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Dynamics of strange, charm and high momentum hadrons in relativistic nucleus nucleus collisions
(2003)
We investigate hadron production and attenuation of hadrons with strange and charm quarks (or antiquarks) as well as high transverse momentum hadrons in relativistic nucleus-nucleus col- lisions from 2 A·GeV to 21.3 A·TeV within two independent transport approaches (UrQMD and HSD). Both transport models are based on quark, diquark, string and hadronic degrees of freedom, but do not include any explicit phase transition to a quark-gluon plasma. From our dynamical calculations we find that both models do not describe the maximum in the K+/ + ratio at 20 - 30 A·GeV in central Au+Au collisions found experimentally, though the excitation functions of strange mesons are reproduced well in HSD and UrQMD. Furthermore, the transport calculations show that the charmonium recreation by D + J/ + meson reactions is comparable to the dissociation by comoving mesons at RHIC energies contrary to SPS energies. This leads to the final result that the total J/ suppression as a function of centrality at RHIC should be less than the suppression seen at SPS energies where the comover dissociation is substantial and the backward channels play no role. Furthermore, our transport calculations in comparison to exper- imental data on transverse momentum spectra from pp, d+Au and Au+Au reactions show that pre-hadronic e ects are responsible for both the hardening of the hadron spectra for low transverse momenta (Cronin e ect) as well as the suppression of high pT hadrons. The mutual interactions of formed hadrons are found to be negligible in central Au+Au collisions at s = 200 GeV for pT e 6 GeV/c and the sizeable suppression seen experimentally is attributed to a large extent to the interactions of leading pre-hadrons with the dense environment.
Introduction: Clinically complex patients often require multiple medications. Polypharmacy is associated with inappropriate prescriptions, which may lead to negative outcomes. Few effective tools are available to help physicians optimise patient medication. This study assesses whether an electronic medication management support system (eMMa) reduces hospitalisation and mortality and improves prescription quality/safety in patients with polypharmacy. Methods and analysis: Planned design: pragmatic, parallel cluster-randomised controlled trial; general practices as randomisation unit; patients as analysis unit. As practice recruitment was poor, we included additional data to our primary endpoint analysis for practices and quarters from October 2017 to March 2021. Since randomisation was performed in waves, final study design corresponds to a stepped-wedge design with open cohort and step-length of one quarter. Scope: general practices, Westphalia-Lippe (Germany), caring for BARMER health fund-covered patients. Population: patients (≥18 years) with polypharmacy (≥5 prescriptions). Sample size: initially, 32 patients from each of 539 practices were required for each study arm (17 200 patients/arm), but only 688 practices were randomised after 2 years of recruitment. Design change ensures that 80% power is nonetheless achieved. Intervention: complex intervention eMMa. Follow-up: at least five quarters/cluster (practice). recruitment: practices recruited/randomised at different times; after follow-up, control group practices may access eMMa. Outcomes: primary endpoint is all-cause mortality and hospitalisation; secondary endpoints are number of potentially inappropriate medications, cause-specific hospitalisation preceded by high-risk prescribing and medication underuse. Statistical analysis: primary and secondary outcomes are measured quarterly at patient level. A generalised linear mixed-effect model and repeated patient measurements are used to consider patient clusters within practices. Time and intervention group are considered fixed factors; variation between practices and patients is fitted as random effects. Intention-to-treat principle is used to analyse primary and key secondary endpoints.
The Transition Radiation Detector (TRD) was designed and built to enhance the capabilities of the ALICE detector at the Large Hadron Collider (LHC). While aimed at providing electron identification and triggering, the TRD also contributes significantly to the track reconstruction and calibration in the central barrel of ALICE. In this paper the design, construction, operation, and performance of this detector are discussed. A pion rejection factor of up to 410 is achieved at a momentum of 1 GeV/c in p-Pb collisions and the resolution at high transverse momentum improves by about 40% when including the TRD information in track reconstruction. The triggering capability is demonstrated both for jet, light nuclei, and electron selection.
The Transition Radiation Detector (TRD) was designed and built to enhance the capabilities of the ALICE detector at the Large Hadron Collider (LHC). While aimed at providing electron identification and triggering, the TRD also contributes significantly to the track reconstruction and calibration in the central barrel of ALICE. In this paper the design, construction, operation, and performance of this detector are discussed. A pion rejection factor of up to 410 is achieved at a momentum of 1 GeV/c in p-Pb collisions and the resolution at high transverse momentum improves by about 40% when including the TRD information in track reconstruction. The triggering capability is demonstrated both for jet, light nuclei, and electron selection.
The Transition Radiation Detector (TRD) was designed and built to enhance the capabilities of the ALICE detector at the Large Hadron Collider (LHC). While aimed at providing electron identification and triggering, the TRD also contributes significantly to the track reconstruction and calibration in the central barrel of ALICE. In this paper the design, construction, operation, and performance of this detector are discussed. A pion rejection factor of up to 410 is achieved at a momentum of 1 GeV/c in p–Pb collisions and the resolution at high transverse momentum improves by about 40% when including the TRD information in track reconstruction. The triggering capability is demonstrated both for jet, light nuclei, and electron selection.
Background: Interventional studies on polypharmacy often fail to significantly improve patient-relevant outcomes, or confine themselves to measuring surrogate parameters. Interventions and settings are complex, with many factors affecting results. The AdAM study’s aim is to reduce hospitalization and death by requiring general practitioners (GPs) to use a computerized decision-support system (CDSS). The study will undergo a process evaluation to identify factors for successful implementation and to assess whether the intervention was implemented as intended.
Objective: To evaluate our complex intervention, based on the Medical Research Council’s guideline dimensions.
Research Questions:
We will assess implementation (reach, fidelity, dose, tailoring) by asking: (1) Who took part in the intervention (proportion of GPs using the CDSS, proportion of patients enrolled in them)? Information on GPs’ and patients’ characteristics will also be collected. (2) How many and which medication alerts were dealt with? (3) Was the intervention implemented as intended? (4) On what days did GPs use the intervention tool?
Methods: The process evaluation is part of a stepped-wedge cluster-randomized controlled trial. Characteristics of practices, GPs and patients using the CDSS will be compared with the non-participating population. CDSS log data will be analyzed to evaluate how the number of medication alerts changed between baseline and 2 months later, and to identify the kind of alerts that were dealt with. Comparison of enrolled patients on weekdays versus weekends will shed light on GPs’ use of the CDSS in the absence or presence of patients. Outcomes will be presented using descriptive statistics, and significance tests will be used to identify associations between them. We will conduct subgroup analyses, including time effects to account for software improvements.
Discussion: This study protocol is the basis for conducting analyses of the quantitative process evaluation. By providing insight into how GPs conduct medication reviews, the evaluation will provide context to the trial results and support their interpretation. The evaluation relies on the proper documentation by GPs, potentially limiting its explanatory power.
We investigate the onset of multifragmentation employing an improved version of the N-body ‘‘quantum’’ molecular-dynamics approach. We study in detail the reaction 18O+197Au at 84 MeV/nucleon and find good agreement between the calculated results and the data for the double-differential proton cross section, the mass yield, the multiplicity, the kinetic energy of the fragments, and even for the kinematic correlations between intermediate mass fragments (IMF’s), which have been measured in this experiment for the first time. We observe a strong correlation between the impact parameter and both the size of the target remnant as well as the average proton multiplicity. Hence both observables can be used to determine the impact parameter experimentally. The IMF’s come from the most central collisions. The calculations confirm the experimental result that they are not emitted from an equilibrated system. Although the inclusive energy spectra look thermal, we cannot identify an impact parameter-independent isotropically emitting source. Even in central collisions global equilibrium is not observed. We find that multifragment emission at this bombarding energy is caused by a process very similar to that proposed in the macroscopic cold multifragmentation model. Thus it has a different origin than at beam energies around 1 GeV/nucleon, although the mass yield has an almost identical slope.