Inpatient costs, mortality and 30-day re-admission in patients with central-line-associated bloodstream infections

AbstractPrevious work has suggested that central-line-associated bloodstream infection (CLABSI) is associated with increased costs and risk of mortality; however, no studies have looked at both total and variable costs, and information on outcomes outside of the intensive-care unit (ICU) is sparse. The aim of this study was to determine the excess in-hospital mortality and costs attributable to CLABSI in ICU and non-ICU patients. We conducted a retrospective cohort and cost-of-illness study from the hospital perspective of 398 patients at a tertiary-care academic medical centre from 1 January 2008 to 31 December 2010. All CLABSI patients and a simple random sample drawn from a list of all central lines inserted during the study period were included. Generalized linear models with log link and gamma distribution were used to model costs as a function of CLABSI and important covariates. Costs were adjusted to 2010 US dollars by use of the personal consumption expenditures for medical care index. We used multivariable logistic regression to identify independent predictors of in-hospital mortality. Among both ICU and non-ICU patients, adjusted variable costs for patients with CLABSI were c. $32 000 (2010 US dollars) higher on average than for patients without CLABSI. After we controlled for severity of illness and other healthcare-associated infections, CLABSI was associated with a 2.27-fold (95% CI 1.15–4.46) increased risk of mortality. Other healthcare-associated infections were also significantly associated with greater costs and mortality. Overall, CLABSI was associated with significantly higher adjusted in-hospital mortality and total and variable costs than those for patients without CLABSI

Secondary phi meson peak as an indicator of QCD phase transition in ultrarelativistic heavy ion collisions

In a previous paper, we have shown that a double phi peak structure appears in the dilepton invariant mass spectrum if a first order QCD phase transition occurs in ultrarelativistic heavy ion collisions. Furthermore, the transition temperature can be determined from the transverse momentum distribution of the low mass phi peak. In this work, we extend the study to the case that a smooth crossover occurs in the quark-gluon plasma to the hadronic matter transition. We find that the double phi peak structure still exists in the dilepton spectrum and thus remains a viable signal for the formation of the quark-gluon plasma in ultrarelativistic heavy ion collisions.Comment: 8 pages, 9 uuencoded postscript figures included, Latex, LBL-3572

Critique of a Pion Exchange Model for Interquark Forces

I describe four serious defects of a widely discussed pion exchange model for interquark forces: it doesn't solve the "spin-orbit problem" as advertised, it fails to describe the internal structure of baryon resonances, it leads to disastrous conclusions when extended to mesons, and it is not reasonably connected to the physics of heavy-light systems.Comment: 20 pages, 6 figures; some clarifications and references adde

Analytic Approach to Perturbative QCD

The two-loop invariant (running) coupling of QCD is written in terms of the Lambert W function. The analyticity structure of the coupling in the complex Q^2-plane is established. The corresponding analytic coupling is reconstructed via a dispersion relation. We also consider some other approximations to the QCD beta-function, when the corresponding couplings are solved in terms of the Lambert function. The Landau gauge gluon propagator has been considered in the renormalization group invariant analytic approach (IAA). It is shown that there is a nonperturbative ambiguity in determination of the anomalous dimension function of the gluon field. Several analytic solutions for the propagator at the one-loop order are constructed. Properties of the obtained analytical solutions are discussed.Comment: Latex-file, 19 pages, 2 tables, 51 references, to be published in Int. J. Mod. Phys.

Dynamics of Hot Bulk QCD Matter: from the Quark-Gluon Plasma to Hadronic Freeze-Out

We introduce a combined macroscopic/microscopic transport approach employing relativistic hydrodynamics for the early, dense, deconfined stage of the reaction and a microscopic non-equilibrium model for the later hadronic stage where the equilibrium assumptions are not valid anymore. Within this approach we study the dynamics of hot, bulk QCD matter, which is expected to be created in ultra-relativistic heavy ion collisions at the SPS, the RHIC and the LHC. Our approach is capable of self-consistently calculating the freeze-out of the hadronic system, while accounting for the collective flow on the hadronization hypersurface generated by the QGP expansion. In particular, we perform a detailed analysis of the reaction dynamics, hadronic freeze-out, and transverse flow.Comment: 55 pages, 15 figure

Hadronic observables from SIS to SPS energies - anything strange with strangeness ?

We calculate $p, \pi^\pm, K^\pm$ and $\Lambda$(+$\Sigma^0$) rapidity distributions and compare to experimental data from SIS to SPS energies within the UrQMD and HSD transport approaches that are both based on string, quark, diquark ($q, \bar{q}, qq, \bar{q}\bar{q}$) and hadronic degrees of freedom. The two transport models do not include any explicit phase transition to a quark-gluon plasma (QGP). It is found that both approaches agree rather well with each other and with the experimental rapidity distributions for protons, $\Lambda$'s, $\pi^\pm$ and $K^\pm$. Inspite of this apparent agreement both transport models fail to reproduce the maximum in the excitation function for the ratio $K^+/\pi^+$ found experimentally between 11 and 40 A$\cdot$GeV. A comparison to the various experimental data shows that this 'failure' is dominantly due to an insufficient description of pion rapidity distributions rather than missing 'strangeness'. The modest differences in the transport model results -- on the other hand -- can be attributed to different implementations of string formation and fragmentation, that are not sufficiently controlled by experimental data for the 'elementary' reactions in vacuum.Comment: 46 pages, including 15 eps figures, to be published in Phys. Rev.

Cluster Transformation Coefficients for Structure and Dynamics Calculations in n-Particle Systems: Atoms, Nuclei, and Quarks

The structure and dynamics of an n-particle system are described with coupled nonlinear Heisenberg's commutator equations where the nonlinear terms are generated by the two-body interaction that excites the reference vacuum via particle-particle and particle-hole excitations. Nonperturbative solutions of the system are obtained with the use of dynamic linearization approximation and cluster transformation coefficients. The dynamic linearization approximation converts the commutator chain into an eigenvalue problem. The cluster coefficients factorize the matrix elements of the (n)-particles or particle-hole systems in terms of the matrix elements of the (n-1)-systems coupled to a particle-particle, particle-hole, and hole-hole boson. Group properties of the particle-particle, particle-hole, and hole-hole permutation groups simplify the calculation of these coefficients. The particle-particle vacuum-excitations generate superconductive diagrams in the dynamics of 3-quarks systems. Applications of the model to fermionic and bosonic systems are discussed.Comment: 13 pages, 5 figures, Wigner Proceedings for Conference Wigner Centenial Pecs, July 8-12, 200

Ozone photochemistry in an oil and natural gas extraction region during winter: simulations of a snow-free season in the Uintah Basin, Utah

The Uintah Basin in northeastern Utah, a region of intense oil and gas extraction, experienced ozone (O3) concentrations above levels harmful to human health for multiple days during the winters of 2009–2010 and 2010–2011. These wintertime O3 pollution episodes occur during cold, stable periods when the ground is snow-covered, and have been linked to emissions from the oil and gas extraction process. The Uintah Basin Winter Ozone Study (UBWOS) was a field intensive in early 2012, whose goal was to address current uncertainties in the chemical and physical processes that drive wintertime O3 production in regions of oil and gas development. Although elevated O3 concentrations were not observed during the winter of 2011–2012, the comprehensive set of observations tests our understanding of O3 photochemistry in this unusual emissions environment. A box model, constrained to the observations and using the nearexplicit Master Chemical Mechanism (MCM) v3.2 chemistry scheme, has been used to investigate the sensitivities of O3 production during UBWOS 2012. Simulations identify the O3 production photochemistry to be highly radical limited (with a radical production rate significantly smaller than the NOx emission rate). Production of OH from O3 photolysis (through reaction of O(1D) with water vapor) contributed only 170 pptv day−1, 8% of the total primary radical source on average (primary radicals being those produced from non-radical precursors). Other radical sources, including the photolysis of formaldehyde (HCHO, 52 %), nitrous acid (HONO, 26 %), and nitryl chloride (ClNO2, 13 %) were larger. O3 production was also found to be highly sensitive to aromatic volatile organic compound (VOC) concentrations, due to radical amplification reactions in the oxidation scheme of these species. Radical production was shown to be small in comparison to the emissions of nitrogen oxides (NOx), such that NOx acted as the primary radical sink. Consequently, the system was highly VOC sensitive, despite the much larger mixing ratio of total non-methane hydrocarbons (230 ppbv (2080 ppbC), 6 week average) relative to NOx (5.6 ppbv average). However, the importance of radical sources which are themselves derived from NOx emissions and chemistry, such as ClNO2 and HONO, make the response of the system to changes in NOx emissions uncertain. Model simulations attempting to reproduce conditions expected during snow-covered cold-pool conditions show a significant increase in O3 production, although calculated concentrations do not achieve the highest seen during the 2010–2011 O3 pollution events in the Uintah Basin. These box model simulations provide useful insight into the chemistry controlling winter O3 production in regions of oil and gas extraction

Ozone Photochemistry in an oil and natural gas extraction region during winter: simulations of a snow-free season in the Uintah Basin, Utah

The Uintah Basin in northeastern Utah, a region of intense oil and gas extraction, experienced ozone (O3) concentrations above levels harmful to human health for multiple days during the winters of 2009–2010 and 2010–2011. These wintertime O3 pollution episodes occur during cold, stable periods when the ground is snow-covered, and have been linked to emissions from the oil and gas extraction process. The Uintah Basin Winter Ozone Study (UBWOS) was a field intensive in early 2012, whose goal was to address current uncertainties in the chemical and physical processes that drive wintertime O3 production in regions of oil and gas development. Although elevated O3 concentrations were not observed during the winter of 2011–2012, the comprehensive set of observations tests our understanding of O3 photochemistry in this unusual emissions environment. A box model, constrained to the observations and using the near-explicit Master Chemical Mechanism (MCM) v3.2 chemistry scheme, has been used to investigate the sensitivities of O3 production during UBWOS 2012. Simulations identify the O3 production photochemistry to be highly radical limited (with a radical production rate significantly smaller than the NOx emission rate). Production of OH from O3 photolysis (through reaction of O(1D) with water vapor) contributed only 170 pptv day−1, 8% of the total primary radical source on average (primary radicals being those produced from non-radical precursors). Other radical sources, including the photolysis of formaldehyde (HCHO, 52%), nitrous acid (HONO, 26%), and nitryl chloride (ClNO2, 13%) were larger. O3 production was also found to be highly sensitive to aromatic volatile organic compound (VOC) concentrations, due to radical amplification reactions in the oxidation scheme of these species. Radical production was shown to be small in comparison to the emissions of nitrogen oxides (NOx), such that NOx acted as the primary radical sink. Consequently, the system was highly VOC sensitive, despite the much larger mixing ratio of total non-methane hydrocarbons (230 ppbv (2080 ppbC), 6 week average) relative to NOx (5.6 ppbv average). However, the importance of radical sources which are themselves derived from NOx emissions and chemistry, such as ClNO2 and HONO, make the response of the system to changes in NOx emissions uncertain. Model simulations attempting to reproduce conditions expected during snow-covered cold-pool conditions show a significant increase in O3 production, although calculated concentrations do not achieve the highest seen during the 2010–2011 O3 pollution events in the Uintah Basin. These box model simulations provide useful insight into the chemistry controlling winter O3 production in regions of oil and gas extraction

Recent Developments in Lattice QCD

I review the current status of lattice QCD results. I concentrate on new analytical developments and on numerical results relevant to phenomenology.Comment: 35 pages, 4 figures (Figures are excerpted from others' work and are not included) Uses harvmac.te