The meaning of variation to healthcare managers, clinical and health-services researchers, and individual patients

Healthcare managers, clinical researchers and individual patients (and their physicians) manage variation differently to achieve different ends. First, managers are primarily concerned with the performance of care processes over time. Their time horizon is relatively short, and the improvements they are concerned with are pragmatic and 'holistic.' Their goal is to create processes that are stable and effective. The analytical techniques of statistical process control effectively reflect these concerns. Second, clinical and health-services researchers are interested in the effectiveness of care and the generalisability of findings. They seek to control variation by their study design methods. Their primary question is: 'Does A cause B, everything else being equal?' Consequently, randomised controlled trials and regression models are the research methods of choice. The focus of this reductionist approach is on the 'average patient' in the group being observed rather than the individual patient working with the individual care provider. Third, individual patients are primarily concerned with the nature and quality of their own care and clinical outcomes. They and their care providers are not primarily seeking to generalise beyond the unique individual. We propose that the gold standard for helping individual patients with chronic conditions should be longitudinal factorial design of trials with individual patients. Understanding how these three groups deal differently with variation can help appreciate these three approaches

Theory of a Higher Order Phase Transition: Superconducting Transition in BKBO

We describe here the properties expected of a higher (with emphasis on the order fourth) order phase transition. The order is identified in the sense first noted by Ehrenfest, namely in terms of the temperature dependence of the ordered state free energy near the phase boundary. We have derived an equation for the phase boundary in terms of the discontinuities in thermodynamic observables, developed a Ginzburg-Landau free energy and studied the thermodynamic and magnetic properties. We also discuss the current status of experiments on $Ba_{0.6}K_{0.4}BiO_3$ and other $BiO_3$ based superconductors, the expectations for parameters and examine alternative explanations of the experimental results.Comment: 18 pages, no figure

Relic Neutrino Absorption Spectroscopy

Resonant annihilation of extremely high-energy cosmic neutrinos on big-bang relic anti-neutrinos (and vice versa) into Z-bosons leads to sizable absorption dips in the neutrino flux to be observed at Earth. The high-energy edges of these dips are fixed, via the resonance energies, by the neutrino masses alone. Their depths are determined by the cosmic neutrino background density, by the cosmological parameters determining the expansion rate of the universe, and by the large redshift history of the cosmic neutrino sources. We investigate the possibility of determining the existence of the cosmic neutrino background within the next decade from a measurement of these absorption dips in the neutrino flux. As a by-product, we study the prospects to infer the absolute neutrino mass scale. We find that, with the presently planned neutrino detectors (ANITA, Auger, EUSO, OWL, RICE, and SalSA) operating in the relevant energy regime above 10^{21} eV, relic neutrino absorption spectroscopy becomes a realistic possibility. It requires, however, the existence of extremely powerful neutrino sources, which should be opaque to nucleons and high-energy photons to evade present constraints. Furthermore, the neutrino mass spectrum must be quasi-degenerate to optimize the dip, which implies m_{nu} >~ 0.1 eV for the lightest neutrino. With a second generation of neutrino detectors, these demanding requirements can be relaxed considerably.Comment: 19 pages, 26 figures, REVTeX

Measurement of the correlation between flow harmonics of different order in lead-lead collisions at √sNN = 2.76 TeV with the ATLAS detector

Correlations between the elliptic or triangular flow coefficients vm (m=2 or 3) and other flow harmonics vn (n=2 to 5) are measured using √sNN=2.76 TeV Pb+Pb collision data collected in 2010 by the ATLAS experiment at the LHC, corresponding to an integrated luminosity of 7 μb−1. The vm−vn correlations are measured in midrapidity as a function of centrality, and, for events within the same centrality interval, as a function of event ellipticity or triangularity defined in a forward rapidity region. For events within the same centrality interval, v3 is found to be anticorrelated with v2 and this anticorrelation is consistent with similar anticorrelations between the corresponding eccentricities, ε2 and ε3. However, it is observed that v4 increases strongly with v2, and v5 increases strongly with both v2 and v3. The trend and strength of the vm−vn correlations for n=4 and 5 are found to disagree with εm−εn correlations predicted by initial-geometry models. Instead, these correlations are found to be consistent with the combined effects of a linear contribution to vn and a nonlinear term that is a function of v22 or of v2v3, as predicted by hydrodynamic models. A simple two-component fit is used to separate these two contributions. The extracted linear and nonlinear contributions to v4 and v5 are found to be consistent with previously measured event-plane correlations

A search for prompt lepton-jets in pp collisions at root s=8 TeV with the ATLAS detector

A search is presented for a new, light boson with a mass of about 1 GeV and decaying promptly to jets of collimated electrons and/or muons (lepton-jets). The analysis is performed with 20.3 fb−1 of data collected by the ATLAS detector at the Large Hadron Collider in proton-proton collisions at a centre-of-mass energy of 8 TeV. Events are required to contain at least two lepton-jets. This study finds no statistically significant deviation from predictions of the Standard Model and places 95% confidence-level upper limits on the contribution of new phenomena beyond the SM, incuding SUSY-portal and Higgs-portal models, on the number of events with lepton-jets.We acknowledge the support of ANPCyT, Argentina; YerPhI, Armenia; ARC, Australia; BMWFW and FWF, Austria; ANAS, Azerbaijan; SSTC, Belarus; CNPq and FAPESP, Brazil; NSERC, NRC and CFI, Canada; CERN; CONICYT, Chile; CAS, MOST and NSFC, China; COLCIENCIAS, Colombia; MSMT CR, MPO CR and VSC CR, Czech Republic; DNRF, DNSRC and Lundbeck Foundation, Denmark; IN2P3-CNRS, CEADSM/IRFU, France; GNSF, Georgia; BMBF, HGF, and MPG, Germany; GSRT, Greece; RGC, Hong Kong SAR, China; ISF, I-CORE and Benoziyo Center, Israel; INFN, Italy; MEXT and JSPS, Japan; CNRST, Morocco; FOM and NWO, Netherlands; RCN, Norway; MNiSW and NCN, Poland; FCT, Portugal; MNE/IFA, Romania; MES of Russia and NRC KI, Russian Federation; JINR; MESTD, Serbia; MSSR, Slovakia; ARRS and MIZ. S, Slovenia; DST/NRF, South Africa; MINECO, Spain; SRC and Wallenberg Foundation, Sweden; SERI, SNSF and Cantons of Bern and Geneva, Switzerland; MOST, Taiwan; TAEK, Turkey; STFC, United Kingdom; DOE and NSF, United States of America. In addition, individual groups and members have received support from BCKDF, the Canada Council, CANARIE, CRC, Compute Canada, FQRNT, and the Ontario Innovation Trust, Canada; EPLANET, ERC, FP7, Horizon 2020 and Marie Sklodowska-Curie Actions, European Union; Investissements d'Avenir Labex and Idex, ANR, Region Auvergne and Fondation Partager le Savoir, France; DFG and AvH Foundation, Germany; Herakleitos, Thales and Aristeia programmes co-financed by EU-ESF and the Greek NSRF; BSF, GIF and Minerva, Israel; BRF, Norway; the Royal Society and Leverhulme Trust, United Kingdom

Measurement of jet charge in dijet events from √s = 8 TeV pp collisions with the ATLAS detector

The momentum-weighted sum of the charges of tracks associated to a jet is sensitive to the charge of the initiating quark or gluon. This paper presents a measurement of the distribution of momentum-weighted sums, called jet charge, in dijet events using 20.3 fb−¹ of data recorded with the ATLAS detector at √s = 8 TeV in pp collisions at the LHC. The jet charge distribution is unfolded to remove distortions from detector effects and the resulting particle-level distribution is compared with several models. The pT dependence of the jet charge distribution average and standard deviation are compared to predictions obtained with several leading-order and next-to-leading-order parton distribution functions. The data are also compared to different Monte Carlo simulations of QCD dijet production using various settings of the free parameters within these models. The chosen value of the strong coupling constant used to calculate gluon radiation is found to have a significant impact on the predicted jet charge. There is evidence for a pT dependence of the jet charge distribution for a given jet flavor. In agreement with perturbative QCD predictions, the data show that the average jet charge of quark-initiated jets decreases in magnitude as the energy of the jet increases

Search for the production of single vector-like and excited quarks in the Wt final state in pp collisions at √s=8 TeV with the ATLAS detector

A search for vector-like quarks and excited quarks in events containing a top quark and a W boson in the final state is reported here. The search is based on 20.3 fb−1 of proton-proton collision data taken at the LHC at a centre-of-mass energy of 8 TeV recorded by the ATLAS detector. Events with one or two leptons, and one, two or three jets are selected with the additional requirement that at least one jet contains a b-quark. Single-lepton events are also required to contain at least one large-radius jet from the hadronic decay of a high-pTW boson or a top quark. No significant excess over the expected background is observed and upper limits on the cross-section times branching ratio for different vector-like quark and excited-quark model masses are derived. For the excited-quark production and decay to Wt with unit couplings, quarks with masses below 1500 GeV are excluded and coupling-dependent limits are set

Isotope fractionation of zinc in the paddy rice soil-water environment and the role of 2’deoxymugineic acid (DMA) as zincophore under Zn limiting conditions

Non-traditional stable isotope systems are increasingly used to study micronutrient cycling and acquisition in terrestrial ecosystems. We previously proposed for zinc (Zn) a conceptual model linking observed isotope signatures and fractionations to biogeochemical processes occurring in the rice soil environment and we suggested that 2’deoxymugineic acid (DMA) could play an important role for rice during the acquisition of Zn when grown under Zn limiting conditions. This proposition was sustained by the extent and direction of isotope fractionation observed during the complexation of Zn with DMA synthesised in our laboratory. Here we report a new set of experimental data from field and laboratory studies designed to further elucidate the mechanisms controlling Zn isotope fractionation in the rice rhizosphere and the role of DMA. First, we present acidity (pKa) and complexation (logK) constants for DMA with H+ and Zn2+, respectively, using synthetic 2’deoxymugineic acid and show that they are significantly different from previously published data using isolates from plants. Our new set of thermodynamic data allows for a more accurate calculation of the formation of ZnDMA complexes over pH ranges typically found in the rhizosphere of flooded lowland rice soils and in rice plant compartments (xylem, phloem). We show that at pH > 6.5, Zn is fully complexed by DMA and at pH <4.5 fully dissociated. This has important implications, i.e. that in alkaline paddy soils, DMA can strip Zn from soil solids (organic and inorganic) and that ZnDMA complexes are stable at the root interface if the pH is alkaline and in the phloem and xylem of the rice shoot. Second, we present a new set of Zn isotope data in rice grown in alkaline soils with low Zn availability with and without Zn addition. We used two genotypes not tested to date, i.e. A69–1, tolerant to low Zn supply, and IR26, sensitive to low Zn supply. We confirm previous findings that, in contrast to observations with rice grown in hydroponic studies, no isotopically light Zn is taken up into the shoot irrespective of Zn fertilization and that isotopically heavier Zn is taken up by rice grown in soils with low Zn supply. Third, we determined the isotope fractionation isotherm for Zn during absorption on goethite, representing the iron phase (plaque) typically forming on rice roots, in acidic solution. The negative Zn isotope fractionation observed (i.e., Δ66Zngoethite-solution < 0, where Δ66Zngoethite-solution = (δ66Zn of goethite) – (δ66Zn of solution)) is in contrast to the positive isotope fractionation (Δ66Zngoethite-solution > 0) detected during adsorption of Zn on goethite in alkaline solutions or between root and soil solution in rice grown in alkaline soils. We show that removal of different Zn species from solution and changes in the Zn coordination control extent and direction of isotope fraction during adsorption. Using the new set of results and combining it with recent findings from the literature, we present a refined conceptual model linking biogeochemical processes to Zn isotope fractionation in the rice soil system. Our results confirm the importance of root induced chemical changes in the rhizosphere of rice growing in soils with low Zn availability, demonstrate the unique ability of isotope signatures to deconvolve geochemical processes and conditions in the plant-soil environment and support the hypothesis of an important role of DMA in Zn acquisition under Zn limiting conditions

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

Search for new phenomena with photon+jet events in proton-proton collisions at √s=13 TeV with the ATLAS detector

A search is performed for the production of high-mass resonances decaying into a photon and a jet in 3.2 fb−1 of proton-proton collisions at a centre-of-mass energy of √s=13 TeV collected by the ATLAS detector at the Large Hadron Collider. Selected events have an isolated photon and a jet, each with transverse momentum above 150 GeV. No significant deviation of the γ+jet invariant mass distribution from the background-only hypothesis is found. Limits are set at 95% confidence level on the cross sections of generic Gaussian-shaped signals and of a few benchmark phenomena beyond the Standard Model: excited quarks with vector-like couplings to the Standard Model particles, and non-thermal quantum black holes in two models of extra spatial dimensions. The minimum excluded visible cross sections for Gaussian-shaped resonances with width-to-mass ratios of 2% decrease from about 6 fb for a mass of 1.5 TeV to about 0.8 fb for a mass of 5 TeV. The minimum excluded visible cross sections for Gaussian-shaped resonances with width-to-mass ratios of 15% decrease from about 50 fb for a mass of 1.5 TeV to about 1.0 fb for a mass of 5 TeV. Excited quarks are excluded below masses of 4.4 TeV, and non-thermal quantum black holes are excluded below masses of 3.8 (6.2) TeV for Randall-Sundrum (Arkani-Hamed-Dimopoulous-Dvali) models with one (six) extra dimensions