Safe use of symbols in handover documentation for medical teams

Concern has been reported about the safe use of medical abbreviations in documents such as handover sheets and medical notes, especially when information is being communicated between staff of different specialties (BBC 2008, Sheppard et al. 2008). This article describes a study to investigate whether the use of symbols in handover documentation that is shared within and between multidisciplinary teams (MDTs) has similar safety implications. We asked 19 healthcare professionals from a range of specialties to identify 45 different combinations of 38 individual symbols. The symbols and combinations of symbols were extracted from 102 handover sheets taken from 6 different healthcare contexts in 4 London hospitals. Three symbols proposed in Microsoft's Common User Interface guidelines for alert symbols were also included. Results reveal that while some symbols are well understood, many others are either ambiguous or unknown. These results have implications for the safe use of symbols in medical documents, including paper and electronic handover documents and Electronic Patient Records (EPRs), especially where teams comprise individuals from different professional backgrounds, i.e. MDTs. We offer initial suggestions for standardisation and further research

Distinct nature of static and dynamic magnetic stripes in cuprate superconductors

We present detailed neutron scattering studies of the static and dynamic stripes in an optimally doped high-temperature superconductor, La$_2$CuO$_{4+y}$. We find that the dynamic stripes do not disperse towards the static stripes in the limit of vanishing energy transfer. We conclude that the dynamic stripes observed in neutron scattering experiments are not the Goldstone modes associated with the broken symmetry of the simultaneously observed static stripes, but rather that the signals originate from different domains in the sample. These domains may be related by structural twinning, or may be entirely different phases, where the static stripes in one phase are pinned versions of the dynamic stripes in the other. Our results explain earlier observations of unusual dispersions in underdoped La$_{2-x}$Sr$_x$CuO$_{4}$ ($x=0.07$) and La$_{2-x}$Ba$_x$CuO$_{4}$ ($x=0.095$). Our findings are relevant for all compounds exhibiting magnetic stripes, and may thus be a vital part in unveiling the nature of high temperature superconductivity

Ractopamine HCl improved cardiac hypertrophy but not poor growth, metabolic inefficiency, or greater white blood cells associated with heat stress in concentrate-fed lambs

Heat stress decreases livestock performance and well-being (Hahn, 1999; Nienaber and Hahn, 2007), causes metabolic dysfunction that decreases growth efficiency (O’Brien et al., 2010), and alters cardiovascular function (Crandall et al., 2008). Each year, heat stress costs the livestock industry up to $2.5 billion (St-Pierre et al., 2003). Ractopamine HCl acts as a nutrient repartitioning agent (Beermann, 2002); classified as a β adrenergic agonist (βAA), it shares pharmacological properties with adrenaline (Beermann, 2002). βAA increase muscle mass and decreases fat deposition through unknown mechanisms (Beermann, 2002). In feedlot cattle, they increase growth efficiency and improve carcass yield and merit (Scramlin et al., 2010; Buntyn et al., 2017), which increases profit and allows more meat to be produced from fewer animals. However, because βAA act via a stress system, it is unclear how the products affect animals under stress conditions. β1AA and β2AA can also cause tachycardia, heart palpitations, and arrhythmias (Sears, 2002). We hypothesize that β1AA combined with heat stress may overstimulate the adrenergic system, resulting is metabolic dysfunction and decreased performance. Sheep are a common model for cattle, and thus, the objective of this study was to determine the impact of ractopamine HCl on health and cardiovascular parameters, growth, and metabolic efficiency in feeder lambs

Hydrodynamic modeling of deconfinement phase transition in nuclear collisions

The (3+1)-dimensional ideal hydrodynamics is used to simulate collisions of gold nuclei with bombarding energies from 1 to 160 GeV per nucleon. The initial state is represented by two cold Lorentz-boosted nuclei. Two equations of state: with and without the deconfinement phase transition are used. We have investigated dynamical trajectories of compressed baryon-rich matter as functions of various thermodynamical variables. The parameters of collective flow and hadronic spectra are calculated. It is shown that presence of the deconfinement phase transition leads to increase of the elliptic flow and to flattening of proton rapidity distributions.Comment: 11 pages, 6 figure

Particle production and equilibrium properties within a new hadron transport approach for heavy-ion collisions

The microscopic description of heavy-ion reactions at low beam energies is achieved within hadronic transport approaches. In this article a new approach SMASH (Simulating Many Accelerated Strongly-interacting Hadrons) is introduced and applied to study the production of non-strange particles in heavy-ion reactions at $E_{\rm kin}=0.4-2A$ GeV. First, the model is described including details about the collision criterion, the initial conditions and the resonance formation and decays. To validate the approach, equilibrium properties such as detailed balance are presented and the results are compared to experimental data for elementary cross sections. Finally results for pion and proton production in C+C and Au+Au collisions is confronted with HADES and FOPI data. Predictions for particle production in $\pi+A$ collisions are made.Comment: 30 pages, 30 figures, replaced with published version; only minor change

Spectrophotometry of HII Regions, Diffuse Ionized Gas and Supernova Remnants in M31: The Transition from Photo- to Shock-Ionization

We present results of KPNO 4-m optical spectroscopy of discrete emission-line nebulae and regions of diffuse ionized gas (DIG) in M31. Long-slit spectra of 16 positions in the NE half of M31 were obtained over a 5-15 kpc range in radial distance from the center of the galaxy. The spectra have been used to confirm 16 supernova remnant candidates from the Braun & Walterbos (1993) catalog. The slits also covered 46 HII regions which show significant differences among the various morphological types (center-brightened, diffuse, rings). Radial gradients in emission-line ratios such as [OIII]/H$\beta$ and [OII]/[OIII] are observed most prominently in the center-brightened HII regions. These line ratio trends are either much weaker or completely absent in the diffuse and ring nebulae. The line ratio gradients previously seen in M31 SNRs (Blair, Kirshner, & Chevalier 1981; 1982) are well reproduced by our new data. The spectra of center-brightened HII regions and SNRs confirm previous determinations of the radial abundance gradient in M31. We use diagnostic diagrams which separate photoionized gas from shock-ionized gas to compare the spectral properties of HII regions, SNRs and DIG. This analysis strengthens earlier claims (Greenawalt, Walterbos, & Braun 1997) that the DIG in the disk of M31 is photoionized by a dilute radiation field.Comment: 45 pages, 9 figures, 7 tables, to appear in the Astronomical Journal (December 1999

Body composition estimated by bioelectrical impedance analyses is diminished by prenatal stress in neonatal lambs and by heat stress in feedlot wethers

Body composition correlates to carcass value in livestock, which makes the ability to accurately estimate body composition in the live animal beneficial (Berg and Marchello, 1994). Bioelectrical impedance analysis (BIA) is a clinical tool used to assess body composition in humans (Lukaski et al., 1985), but its use in livestock has been minimal. Lean and fat content contribute to profitability for livestock producers, and poor body composition can be caused by stress that occurs either during in utero development (De Blasio et al., 2007) or during postnatal growth (Boyd et al., 2015). Maternal hyperthermia-induced placental insufficiency (Brown et al., 2015) and sustained maternal inflammation (Cadaret et al., 2018) are two established causes of intrauterine growth restriction (IUGR). IUGR-born animals are characterized by asymmetrical growth restriction that alters lifelong body composition due to impaired muscle growth capacity (Yates et al., 2018). In addition, acute heat stress during periods of peak postnatal growth can alter body composition in livestock (Boyd et al., 2015). We postulate that BIA can detect these changes in the live animal. Thus, the objective of this study was to determine whether BIA measurements can predict changes to body composition in live neonatal lambs exposed to intrauterine stress and in heat-stressed feedlot lambs

Response of greater sage-grouse to surface coal mining and habitat conservation in association with the mine

Greater sage-grouse (Centrocercus urophasianus; sage-grouse) is a sagebrushobligate species that has experienced species-wide declines in population density and distribution. Sage-grouse habitats support human-related needs including domestic livestock grazing, urban development, and energy extraction. The U.S. Fish and Wildlife Service identified energy extraction as a range-wide sage-grouse conservation threat. Mining has been of specific concern because of observed sage-grouse population declines and impaired habitat within close proximity to the activity. Mining may be particularly problematic for small, isolated sage-grouse populations. In southwestern Utah, proactive habitat improvements and predator management have been implemented to mitigate the potential effects of surface mining on the southernmost population of sage-grouse in the United States. We evaluated sage-grouse lek attendance trends before (1991–2010) and during (2011–2016) mining on a lek located near the mine (Sink Valley lek) to assess population responses to coal mining and related mitigation activities. Changes in lek trends have been demonstrated as a valid metric to assess the effects of conservation actions on sage-grouse populations. We used a paired t-test to compare differences in male lek attendance before and during mining and analysis of variance to determine if sage-grouse densities and distance to mining changed during the mining period. We recorded bird coordinate location and the number of birds observed at each sighting location along 10 transects within the study site area. Differences in location from mining was tested using Analysis of Variance with α \u3c 0.5. There was no difference in the number of males attending the Sink Valley lek before and during mining. Population cycles were consistent over the time period sampled. With the exception of 2013, which had an unusually high number of sage-grouse found within the Sink Valley area, there were no differences in the number of birds observed at each sighting location in relation to the mine center (P = 0.37), the coal crushing facility (P = 0.34), and the mine boundary (P = 0.24). Coupled with ongoing mitigation activities including habitat restoration, pinyon-juniper (Pinus edulis, Juniperus osteosperma) removal, aggressive predator control, pre-mining acclimation to human influences, and removal of pinyon-juniper woodlands, surface coal mining had no negative effect on population cycles in the Alton/Sink Valley area

Network Cournot Competition

Cournot competition is a fundamental economic model that represents firms competing in a single market of a homogeneous good. Each firm tries to maximize its utility---a function of the production cost as well as market price of the product---by deciding on the amount of production. In today's dynamic and diverse economy, many firms often compete in more than one market simultaneously, i.e., each market might be shared among a subset of these firms. In this situation, a bipartite graph models the access restriction where firms are on one side, markets are on the other side, and edges demonstrate whether a firm has access to a market or not. We call this game \emph{Network Cournot Competition} (NCC). In this paper, we propose algorithms for finding pure Nash equilibria of NCC games in different situations. First, we carefully design a potential function for NCC, when the price functions for markets are linear functions of the production in that market. However, for nonlinear price functions, this approach is not feasible. We model the problem as a nonlinear complementarity problem in this case, and design a polynomial-time algorithm that finds an equilibrium of the game for strongly convex cost functions and strongly monotone revenue functions. We also explore the class of price functions that ensures strong monotonicity of the revenue function, and show it consists of a broad class of functions. Moreover, we discuss the uniqueness of equilibria in both of these cases which means our algorithms find the unique equilibria of the games. Last but not least, when the cost of production in one market is independent from the cost of production in other markets for all firms, the problem can be separated into several independent classical \emph{Cournot Oligopoly} problems. We give the first combinatorial algorithm for this widely studied problem