First star formation with dark matter annihilation

We include an energy term based on Dark Matter (DM) self-annihilation during the cooling and subsequent collapse of the metal-free gas, in halos hosting the formation of the first stars in the Universe. We have found that the feedback induced on the chemistry of the cloud does modify the properties of the gas throughout the collapse. However, the modifications are not dramatic, and the typical Jeans mass within the halo is conserved throughout the collapse, for all the DM parameters we have considered. This result implies that the presence of Dark Matter annihilations does not substantially modify the Initial Mass Function of the First Stars, with respect to the standard case in which such additional energy term is not taken into account. We have also found that when the rate of energy produced by the DM annihilations and absorbed by the gas equals the chemical cooling (at densities yet far from the actual formation of a proto-stellar core) the structure does not halt its collapse, although that proceeds more slowly by a factor smaller than few per cent of the total collapse time.Comment: 12 pages, 8 figures, 3 tables; replaced with published version after minor change

Echinacea purpurea Significantly Induces Cytochrome P450 3A Activity but Does Not Alter Lopinavir‐Ritonavir Exposure in Healthy Subjects

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90291/1/phco.30.8.797.pd

Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records

<p>Abstract</p> <p>Background</p> <p>We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the clinical knowledge management features, functions, tools, and techniques required to deliver and maintain the clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria.</p> <p>Methods</p> <p>We developed and fielded a 17-question survey to representatives from nine commercially available EHR vendors and four leading internally developed EHRs. The first part of the survey asked basic questions about the vendor's EHR. The second part asked specifically about the CDS-related system tools and capabilities that each vendor provides. The final section asked about clinical content.</p> <p>Results</p> <p>All of the vendors and institutions have multiple modules capable of providing clinical decision support interventions to clinicians. The majority of the systems were capable of performing almost all of the key knowledge management functions we identified.</p> <p>Conclusion</p> <p>If these well-designed commercially-available systems are coupled with the other key socio-technical concepts required for safe and effective EHR implementation and use, and organizations have access to implementable clinical knowledge, we expect that the transformation of the healthcare enterprise that so many have predicted, is achievable using commercially-available, state-of-the-art EHRs.</p

Impact of baryon physics on dark matter structures: a detailed simulation study of halo density profiles

The back-reaction of baryons on the dark matter halo density profile is of great interest, not least because it is an important systematic uncertainty when attempting to detect the dark matter. Here, we draw on a large suite of high resolution cosmological hydrodynamical simulations, to systematically investigate this process and its dependence on the baryonic physics associated with galaxy formation. The inclusion of baryons results in significantly more concentrated density profiles if radiative cooling is efficient and feedback is weak. The dark matter halo concentration can in that case increase by as much as 30 (10) per cent on galaxy (cluster) scales. The most significant effects occur in galaxies at high redshift, where there is a strong anti-correlation between the baryon fraction in the halo centre and the inner slope of both the total and the dark matter density profiles. If feedback is weak, isothermal inner profiles form, in agreement with observations of massive, early-type galaxies. However, we find that AGN feedback, or extremely efficient feedback from massive stars, is necessary to match observed stellar fractions in groups and clusters, as well as to keep the maximum circular velocity similar to the virial velocity as observed for disk galaxies. These strong feedback models reduce the baryon fraction in galaxies by a factor of 3 relative to the case with no feedback. The AGN is even capable of reducing the baryon fraction by a factor of 2 in the inner region of group and cluster haloes. This in turn results in inner density profiles which are typically shallower than isothermal and the halo concentrations tend to be lower than in the absence of baryons.Comment: 20 pages, 14 figures, 1 table. MNRAS in press. Version 2: added a few references

Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey

<p>Abstract</p> <p>Background</p> <p>Commercial sources of information are known to have greater influence than scientific sources on general practitioners' (GPs) prescribing behavior in under developed and developing countries. The study aimed to determine the self-reported impact of pharmaceutical promotion on the decision-making process of prescription of GPs in Eastern Turkey.</p> <p>Methods</p> <p>A cross-sectional, exploratory survey was performed among 152 GPs working in the primary health centers and hospitals in Erzurum province of Eastern Turkey in 2006. A self-administered structured questionnaire was used. The questionnaire included questions regarding sociodemographics, number of patients per day, time per patient, frequency of sales representative visits to GPs, participation of GPs in training courses on prescribing (in-service training, drug companies), factors affecting prescribing decision, reference sources concerning prescribing and self-reported and self-rated effect of the activities of sales representatives on GPs prescribing decisions.</p> <p>Results</p> <p>Of 152 subjects, 53.3% were male and 65.8% were working at primary health care centers, respectively. Mean patient per day was 58.3 ± 28.8 patients per GP. For majority of the GPs (73.7%), the most frequent resource used in case of any problems in prescribing process was drug guides of pharmaceutical companies. According to self-report of the GPs, their prescribing decisions were affected by participation in any training activity of drug companies, frequent visits by sales representatives, high number of patient examinations per day and low year of practice (p < 0.05 for all).</p> <p>Conclusion</p> <p>The results of this study suggest that for the majority of the GPs, primary reference sources concerning prescribing was commercial information provided by sales representatives of pharmaceutical companies, which were reported to be highly influential on their decision-making process of prescribing by GPs. Since this study was based on self-report, the influence reported by the GPs may have been underestimated.</p

Improved limits on dark matter annihilation in the Sun with the 79-string IceCube detector and implications for supersymmetry

We present an improved event-level likelihood formalism for including neutrino telescope data in global fits to new physics. We derive limits on spin-dependent dark matter-proton scattering by employing the new formalism in a re-analysis of data from the 79-string IceCube search for dark matter annihilation in the Sun, including explicit energy information for each event. The new analysis excludes a number of models in the weak-scale minimal supersymmetric standard model (MSSM) for the first time. This work is accompanied by the public release of the 79-string IceCube data, as well as an associated computer code for applying the new likelihood to arbitrary dark matter models.Comment: 24 pages, 8 figs, 1 table. Contact authors: Pat Scott & Matthias Danninger. Likelihood tool available at http://nulike.hepforge.org. v2: small updates to address JCAP referee repor

Impact of Provider Incentives on Quality and Value of Health Care

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value- Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates

The Standard Cosmological Model

The Standard Model of Particle Physics (SMPP) is an enormously successful description of high energy physics, driving ever more precise measurements to find "physics beyond the standard model", as well as providing motivation for developing more fundamental ideas that might explain the values of its parameters. Simultaneously, a description of the entire 3-dimensional structure of the present-day Universe is being built up painstakingly. Most of the structure is stochastic in nature, being merely the result of the particular realisation of the "initial conditions" within our observable Universe patch. However, governing this structure is the Standard Model of Cosmology (SMC), which appears to require only about a dozen parameters. Cosmologists are now determining the values of these quantities with increasing precision in order to search for "physics beyond the standard model", as well as trying to develop an understanding of the more fundamental ideas which might explain the values of its parameters. Although it is natural to see analogies between the two Standard Models, some intrinsic differences also exist, which are discussed here. Nevertheless, a truly fundamental theory will have to explain both the SMPP and SMC, and this must include an appreciation of which elements are deterministic and which are accidental. Considering different levels of stochasticity within cosmology may make it easier to accept that physical parameters in general might have a non-deterministic aspect.Comment: 16 pages, 2 figures, invited talk at "Theory Canada 1", June 2005, Vancouve

Caregiver-assisted coping skills training for patients with COPD: background, design, and methodological issues for the INSPIRE-II study

Chronic Obstructive Pulmonary Disease (COPD) is a progressive illness characterized by airflow obstruction and dyspnea that afflicts over 12 million people and represents a leading cause of death in the United States. Not surprisingly, COPD is often associated with emotional distress and reduced psychosocial adjustment, which can negatively impact physical functioning and impair quality of life. However, the psychosocial consequences of COPD remain largely untreated. A previous randomized trial from our research team demonstrated that coping skills training (CST) can improve pulmonary-specific quality of life among pulmonary patients awaiting lung transplant (the INSPIRE study). To date, however, no studies have examined the effects of a caregiver-assisted CST intervention in patients with COPD with less severe disease