Summary
Aim: In 2007, the National Patient Safety Agency performed a study demonstrating that errors in prescribing led to nearly 12,000 adverse clinical incidents a year. The following year, they ...issued a rapid response report entitled ‘Reducing Dosing Errors with Opioid Medicines’ designed to be implemented by all NHS trusts. We performed a prevalence study to assess opioid prescribing errors in our large multi‐speciality teaching hospital prior to implementation of these recommendations.
Methodology: We conducted a 1 day snapshot of opioid prescriptions on inpatient drug charts. For every chart, all opioid information was entered into the study proforma. All data were reviewed by consensus group and errors categorised by quality and whether they were potentially lethal, serious, significant or minor.
Results: A total of 330/722 (46%) charts were found to have opioid prescriptions. On the study day, there were 74 charts with errors and on expert review another 16 erroneous charts were found giving a total of 90/330 (27.2%). The largest quality statement error group was ‘unclear prescription, missing information’. There were 4 potentially lethal, 26 serious, 38 significant and 22 minor errors.
Discussion: Previous studies have reported opioid prescription error rates of 51.2–70%. Compared with the opioid literature, our trust fares well with an error rate of 27%– four of these errors being potentially lethal. This study has identified where there are weaknesses in our hospital opioid prescribing practice and has aided us in rewriting our acute and chronic pain guidelines with the explicit inclusion of the National Patient Safety Agency recommendations. We have also disseminated the study results at the Trust academic meeting and developed an opioid e‐learning package which will be mandatory for all new staff.
In this work, we present measurements of the E-mode (EE) polarization power spectrum and temperature-E-mode (TE) cross-power spectrum of the cosmic microwave background using data collected by ...SPT-3G, the latest instrument installed on the South Pole Telescope. This analysis uses observations of a 1500 deg2 region at 95, 150, and 220 GHz taken over a four-month period in 2018. We report binned values of the EE and TE power spectra over the angular multipole range 300≤ℓ<3000, using the multifrequency data to construct six semi-independent estimates of each power spectrum and their minimum-variance combination. These measurements improve upon the previous results of SPTpol across the multipole ranges 300 ≤ ℓ ≤ 1400 for EE and 300 ≤ ℓ ≤ 1700 for TE, resulting in constraints on cosmological parameters comparable to those from other current leading ground-based experiments. We find that the SPT-3G data set is well fit by a ΛCDM cosmological model with parameter constraints consistent with those from Planck and SPTpol data. From SPT-3G data alone, we find H0=68.8±1.5 km s-1 Mpc-1 and σ8=0.789±0.016, with a gravitational lensing amplitude consistent with the ΛCDM prediction (AL=0.98±0.12). We combine the SPT-3G and the Planck data sets and obtain joint constraints on the ΛCDM model. The volume of the 68% confidence region in six-dimensional ΛCDM parameter space is reduced by a factor of 1.5 compared to Planck-only constraints, with no significant shifts in central values. We note that the results presented here are obtained from data collected during just half of a typical observing season with only part of the focal plane operable, and that the active detector count has since nearly doubled for observations made with SPT-3G after 2018.
Nearly a decade ago, landmark clinical trials revealed an increase in the risks associated with hormone therapy in postmenopausal women, leading to early changes in prescribing patterns. Long-term ...prescribing patterns in the United States after these trials are unknown. The objective of this study was to describe changes in hormone therapy prescribing including dose, formulation, patient age, and prescriber specialty from 2000 to 2009.
A national pharmacy claims database was used to describe the annual prevalence and incidence rates of hormone therapy prescribing from 2000 to 2009 in women 50 years and older.
Throughout the decade, a number of prescribing trends were observed: a continuous decline in hormone therapy overall, an initial drop in new therapy that stabilized after 2003, a decline in oral formulations and increase in vaginal formulations, a decline in standard- and high-dose and an increase in low-dose oral formulations, and an increase in the proportion of women who received hormone therapy from gynecologists.
Overall prescribing of hormone therapy continued to decline during the past decade, suggesting a long-term impact of the Women's Health Initiative findings. During this same time, treatment regimens shifted to favor vaginal and lower-dose oral formulations.
First published in 1931. None of the manuscripts which have come down to us represent the original form of Marco Polo's narrative, but it is clear that certain texts are closer to the lost original ...than others. Entrusted with the task of preparing a new Italian edition of Marco Polo, Benedetto discovered many unknown manuscripts. He carefully edited the most famous of the manuscripts (the Geographic text) and collated it with the other best known ones. · An invaluable index has been added to Aldo Ricci's of Benedetto's text, which includes all the identifications made in the Geographic text and also later editions by Marsden (1818), Pauthier (1865) and Yule (1871). · The difficulty of following Polo on his many journeys has also been simplified by the process of distinguishing between those places on his main route to China and his return journey by sea to Persia and those places which he visited during his stay in China and those he never visited at all.
The Design and Integrated Performance of SPT-3G Bender, A. N.; Benson, B. A.; Dutcher, D. ...
The Astrophysical journal. Supplement series,
02/2022, Letnik:
258, Številka:
2
Journal Article
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Abstract
SPT-3G is the third survey receiver operating on the South Pole Telescope dedicated to high-resolution observations of the cosmic microwave background (CMB). Sensitive measurements of the ...temperature and polarization anisotropies of the CMB provide a powerful data set for constraining cosmology. Additionally, CMB surveys with arcminute-scale resolution are capable of detecting galaxy clusters, millimeter-wave bright galaxies, and a variety of transient phenomena. The SPT-3G instrument provides a significant improvement in mapping speed over its predecessors, SPT-SZ and SPTpol. The broadband optics design of the instrument achieves a 430 mm diameter image plane across observing bands of 95, 150, and 220 GHz, with 1.2′ FWHM beam response at 150 GHz. In the receiver, this image plane is populated with 2690 dual-polarization, trichroic pixels (∼16,000 detectors) read out using a 68× digital frequency-domain multiplexing readout system. In 2018, SPT-3G began a multiyear survey of 1500 deg
2
of the southern sky. We summarize the unique optical, cryogenic, detector, and readout technologies employed in SPT-3G, and we report on the integrated performance of the instrument.
Here, we present constraints on extensions to the Λ CDM cosmological model from measurements of the E-mode polarization autopower spectrum and the temperature-E-mode cross-power spectrum of the ...cosmic microwave background (CMB) made using 2018 SPT-3G data. The extensions considered vary the primordial helium abundance, the effective number of relativistic degrees of freedom, the sum of neutrino masses, the relativistic energy density and mass of a sterile neutrino, and the mean spatial curvature. We do not find clear evidence for any of these extensions, from either the SPT-3G 2018 dataset alone or in combination with baryon acoustic oscillation and Planck data. None of these model extensions significantly relax the tension between Hubble-constant, H0, constraints from the CMB and from distance-ladder measurements using Cepheids and supernovae. The addition of the SPT-3G 2018 data to Planck reduces the square-root of the determinants of the parameter covariance matrices by factors of 1.3–2.0 across these models, signaling a substantial reduction in the allowed parameter volume. We also explore CMB-based constraints on H0 from combined SPT, Planck, and ACT DR4 datasets. While individual experiments see some indications of different H0 values between the TT, TE, and EE spectra, the combined H0 constraints are consistent between the three spectra. For the full combined datasets, we report H0 = 67.49 ± 0.53 km s-1 Mpc -1, which is the tightest constraint on H0 from CMB power spectra to date and in 4.1σ tension with the most precise distance-ladder-based measurement of H0. The SPT-3G survey is planned to continue through at least 2023, with existing maps of combined 2019 and 2020 data already having ~ 3.5 x lower noise than the maps used in this analysis.
We present a catalog of 4195 optically confirmed Sunyaev-Zel'dovich (SZ) selected galaxy clusters detected with signal-to-noise ratio >4 in 13,211 deg2 of sky surveyed by the Atacama Cosmology ...Telescope (ACT). Cluster candidates were selected by applying a multifrequency matched filter to 98 and 150 GHz maps constructed from ACT observations obtained from 2008 to 2018 and confirmed using deep, wide-area optical surveys. The clusters span the redshift range 0.04 < z < 1.91 (median z = 0.52). The catalog contains 222 z > 1 clusters, and a total of 868 systems are new discoveries. Assuming an SZ signal versus mass-scaling relation calibrated from X-ray observations, the sample has a 90% completeness mass limit of M500c > 3.8 × 1014 M , evaluated at z = 0.5, for clusters detected at signal-to-noise ratio >5 in maps filtered at an angular scale of 2 4. The survey has a large overlap with deep optical weak-lensing surveys that are being used to calibrate the SZ signal mass-scaling relation, such as the Dark Energy Survey (4566 deg2), the Hyper Suprime-Cam Subaru Strategic Program (469 deg2), and the Kilo Degree Survey (825 deg2). We highlight some noteworthy objects in the sample, including potentially projected systems, clusters with strong lensing features, clusters with active central galaxies or star formation, and systems of multiple clusters that may be physically associated. The cluster catalog will be a useful resource for future cosmological analyses and studying the evolution of the intracluster medium and galaxies in massive clusters over the past 10 Gyr.
Surveillance of Culicoides (Diptera: Ceratopogonidae) biting midges was carried out between 2001 and 2003, at 119 sites within a 50 × 50‐km grid distributed across Bulgaria, using light trap ...collections around the time of peak adult midge abundance. Sentinel and ad hoc serum surveillance of hosts susceptible to bluetongue infection was carried out at around 300 sites between 1999 and 2003. Following the initial incursion of bluetongue virus 9 (BTV‐9) into Bourgas province in 1999, affecting 85 villages along the southern border, a further 76 villages were affected along the western border in 2001, with outbreaks extending as far north as 43.6°N. The BTV‐9 strain in circulation was found to have a low pathogenicity for Bulgarian sheep populations, with less than 2% of susceptible individuals becoming sick and seroconversions detected up to 30 km from recorded outbreaks in the south. The major Old World vector Culicoides imicola Kieffer was not detected among over 70 000 Culicoides identified in summer collections, suggesting that BTV‐9 transmission in Bulgaria was primarily carried out by indigenous European vectors. The most likely candidates, the Palaearctic species complexes – the Culicoides obsoletus Meigen and C. pulicaris L. complexes – were widespread and abundant across the whole country. The C. obsoletus complex represented 75% of all individuals trapped in summer and occurred in high catch sizes (up to 15 000 individuals per night) but was not found across all outbreak sites, indicating that both Palearctic complexes probably played a role in transmission. Within the C. pulicaris complex, only C. pulicaris s.s., C. punctatus Meigen and C. newsteadi Austen were sufficiently abundant and prevalent to have been widely involved in transmission, whilst within the C. obsoletus complex most trapped males were C. obsoletus s.s. Adult vectors were found to be largely absent from sites in west Bulgaria for a period of at least 3 months over winter, which, taken along with the spatiotemporal pattern of outbreaks in the region between years, indicates the virus may be overwintering here by an alternative mechanism – either by covert persistence in the vertebrate host or possibly by persistence in larval stages of the vector.
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