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Using a Beers Criteria-Based Eductaional Intervention to Increase Practitioners\u27 Knowledge and Confidence of Potentially Inappropriate Medications with Older Adults
Identification of potentially inappropriate medications for adults 65 years and older is important to prevent adverse drug events, falls, delirium, and gastrointestinal bleeding. The aim of this project was to implement an evidence-based educational intervention designed for practitioners that increases knowledge and confidence about the 2012 American Geriatrics Society (AGS) Beers Criteria for Potentially Inappropriate Medications (PIM) use in older adults, Centers for Medicare and Medicaid (CMS) high-risk medications, and prescribing alternatives. The study used a pre- and posttest design to measure knowledge of PIMs and prescribing alternatives, confidence level in identifying PIMs, provider engagement, and patient engagement. The evidence-based education intervention improved practitioners’ knowledge and confidence.
Additionally, the number of PIMs filled decreased 36% after the intervention. The findings indicate that the evidence-based educational intervention using 2012 AGS Beers Criteria for PIM use in older adults can improve practitioners’ knowledge and confidence to identify PIMs, CMS high-risk medications, and prescribing alternatives and further promote patient safety by preventing adverse drug events, falls, delirium, and gastrointestinal bleeding
Investigation of nonlinear absorption processes with femtosecond light pulses in lithium niobate crystals
The propagation of high-power femtosecond light pulses in lithium niobate crystals (LiNbO3) is investigated experimentally and theoretically in collinear pump-probe transmission experiments. It is found within a wide intensity range that a strong decrease of the pump transmission coefficient at wavelength 388 nm fully complies with the model of two-photon absorption; the corresponding nonlinear absorption coefficient is betap~=3.5 cm/GW. Furthermore, strong pump pulses induce a considerable absorption for the probe at 776 nm. The dependence of the probe transmission coefficient on the time delay Deltat between probe and pump pulses is characterized by a narrow dip (at Deltat~=0) and a long (on the picosecond time scale) lasting plateau. The dip is due to direct two-photon transitions involving pump and probe photons; the corresponding nonlinear absorption coefficient is betar~=0.9 cm/GW. The plateau absorption is caused by the presence of pump-excited charge carriers; the effective absorption cross section at 776 nm is sigmar~=8×10^–18 cm^2. The above nonlinear absorption parameters are not strongly polarization sensitive. No specific manifestations of the relaxation of hot carriers are found for a pulse duration of ~=0.24 ps
Femtosecond time-resolved absorption processes in lithium niobate crystals
emtosecond pump pulses are strongly attenuated in lithium niobate owing to two-photon absorption; the relevant nonlinear coefficient beta_p ranges from ~3.5 cm/GW for lambda_p = 388 nm to ~0.1 cm/GW for 514 nm. In collinear pump-probe experiments the probe transmission at the double pump wavelength 2lambda_p=776 nm is controlled by two different processes: A direct absorption process involving pump and probe photons (beta_r ~ or = 0.9 cm/GW) leads to a pronounced short-duration transmission dip, whereas the probe absorption by pump-excited charge carriers results in a long-duration plateau. Coherent pump-probe interactions are of no importance. Hot-carrier relaxation occurs on the time scale of < or ~0.1 ps
The Initial-Boundary Value Problem in General Relativity
In this article we summarize what is known about the initial-boundary value
problem for general relativity and discuss present problems related to it.Comment: 11 pages, 2 figures. Contribution to a special volume for Mario
Castagnino's seventy fifth birthda
Are tyrosine kinase inhibitors promising for the treatment of systemic sclerosis and other fibrotic diseases?
Tissue fibrosis causes organ failure and death in patients with systemic sclerosis (SSc), but clearly effective anti-fibrotic therapies are not available. The tyrosine kinase inhibitor (TKI) imatinib, which blocks the pro-fibrotic c-Abl kinase and PDGF receptor, is currently evaluated in clinical proof-of-concept trials for the treatment of patients with SSc. In experimental models, imatinib efficiently prevented and reduced tissue fibrosis. First clinical case studies demonstrated anti-fibrotic effects of imatinib in selected patients with SSc and other fibrotic diseases, and observational studies in sclerotic chronic graft-versus-host disease showed promising results. Besides imatinib, the two novel TKIs of c-Abl and PDGF receptor nilotinib and dasatinib have recently proven efficacy in experimental models of SSc. The potential of TKIs of the VEGF receptor (e.g., semaxinib, vatalanib, sutent, and sorafenib) and the EGF receptor (e.g., erlotinib, gefitinib, lapatinib, and canertinib) as anti-fibrotic treatments are also discussed in this review. Prior to clinical use, however, controlled trials need to address efficacy as well as tolerability of TKIs in patients with different fibrotic diseases
Noisy Optimization: Convergence with a Fixed Number of Resamplings
It is known that evolution strategies in continuous domains might not
converge in the presence of noise. It is also known that, under mild
assumptions, and using an increasing number of resamplings, one can mitigate
the effect of additive noise and recover convergence. We show new sufficient
conditions for the convergence of an evolutionary algorithm with constant
number of resamplings; in particular, we get fast rates (log-linear
convergence) provided that the variance decreases around the optimum slightly
faster than in the so-called multiplicative noise model. Keywords: Noisy
optimization, evolutionary algorithm, theory.Comment: EvoStar (2014
Analysis of Different Types of Regret in Continuous Noisy Optimization
The performance measure of an algorithm is a crucial part of its analysis.
The performance can be determined by the study on the convergence rate of the
algorithm in question. It is necessary to study some (hopefully convergent)
sequence that will measure how "good" is the approximated optimum compared to
the real optimum. The concept of Regret is widely used in the bandit literature
for assessing the performance of an algorithm. The same concept is also used in
the framework of optimization algorithms, sometimes under other names or
without a specific name. And the numerical evaluation of convergence rate of
noisy algorithms often involves approximations of regrets. We discuss here two
types of approximations of Simple Regret used in practice for the evaluation of
algorithms for noisy optimization. We use specific algorithms of different
nature and the noisy sphere function to show the following results. The
approximation of Simple Regret, termed here Approximate Simple Regret, used in
some optimization testbeds, fails to estimate the Simple Regret convergence
rate. We also discuss a recent new approximation of Simple Regret, that we term
Robust Simple Regret, and show its advantages and disadvantages.Comment: Genetic and Evolutionary Computation Conference 2016, Jul 2016,
Denver, United States. 201
Disentanglement of the electronic and lattice parts of the order parameter in a 1D Charge Density Wave system probed by femtosecond spectroscopy
We report on the high resolution studies of the temperature (T) dependence of
the q=0 phonon spectrum in the quasi one-dimensional charge density wave (CDW)
compound K0.3MoO3 utilizing time-resolved optical spectroscopy. Numerous modes
that appear below Tc show pronounced T-dependences of their amplitudes,
frequencies and dampings. Utilizing the time-dependent Ginzburg-Landau theory
we show that these modes result from linear coupling of the electronic part of
the order parameter to the 2kF phonons, while the (electronic) CDW amplitude
mode is overdamped.Comment: 4 pages, 3 figures + supplementary material, accepted for publication
in Phys. Rev. Let
El cálculo infinitesimal en la formación de ingenieros y su profesorado en el siglo XIX venezolano
Este escrito presenta un estudio histórico-documental acerca del proceso que condujo a la incorporación del Cálculo Infinitesimal en los estudios superiores de Venezuela, acerca de algunos docentes que contribuyeron a ello, las instituciones en donde esto se dio y los textos que fueron empleados. Se sintetiza la evolución de los estudios matemáticos y el desarrollo de los estudios de ingeniería en la Academia Matemática de Caracas (AMC), la Universidad y la Escuela de Ingeniería. Partiendo de estudios históricos y bibliográficos, de catálogos de las empresas libreras y de bibliotecas, de los informes de la AMC, se realizó un arqueo de las obras de cálculo infinitesimal que circularon por Venezuela en el siglo XIX. Se consideró dichos textos como fuente privilegiada para estudiar el proceso. Se analizaron estas obras y a la luz de diversas investigaciones que sobre éstas y sus autores están disponibles en la literatura, se pudo determinar los principales rasgos que configuraron las asignaturas de cálculo. El estudio condujo a destacar el papel de la AMC y de su primer director Juan Manuel Cagigal como el introductor al país de las ideas de Cauchy, así como determinar algunos de los textos (Boucharlat, Bézout, Sturm) que guiaron este proceso, los cuales mayoritariamente eran de origen francés
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