pinecone/core-2020-05-10-deduplication huggingface dataset:
'Emerge' : benchmarking of clinical performance and patients experiences with emergency care in Switzerland

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch)Objective. To assess the effects of uniform indicator measurement and group benchmarking followed by hospital-specific activities on clinical performance measures and patients’ experiences with emergency care in Switzerland.
Design. Data were collected in a pre–post design in two measurement cycles, before and after implementation of improvement activities. Trained hospital staff recorded patient characteristics and clinical performance data. Patients completed a questionnaire after discharge/transfer from the emergency unit.
Setting. Emergency departments of 12 community hospitals in Switzerland, participating in the ‘Emerge’ project.
Subjects. Eligible patients were entered into the study (18 544 in total: 9174 and 9370 in the first and second cycles, respectively), and 2916 and 3370 patients returned the questionnaire in the first and second measurement cycles, respectively (response rates 32% and 36%, respectively).
Main outcome measures. Clinical performance measures (concordance of prospective and retrospective assessment of urgency of care needs, and time intervals between sequences of events) and patients’ reports about care provision in emergency departments (EDs), measured by a 22-item, self-administered questionnaire.
Results. Concordance of prospective and retrospective assignments to one of three urgency categories improved significantly by 1%, and both under- and over-prioritization, were reduced. The median duration between ED admission and documentation of post-ED disposition fell from 137 minutes in 2001 to 130 minutes in 2002 (P < 0.001). Significant improvements in the reports provided by patients were achieved in 10 items, and were mainly demonstrated in structures of care provision and perceived humanity.
Conclusion. Undertaken in a real-world setting, small but significant improvements in performance measures and patients’ perceptions of emergency care could be achieved. Hospitals accomplished these improvements mainly by averting strong outliers, and were most successful in preventing series of negative events. Uniform outcomes measurement, group benchmarking, and data-driven hospital-specific strategies for change are suggested as valuable tools for continuous improvement. Several hospitals have already implemented the developed measures in their internal quality systems and subsequent measurements are projected
Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loos of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study

Aims: To assess the clinical presentation and acute management of patients with transient loss of consciousness (T-LOC) in the emergency department (ED).\ud
Methods and results: A multi-centre prospective observational study was carried out in 19 Spanish hospitals over 1 month. The patients included were  14 years old and were admitted to the ED because of an episode of T-LOC. Questionnaires and corresponding electrocardiograms (ECGs) were reviewed by a Steering Committee (SC) to unify diagnostic criteria, evaluate adherence to guidelines, and diagnose correctly the ECGs. We included 1419 patients (prevalence, 1.14%).ECG was performed in 1335 patients (94%) in the ED: 498 (37.3%) ECGs were classiﬁed as abnormal. The positive diagnostic yield ranged from 0% for the chest X-ray to 12% for the orthostatic test. In the ED, 1217 (86%) patients received a ﬁnal diagnosis of syncope, whereas the remaining 202 (14%) were diagnosed of non-syncopal transient lossof consciousness (NST-LOC). After ﬁnal review by the SC, 1080 patients (76%) were diagnosed of syncope, whereas 339 (24%) were diagnosed of NST-LOC (P , 0.001). Syncope was diagnosed correctly in 84% of patients. Only 25% of patients with T-LOC were admitted to hospitals.\ud
Conclusion Adherence to clinical guidelines for syncope management was low; many diagnostic tests were performed with low diagnostic yield. Important differences were observed between syncope diagnoses at the ED and by SC decision
A genome-wide survey of human short-term memory

Recent advances in the development of high-throughput genotyping platforms allow for the unbiased identification of genes and genomic sequences related to heritable traits. In this study, we analyzed human short-term memory, which refers to the ability to remember information over a brief period of time and which has been found disturbed in many neuropsychiatric conditions, including schizophrenia and depression. We performed a genome-wide survey at 909 622 polymorphic loci and report six genetic variations significantly associated with human short-term memory performance after genome-wide correction for multiple comparisons. A polymorphism within SCN1A (encoding the alpha subunit of the type I voltage-gated sodium channel) was replicated in three independent populations of 1699 individuals. Functional magnetic resonance imaging during an n-back working memory task detected SCN1A allele-dependent activation differences in brain regions typically involved in working memory processes. These results suggest an important role for SCN1A in human short-term memory
Evaluation of the performance of coated and uncoated carbide tools in drilling thick CFRP/aluminium alloy stacks

This paper aims to establish the wear mechanisms of coated and uncoated tungsten carbide drills when drilling carbon fibre reinforced plastics (CFRP)/aluminium alloy (Al) stacks. During the drilling experiments, thrust forces were measured. A scanning electron microscope (SEM) and a numerical microscope, provided with a scanning device, were periodically used to analyse tool wear mechanisms and to measure wear progression of the tool cutting edges. For both coated and uncoated drills, abrasion was the dominant
tool wear mechanism, affecting the entire cutting edges. Higher wear was observed on uncoated tools which caused a significant increase in thrust force during drilling both Al
and CFRP materials. The influence of these phenomena on the quality of the holes and on the generated roughness was also discussed.FUI-Usinage de Multi-Matériaux et Innovation (U2MI
Dissociation of ground and nσ* states of CF3Cl using multireference configuration interaction with singles and doubles and with multireference average quadratic coupled cluster extensivity corrections

Extended complete active space self-consistent field (CASSCF), multireference configuration interaction with singles and doubles (MR-CISD), and multireference average quadratic coupled cluster (MR-AQCC) calculations have been performed on the ground (S0) and first excited (nσ*,S1) states of the CF3Cl molecule. Full geometry optimizations have been carried out for S0 as well as “relaxed” potential energy calculations for both states, along the C–Cl bond distance. Vertical excitation energies (ΔEvertical), dissociation energies (ΔEdiss), dissociation enthalpies (ΔHdiss), and the oscillator strength (f) have also been computed. Basis set effects, basis set superposition error (BSSE), and spin-orbit and size-extensivity corrections have also been considered. The general agreement between theoretical and available experimental results is very good. The best results for the equilibrium geometrical parameters of S0 (at MR-AQCC/aug-cc-pVTZ+d level) are 1.762 and 1.323 Å, for the C–Cl and C–F bond distances, respectively, while the corresponding experimental values are 1.751 and 1.328 Å. The ∠ClCF and ∠FCF bond angles are in excellent agreement with the corresponding experimental values (110.3° and 108.6°). The best calculated values for ΔEvertical, ΔHdiss, and f are 7.63 eV [at the MR-AQCC/aug-cc-pV(T+d)Z level], 3.59 eV[MR-AQCC/aug-cc-pV(T+d)Z level+spin-orbit and BSSE corrections], and 2.74×10−3 (MR-CISD/cc-pVTZ), in comparison with the corresponding experimental values of 7.7±0.1 eV, 3.68 eV, and 3.12×10−3±2.50×10−4. The results concerning the potential energy curves for S0 and S1 show a tendency toward the nonoccurrence of crossing between these two states (in the intermediate region along the C–Cl coordinate), as the basis set size increases. Such tendency is accompanied by a decreasing well depth for the S1 state. Dynamic electronic correlation (especially at the MR-AQCC level) is also an important factor toward an absence of crossing along the C–Cl coordinate. Further investigations of a possible crossing using gradient driven techniques (at CASSCF and MR-CISD levels) seem to confirm its absence
Influence Analysis of Robust Wald-type Tests

We consider a robust version of the classical Wald test statistics for
testing simple and composite null hypotheses for general parametric models.
These test statistics are based on the minimum density power divergence
estimators instead of the maximum likelihood estimators. An extensive study of
their robustness properties is given though the influence functions as well as
the chi-square inflation factors. It is theoretically established that the
level and power of these robust tests are stable against outliers, whereas the
classical Wald test breaks down. Some numerical examples confirm the validity
of the theoretical results.Comment: 36 page
Tool-life and wear mechanisms of CBN tools in machining of Inconel 718

The demand for increasing productivity when machining heat resistant alloys has resulted in the use of new tool materials such as cubic boron nitride (CBN) or ceramics. However, CBN tools are mostly used by the automotive industry in hard turning, and the wear of those tools is not sufficiently known in aerospace materials. In addition, the grade of these tools is not optimized for superalloys due to these being a small part of the market, although expanding (at 20% a year). So this investigation has been conducted to show which grade is optimal and what the wear mechanisms are during finishing operations of Inconel 718. It is shown that a low CBN content with a ceramic binder and small grains gives the best results. The wear mechanisms on the rake and flank faces were investigated. Through SEM observations and chemical analysis of the tested inserts, it is shown that the dominant wear mechanisms are adhesion and diffusion due to chemical affinity between elements from workpiece and insert
Minding the gap: Applying a service marketing model into government policy communications

In order to bolster the emerging but still underdeveloped conceptualization of public communication over potential policies, we apply a framework primarily used in business service marketing to improve service quality (“gap analysis”). We argue that this model has strong heuristic qualities that can alert practitioners who are interested in improving communication regarding potential policies. While we recognize problems
implementing the model, we suggest some ways that both practitioners and the public ameliorate the identified issues. Seeing communication about potential policies as a crucial part of the political process, we argue that such efforts have democratic merit
Investigation of plasma hydrogenation and trapping mechanism for layer transfer

Hydrogen ion implantation is conventionally used to initiate the transfer of Si thin layers onto Si wafers coated with thermal oxide. In this work, we studied the feasibility of using plasma hydrogenation to replace high dose H implantation for layer transfer. Boron ion implantation was used to introduce H -trapping centers into Si wafers to illustrate the idea. Instead of the widely recognized interactions between boron and hydrogen atoms, this study showed that lattice damage, i.e., dangling bonds, traps H atoms and can lead to surface blistering during hydrogenation or upon postannealing at higher temperature. The B implantation and subsequent processes control the uniformity of H trapping and the trap depths. While the trap centers were introduced by B implantation in this study, there are many other means to do the same without implantation. Our results suggest an innovative way to achieve high quality transfer of Si layers without H implantation at high energies and high doses. © 2005 American Institute of Physics
N-partite information in Hawking radiation

We study the entanglement among sequential Hawking radiations in the ParikhWilczek tunneling model of Schwarzschild black hole. We identify the part of classical correlation and that of quantum entanglement in bipartite information and point out its imitated relation to quantum gravity correction. Explicit computation of n-partite information shows that it is positive (negative) for even (odd) n , which happens to agree with the holographic computation. The fact that entanglement in the mutual information grows with time mimics the second law of thermodynamics. Later we extend our study to the AdS black hole and find the total mutual information which includes the classical correlation is sensible to the Hawking-Page phase transition
GeV-scale dark matter: production at the Main Injector

Assuming that dark matter particles interact with quarks via a GeV-scale mediator, we study dark matter production in fixed target collisions. The ensuing signal in a neutrino near detector consists of neutral-current events with an energy distribution peaked at higher values than the neutrino background. We find that for a Z ′ boson of mass around a few GeV that decays to dark matter particles, the dark matter beam produced by the Main Injector at Fermilab allows the exploration of a range of values for the gauge coupling that currently satisfy all experimental constraints. The NO ν A near detector is well positioned for probing the presence of a dark matter beam, and future LBNF near detectors would provide more sensitive probes
Origin of freshwater and polynya water in the Arctic Ocean halocline in summer 2007

Extremely low summer sea-ice coverage in the Arctic Ocean in 2007 allowed extensive sampling and a wide quasi-synoptic hydrographic and δ18O dataset could be collected in the Eurasian Basin and the Makarov Basin up to the Alpha Ridge and the East Siberian continental margin. With the aim of determining the origin of freshwater in the halocline, fractions of river water and sea-ice meltwater in the upper 150 m were quantified by a combination of salinity and δ18O in the Eurasian Basin. Two methods, applying the preformed phosphate concentration (PO*) and the nitrate-to-phosphate ratio (N/P), were compared to further differentiate the marine fraction into Atlantic and Pacific-derived contributions. While PO*-based assessments systematically underestimate the contribution of Pacific-derived waters, N/P-based calculations overestimate Pacific-derived waters within the Transpolar Drift due to denitrification in bottom sediments at the Laptev Sea continental margin.\ud
\ud
Within the Eurasian Basin a west to east oriented front between net melting and production of sea-ice is observed. Outside the Atlantic regime dominated by net sea-ice melting, a pronounced layer influenced by brines released during sea-ice formation is present at about 30–50 m water depth with a maximum over the Lomonosov Ridge. The geographically distinct definition of this maximum demonstrates the rapid release and transport of signals from the shelf regions in discrete pulses within the Transpolar Drift.\ud
\ud
The ratio of sea-ice derived brine influence and river water is roughly constant within each layer of the Arctic Ocean halocline. The correlation between brine influence and river water reveals two clusters that can be assigned to the two main mechanisms of sea-ice formation within the Arctic Ocean. Over the open ocean or in polynyas at the continental slope where relatively small amounts of river water are found, sea-ice formation results in a linear correlation between brine influence and river water at salinities of about 32–34. In coastal polynyas in the shallow regions of the Laptev Sea and southern Kara Sea, sea-ice formation transports river water into the shelf’s bottom layer due to the close proximity to the river mouths. This process therefore results in waters that form a second linear correlation between brine influence and river water at salinities of about 30–32. Our study indicates which layers of the Arctic Ocean halocline are primarily influenced by sea-ice formation in coastal polynyas and which layers are primarily influenced by sea-ice formation over the open ocean. Accordingly we use the ratio of sea-ice derived brine influence and river water to link the maximum in brine influence within the Transpolar Drift with a pulse of shelf waters from the Laptev Sea that was likely released in summer 2005
The interaction between heteroditopic pyridine–nitrogen NHC with novel sulfur NHC ligands in palladium(0) derivatives: Synthesis and structural characterization of a bis-carbene palladium(0) olefin complex and formation in solution of an alkene–alkyne mixed intermediate as a consequence of the ligandshemilability

We have synthesized a new class of heteroditopic chelating ligands bearing the phenylthiomethyl group
and variously substituted imidazole derivatives and the corresponding complexes [Pd(eta2-ma)(R-NHCCH2-
SPh) (ma = maleic anhydride; R = methyl, mesityl, di-i-propylphenyl). We have compared their
chemical characteristics and reactivity with those of similar palladium(0) complexes bearing the RNHC-
CH2-Py ligands.
The hemilability of the above-mentioned moieties is apparent when their palladium derivatives react
with an excess of the same or different heteroditopic ligands. In these cases, we obtained complexes bearing
maleic anhydride and two mono-coordinated heteroditopic ligands bound to the same metal center.
However, at variance with the generally accepted opinion, precipitation of AgBr does not warrant the
quantitative formation of the bis-heteroditopic Pd(0) derivative and in some cases, a reaction involving
a heterogeneous equilibrium is observed.
The reaction of the palladium(0) carbene–sulfur or carbene–nitrogen complexes with the alkyne
dimethyl-2-butynedioate (dmbd) to give palladacyclometallate derivatives is not always warranted
and formation of the intermediate [Pd(eta2-ma)(eta2-dmdb)(chi1-Mes-NHC-CH2-SPh)] is detected only in
one case.
Finally, we have carried out a diffractometric study on the solid-state structures of two derivatives and
in particular we describe the configurations of the complex [Pd(eta2-ma)(j1-Me-NHC-CH2-SPh)2] and of
[Pd(eta2-ma)(Me-NHC-CH2-SPh)]
Shock-induced polarized hydrogen emission lines in the Mira star o Ceti

International audienceContext. In the spectra of variable pulsating stars, especially Mira stars, the detection of intense hydrogen emission lines has been explained by the presence of a radiative and hypersonic shock wave, periodically propagating throughout the stellar atmosphere. Previous observation of the Mira star o Ceti around one of its brightest maximum light led to the detection of a strong level of linear polarization associated to Balmer emissions, although the origin of this phenomenon is not fully explained yet. Aims: With the help of spectropolarimetry, we propose to investigate the nature of shock waves propagating throughout the stellar atmosphere and present, for o Ceti (the prototype of Mira stars), a full observational study of hydrogen emission lines formed in the radiative region of such a shock. Methods: Using the instrument NARVAL mounted on the Télescope Bernard Lyot (TBL) in Pic du Midi Observatory (France), we performed a spectropolarimetric monitoring of o Ceti during three consecutive pulsation cycles. For this survey, the four Stokes parameters (I for intensity, Q and U for linear polarization, and V for circular polarization) were systematically collected, with a particular emphasis on the maxima of luminosity, i.e. when a radiative shock wave is supposed to emerge from the photosphere and starts to propagate outward. Results: On hydrogen Balmer lines, over a large part of the luminosity cycle, we report clear detection of polarimetric structures in Q and U Stokes spectra (and also in V Stokes spectra but to a lesser extent). We report a temporal evolution of these spectropolarimetric signatures, which appear strongly correlated to the presence of an intense shock wave responsible for the hydrogen emission lines. We establish that the hydrogen lines are polarized by a physical process inherent to the mechanism responsible for the emission line formation: the shock wave itself. Two mechanisms are thus considered: a global one that implies a polarization induced by some giant convective cells located around the photosphere and a local one that implies a charge separation due to the passage of the shock wave, inducing an electrical current. Combined with the existing turbulence, this may generate a magnetic field, hence polarization. Based on spectropolarimetric observations obtained at the Télescope Bernard Lyot (TBL at Observatoire du Pic du Midi, CNRS and Université de Toulouse, France)
A Semiotic Approach to Integrative Negotiation

Part 1: Organizational Semiotics: Theory and ConceptsInternational audienceAn analysis of two-party integrative negotiation reveals the potential of this type of bargaining for being interpreted as a conceptualization process. Past research on a semiotic model of human processing shows the possibility of a definition of a uniform representation of knowledge. In this paper we suggest that by combining the above results integrative negotiation can be positioned as an abductive process. We justify our hypothesis by means of experimental data
Everyday Physical Education for 11-year-olds in a "rurban" (outer city) secondary school in the south of France: the conflict between norms and arts de faire - an ethnographic approach

International audienceThis paper presents direct, participative observations of the social behaviour of eleven-year-old pupils and teachers during compulsory Physical Education classes in France with the aim of improving understanding of the myriad expected and unexpected behavioural incidents in an interactive and micro-sociological perspective. Pupils recieve four hours per week " total immersion " for a full school year (two hours twice a week). The findings led to a further discussion of fundamental related teaching and learning issues in this discipline. Findings also brought to light the reality of learning from peers, which is virtually independent of the institution and the will of the teacher, although a dialogue may be maintained with the latter
Environmental conservation and the production of new territories: the example of French départements

International audienceVery important initiatives have been taken and policies have been adopted in the European Union to protect areas of great importance for threatened species and habitats. Protected areas differ broadly in terms of category, natural conditions and administrative organisation, from international initiative such as Biosphere Reserves, European ones with Natura 2000 network until the institution of national and regional protected areas. In France, the administrative subdivisions known as “départements” were created with the French Revolution in the end of the 18th century; in 1985 an original and autonomous procedure to establish special protected areas, called “Sensitive Natural Spaces” (SNS) was devolved to them. The scope of this paper is to present an overview of these devolved powers which enable French départements to create protected areas and to levy a departmental tax on sensitive natural spaces (DTSNS). We statistically studied some parameters by multivariate methods in order to explain the choices of this policy by the départements. The huge variations in the way these powers are implemented prove the development of new environmental territories