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"Ray, Michael"
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Dirac pairings, one-form symmetries and Seiberg-Witten geometries
A
bstract
The Coulomb phase of a quantum field theory, when present, illuminates the analysis of its line operators and one-form symmetries. For 4d
N
= 2 field theories the low energy physics of this phase is encoded in the special Kähler geometry of the moduli space of Coulomb vacua. We clarify how the information on the allowed line operator charges and one-form symmetries is encoded in the special Kähler structure. We point out the important difference between the lattice of charged states and the homology lattice of the abelian variety fibered over the moduli space, which, when principally polarized, is naturally identified with a choice of the lattice of mutually local line operators. This observation illuminates how the distinct S-duality orbits of global forms of
N
= 4 theories are encoded geometrically.
Journal Article
Antibiotic prescribing without documented indication in ambulatory care clinics: national cross sectional study
AbstractObjectivesTo identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with antibiotic prescribing without a documented indication.DesignCross sectional study.Setting2015 National Ambulatory Medical Care Survey.Participants28 332 sample visits representing 990.9 million ambulatory care visits nationwide.Main outcome measuresOverall antibiotic prescribing and whether each antibiotic prescription was accompanied by appropriate, inappropriate, or no documented indication as identified through ICD-9-CM (international classification of diseases, 9th revision, clinical modification) codes. Survey weighted multivariable logistic regression was used to evaluate potential risk factors for receipt of an antibiotic prescription without a documented indication.ResultsAntibiotics were prescribed during 13.2% (95% confidence interval 11.6% to 13.7%) of the estimated 990.8 million ambulatory care visits in 2015. According to the criteria, 57% (52% to 62%) of the 130.5 million prescriptions were for appropriate indications, 25% (21% to 29%) were inappropriate, and 18% (15% to 22%) had no documented indication. This corresponds to an estimated 24 million prescriptions without a documented indication. Being an adult male, spending more time with the provider, and seeing a non-primary care specialist were significantly positively associated with antibiotic prescribing without an indication. Sulfonamides and urinary anti-infective agents were the antibiotic classes most likely to be prescribed without documentation.ConclusionsThis nationally representative study of ambulatory visits identified a large number of prescriptions for antibiotics without a documented indication. Antibiotic prescribing in the absence of a documented indication may severely bias national estimates of appropriate antibiotic use in this setting. This study identified a wide range of factors associated with antibiotic prescribing without a documented indication, which may be useful in directing initiatives aimed at supporting better documentation.
Journal Article
Alternative, country, hip-hop, rap, and more : music from the 1980s to today
With music today available on YouTube, online and satellite radio, MTV, through digital downloads, and on iPods and other handheld devices, we may think that we have heard all there is to hear about modern artists. The stories behind the songs that keep us humming are less often explored.
Book
Spread of Carbapenem-Resistant Enterobacteriaceae Among Illinois Healthcare Facilities: The Role of Patient Sharing
Background. Carbapenem-resistant Enterobacteriaceae (CRE) spread regionally throughout healthcare facilities through patient transfer and cause difficult-to-treat infections. We developed a state-wide patient-sharing matrix and applied social network analyses to determine whether greater connectedness (centrality) to other healthcare facilities and greater patient sharing with long-term acute care hospitals (LTACHs) predicted higher facility CRE rates. Methods. We combined CRE case information from the Illinois extensively drug-resistant organism registry with measures of centrality calculated from a state-wide hospital discharge dataset to predict facility-level CRE rates, adjusting for hospital size and geographic characteristics. Results. Higher CRE rates were observed among facilities with greater patient sharing, as measured by degree centrality. Each additional hospital connection (unit of degree) conferred a 6% increase in CRE rate in rural facilities (relative risk [RR] = 1.056; 95% confidence interval [CI], 1.030–1.082) and a 3% increase among Chicagoland and non-Chicago urban facilities (RR = 1.027; 95% CI, 1.002–1.052 and RR = 1.025; 95% CI, 1.002–1.048, respectively). Sharing 4 or more patients with LTACHs was associated with higher CRE rates, but this association may have been due to chance (RR = 2.08; 95% CI, .85–5.08; P = .11). Conclusions. Hospitals with greater connectedness to other hospitals in a statewide patient-sharing network had higher CRE burden. Centrality had a greater effect on CRE rates in rural counties, which do not have LTACHs. Social network analysis likely identifies hospitals at higher risk of CRE exposure, enabling focused clinical and public health interventions.
Journal Article
Validation of electronic health record data to identify hospital-associated Clostridioides difficile infections for retrospective research
Clostridioides difficile infection (CDI) research relies upon accurate identification of cases when using electronic health record (EHR) data. We developed and validated a multi-component algorithm to identify hospital-associated CDI using EHR data and determined that the tandem of CDI-specific treatment and laboratory testing has 97% accuracy in identifying HA-CDI cases.
Journal Article
Examining the impact of the COVID-19 pandemic on hospital-associated Clostridioides difficile infection
To evaluate the impact of changes in the size and characteristics of the hospitalized patient population during the COVID-19 pandemic on the incidence of hospital-associated
infection (HA-CDI).
Interrupted time-series analysis.
A 576-bed academic medical center in Portland, Oregon.
We established March 23, 2020 as our pandemic onset and included 24 pre-pandemic and 24 pandemic-era 30-day intervals. We built an autoregressive segmented regression model to evaluate immediate and gradual changes in HA-CDI rate during the pandemic while controlling for changes in known CDI risk factors.
We observed 4.5 HA-CDI cases per 10,000 patient-days in the two years prior to the pandemic and 4.7 cases per 10,000 patient-days in the first two years of the pandemic. According to our adjusted segmented regression model, there were neither significant changes in HA-CDI rate at the onset of the pandemic (level-change coefficient = 0.70,
-value = 0.57) nor overtime during the pandemic (slope-change coefficient = 0.003,
-value = 0.97). We observed significant increases in frequency and intensity of antibiotic use, time at risk, comorbidities, and patient age before and after the pandemic onset. Frequency of
testing did not significantly change during the pandemic (
= 0.72).
Despite large increases in several CDI risk factors, we did not observe the expected corresponding changes in HA-CDI rate during the first two years of the COVID-19 pandemic. We hypothesize that infection prevention measures responding to COVID-19 played a role in CDI prevention.
Journal Article