A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

A comparison of a multistate inpatient EHR database to the HCUP Nationwide Inpatient Sample

Background The growing availability of electronic health records (EHRs) in the US could provide researchers with a more detailed and clinically relevant alternative to using claims-based data. Methods In this study we compared a very large EHR database (Health Facts©) to a well-established population estimate (Nationwide Inpatient Sample). Weighted comparisons were made using t-value and relative difference over diagnoses and procedures for the year 2010. Results The two databases have a similar distribution pattern across all data elements, with 24 of 50 data elements being statistically similar between the two data sources. In general, differences that were found are consistent across diagnosis and procedures categories and were specific to the psychiatric–behavioral and obstetrics–gynecology services areas. Conclusions Large EHR databases have the potential to be a useful addition to health services researchers, although they require different analytic techniques compared to administrative databases; more research is needed to understand the differences

Cooperative Federalism: Nevada’s Indigent Defense Crisis and the Role of Federal Courts in Protecting the Right to Counsel in Non-Capital Cases

In Martinez v. Ryan, the United States Supreme Court held the ineffective assistance of post-conviction counsel, or the lack of representation in a state post-conviction proceeding, provides cause to allow a federal habeas petitioner to overcome a procedural default on an ineffective assistance of trial counsel claim. This represented a radical shift in the criminal justice system. Prior to Martinez, state post-conviction proceedings—the typical mechanism for a criminal defendant to challenge the performance of his trial attorney—were not heavily scrutinized. It was understood and accepted that defendants did not have the right to counsel in these post-conviction proceedings. Whether a defendant represented himself in the state post-conviction proceedings or had counsel to assist him, federal review was strictly limited to those claims raised in that proceeding, regardless of how well they were investigated or presented. However, Martinez has now altered that calculus and, in doing so, shined a bright spotlight on whether these state post-convictions proceedings adequately protect a defendant’s right to the effective assistance of counsel. The Supreme Court explained why this is so important: “[T]he right to the effective assistance of counsel at trial is a bedrock principle in our justice system . . . . Indeed, the right to counsel is the foundation for our adversary system.” In light of Martinez, a criminal defendant now has a broader mechanism for protecting this fundamental constitutional right. A defendant can raise new challenges to his attorney’s performance in a federal habeas proceeding and argue that what occurred in the state post-conviction proceedings was inadequate. Martinez’s impact in non-capital cases in Nevada could be quite significant. The need for vigorous post-conviction review in Nevada is hard to deny. There have been systematic problems in the indigent defense system that continue to this day. Despite these nearly intractable issues, the Nevada Supreme Court refused to extend Martinez to its own state post-conviction process. Rather, the court chose to elevate the concept of finality of the conviction over rigorous protection of this invaluable constitutional right. It is this cramped vision of post-conviction review that Martinez was clearly meant to address

Local Change Point Detection and Signal Cleaning using EEMD with applications to Acoustic Shockwaves

The Ensemble Empirical Mode Decomposition (EEMD) has become a preferred technique to decompose nonlinear and non-stationary signals due to its ability to create time-varying basis functions. However, current EEMD signal cleaning techniques are unable to deal with situations where a signal only occurs for a portion of the entire recording length. By combining change point detection and statistical hypothesis testing, we demonstrate how to clean a signal to emphasize unique local changes within each basis function. This not only allows us to observe which frequency bands are undergoing a change, but also leads to improved recovery of the underlying information. Using this technique, we demonstrate improved signal cleaning performance for acoustic shockwave signal detection. The technique is implemented in R via the LCDSC package

The Trilogy of Personal Jurisdiction and the Importance of \u3cem\u3eFord\u3c/em\u3e

Litigants and judges alike have struggled to understand and resolve the parameters of personal jurisdiction, particularly in product liability cases. This results in significant costs and time which is likely to be of little benefit to anyone. Much of this confusion arises from two problems: (1) most of the early Supreme Court decisions on personal jurisdiction arose from contractual disputes; and (2) when the economy expanded after World War II, and new automobiles, commercial aircraft, appliances, and other complex products appeared, the Court’s attempts to resolve personal jurisdiction issues were unsuccessful. For over three decades, the Supreme Court failed to produce a clear majority opinion, while at the same time, these cases were becoming more common and complex. In the past decade, however, the Court has quietly produced a trilogy of virtually unanimous opinions that offer pathways to resolve personal jurisdiction disputes. These decisions will be particularly useful in product liability cases of all kinds, which often involve suit-related events occurring across multiple jurisdictions. Once lawyers and judges understand this clarified framework, it should become easier for plaintiffs to make better decisions about where to bring their case and enable both plaintiffs and defendants to spend less time and expense litigating personal jurisdiction disputes

Optical nanofiber fabrication and analysis towards coupling atoms to superconducting qubits

We describe advancements towards coupling superconducting qubits to neutral atoms. To produce a measurably large coupling, the atoms will need to be on the order of a few micrometers away from the qubit. A consequence of combining superconducting qubits and atoms is addressing their operational constraints, such as the deleterious light effects on superconducting systems and the magnetic field sensitivity of superconducting qubits. Our group proposes the use of optical-nanofiber-based optical dipole traps to confine atoms near the superconductor. Optical nanofibers (ONFs) have high-intensity evanescent waves that require less power than equivalent standard dipole traps. This thesis focuses on the fabrication and analysis of the behavior of ONFs. First we present the construction of the pulling apparatus. We outline the necessary steps for a typical pull, detailing the cleaning and alignment process. Then we examine the quality of the fibers by measuring their transmission and comparing our results to other reported measurements, demonstrating a two-order of magnitude decrease in loss. Next we present the modal evolution in ONFs using simulations and spectrogram analysis. We identify crucial elements to improve the transmission and demonstrate understanding of the modal dynamics during the pull. Then we study higher-order modes (HOMs) with ONFs using the first excited TE01, TM01, and HE21 modes. We demonstrate transmissions greater than 97% for 780 nm light when we launch the first excited LP11 family of modes through fibers with a 350 nm waist. This setup enables us to launch these three modes with high purity at the output, where less than 1% of the light is coupled to the fundamental mode. We then focus on the identification of modes on the ONF waist. First we use Rayleigh scattering to identify the modal content of an ONF. Bulk optics can convert the modes in the ONF, and we observe the controllable conversion of superpositions of modes. Finally, we use an evanescently-coupled tapered optical fiber probe that allows for the identification of the fundamental mode beating with HOMs and compare the results to simulations