Documentation of specific mesh implant at the time of midurethral sling surgery in women with stress incontinence

Objective: We aimed to assess documentation completeness of the operative record for mesh implanted at the time of midurethral sling surgery and to identify modifiable predictors of documentation completeness. Methods: A retrospective cross-sectional study of women with stress incontinence who underwent midurethral sling placement between January 2009 and December 2011 was conducted. Data from the dictated operative note and nursing operative record were extracted to determine if the specific mesh implanted during surgery was documented. The primary outcome was the rate of documentation of mesh implanted in the physician's dictated operative note and in the nursing record. Logistic regression was used to determine if any characteristics were associated with the rate of documentation while accounting for correlation of patients from the same dictating surgeon. Results: There were 816 surgeries involving the implantation of a midurethral sling during the study period. All surgeries were performed at 6 Indiana University hospitals. Fifty-two surgeons of varying specialties and levels of training dictated the operative notes. A urogynecologist dictated 71% of the operative notes. The rate of documentation completeness for mesh implanted in the physician's note was 10%. The rate of documentation completeness for mesh implanted in the nursing operative record was 92%. Documentation of mesh implanted in the physician's note was not significantly associated with the level of training, specialty, or year of surgery. Conclusions: Documentation completeness for specific mesh implant in the physician's note is low, independent of specialty and level of training. Nursing documentation practices are more rigorous. Postmarket surveillance, currently mandated by the Food and Drug Administration, may not be feasible if only the physician's note is available or if nursing practices are inconsistent. Development of documentation guidelines for physicians would improve the feasibility of surveillance

Investigating the properties of granulation in the red giants observed by Kepler

More than 1000 red giants have been observed by NASA/Kepler mission during a nearly continuous period of ~ 13 months. The resulting high-frequency resolution (< 0.03 muHz) allows us to study the granulation parameters of these stars. The granulation pattern results from the convection motions leading to upward flows of hot plasma and downward flows of cooler plasma. We fitted Harvey-like functions to the power spectra, to retrieve the timescale and amplitude of granulation. We show that there is an anti-correlation between both of these parameters and the position of maximum power of acoustic modes, while we also find a correlation with the radius, which agrees with the theory. We finally compare our results with 3D models of the convection.Comment: 4 pages, 1 figure. To appear in the ASP proceedings of "The 61st Fujihara seminar: Progress in solar/stellar physics with helio- and asteroseismology", 13th-17th March 2011, Hakone, Japa

An Extended and More Sensitive Search for Periodicities in RXTE/ASM X-ray Light Curves

We present the results of a systematic search in approximately 14 years of Rossi X-ray Timing Explorer All-Sky Monitor data for evidence of periodicities not reported by Wen et al. (2006). Two variations of the commonly used Fourier analysis search method have been employed to achieve significant improvements in sensitivity. The use of these methods and the accumulation of additional data have resulted in the detection of the signatures of the orbital periods of eight low-mass X-ray binary systems and of ten high-mass X-ray binaries not listed in the tables of Wen et al.Comment: 20 pages, 22 figures, in emulateapj format; submitted to ApJ

Evolution of active and polar photospheric magnetic fields during the rise of Cycle 24 compared to previous cycles

The evolution of the photospheric magnetic field during the declining phase and minimum of Cycle 23 and the recent rise of Cycle 24 are compared with the behavior during previous cycles. We used longitudinal full-disk magnetograms from the NSO's three magnetographs at Kitt Peak, the Synoptic Optical Long-term Investigations of the Sun (SOLIS) Vector Spectro-Magnetograph (VSM), the Spectromagnetograph and the 512-Channel Magnetograph instruments, and longitudinal full-disk magnetograms from the Mt. Wilson 150-foot tower. We analyzed 37 years of observations from these two observatories that have been observing daily, weather permitting, since 1974, offering an opportunity to study the evolving relationship between the active region and polar fields in some detail over several solar cycles. It is found that the annual averages of a proxy for the active region poloidal magnetic field strength, the magnetic field strength of the high-latitude poleward streams, and the time derivative of the polar field strength are all well correlated in each hemisphere. These results are based on statistically significant cyclical patterns in the active region fields and are consistent with the Babcock-Leighton phenomenological model for the solar activity cycle. There was more hemispheric asymmetry in the activity level, as measured by total and maximum active region flux, during late Cycle 23 (after around 2004), when the southern hemisphere was more active, and Cycle 24 up to the present, when the northern hemisphere has been more active, than at any other time since 1974. The active region net proxy poloidal fields effectively disappeared in both hemispheres around 2004, and the polar fields did not become significantly stronger after this time. We see evidence that the process of Cycle 24 field reversal has begun at both poles.Comment: Accepted for publication in Solar Physic

Temporary changes in STI & HIV testing & diagnoses across different phases of the COVID-19 pandemic, Chicago IL

IntroductionWhile the U.S. has seen a sustained rise in STI cases over the past decade, the impact of the COVID-19 on STIs and HIV is unclear.MethodsTo examine the short- and medium-term impacts of COVID-19 and HIV and STI testing and diagnosis, we compared pre-pandemic trends to three periods of the pandemic: early- pandemic, March-May 2020; mid-pandemic June 2020-May 2021; and late-pandemic, June 2021-May 2022. We compared average number of monthly tests and diagnoses, overall and by gender, as well as the monthly change (slope) in testing and diagnoses.ResultsWe find that after decreases in average monthly STI and HIV testing and diagnoses during the early- and mid-pandemic, cases were largely back to pre-pandemic levels by the late-pandemic, with some variation by gender.ConclusionChanges in testing and diagnoses varied by phase of the pandemic. Some key populations may require additional outreach efforts to attain pre-pandemic testing levels

Indirect study of 19Ne states near the 18F+p threshold

The early E < 511 keV gamma-ray emission from novae depends critically on the 18F(p,a)15O reaction. Unfortunately the reaction rate of the 18F(p,a)15O reaction is still largely uncertain due to the unknown strengths of low-lying proton resonances near the 18F+p threshold which play an important role in the nova temperature regime. We report here our last results concerning the study of the d(18F,p)19F(alpha)15N transfer reaction. We show in particular that these two low-lying resonances cannot be neglected. These results are then used to perform a careful study of the remaining uncertainties associated to the 18F(p,a)15O and 18F(p,g)19Ne reaction rates.Comment: 18 pages, 8 figures. Accepted in Nuclear Physics

Solar-like oscillations in KIC11395018 and KIC11234888 from 8 months of Kepler data

We analyze the photometric short-cadence data obtained with the Kepler Mission during the first eight months of observations of two solar-type stars of spectral types G and F: KIC 11395018 and KIC 11234888 respectively, the latter having a lower signal-to-noise ratio compared to the former. We estimate global parameters of the acoustic (p) modes such as the average large and small frequency separations, the frequency of the maximum of the p-mode envelope and the average linewidth of the acoustic modes. We were able to identify and to measure 22 p-mode frequencies for the first star and 16 for the second one even though the signal-to-noise ratios of these stars are rather low. We also derive some information about the stellar rotation periods from the analyses of the low-frequency parts of the power spectral densities. A model-independent estimation of the mean density, mass and radius are obtained using the scaling laws. We emphasize the importance of continued observations for the stars with low signal-to-noise ratio for an improved characterization of the oscillation modes. Our results offer a preview of what will be possible for many stars with the long data sets obtained during the remainder of the mission.Comment: 39 pages, 9 figures. Accepted for publication in Ap

Predicting the detectability of oscillations in solar-type stars observed by Kepler

Asteroseismology of solar-type stars has an important part to play in the exoplanet program of the NASA Kepler Mission. Precise and accurate inferences on the stellar properties that are made possible by the seismic data allow very tight constraints to be placed on the exoplanetary systems. Here, we outline how to make an estimate of the detectability of solar-like oscillations in any given Kepler target, using rough estimates of the temperature and radius, and the Kepler apparent magnitude.Comment: 21 pages, 6 figures, accepted for publication Astrophysical Journa

A mathematical framework for critical transitions: normal forms, variance and applications

Critical transitions occur in a wide variety of applications including mathematical biology, climate change, human physiology and economics. Therefore it is highly desirable to find early-warning signs. We show that it is possible to classify critical transitions by using bifurcation theory and normal forms in the singular limit. Based on this elementary classification, we analyze stochastic fluctuations and calculate scaling laws of the variance of stochastic sample paths near critical transitions for fast subsystem bifurcations up to codimension two. The theory is applied to several models: the Stommel-Cessi box model for the thermohaline circulation from geoscience, an epidemic-spreading model on an adaptive network, an activator-inhibitor switch from systems biology, a predator-prey system from ecology and to the Euler buckling problem from classical mechanics. For the Stommel-Cessi model we compare different detrending techniques to calculate early-warning signs. In the epidemics model we show that link densities could be better variables for prediction than population densities. The activator-inhibitor switch demonstrates effects in three time-scale systems and points out that excitable cells and molecular units have information for subthreshold prediction. In the predator-prey model explosive population growth near a codimension two bifurcation is investigated and we show that early-warnings from normal forms can be misleading in this context. In the biomechanical model we demonstrate that early-warning signs for buckling depend crucially on the control strategy near the instability which illustrates the effect of multiplicative noise.Comment: minor corrections to previous versio

PTF10fqs: A Luminous Red Nova in the Spiral Galaxy Messier 99

The Palomar Transient Factory (PTF) is systematically charting the optical transient and variable sky. A primary science driver of PTF is building a complete inventory of transients in the local Universe (distance less than 200 Mpc). Here, we report the discovery of PTF10fqs, a transient in the luminosity "gap" between novae and supernovae. Located on a spiral arm of Messier 99, PTF 10fqs has a peak luminosity of Mr = -12.3, red color (g-r = 1.0) and is slowly evolving (decayed by 1 mag in 68 days). It has a spectrum dominated by intermediate-width H (930 km/s) and narrow calcium emission lines. The explosion signature (the light curve and spectra) is overall similar to thatof M85OT2006-1, SN2008S, and NGC300OT. The origin of these events is shrouded in mystery and controversy (and in some cases, in dust). PTF10fqs shows some evidence of a broad feature (around 8600A) that may suggest very large velocities (10,000 km/s) in this explosion. Ongoing surveys can be expected to find a few such events per year. Sensitive spectroscopy, infrared monitoring and statistics (e.g. disk versus bulge) will eventually make it possible for astronomers to unravel the nature of these mysterious explosions.Comment: 12 pages, 12 figures, Replaced with published versio