Rapid repetitive administration of short-acting β-agonists (SABA) is the most effective means of reducing acute airflow obstruction in asthma. Little evidence exists that assesses process measures ...(ie, timeliness) and outcomes for asthma. We used quality improvement (QI) methods to improve emergency department care in accordance with national guidelines including timely SABA administration and use of asthma severity scores.
The Model for Improvement was used and interventions were targeted at 4 key drivers: knowledge, engagement, decision support, and workflow enhancement. Time series analysis was performed and outcomes assessed on statistical process control charts.
Asthma severity scoring increased from 0% to >95% in triage and to >75% for repeat scores. Time to first SABA (T1) improved by 32.8 minutes (47%). T1 for low severity patients improved by 17.6 minutes (28%). T1 for high severity patients improved by 3.1 minutes to 18.1 minutes (15%). Time to third SABA (T3) improved by 30 minutes (24%). T3 for low severity patients improved by 42.5 minutes (29%) and T3 for high severity patients improved by 21 minutes (23%). Emergency department length of stay for low severity patients discharged to home improved by 29.3 minutes (15%). The number of asthma-related visits between 48-hour return hospitalizations increased from 114 to 261. The admission rate decreased 6.0%.
We implemented standardized asthma severity scoring with high rates of compliance, improved timely administration of β-agonist treatments, demonstrated early improvements in Emergency department length of stay, and reduced admission rates without increasing unplanned return admissions.
This paper presents a radical critique of the Tobin tax—a tax on currency transactions—by undercutting certain assumptions about the size and character of the world's foreign exchange markets which ...furnish the tax with its basic rationale. While it is acknowledged that only a fraction of the massive volumes of FX transactions relate directly to trade in goods and services or to cross border investments, it is denied that all the residual transactions are motivated purely by exchange rate considerations (speculative or hedging activities). Rather, the argument is that a significant proportion of FX trades have money market characteristics and that these trades, together with domestic money market transactions, play an important role in the day to day operation of the global financial system. This perspective is used to show that the imposition of a Tobin tax would cause extensive material damage to the system, with consequences that may run counter to the expectations of supporters of the tax.
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We describe a parameter-free estimation-of-distribution algorithm (EDA) called the adapted maximum-likelihood Gaussian model iterated density-estimation evolutionary algorithm (AMaLGaM-ID
A, or ...AMaLGaM for short) for numerical optimization. AMaLGaM is benchmarked within the 2009 black box optimization benchmarking (BBOB) framework and compared to a variant with incremental model building (iAMaLGaM). We study the implications of factorizing the covariance matrix in the Gaussian distribution, to use only a few or no covariances. Further, AMaLGaM and iAMaLGaM are also evaluated on the noisy BBOB problems and we assess how well multiple evaluations per solution can average out noise. Experimental evidence suggests that parameter-free AMaLGaM can solve a wide range of problems efficiently with perceived polynomial scalability, including multimodal problems, obtaining the best or near-best results among all algorithms tested in 2009 on functions such as the step-ellipsoid and Katsuuras, but failing to locate the optimum within the time limit on skew Rastrigin-Bueche separable and Lunacek bi-Rastrigin in higher dimensions. AMaLGaM is found to be more robust to noise than iAMaLGaM due to the larger required population size. Using few or no covariances hinders the EDA from dealing with rotations of the search space. Finally, the use of noise averaging is found to be less efficient than the direct application of the EDA unless the noise is uniformly distributed. AMaLGaM was among the best performing algorithms submitted to the BBOB workshop in 2009.
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This book constitutes the refereed proceedings of the International Conference on the Applications of Evolutionary Computation, EvoApplications 2011, held in Torino, Italy, in April 2011 colocated ...with the Evo* 2011 events. Thanks to the large number of submissions received, the proceedings for EvoApplications 2011 are divided across two volumes (LNCS 6624 and 6625). The present volume contains contributions for EvoCOMNET, EvoFIN, EvoIHOT, EvoMUSART, EvoSTIM, and EvoTRANSLOC. The 51 revised full papers presented were carefully reviewed and selected from numerous submissions. This volume presents an overview about the latest research in EC. Areas where evolutionary computation techniques have been applied range from telecommunication networks to complex systems, finance and economics, games, image analysis, evolutionary music and art, parameter optimization, scheduling, and logistics. These papers may provide guidelines to help new researchers tackling their own problem using EC.
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It is widely recognised that the institutional architecture housing monetary union in Europe is deeply flawed. Although there has been considerable discussion about how these shortcomings can be put ...right, relatively little has been said about the role EU social policy can play in making the eurozone more stable and sustainable. The purpose of this paper is to address this shortcoming. It is argued that that some form of EU 'social union' is urgent, for without it the immediate financial problems facing the members of the eurozone cannot be resolved. The paper seeks to explain what role EU social policies can play in the construction of an adequate federal framework for the monetary union. It is argued that a fully fledged social union is unlikely to emerge that involves massive transfers from the European core to the periphery. At the same time, it is envisaged that EU social policy will need to be strengthened considerably, with interventions focusing on employment creation and on the capacity of national governments to maintain domestic social safety nets.
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7.
Radiation hard avalanche photodiodes for CMS ECAL Grahl, J.; Kronquist, I.; Rusack, R. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
05/2003, Volume:
504, Issue:
1-3
Journal Article
Peer reviewed
The photo detectors of the CMS electromagnetic calorimeter have to operate in a rather hostile environment, in a strong magnetic field of 4T and under unprecedented radiation levels. Avalanche Photo ...Diodes (APDs) have been chosen to detect the scintillation light of the 62,000 lead tungstate crystals in the barrel part of the calorimeter. After a 6 year long R&D work Hamamatsu Photonics produces APDs with a structure that is basically radiation hard. Only a few percent of the delivered APDs are weak due to defects at the surface caused by dust particles in the production process. Since a reliability of 99.9% is required, a method to detect weak APDs before they are built into the detector had to be developed. The described screening method is a combination of 60Co irradiations and annealing under bias of all APDs and irradiations with hadrons on a sampling basis.
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8.
Hamamatsu APD for CMS ECAL: quality insurance Bailleux, D.; Britvitch, I.; Deiters, K. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
02/2004, Volume:
518, Issue:
1
Journal Article
Peer reviewed
The Hamamatsu Photonics S8148 large area Avalanche Photo Diodes (APD) were designed for the crystal electromagnetic calorimeter of the CMS setup at LHC in a close collaboration of Hamamatsu Photonics ...and CMS APD group (PSI, Northeastern University and University of Minnesota). All essential parameters of these devices are controlled by the producer and are fairly stable during the mass production, except the radiation hardness. To insure 99.9% reliability of APDs in the radiation hard environment of LHC, the CMS APD group had to invent a dedicated screening procedure. The details of this procedure and some results of the screening are discussed.
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The misfortunes of the euro as a portent of US pressures to come. Can stakeholder variants of capitalism in east Asia or Europe resist the rise to global dominance of Anglo-American shareholder ...value? Grahl argues that 'exit' trumps 'voice' - disembedded forms of corporate finance are inherently more capable of spreading uniformly round the world than embedded ones, which remain particular to local settings. (Original abstract)
The integration of financial markets is at present a central policy objective of the EU. The actual policy priorities of the EU in this context have been to accelerate integration and to reduce ...transactions costs in financial markets. The present paper starts from the view that the minimisation of transactions costs is too narrow an objective in the sphere of financial policy. It seeks to specify other objectives, which should be pursued in the course of financial integration. These objectives include
stability,
consumer protection and the assertion of
the public interest in the financial sector. The paper then links the process of financial integration with other problems in European policy: taxation and the threat of tax competition, changes in corporate governance and pressures on social protection. It is argued that policies for financial integration should be formulated with these connections to other policy fields in mind.
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