The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This ...Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
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CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
CONTEXT Lower respiratory tract infection (LRI) is a leading cause of mortality
and hospitalization in nursing home residents. Treatment decisions may be
aided by a clinical prediction rule that ...identifies residents at low and high
risk of mortality. OBJECTIVE To identify patient characteristics predictive of 30-day mortality in
nursing home residents with an LRI. DESIGN, SETTING, AND PATIENTS Prospective cohort study of 1406 episodes of LRI in 1044 residents of
36 nursing homes in central Missouri and the St Louis, Mo, area between August
15, 1995, and September 30, 1998. MAIN OUTCOME MEASURE Thirty-day all-cause mortality. RESULTS Thirty-day mortality was 14.7% (n = 207). In a logistic analysis, using
generalized estimating equations to adjust for clustering, we developed an
8-variable model to predict 30-day mortality, including serum urea nitrogen,
white blood cell count, body mass index, pulse rate, activities of daily living
status, absolute lymphocyte count of less than 800/µL (0.8 × 109/L), male sex, and deterioration in mood over 90 days. In validation
testing, the model exhibited reasonable discrimination (c = .76) and calibration (nonsignificant Hosmer-Lemeshow goodness-of-fit
statistic, P = .54). A point score based on this
model's variables fit to the entire data set closely matched observed mortality.
Fifty-two percent of residents had low (score of 0-4) or relatively low (score
of 5-6) predicted 30-day mortality, with 2.2% and 6.2% actual mortality, respectively. CONCLUSIONS Our model distinguishes nursing home residents at relatively low risk
for mortality due to LRI. If independently validated, our findings could help
physicians identify nursing home residents in need of different therapeutic
approaches for LRI.
Syntactic clustering of the Web Broder, Andrei Z.; Glassman, Steven C.; Manasse, Mark S. ...
Computer networks and ISDN systems,
09/1997, Volume:
29, Issue:
8
Journal Article, Conference Proceeding
Peer reviewed
We have developed an efficient way to determine the syntactic similarity of files and have applied it to every document on the World Wide Web. Using this mechanism, we built a clustering of all the ...documents that are syntactically similar. Possible applications include a “Lost and Found” service, filtering the results of Web searches, updating widely distributed web-pages, and identifying violations of intellectual property rights.
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IJS, IMTLJ, KILJ, KISLJ, NUK, SBCE, SBJE, UL, UM, UPCLJ, UPUK
(See editorial comments by Dr. Joan Teno on pp 159–160)
Objectives: To determine resident and facility characteristics associated with do‐not‐resuscitate (DNR) orders and to test the effect of DNR ...orders on hospitalization of acutely ill nursing home (NH) residents with lower respiratory tract infections (LRIs).
Design: Prospective cohort.
Setting: Thirty‐six NHs (almost 4,000 residents) in central and eastern Missouri in the Missouri Lower Respiratory Infection study.
Participants: NH residents with a LRI (n=1031).
Measurements: Data were obtained from new Minimum Data Set evaluations, resident examination, and chart review. Associations between resident, physician, and facility characteristics and the presence of a DNR order and hospitalization within 30 days from evaluation for an LRI were analyzed.
Results: Sixty percent of subjects had a DNR order, and 2% had a do‐not‐hospitalize order. Resident characteristics associated with a DNR order included older age, white race, having a surrogate decision‐maker, NH residence for longer than 3 years, and more‐impaired cognition. Residents with DNR orders were more likely to live in facilities with more licensed beds, a lower proportion of Medicaid recipients, and a higher prevalence of influenza vaccination. After controlling for potential confounders, residents with a DNR order before the acute illness episode were significantly less likely to be hospitalized (adjusted odds ratio=0.69, 95% confidence interval=0.49–0.97).
Conclusion: DNR orders independently reduce the risk of hospitalization for LRI and may function as a marker for undocumented care limitations or as a mandate to limit care (unrelated to resuscitation) in NH residents with LRI.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Searches for dark matter with liquid xenon time projection chamber experiments have traditionally focused on the region of the parameter space that is characteristic of weakly interacting massive ...particles, ranging from a few GeV / c 2 to a few TeV / c 2 . Models of dark matter with a mass much heavier than this are well motivated by early production mechanisms different from the standard thermal freeze-out, but they have generally been less explored experimentally. In this work, we present a reanalysis of the first science run of the LZ experiment, with an exposure of 0.9 tonne × yr , to search for ultraheavy particle dark matter. The signal topology consists of multiple energy deposits in the active region of the detector forming a straight line, from which the velocity of the incoming particle can be reconstructed on an event-by-event basis. Zero events with this topology were observed after applying the data selection calibrated on a simulated sample of signal-like events. New experimental constraints are derived, which rule out previously unexplored regions of the dark matter parameter space of spin-independent interactions beyond a mass of 10 17 GeV / c 2 . Published by the American Physical Society 2024
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Subtle presentation and the frequent lack of on-site physicians complicate the diagnosis of pneumonia in nursing home residents. We sought to identify clinical findings (signs, symptoms, and simple ...laboratory studies) associated with radiographic pneumonia in sick nursing home residents.
This was a prospective cohort study.
The residents of 36 nursing homes in central Missouri and the St. Louis area with signs or symptoms suggesting a lower respiratory infection were included.
We compared evaluation findings by project nurses with findings reported from chest radiographs.
Among 2334 episodes of illness in 1474 nursing home residents, 45% of the radiograph reports suggested pneumonia (possible=12%; probable or definite = 33%). In 80% of pneumonia episodes, subjects had 3 or fewer respiratory or general symptoms. Eight variables were significant independent predictors of pneumonia (increased pulse, respiratory rate =30, temperature =38 degrees C, somnolence or decreased alertness, presence of acute confusion, lung crackles on auscultation, absence of wheezes, and increased white blood count). A simple score (range = -1 to 8) on the basis of these variables identified 33% of subjects (score > or =3) with more than 50% probability of pneumonia and an additional 24% (score of 2) with 44% probability of pneumonia.
Pneumonia in nursing home residents is usually associated with few symptoms. Nonetheless, a simple clinical prediction rule can identify residents at very high risk of pneumonia. If validated in other studies, physicians could consider treating such residents without obtaining a chest radiograph.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background. Scant information exists about the risk of functional decline following treatment of acute illness in the nursing home (NH) setting. The aim of this study was to determine the incidence ...of short-term (30-day) functional decline among survivors of NH-acquired lower respiratory tract infection (LRI) and the factors that predict such decline, including the role of initial hospitalization. Methods. We used a prospective cohort design to study 781 episodes of LRI in 1044 NH residents in 36 NHs in central Missouri and the St. Louis metropolitan area. Functional decline was defined as a 3-point increase on the Minimum Data Set (MDS) activities of daily living (ADL) long form scale. Results. Of 781 LRI cases who survived to 30 days, the incidence of ADL decline was 28.8%. In a logistic regression model that used generalized estimating equations to adjust for clustering, variables associated with ADL decline included the following: chronic feeding tube use (AOR = 4.54, 95% confidence interval, or CI, 1.61, 12.80), decubitus ulcer (adjusted odds ratio AOR = 2.29, 95% CI 1.35, 3.90), shortness of breath (AOR = 2.18, 95% CI 1.44, 3.30), short-term memory problems (AOR = 2.07, 95% CI 1.33, 3.23), decline in self-performance of toilet use in the 24 hours prior to evaluation (AOR = 1.65, 95% CI 1.29, 2.12), age (AOR = 1.02, 95% CI 1.00, 1.05), and baseline ADL score. Addition of treatment variables to the model showed that initial hospitalization was also associated with ADL decline (AOR = 1.90, 95% CI 1.20, 3.00). Residents with ADL decline at 30 days were less likely to recover to their baseline ADL status at 90 days. Conclusions. Many NH residents who survive to 30 days following LRI develop new functional limitations, and such individuals are at risk for ADL decline at 90 days. A limited number of clinical variables may predict short-term functional decline. Initial hospitalization for acute treatment of LRI may increase the risk of subsequent ADL decline among individuals who survive to 30 days.
Background. Determining prognosis for nursing home residents is important for care planning, but reliable prediction is difficult. We compared performance of four long-term mortality risk indices for ...nursing home residents—the Minimum Data Set Mortality Risk Index (MMRI), a recent revision to this index (MMRI-R), and the original and revised Flacker–Kiely models. Methods. We conducted a prospective cohort study in one 92-bed facility in Missouri. Participants were 130 residents who received a Minimum Data Set assessment from May through October, 2007. We collected the Minimum Data Set variables needed to calculate the mortality risk scores. We determined 6- and 12-month mortality for included residents. Using each mortality risk score as the sole independent predictor in logistic models predicting mortality, we determined discrimination (c-statistic) and calibration (Hosmer–Lemeshow goodness-of-fit statistic) for each model. Results. In our sample, discrimination was 0.59 for both the MMRI and the MMRI-R. Discrimination of the original Flacker–Kiely model was 0.69 for both 6 months and 1 year and 0.71 and 0.70, respectively, for the revised model. Model calibration was adequate for all models. Conclusions. Performance of four models that predict long-term mortality of nursing home residents was fair. In our population, the Flacker–Kiely models had similar and markedly better discrimination than either the MMRI or the MMRI-R.
Lower respiratory infections (LRI) are an important cause of morbidity, mortality, and hospitalization of nursing home residents, yet treatment recommendations have primarily been based on the ...minority who are hospitalized. We sought to prospectively evaluate risk factors for mortality from LRI in community nursing home residents.
We studied residents of 10 central Missouri nursing homes (910 beds) from January 1994 to September 1994. Attending physicians authorized nurse evaluations of ill residents who showed symptoms of an LRI. Those residents who met the study definition of LRI received a more detailed assessment and follow ups at 30 and 90 days.
The 231 evaluations identified 141 LRIs in 121 individuals. Sixteen (11%) residents died within 30 days of evaluation. The most important univariate predictor of 30-day mortality was severe activities of daily living (ADL) dependency (relative risk = 8.8, 95% confidence interval, 2.55-30.1). Several other clinical and laboratory findings were also significant predictors. In multivariable logistic regression, ADL dependency, respiratory rate, and pneumonia on chest radiograph independently predicted mortality; the model showed good discriminating ability (c = .83).
For nursing home residents with LRI, ADL dependency is an important mortality predictor. Further research with a larger sample should lead to a useful prediction rule for outcome from nursing home-acquired LRI.
Abstract
For more than two decades, the UCSC Genome Browser database (https://genome.ucsc.edu) has provided high-quality genomics data visualization and genome annotations to the research community. ...As the field of genomics grows and more data become available, new modes of display are required to accommodate new technologies. New features released this past year include a Hi-C heatmap display, a phased family trio display for VCF files, and various track visualization improvements. Striving to keep data up-to-date, new updates to gene annotations include GENCODE Genes, NCBI RefSeq Genes, and Ensembl Genes. New data tracks added for human and mouse genomes include the ENCODE registry of candidate cis-regulatory elements, promoters from the Eukaryotic Promoter Database, and NCBI RefSeq Select and Matched Annotation from NCBI and EMBL-EBI (MANE). Within weeks of learning about the outbreak of coronavirus, UCSC released a genome browser, with detailed annotation tracks, for the SARS-CoV-2 RNA reference assembly.
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