203 research outputs found

    Sharpening the AZ()hA\to Z^{(*)}h Signature of the Type-II 2HDM at the LHC through Advanced Machine Learning

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    The AZ()hA\to Z^{(*)}h decay signature has been highlighted as possibly being the first testable probe of the Standard Model (SM) Higgs boson discovered in 2012 (hh) interacting with Higgs companion states, such as those existing in a 2-Higgs Doublet Model (2HDM), chiefly, a CP-odd one (AA). The production mechanism of the latter at the Large Hadron Collider (LHC) takes place via bbˉb\bar b-annihilation and/or gggg-fusion, depending on the 2HDM parameters, in turn dictated by the Yukawa structure of this Beyond the SM (BSM) scenario. Among the possible incarnations of the 2HDM, we test here the so-called Type-II, for a twofold reason. On the one hand, it intriguingly offers two very distinct parameter regions compliant with the SM-like Higgs measurements, i.e., where the so-called `SM limit' of the 2HDM can be achieved. On the other hand, in both configurations, the AZhAZh coupling is generally small, hence the signal is strongly polluted by backgrounds, so that the exploitation of Machine Learning (ML) techniques becomes extremely useful. In this paper, we show that the application of advanced ML implementations can be decisive in establishing such a signal. This is true for all distinctive kinematical configurations involving the AZ()hA\to Z^{(*)}h decay, i.e., below threshold (mA<mZ+mhm_A<m_Z+m_h), at its maximum (mZ+mh<mA<2mtm_Z+m_h<m_A<2m_t) and near the onset of ttˉt\bar t pair production (mA2mtm_A \approx 2m_t), for which we propose Benchmark Points (BPs) for future phenomenological analyses.Comment: JHEP accepted version., 33 pages, 15 figures, 2 table

    Studying The Collector Performance Of Updraft Solar Chimney Power Plant

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    In the shadow of increasing energy consumption, renewable energy is the best choicefor a sustainable environment. The solar chimney power plant (SCPP) is a new technology, many researchers are paying their attention to improve its performance. In this study, experimental and numerical studies were used to understand the effect of the collector geometry on the SCPP performance. The SCPP prototype under our investigation is installed in Aswan city, its chimney height is 20m, its diameter is 1 m and the collector is a square which has a side length of 28.5m. Three dimensional CFD simulations were made to calculate the temperature and velocity distribution inside two different shapes of SCPP collector. The conclusion is that the square shaped collector achieved higher output power than the circular collector by 7.6 % at the same surface area exposed to solar radiation

    A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care

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    This is the final version of the article. Available from Taylor & Francis via the DOI in this record.BACKGROUND: Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. OBJECTIVE: To outline a research agenda for patient safety improvement in primary care in Europe and beyond. METHODS: The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. RESULTS: This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. CONCLUSION: Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement.The research leading to these results has received funding from the European Community’s Seventh Framework Programme FP7/2008–2012 under grant agreement no. 223424

    Next steps in dermatology training: choosing to enter higher speciality training and the transition from trainee to consultant dermatologist

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    From Wiley via Jisc Publications RouterHistory: accepted 2020-11-19, pub-electronic 2021-01-17, pub-print 2021-06Article version: VoRPublication status: PublishedSummary: Background: Junior doctors are required to make career decisions at an early stage in their postgraduate training. Trainees also feel inadequately prepared for the transition to consultant roles. Aim: To explore the key factors influencing the choice of dermatology as a postgraduate medical career and to identify the training needs required for transition from trainee to consultant. Methods: An online questionnaire was designed to identify (i) why trainees chose a postgraduate medical career in dermatology, and (ii) the training required for transition from trainee to consultant. Results: In total, 46 responses were received from trainees in their first to final years (ST3–6), of whom 89% had undertaken an undergraduate dermatology placement, with a median duration of 2 weeks. Dermatology was considered as a career during medical school by 61% of trainees, and 41% confirmed their decision to pursue a career in dermatology during foundation training. The most influential factors involved in speciality selection were first, enjoyment of the work, second, postgraduate experience and equal third, the variety of the speciality and the regularity of working hours (P < 0.05). Mentoring was pivotal to career decision‐making. Significant numbers of trainees expressed a need for training in medical leadership, such as running an outpatient clinic and supervising clinical multidisciplinary teams. Although larger numbers of trainees had training in management of dermatology services, such as service improvement (52%) and local governance/National Health Service structures (43%), significant numbers of trainees had no training in writing job plans (89%) or business plans (85%). Training was significantly deficient for personal management and self‐awareness. Conclusion: Our study highlights important considerations in career decision‐making for trainees. Training in medical leadership, management and self‐awareness could be enhanced to ensure that trainees feel adequately equipped for consultant roles

    Motivations for consulting complementary and alternative medicine practitioners: A comparison of consumers from 1997–8 and 2005

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    Background: Use of complementary and alternative medicine (CAM), and especially CAM practitioners, has continued to rise in recent years. Although several motivators of CAM use have been identified, little is known about how and if the motivations for using CAM have changed over time. The purpose of the current study was to compare the reasons for consulting CAM practitioners in consumers in 1997–8 and eight years later in 2005. Methods: Surveys were displayed in CAM and conventional medicine offices and clinics in Ontario, Canada in 1997–8 and again in 2005, and self-selected participants returned the surveys by mail. Results: In 1997–8, 141 CAM consumers were identified from the 199 surveys returned, and 185 CAM consumers were identified from the 239 surveys returned in 2005. Five of the six CAM motivations were more likely to be endorsed by the 2005 CAM consumers compared to the 1997– 8 CAM consumers (all p's < .0001). In 1997–8 the two top reasons for using CAM were that CAM allowed them to take an active role in their health (51.8%), and because conventional medicine was ineffective for their health problem (41.8%). In 2005, the treatment of the whole person (78.3%) was the top reason for using CAM followed by taking an active role in one's health (76.5%). The 2005 consumers were less educated, had slightly more chronic health complaints, had been using CAM for longer, and were more likely to consult chiropractors, reflexologists, and therapeutic touch practitioners than the 1997–8 consumers. Otherwise, the socio-demographic and health profiles of the two groups of CAM consumers were similar, as was their use of CAM. Conclusion: Compared to consumers in 1997–8, consumers in 2005 were more likely to endorse five of the six motivations for consulting CAM practitioners. A shift towards motivations focusing more on the positive aspects of CAM and less on the negative aspects of conventional medicine was also noted for the 2005 consumers. Findings suggest that CAM motivations may shift over time as public knowledge of and experience with CAM also changes

    Predicting fitness to practise events in international medical graduates who registered as UK doctors via the Professional and Linguistic Assessments Board (PLAB) system: a national cohort study

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    Background International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council’s (GMC’s) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to predict later educational performance in this group of doctors. It is unknown whether the PLAB system is also a valid predictor of unprofessional behaviour and malpractice. The findings would have implications for regulatory policy. Methods This was an observational study linking data relating to fitness to practise events (referral or censure), PLAB performance, demographic variables and English language competence, as evaluated via the International English Language Test System (IELTS). Data from 27,330 international medical graduates registered with the GMC were analysed, including 210 doctors who had been sanctioned in relation to at least one fitness to practise issue. The main outcome was risk of eventual censure (including a warning). Results The significant univariable educational predictors of eventual censure (versus no censures or referrals) were lower PLAB part 1 (hazard ratio [HR], 0.99; 95% confidence interval, 0.98 to 1.00) and part 2 scores (HR, 0.94; 0.91 to 0.97) at first sitting, multiple attempts at both parts of the PLAB, lower IELTS reading (HR, 0.79; 0.65 to 0.94) and listening scores (HR, 0.76; 0.62 to 0.93) and higher IELTS speaking scores (HR, 1.28; 1.04 to 1.57). Multiple resits at either part of the PLAB and higher IELTS speaking score (HR, 1.49; 1.20 to 1.84) were also independent predictors of censure. We estimated that the proposed limit of four attempts at both parts of the PLAB would reduce the risk in this entire group by only approximately two censures per 5 years in this group of doctors. Conclusions Making the PLAB, or any replacement assessment, more stringent and raising the required standards of English reading and listening may result in fewer fitness to practice events in international medical graduates. However, the number of PLAB resits permitted would have to be further capped to meaningfully impact the risk of sanctions in this group of doctor

    A New Human Somatic Stem Cell from Placental Cord Blood with Intrinsic Pluripotent Differentiation Potential

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    Here a new, intrinsically pluripotent, CD45-negative population from human cord blood, termed unrestricted somatic stem cells (USSCs) is described. This rare population grows adherently and can be expanded to 1015 cells without losing pluripotency. In vitro USSCs showed homogeneous differentiation into osteoblasts, chondroblasts, adipocytes, and hematopoietic and neural cells including astrocytes and neurons that express neurofilament, sodium channel protein, and various neurotransmitter phenotypes. Stereotactic implantation of USSCs into intact adult rat brain revealed that human Tau-positive cells persisted for up to 3 mo and showed migratory activity and a typical neuron-like morphology. In vivo differentiation of USSCs along mesodermal and endodermal pathways was demonstrated in animal models. Bony reconstitution was observed after transplantation of USSC-loaded calcium phosphate cylinders in nude rat femurs. Chondrogenesis occurred after transplanting cell-loaded gelfoam sponges into nude mice. Transplantation of USSCs in a noninjury model, the preimmune fetal sheep, resulted in up to 5% human hematopoietic engraftment. More than 20% albumin-producing human parenchymal hepatic cells with absence of cell fusion and substantial numbers of human cardiomyocytes in both atria and ventricles of the sheep heart were detected many months after USSC transplantation. No tumor formation was observed in any of these animals

    Global Research Priorities to Better Understand the Burden of Iatrogenic Harm in Primary Care: An International Delphi Exercise

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    There is a need to identify and reach agreement on key foci for patient safety research in primary care contexts and understand how these priorities differ between low-, middle-, and high-income settings. We conducted a modified Delphi exercise, which was distributed to an international panel of experts in patient safety and primary care. Family practice and pharmacy were considered the main contexts on which to focus attention in order to advance patient safety in primary care across all income categories. Other clinical contexts prioritised included community midwifery and nursing in low-income countries and care homes in high-income countries. The sources of patient safety incidents requiring further study across all economic settings that were identified were communication between health care professionals and with patients, teamwork within the health care team, laboratory and diagnostic imaging investigations, issues relating to data management, transitions between different care settings, and chart/patient record com- pleteness. This work lays the foundation for a range of research initiatives that aim to promote a more comprehensive appreciation of the burden of unsafe primary care, develop understanding of the main areas of risk, and identify interventions that can enhance the safety of primary care provision internationall
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