Primary care follow up of patients discharged from the emergency department: a retrospective study

BACKGROUND: The visit to the emergency department (ED) constitutes a brief, yet an important point in the continuum of medical care. The aim of our study was to evaluate the continuity of care of adult ED visitors. METHODS: We retrospectively reviewed all ED discharge summaries for over a month 's period. The ED chart, referral letter and the patient's primary care file were reviewed. Data collected included: age, gender, date and hour of ED visit, documentation of ED referral and ED discharge letter in the primary care file. RESULTS: 359 visits were eligible for the study. 192 (53.5%) of the patients were women, average age 54.1 ± 18.7 years (mean ± SD). 214 (59.6%) of the visits were during working hours of primary care clinics ("working hours"), while the rest were "out of hours" visits. Only 196 (54.6%) of patients had a referral letter, usually from their family physician. A third (71/214) of "working hours" visits were self referrals, the rate rose to 63.5% (92/145) of "out of hours" visits (p < 0.0001). The ED discharge letter was found in 50% (179/359) of the primary care files. A follow-up visit was documented in only 31% (111/359). Neither follow up visit nor discharge letter were found in 43% of the files (153/359). CONCLUSIONS: We have found a high rate of ED self referrals throughout the day together with low documentation rates of ED visits in the primary care charts. Our findings point to a poor continuity of care of ED attendees

Probing natural SUSY from stop pair production at the LHC

We consider the natural supersymmetry scenario in the framework of the R-parity conserving minimal supersymmetric standard model (called natural MSSM) and examine the observability of stop pair production at the LHC. We first scan the parameters of this scenario under various experimental constraints, including the SM-like Higgs boson mass, the indirect limits from precision electroweak data and B-decays. Then in the allowed parameter space we study the stop pair production at the LHC followed by the stop decay into a top quark plus a lightest neutralino or into a bottom quark plus a chargino. From detailed Monte Carlo simulations of the signals and backgrounds, we find the two decay modes are complementary to each other in probing the stop pair production, and the LHC with $\sqrt{s}= 14$ TeV and 100 $fb^{-1}$ luminosity is capable of discovering the stop predicted in natural MSSM up to 450 GeV. If no excess events were observed at the LHC, the 95% C.L. exclusion limits of the stop masses can reach around 537 GeV.Comment: 19 pages, 10 figures, version accepted by JHE

Human-Centered Design Components in Spiral Model to Improve Mobility of Older Adults

As humans grow older, their cognitive needs change more frequently due to distal and proximal life events. Designers and developers need to come up with better designs that integrate older users’ needs in a short period of time with more interaction with the users. Therefore, the positioning of human end users in the center of the design itself is not the key to the success of design artifacts while designing applications for older adults to use a smartphone as a promising tool for journey planner while using public transportation. This study analyzed the use of human-centered design (HCD) components, the spiral model, and the design for failure (DfF) approach to improve the interactions between older users and designers/developers in gathering usability needs in the concept stage and during the development of the app with short iterative cycles. To illustrate the importance of the applied approach, a case study with particular focus on older adults is presented.The results presented in this study are based on “Assistant” project funded by AAL JP, co-funded by the European Union. The authors would like to thank Dr. Stefan Carmien, my colleague in Assistant, for mentoring and for reading and making comments in the earlier versions of this chapter; participating research institutes; funding agencies; and companies from Finland, Spain, Austria, France, and the United Kingdom for their active support throughout the project

Severe Respiratory Syncytial Virus Bronchiolitis in Infants Is Associated with Reduced Airway Interferon Gamma and Substance P

Severe human respiratory syncytial virus (hRSV) bronchiolitis in previously well infants may be due to differences in the innate immune response to hRSV infection. Aim: to determine if factors mediating proposed mechanisms for severe bronchiolitis differ with severity of disease

Lawson criterion for ignition exceeded in an inertial fusion experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion

Measurement and interpretation of same-sign W boson pair production in association with two jets in pp collisions at s = 13 TeV with the ATLAS detector

This paper presents the measurement of fducial and diferential cross sections for both the inclusive and electroweak production of a same-sign W-boson pair in association with two jets (W±W±jj) using 139 fb−1 of proton-proton collision data recorded at a centre-of-mass energy of √s = 13 TeV by the ATLAS detector at the Large Hadron Collider. The analysis is performed by selecting two same-charge leptons, electron or muon, and at least two jets with large invariant mass and a large rapidity diference. The measured fducial cross sections for electroweak and inclusive W±W±jj production are 2.92 ± 0.22 (stat.) ± 0.19 (syst.)fb and 3.38±0.22 (stat.)±0.19 (syst.)fb, respectively, in agreement with Standard Model predictions. The measurements are used to constrain anomalous quartic gauge couplings by extracting 95% confdence level intervals on dimension-8 operators. A search for doubly charged Higgs bosons H±± that are produced in vector-boson fusion processes and decay into a same-sign W boson pair is performed. The largest deviation from the Standard Model occurs for an H±± mass near 450 GeV, with a global signifcance of 2.5 standard deviations

Combination of searches for heavy spin-1 resonances using 139 fb−1 of proton-proton collision data at s = 13 TeV with the ATLAS detector

A combination of searches for new heavy spin-1 resonances decaying into different pairings of W, Z, or Higgs bosons, as well as directly into leptons or quarks, is presented. The data sample used corresponds to 139 fb−1 of proton-proton collisions at = 13 TeV collected during 2015–2018 with the ATLAS detector at the CERN Large Hadron Collider. Analyses selecting quark pairs (qq, bb, , and tb) or third-generation leptons (τν and ττ) are included in this kind of combination for the first time. A simplified model predicting a spin-1 heavy vector-boson triplet is used. Cross-section limits are set at the 95% confidence level and are compared with predictions for the benchmark model. These limits are also expressed in terms of constraints on couplings of the heavy vector-boson triplet to quarks, leptons, and the Higgs boson. The complementarity of the various analyses increases the sensitivity to new physics, and the resulting constraints are stronger than those from any individual analysis considered. The data exclude a heavy vector-boson triplet with mass below 5.8 TeV in a weakly coupled scenario, below 4.4 TeV in a strongly coupled scenario, and up to 1.5 TeV in the case of production via vector-boson fusion