Anesthesia Alarm Fatigue Policy Recommendations: The Path of Development

Healthcare workers are inundated with alarms every minute, yet 80-95% of these alarms do not result in provider intervention. False alarms cause a “cry-wolf” phenomenon among providers resulting in cognitive stress and workflow interruptions. A cross-sectional design was used to examine the perceptions of alarm fatigue and alarm management of Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs) and Anesthesiologists. This Likert-scale questionnaire was sent to approximately 150 anesthesia providers at NorthShore University HealthSystem (NSUHS) through an online survey. Data analysis revealed anesthesia trainees and providers with less total years in practice and less clinical experience exhibit statistically significant (p=0.011), higher levels (10.60%) of alarm fatigue and associated provider distress. A p value of 0.007 indicated students appreciate significantly higher levels (11.76%) of alarm fatigue than their CRNA colleagues. In conjunction with survey responses, a survey development table based on evidence and current endorsements in the literature was used to guide proposed policy recommendations for the anesthesia department at NSUHS. Future work involves adoption and implementation of the policy and evaluation to determine if it improved provider workflow, their alarm fatigue experience or patient safety

Higgs triplet effects in purely leptonic processes

We consider the effect of complex Higgs triplets on purely leptonic processes and survey the experimental constraints on the mass and couplings of their single and double charge members. Present day experiments tolerate values of the Yukawa couplings of these scalars at the level of the standard electroweak gauge couplings. We show that the proposed measurement of the ratio R_{LCD}=\sigma (\nu_{\mu}e)/ [\sigma (\bb\nu_{\mu}e) + \sigma (\nu_e e )] would allow to explore a large region of the parameter space inaccessible to the usual ratio R=\sigma (\nu_{\mu}e)/\sigma (\bb\nu_{\mu}e).Comment: 14 pages, LaTeX, Three figures included using uufiles. A postscript version is available at ftp://ftp.ifae.es/preprint/ft/uabft378.p

Jarosite in Gale Crater, Mars: The Importance of Temporal and Spatial Variability and Implications for Habitiability

The Curiosity rover has recently found evidence for small amounts of jarosite, a ferric sulfate, in the Pahrump Hills region at the base of Aeolis Mons (Mount Sharp), Gale crater. While jarosite has been described previously at other locations on Mars, including several sites at Meridiani Planum (explored by the Opportunity rover; and Mawrth Vallis (by remote MRO-CRISM observations; this is the first identification in Gale. Jarosite is interpreted to be a mineral indicator of acidic conditions (pH less than 4; on Earth, it is most commonly found in acid rock-drainage or acid sulfate soil environments. However, jarosite has also been described from a number of terrestrial environments where widespread acidic conditions are not prevalent. As a case study, we describe here an occurrence of sedimentary pyrite nodules that have been variably oxidized in situ to gypsum, schwertmannite, K-/Na-jarosite and iron oxides in a polar desert environment on Devon Island, Nunavut, Canada. Remarkably, these nodules occur in loosely consolidated carbonate sediments, which would have required a higher pH environment at their time of formation and deposition. Thus, acidic conditions may only exist at a small (sub-cm) scale or in a restricted temporal window in an otherwise well-buffered environment. On Devon Island, the jarosite occurs in the most oxidized nodules and is never associated directly with pyrite. Schwertmannite, a metastable iron oxyhydroxysulfate that can form at pH higher than that required for jarosite, occurs in association with partially oxidized pyrite. The paragenetic sequence observed here suggests initial formation of schwertmannite and late-stage precipitation of jarosite in restricted micro-environments, possibly forming via transformation of an amorphous schwertmannite-like phase. While the carbonate environment on Devon Island differs significantly from that of Gale crater, i.e., where we find predominantly basaltic sedimentary rocks, this terrestrial analog provides insight into the significance of jarosite with respect to habitability. For example, the variable abundance of jarosite on Mars and possibly in Gale crater points to potentially localized conditions favorable for jarosite formation. Interestingly, small amounts of sulfide minerals have also been detected by Curiosity at Yellowknife Bay; oxidation of sulfide minerals at Pahrump could explain the presence of small amounts of jarosite. The iron-rich rocks at Pahrump may also represent relatively altered basaltic sediments, or they could be sediments that were altered further by a fluid with a distinct, possibly more acidic, composition. In addition, the abundance of iron-rich amorphous material in Gale rocks allows for the possibility that pre-cursor, iron-bearing phases transform to jarosite post-depositionally. Thus, the occurrence of jarosite at Pahrump could reflect changing paleoenvironmental conditions, though continuing study of its context and textural relationships should provide a fuller understanding of the significance of this mineral to past fluid compositions and past habitability at Gale crater

Yet Another Extension of the Standard Model: Oases in the Desert?

We have searched for conceptually simple extensions of the standard model, and describe here a candidate model which we find attractive. Our starting point is the assumption that off-diagonal CKM mixing matrix elements are directly related by lowest order perturbation theory to the quark mass matrices. This appears to be most easily and naturally implemented by assuming that all off-diagonal elements reside in the down-quark mass matrix. This assumption is in turn naturally realized by introducing three generations of heavy, electroweak-singlet down quarks which couple to the Higgs sector diagonally in flavor, while mass-mixing off-diagonally with the light down-quarks. Anomaly cancellation then naturally leads to inclusion of electroweak vector-doublet leptons. It is then only a short step to completing the extension to three generations of fundamental representations of E(6). Assuming only that the third generation B couples to the Higgs sector at least as strongly as does the top quark, the mass of the B is roughly estimated to lie between 1.7 TeV and 10 TeV, with lower-generation quarks no heavier. The corresponding guess for the new leptons is a factor two lower. Within the validity of the model, flavor and CP violation are ``infrared'' in nature, induced by semi-soft mass mixing terms, not Yukawa couplings. If the Higgs couplings of the new quarks are flavor symmetric, then there necessarily must be at least one ``oasis'' in the desert, induced by new radiative corrections to the top quark and Higgs coupling constants, and roughly at 1000 TeV.Comment: LaTex, 40 page

Comparison between variable flavor number schemes for charm quark electroproduction

Where appropriate, the abbreviation 'VFNS' is replaced by 'CSN' to indicate the scheme using massive heavy quark coefficient functions proposed in this paper. The text below Eq. (2.13) and between Eqs. (2.33) and (2.36) has been considerably changed.Comment: 64 pages, LaTeX, 16 Postscript figure

Muon anomalous magnetic moment in string inspired extended family models

We propose a standard model minimal extension with two lepton weak SU(2) doublets and a scalar singlet to explain the deviation of the measured anomalous magnetic moment of the muon from the standard model expectation. This scheme can be naturally motivated in string inspired models such as E_6 and AdS/CFT.Comment: 9 pages, RevTeX, 2 figures, version to be published in Phys. Rev.

Don't Stop Thinking About Leptoquarks: Constructing New Models

We discuss the general framework for the construction of new models containing a single, fermion number zero scalar leptoquark of mass $\simeq 200-220$ GeV which can both satisfy the D0/CDF search constraints as well as low energy data, and can lead to both neutral and charged current-like final states at HERA. The class of models of this kind necessarily contain new vector-like fermions with masses at the TeV scale which mix with those of the Standard Model after symmetry breaking. In this paper we classify all models of this type and examine their phenomenological implications as well as their potential embedding into SUSY and non-SUSY GUT scenarios. The general coupling parameter space allowed by low energy as well as collider data for these models is described and requires no fine-tuning of the parameters.Comment: Modified text, added table, and updated reference

Complete Next to Leading Order QCD Corrections to the Photon Structure Functions F2γ(x,Q2)F^\gamma_2(x,Q^2) and FLγ(x,Q2)F_L^\gamma(x,Q^2)

We present the complete NLO QCD analysis of the photon structure functions $F_2^\gamma(x,Q^2)$ and $F_L^\gamma(x,Q^2)$ for a real photon target. In particular we study the heavy flavor content of the structure functions which is due to two different production mechanisms, namely collisions of a virtual photon with a real photon, and with a parton. We observe that the charm contributions are noticeable for $F_2^\gamma(x,Q^2)$ as well as $F_L^\gamma(x,Q^2)$ in the x-region studied.Comment: Latex 34 pages, 24 figures, uuencoded, attached at end, ITP-SB-93-46, FERMILAB-Pub-93/240-T, SMU HEP 93-1