Introduction: This is the second of two articles about best practice in the management of coding services. The best practice project was part of a year-long project conducted in the Republic of ...Ireland to review the quality of the Hospital Inpatient Enquiry data for its use in activity-based funding.
Methods: The four methods used to address the best practice aspect of the project were described in detail in Part 1.
Results: The results included in this article are those relating to the coding manager's background, preparation and style, clinical coder (CC) workforce adequacy, the CC workforce structure and career pathway, and the physical and psychological work environment for the clinical coding service.
Conclusion: Examples of best practice were found in the study hospitals but there were also areas for improvement. Coding managers would benefit from greater support in the form of increased opportunities for management training and a better method for calculating CC workforce numbers. A career pathway is needed for CCs to progress from entry to expert CC, mentor, manager and quality controller. Most hospitals could benefit from investment in infrastructure that places CCs in a physical environment that tells them they are an important part of the hospital and their work is valued.
We report the discovery of a tight substellar companion to the young solar analog PZ Tel, a member of the {beta} Pic moving group observed with high-contrast adaptive optics imaging as part of the ...Gemini Near-Infrared Coronagraphic Imager Planet-Finding Campaign. The companion was detected at a projected separation of 16.4 {+-} 1.0 AU (0.''33 {+-} 0.''01) in 2009 April. Second-epoch observations in 2010 May demonstrate that the companion is physically associated and shows significant orbital motion. Monte Carlo modeling constrains the orbit of PZ Tel B to eccentricities >0.6. The near-IR colors of PZ Tel B indicate a spectral type of M7 {+-} 2 and thus this object will be a new benchmark companion for studies of ultracool, low-gravity photospheres. Adopting an age of 12{sup +8} {sub -4} Myr for the system, we estimate a mass of 36 {+-} 6 M {sub Jup} based on the Lyon/DUSTY evolutionary models. PZ Tel B is one of the few young substellar companions directly imaged at orbital separations similar to those of giant planets in our own solar system. Additionally, the primary star PZ Tel A shows a 70 {mu}m emission excess, evidence for a significant quantity of circumstellar dust that has not been disrupted by the orbital motion of the companion.
The upcoming generation of Sunyaev-Zel'dovich effect (SZE) surveys will shed fresh light onto the study of clusters. What will this new observational window reveal about cluster properties? What can ...we learn from combining X-ray, SZE, and optical observations? How do variations in the gas entropy profile, dark matter concentration, accretion pressure, and intracluster medium (ICM) mass fraction affect SZE observables? We investigate the signature of these important cluster parameters with an analytic model of the ICM. Given the current uncertainties in ICM physics, our approach is to span the range of plausible models motivated by observations and a small set of assumptions. We find a tight relation between the central Compton parameter and the X-ray luminosity outside the cluster core, suggesting that these observables carry the same information about the ICM. The total SZE luminosity is proportional to the thermal energy of the gas and is a surprisingly robust indicator of cluster mass: L sub(SZ) 8f sub(ICM)M super(5/3). We show that a combination of L sub(SZ) and the half-luminosity radius r sub(SZ) provides a measure of the potential energy of the cluster gas, and thus we can deduce the total energy content of the ICM. We caution that any systematic variation of the ICM mass fraction will distort the expected L sub(SZ)-M calibration to be used to study the evolution of cluster number density, and propose a technique using the kinetic Sunyaev-Zel'dovich (kSZ) effect to constrain f sub(ICM)(M,z).
We use the observed anisotropic clustering of galaxies in the Baryon Oscillation Spectroscopic Survey Data Release 11 CMASS sample to measure the linear growth rate of structure, the Hubble expansion ...rate and the comoving distance scale. Our sample covers 8498 deg2 and encloses an effective volume of 6 Gpc3 at an effective redshift of
. We find fσ8 = 0.441 ± 0.044, H = 93.1 ± 3.0 km s−1 Mpc−1 and D
A = 1380 ± 23 Mpc when fitting the growth and expansion rate simultaneously. When we fix the background expansion to the one predicted by spatially flat Λ cold dark matter (ΛCDM) model in agreement with recent Planck
results, we find fσ8 = 0.447 ± 0.028 (6 per cent accuracy). While our measurements are generally consistent with the predictions of ΛCDM and general relativity, they mildly favour models in which the strength of gravitational interactions is weaker than what is predicted by general relativity. Combining our measurements with recent cosmic microwave background data results in tight constraints on basic cosmological parameters and deviations from the standard cosmological model. Separately varying these parameters, we find w = −0.983 ± 0.075 (8 per cent accuracy) and γ = 0.69 ± 0.11 (16 per cent accuracy) for the effective equation of state of dark energy and the growth rate index, respectively. Both constraints are in good agreement with the standard model values of w = −1 and γ = 0.554.
The low number density of the Sloan Digital Sky Survey (SDSS) luminous red galaxies (LRGs) suggests that LRGs occupying the same dark matter halo can be separated from pairs occupying distinct dark ...matter halos with high fidelity. We present a new technique, Counts-in-Cylinders (CiC), to constrain the parameters of the satellite contribution to the LRG halo occupation distribution once the parameters of the central galaxy contribution have been fixed. For a fiber-collision-corrected SDSS spectroscopic LRG subsample at 0.16 < z < 0.36, we find that the CiC multiplicity function is fitted by a halo model where the average number of satellites in a halo of mass M is = ((M - M cut)/M 1) alpha with M cut = 5.0+1.5 -1.3(+2.9 -2.6) X 1013 M , M 1 = 4.95+0.37 -0.26(+0.79 -0.53) X 1014 M , and alpha = 1.035+0.10 -0.17(+0.24 -0.31) at the 68% and 95% confidence levels using a WMAP3 cosmology and z = 0.2 halo catalog. Our method tightly constrains the fraction of LRGs that are satellite galaxies, 6.36+0.38 -0.39%, and the combination M cut/1014 M + alpha = 1.53+0.08 -0.09 at the 95% confidence level, though these constraints may be relaxed when cosmological parameters and the central galaxy parameters are allowed to vary simultaneously. We also find that mocks based on a halo catalog produced by a spherical overdensity finder reproduce both the measured CiC multiplicity function and the projected correlation function, while mocks based on a Friends-of-Friends halo catalog has a deficit of close pairs at ~1 h -1 Mpc separations. Because the CiC method relies on higher order statistics of close pairs, it is robust to the choice of halo finder, and yields mock catalogs reproducing Finger-of-God (FOG) features in the observations probed by the CiC group multiplicity function. In a companion paper, we will apply this technique to optimize FOG compression to eliminate the one-halo contribution to the LRG power spectrum.
Purpose
Corticorelin acetate (CrA) is a synthetic form of corticotropin-releasing factor undergoing clinical trials in the treatment of peritumoral brain edema (PBE). We sought to investigate ...preclinically its potential as an antitumor agent against human solid tumors and to assess its ability to enhance the therapeutic activity of bevacizumab (BEV) in these same models.
Methods
The in vivo efficacy of CrA as a single agent and in combination with the antiangiogenic agent, BEV, was examined in two preclinical human tumor models, the MX-1 breast and Colo-205 colon carcinomas. These models were selected based on their known sensitivity to BEV and were tumor types in which BEV has been approved for clinical use. The corneal micropocket assay was also performed to assess the antiangiogenic activity of CrA relative to BEV. The exposure level of CrA in the mouse using a typical preclinical regimen was measured so as to compare it to reported clinical exposure levels.
Results
CrA was active as a single agent in the MX-1 breast carcinoma, but did not exhibit statistically significant activity as a single agent in the Colo-205 colon carcinoma under the doses and schedules used in the study. When BEV, which was active or near active in both the MX-1 and Colo-205 models, was administered concomitantly with CrA, therapeutic outcomes were observed that were significantly better than those obtained using either monotherapy. These therapeutic potentiations using CrA plus BEV were obtained in the absence of any observable increase in toxicities. CrA was active in the corneal micropocket assay, producing a substantial (>70%) inhibition of neovascularization. A representative CrA regimen in mice produced an exposure within eightfold of human exposure determined at one-half the current clinical dose.
Conclusions
The application of CrA for the treatment of PBE likely involves its activity as an antiangiogenic agent, which may be one possible mechanism to explain its observed preclinical antitumor activity. That activity, as well as its ability to provide an enhanced therapeutic outcome when given in conjunction with BEV in the absence of increased toxicity, supports the use of CrA clinically as other than a replacement therapy for dexamethasone in PBE.
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