We have determined the coexistence at positive temperature between a Wigner crystal and a fluid plasma using path integral Monte Carlo. The total energies are significantly different from classical and semiclassical predictions. The location of the phase transition between liquid and solid is higher in temperature than predicted by a generalized Lindemann criterion. Some features of the phase diagram can be understood using a novel application of the Clausius-Clapeyron equation. We find a maximum melting temperature of 6.0͑5͒ 3 10 25 Ry at r s Ӎ 180͑20͒. [S0031-9007(96)00437-1]
In this large, multicenter study, patients who received cefazolin had a lower risk of mortality and similar odds of recurrent infections compared with nafcillin or oxacillin for MSSA infections complicated by bacteremia. Physicians might consider definitive therapy with cefazolin for these infections.
BackgroundClinical experts’ cognitive mechanisms for managing complexity have implications for the design of future innovative healthcare systems. The purpose of the study is to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment.MethodsWe used Cognitive Task Analysis (CTA) methods to interview 10 Infectious Disease (ID) experts at the University of Utah and Salt Lake City Veterans Administration Medical Center. Participants were asked to recall a complex, critical and vivid antibiotic-prescribing incident using the Critical Decision Method (CDM), a type of Cognitive Task Analysis (CTA). Using the four iterations of the Critical Decision Method, questions were posed to fully explore the incident, focusing in depth on the clinical components underlying the complexity. Probes were included to assess cognitive and decision strategies used by participants.ResultsThe following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety. All these factors contribute to decision complexity. These factors almost always occurred together, creating unexpected events and uncertainty in clinical reasoning. Five themes emerged in the analyses of how experts deal with the complexity. Expert clinicians frequently used 1) watchful waiting instead of over- prescribing antibiotics, engaged in 2) theory of mind to project and simulate other practitioners’ perspectives, reduced very complex cases into simple 3) heuristics, employed 4) anticipatory thinking to plan and re-plan events and consulted with peers to share knowledge, solicit opinions and 5) seek help on patient cases.ConclusionThe cognitive strategies to deal with decision complexity found in this study have important implications for design future decision support systems for the management of complex patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-015-0221-z) contains supplementary material, which is available to authorized users.
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