A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design

Fermion Pair Production From an Electric Field Varying in Two Dimensions

The Hamiltonian describing fermion pair production from an arbitrarily time-varying electric field in two dimensions is studied using a group-theoretic approach. We show that this Hamiltonian can be encompassed by two, commuting SU(2) algebras, and that the two-dimensional problem can therefore be reduced to two one-dimensional problems. We compare the group structure for the two-dimensional problem with that previously derived for the one-dimensional problem, and verify that the Schwinger result is obtained under the appropriate conditions.Comment: Latex, 14 pages of text. Full postscript version available via the worldwide web at http://nucth.physics.wisc.edu/ or by anonymous ftp from ftp://nucth.physics.wisc.edu:/pub/preprints

A Multi-Site Survey Study of Patient Satisfaction with Teledermatology

Introduction. Telemedicine has been of heightened focus due to spikes in usage during the COVID-19 pandemic. Disparities in health care may affect patient satisfaction with this resource depending on factors such as patient race, age, or socioeconomic background. The purpose of this study was to analyze patient satisfaction with teledermatology to identify any differences in satisfaction based on race, age, and income during the COVID-19 pandemic period. Methods. A 21-question, IRB-approved survey was administered to patients at two academic dermatology clinics in Kansas City. Patient satisfaction was measured using a five-point Likert scale. Results. A total of 64 completed surveys were analyzed (17.8% response rate). Most of the participants were female (n = 48, 75%), age 45 to 60 (n = 17, 26.6%), and reported White for race (n = 55, 85.9%). Overall, 73.4% (n = 47) of patients reported being satisfied with their visit. However, only 38.7% (n = 24) of participants were likely to choose a video over an in-person visit. Reasons for low patient satisfaction included concerns regarding ability to perform an accurate physical exam with a video visit (n = 9, 14.1%), receiving inadequate care (n = 4, 6.3%), protected privacy (n = 3, 4.7%), and provider understanding the patient (n = 2, 3.1%). Conclusions. Our findings were similar to prior studies stating no difference in patient satisfaction with regards to age, income, or race and patients reporting high satisfaction with teledermatology appointments despite a preference for in-person dermatology visits. Future studies with a larger diverse cohort of participants are needed to elucidate and address possible disparities associated with teledermatology use

The Physics of Ultraperipheral Collisions at the LHC

We discuss the physics of large impact parameter interactions at the LHC: ultraperipheral collisions (UPCs). The dominant processes in UPCs are photon-nucleon (nucleus) interactions. The current LHC detector configurations can explore small $x$ hard phenomena with nuclei and nucleons at photon-nucleon center-of-mass energies above 1 TeV, extending the $x$ range of HERA by a factor of ten. In particular, it will be possible to probe diffractive and inclusive parton densities in nuclei using several processes. The interaction of small dipoles with protons and nuclei can be investigated in elastic and quasi-elastic $J/\psi$ and $\Upsilon$ production as well as in high $t$ $\rho^0$ production accompanied by a rapidity gap. Several of these phenomena provide clean signatures of the onset of the new high gluon density QCD regime. The LHC is in the kinematic range where nonlinear effects are several times larger than at HERA. Two-photon processes in UPCs are also studied. In addition, while UPCs play a role in limiting the maximum beam luminosity, they can also be used a luminosity monitor by measuring mutual electromagnetic dissociation of the beam nuclei. We also review similar studies at HERA and RHIC as well as describe the potential use of the LHC detectors for UPC measurements.Comment: 229 Pages, 121 figure

Regulatory control and the costs and benefits of biochemical noise

Experiments in recent years have vividly demonstrated that gene expression can be highly stochastic. How protein concentration fluctuations affect the growth rate of a population of cells, is, however, a wide open question. We present a mathematical model that makes it possible to quantify the effect of protein concentration fluctuations on the growth rate of a population of genetically identical cells. The model predicts that the population's growth rate depends on how the growth rate of a single cell varies with protein concentration, the variance of the protein concentration fluctuations, and the correlation time of these fluctuations. The model also predicts that when the average concentration of a protein is close to the value that maximizes the growth rate, fluctuations in its concentration always reduce the growth rate. However, when the average protein concentration deviates sufficiently from the optimal level, fluctuations can enhance the growth rate of the population, even when the growth rate of a cell depends linearly on the protein concentration. The model also shows that the ensemble or population average of a quantity, such as the average protein expression level or its variance, is in general not equal to its time average as obtained from tracing a single cell and its descendants. We apply our model to perform a cost-benefit analysis of gene regulatory control. Our analysis predicts that the optimal expression level of a gene regulatory protein is determined by the trade-off between the cost of synthesizing the regulatory protein and the benefit of minimizing the fluctuations in the expression of its target gene. We discuss possible experiments that could test our predictions.Comment: Revised manuscript;35 pages, 4 figures, REVTeX4; to appear in PLoS Computational Biolog

Specific emotions as mediators of the effect of intergroup contact on prejudice: findings across multiple participant and target groups

Emotions are increasingly being recognised as important aspects of prejudice and intergroup behaviour. Specifically, emotional mediators play a key role in the process by which intergroup contact reduces prejudice towards outgroups. However, which particular emotions are most important for prejudice reduction, as well as the consistency and generality of emotion–prejudice relations across different in-group–out-group relations, remain uncertain. To address these issues, in Study 1 we examined six distinct positive and negative emotions as mediators of the contact–prejudice relations using representative samples of U.S. White, Black, and Asian American respondents (N = 639). Admiration and anger (but not other emotions) were significant mediators of the effects of previous contact on prejudice, consistently across different perceiver and target ethnic groups. Study 2 examined the same relations with student participants and gay men as the out-group. Admiration and disgust mediated the effect of past contact on attitude. The findings confirm that not only negative emotions (anger or disgust, based on the specific types of threat perceived to be posed by an out-group), but also positive, status- and esteem-related emotions (admiration) mediate effects of contact on prejudice, robustly across several different respondent and target groups

Fatty acids and stable isotopes (13C, 15N) in southern right whale Eubalaena australis calves in relation toage and mortality at Peninsula Valdes, Argentina

Baleen whales accumulate fat reserves during the summer to sustain reproduction while fasting in the winter. The southern right whale Eubalaena australis population that calves off Península Valdés, Argentina, experienced high calf mortality events from 2003 to 2013 and poor nutritional states of mothers could be a contributing cause. Previous studies found that the population’s reproductive success is influenced by prey availability. Mothers unable to build sufficient fat reserves or feeding on prey with different nutritional value may fail to meet the demands of lactation. Milk is the only source of nutrients and energy for calves at Valdés, so their fatty acids (FAs) and stable isotopes should reflect their mother’s diet and feeding-ground locations. Here, we compared FA profiles and C and N stable isotopes of dead calves with those of living calves to evaluate the potential impact of maternal nutrition on calf survival. We found no differences in the FA composition of blubber in dead and living calves, indicating similar maternal diets. Likewise, the isotopic values of living and dead calves imply that their mothers had similar foraging ranges. However, FA composition was greatly affected by calf length, indicating effects of calf age and duration of nursing. These findings suggest that mothers of dead calves did not feed on different diets or feeding grounds compared to mothers of living calves. Future research should further assess the overall health and body condition of the Valdés southern right whale calves.Fil: Marón, Carina Flavia. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Diversidad Biológica y Ecológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Conservación de Ballenas; ArgentinaFil: Budge, Suzanne M.. Dalhousie University Halifax; CanadáFil: Ward, Robert E.. Utah State University; Estados UnidosFil: Valenzuela, Luciano Oscar. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Sociales. Departamento de Arqueología. Laboratorio de Ecología Evolutiva Humana (Sede Quequén); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil; ArgentinaFil: Di Martino, Matías. Programa de Monitoreo Sanitario Ballena Franca Austral; ArgentinaFil: Ricciardi, Marcos. Instituto de Conservación de Ballenas; ArgentinaFil: Sironi, Mariano. Instituto de Conservación de Ballenas; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Diversidad Biológica y Ecológica; Argentina. Programa de Monitoreo Sanitario Ballena Franca Austral; ArgentinaFil: Uhart, Marcela. Programa de Monitoreo Sanitario Ballena Franca Austral; Argentina. University of California; Estados UnidosFil: Seger, Jon. University Of Utah. Department Of Biology; Estados UnidosFil: Rowntree, Victoria J.. University Of Utah. Department Of Biology; Estados Unidos. Instituto de Conservación de Ballenas; Argentina. Programa de Monitoreo Sanitario Ballena Franca Austral; Argentina. Whale Conservation Institute/Ocean Alliance; Estados Unido

The Value of Information for Populations in Varying Environments

The notion of information pervades informal descriptions of biological systems, but formal treatments face the problem of defining a quantitative measure of information rooted in a concept of fitness, which is itself an elusive notion. Here, we present a model of population dynamics where this problem is amenable to a mathematical analysis. In the limit where any information about future environmental variations is common to the members of the population, our model is equivalent to known models of financial investment. In this case, the population can be interpreted as a portfolio of financial assets and previous analyses have shown that a key quantity of Shannon's communication theory, the mutual information, sets a fundamental limit on the value of information. We show that this bound can be violated when accounting for features that are irrelevant in finance but inherent to biological systems, such as the stochasticity present at the individual level. This leads us to generalize the measures of uncertainty and information usually encountered in information theory