QCD calculations based on the photon-gluon
fusion production mechanism. After an extrapolation of the cross section to the
full kinematic region in p_T(D^{*\pm}) and (D^{*\pm}), the charm
contribution to the proton structure function is
determined for Bjorken between 2 10 and 5 10.Comment: 17 pages including 4 figure
Observation of Scaling Violations in Scaled Momentum Distributions at HERA
Charged particle production has been measured in deep inelastic scattering
(DIS) events over a large range of and using the ZEUS detector. The
evolution of the scaled momentum, , with in the range 10 to 1280
, has been investigated in the current fragmentation region of the Breit
frame. The results show clear evidence, in a single experiment, for scaling
violations in scaled momenta as a function of .Comment: 21 pages including 4 figures, to be published in Physics Letters B.
Two references adde
Observation of hard scattering in photoproduction events with a large rapidity gap at HERA
Events with a large rapidity gap and total transverse energy greater than 5
GeV have been observed in quasi-real photoproduction at HERA with the ZEUS
detector. The distribution of these events as a function of the
centre of mass energy is consistent with diffractive scattering. For total
transverse energies above 12 GeV, the hadronic final states show predominantly
a two-jet structure with each jet having a transverse energy greater than 4
GeV. For the two-jet events, little energy flow is found outside the jets. This
observation is consistent with the hard scattering of a quasi-real photon with
a colourless object in the proton.Comment: 19 pages, latex, 4 figures appended as uuencoded fil
Extragalactic Inverse Compton Light from Dark Matter Annihilation and the Pamela Positron Excess
We calculate the extragalactic diffuse emission originating from the
up-scattering of cosmic microwave photons by energetic electrons and positrons
produced in particle dark matter annihilation events at all redshifts and in
all halos. We outline the observational constraints on this emission and we
study its dependence on both the particle dark matter model (including the
particle mass and its dominant annihilation final state) and on assumptions on
structure formation and on the density profile of halos. We find that for
low-mass dark matter models, data in the X-ray band provide the most stringent
constraints, while the gamma-ray energy range probes models featuring large
masses and pair-annihilation rates, and a hard spectrum for the injected
electrons and positrons. Specifically, we point out that the all-redshift,
all-halo inverse Compton emission from many dark matter models that might
provide an explanation to the anomalous positron fraction measured by the
Pamela payload severely overproduces the observed extragalactic gamma-ray
background.Comment: Version accepted for publication in JCAP, one new figure and text
added; 19 pages, 5 figure
Search for a W' boson decaying to a bottom quark and a top quark in pp collisions at sqrt(s) = 7 TeV
Results are presented from a search for a W' boson using a dataset
corresponding to 5.0 inverse femtobarns of integrated luminosity collected
during 2011 by the CMS experiment at the LHC in pp collisions at sqrt(s)=7 TeV.
The W' boson is modeled as a heavy W boson, but different scenarios for the
couplings to fermions are considered, involving both left-handed and
right-handed chiral projections of the fermions, as well as an arbitrary
mixture of the two. The search is performed in the decay channel W' to t b,
leading to a final state signature with a single lepton (e, mu), missing
transverse energy, and jets, at least one of which is tagged as a b-jet. A W'
boson that couples to fermions with the same coupling constant as the W, but to
the right-handed rather than left-handed chiral projections, is excluded for
masses below 1.85 TeV at the 95% confidence level. For the first time using LHC
data, constraints on the W' gauge coupling for a set of left- and right-handed
coupling combinations have been placed. These results represent a significant
improvement over previously published limits.Comment: Submitted to Physics Letters B. Replaced with version publishe
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