494 research outputs found
A robust semantics hides fewer errors
In this paper we explore how formal models are interpreted and to what degree meaning is captured in the formal semantics and to what degree it remains in the informal interpretation of the semantics. By applying a robust approach to the definition of refinement and semantics, favoured by the event-based community, to state-based theory we are able to move some aspects from the informal interpretation into the formal semantics
18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging
Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced breast cancer. Baseline tumor glycolytic activity is associated with tumor biology and prognosis
Getting Better Hospital Alarm Sounds Into a Global Standard
The reserved set of audible alarm signals embodied within the global medical device safety standard, IEC 60601-1-8, is known to be problematic and in need of updating. The current alarm signals are not only suboptimal, but there is also little evidence beyond learnability (which is known to be poor) that demonstrates their performance in realistic and representative clinical environments. In this article, we describe the process of first designing and then testing potential replacement audible alarm signals for IEC 60601-1-8, starting with the design of several sets of candidate sounds and initial tests on learnability and localizability, followed by testing in simulated clinical environments. We demonstrate that in all tests, the alarm signals selected for further development significantly outperform the current alarm signals. We describe the process of collecting considerably more data on the performance of the new sounds than exists for the current sounds, which ultimately will be of use to end users. We also reflect on the process and practice of working with the relevant committees and other practical issues beyond the science, which also need constant attention if the alarms we have developed are to be included successfully in an updated version of the standard
The Intentional Use of Service Recovery Strategies to Influence Consumer Emotion, Cognition and Behaviour
Service recovery strategies have been identified as a critical factor in the success of. service organizations. This study develops a conceptual frame work to investigate how specific service recovery strategies influence the emotional, cognitive and negative behavioural responses of . consumers., as well as how emotion and cognition influence negative behavior. Understanding the impact of specific service recovery strategies will allow service providers' to more deliberately and intentionally engage in strategies that result in positive organizational outcomes. This study was conducted using a 2 x 2 between-subjects quasi-experimental design. The results suggest that service recovery has a significant impact on emotion, cognition and negative behavior. Similarly, satisfaction, negative emotion and positive emotion all influence negative behavior but distributive justice has no effect
Circulating desmosine levels do not predict emphysema progression but are associated with cardiovascular risk and mortality in COPD
Elastin degradation is a key feature of emphysema and may have a role in the pathogenesis of atherosclerosis associated with chronic obstructive pulmonary disease (COPD). Circulating desmosine is a specific biomarker of elastin degradation. We investigated the association between plasma desmosine (pDES) and emphysema severity/progression, coronary artery calcium score (CACS) and mortality.
pDES was measured in 1177 COPD patients and 110 healthy control subjects from two independent cohorts. Emphysema was assessed on chest computed tomography scans. Aortic arterial stiffness was measured as the aortic–femoral pulse wave velocity.
pDES was elevated in patients with cardiovascular disease (p<0.005) and correlated with age (rho=0.39, p<0.0005), CACS (rho=0.19, p<0.0005) modified Medical Research Council dyspnoea score (rho=0.15, p<0.0005), 6-min walking distance (rho=−0.17, p<0.0005) and body mass index, airflow obstruction, dyspnoea, exercise capacity index (rho=0.10, p<0.01), but not with emphysema, emphysema progression or forced expiratory volume in 1 s decline. pDES predicted all-cause mortality independently of several confounding factors (p<0.005). In an independent cohort of 186 patients with COPD and 110 control subjects, pDES levels were higher in COPD patients with cardiovascular disease and correlated with arterial stiffness (p<0.05).
In COPD, excess elastin degradation relates to cardiovascular comorbidities, atherosclerosis, arterial stiffness, systemic inflammation and mortality, but not to emphysema or emphysema progression. pDES is a good biomarker of cardiovascular risk and mortality in COPD.Elastin degradation is a hallmark of emphysema and may have a role in the pathogenesis of atherosclerosis with COPD http://ow.ly/Y9Gs
Black Hole Spin via Continuum Fitting and the Role of Spin in Powering Transient Jets
The spins of ten stellar black holes have been measured using the
continuum-fitting method. These black holes are located in two distinct classes
of X-ray binary systems, one that is persistently X-ray bright and another that
is transient. Both the persistent and transient black holes remain for long
periods in a state where their spectra are dominated by a thermal accretion
disk component. The spin of a black hole of known mass and distance can be
measured by fitting this thermal continuum spectrum to the thin-disk model of
Novikov and Thorne; the key fit parameter is the radius of the inner edge of
the black hole's accretion disk. Strong observational and theoretical evidence
links the inner-disk radius to the radius of the innermost stable circular
orbit, which is trivially related to the dimensionless spin parameter a_* of
the black hole (|a_*| < 1). The ten spins that have so far been measured by
this continuum-fitting method range widely from a_* \approx 0 to a_* > 0.95.
The robustness of the method is demonstrated by the dozens or hundreds of
independent and consistent measurements of spin that have been obtained for
several black holes, and through careful consideration of many sources of
systematic error. Among the results discussed is a dichotomy between the
transient and persistent black holes; the latter have higher spins and larger
masses. Also discussed is recently discovered evidence in the transient sources
for a correlation between the power of ballistic jets and black hole spin.Comment: 30 pages. Accepted for publication in Space Science Reviews. Also to
appear in hard cover in the Space Sciences Series of ISSI "The Physics of
Accretion onto Black Holes" (Springer Publisher). Changes to Sections 5.2,
6.1 and 7.4. Section 7.4 responds to Russell et al. 2013 (MNRAS, 431, 405)
who find no evidence for a correlation between the power of ballistic jets
and black hole spi
Measurement of the Charged Multiplicities in b, c and Light Quark Events from Z0 Decays
Average charged multiplicities have been measured separately in , and
light quark () events from decays measured in the SLD experiment.
Impact parameters of charged tracks were used to select enriched samples of
and light quark events, and reconstructed charmed mesons were used to select
quark events. We measured the charged multiplicities:
,
, from
which we derived the differences between the total average charged
multiplicities of or quark events and light quark events: and . We compared
these measurements with those at lower center-of-mass energies and with
perturbative QCD predictions. These combined results are in agreement with the
QCD expectations and disfavor the hypothesis of flavor-independent
fragmentation.Comment: 19 pages LaTex, 4 EPS figures, to appear in Physics Letters
Toward an internally consistent astronomical distance scale
Accurate astronomical distance determination is crucial for all fields in
astrophysics, from Galactic to cosmological scales. Despite, or perhaps because
of, significant efforts to determine accurate distances, using a wide range of
methods, tracers, and techniques, an internally consistent astronomical
distance framework has not yet been established. We review current efforts to
homogenize the Local Group's distance framework, with particular emphasis on
the potential of RR Lyrae stars as distance indicators, and attempt to extend
this in an internally consistent manner to cosmological distances. Calibration
based on Type Ia supernovae and distance determinations based on gravitational
lensing represent particularly promising approaches. We provide a positive
outlook to improvements to the status quo expected from future surveys,
missions, and facilities. Astronomical distance determination has clearly
reached maturity and near-consistency.Comment: Review article, 59 pages (4 figures); Space Science Reviews, in press
(chapter 8 of a special collection resulting from the May 2016 ISSI-BJ
workshop on Astronomical Distance Determination in the Space Age
Search for W' bosons decaying to an electron and a neutrino with the D0 detector
This Letter describes the search for a new heavy charged gauge boson W'
decaying into an electron and a neutrino. The data were collected with the D0
detector at the Fermilab Tevatron proton-antiproton Collider at a
center-of-mass energy of 1.96 TeV, and correspond to an integrated luminosity
of about 1 inverse femtobarn. Lacking any significant excess in the data in
comparison with known processes, an upper limit is set on the production cross
section times branching fraction, and a W' boson with mass below 1.00 TeV can
be excluded at the 95% C.L., assuming standard-model-like couplings to
fermions. This result significantly improves upon previous limits, and is the
most stringent to date.Comment: submitted to Phys. Rev. Let
Measurement of the ratios of the Z/G* + >= n jet production cross sections to the total inclusive Z/G* cross section in ppbar collisions at sqrt(s) = 1.96 TeV
We present a study of events with Z bosons and jets produced at the Fermilab
Tevatron Collider in ppbar collisions at a center of mass energy of 1.96 TeV.
The data sample consists of nearly 14,000 Z/G* -> e+e- candidates corresponding
to the integrated luminosity of 0.4 fb-1 collected using the D0 detector.
Ratios of the Z/G* + >= n jet cross sections to the total inclusive Z/G* cross
section have been measured for n = 1 to 4 jet events. Our measurements are
found to be in good agreement with a next-to-leading order QCD calculation and
with a tree-level QCD prediction with parton shower simulation and
hadronization.Comment: 7 pages, 2 figures, slightly modified, submitted to Phys. Lett.
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