Implementation of the DCS System for the validation of MM HV Boards and the DCS System of the new BIS78 Chambers for the upgrade of muon system of the ATLAS Experiment

The ATLAS Muon Spectrometer is going through upgrades on the Phase I in order to achieve higher rates for the upcoming LHC runs. The two main projects of this Phase I upgrade are the New Small Wheels (NSW), which are expected to complement the ATLAS muon spectrometer in the end-cap regions and a smaller size project, known as BIS78 (Barrel Inner Small sectors). The NSW is expected to replace the Small Wheel (SW) and it will be installed in the ATLAS underground cavern during the summer by the end of the LHC Long Shutdown 2. This new system will be consisted by two prototype detectors, the sTGC (small Thin Gas Chambers) and the resistive Micromegas (MM). In order to cope with higher LHC luminosities, the installation of NSW will help the reduction of the trigger rate in the forward region. With half of the rate in the barrel-endcap transition region reduced by the existing TGCs, the other half of the fake trigger rate in transition region will be reduced by the new BIS78 stations. The BIS78 subproject foresees the replacement of the existing Monitored Drift Tubes (MDTs), used for the precise position measurement in this area, with muon stations formed by integrated smaller diameter tubes (sMDT) and a new generation of RPCs, capable of withstanding the higher rates and provide a robust standalone muon confirmation. The existing BIS7 and BIS8 MDT Chambers will be replaced by 16 new muon stations of one small (sMDT) chamber and two RPC triplets, and it will be the pilot project for the Phase II BI Upgrade. This work is divided into two parts. First will be presented the development and the implementation of a Detector Control System (DCS) for the HV system for the MM detectors of NSW and specifically the validation of a new type of HV Boards (A7038AP). Second, the development of the DCS for the monitoring and operation of the new sMDT chambers of the MDT Sub-System will be presented.

Implementation and Evaluation of an Electronic Maternal Early Warning Trigger Tool to Reduce Maternal Morbidity

Objective We compare maternal morbidity and clinical care metrics before and after the electronic implementation of a maternal early warning trigger (MEWT) tool. Study Design This is a study of maternal morbidity and clinical care within three linked hospitals comparing 1 year before and after electronic MEWT implementation. We compare severe maternal morbidity overall as well as within the subcategories of hemorrhage, hypertension, cardiopulmonary, and sepsis in addition to relevant process metrics in each category. We describe the MEWT trigger rate in addition to MEWT sensitivity and specificity for morbidity overall and by morbidity type. Results The morbidity rate ratio increased from 1.6 per 100 deliveries in the pre-MEWT period to 2.06 per 100 deliveries in the post-MEWT period (incidence rate ratio = 1.28, p = 0.018); however, in cases of septic morbidity, time to appropriate antibiotics decreased (pre-MEWT: 1.87 hours [1.11–2.63] vs. post-MEWT: 0.75 hours [0.31–1.19], p = 0.036) and in cases of hypertensive morbidity, the proportion of cases treated with appropriate antihypertensive medication within 60 minutes improved (pre-MEWT: 62% vs. post-MEWT: 83%, p = 0.040). The MEWT trigger rate was 2.3%, ranging from 0.8% in the less acute centers to 2.9% in our tertiary center. The MEWT sensitivity for morbidity overall was 50%; detection of hemorrhage morbidity was lowest (30%); however, it ranged between 69% for septic morbidity, 74% for cardiopulmonary morbidity, and 82% for cases of hypertensive morbidity. Conclusion Overall, maternal morbidity did not decrease after implementation of the MEWT system; however, important clinical metrics such as time to antibiotics and antihypertensive care improved. We suspect increased morbidity was related to annual variation and unexpected lower morbidity in the pre-MEWT comparison year. Because MEWT sensitivity for hemorrhage was low, and because hemorrhage dominates administrative metrics of morbidity, process metrics around sepsis, hypertension, and cardiopulmonary morbidity are important to track as markers of MEWT efficacy. Key Points

Establishment of a pediatric trigger tool based on Global Trigger Tool to identify adverse drug events of children: experience in a Chinese hospital

Background The Global Trigger Tool (GTT),which is a method using “triggers” to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs. Methods The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People’s Hospital. Results Thirty-three preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 admissions were 49.0. ADEs/1000 patient days were 46.89. The most common ADE categories were leukocyte disorders, skin disorders and platelet disorders. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs. Conclusions The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.

Establishment of a Pediatric Trigger Tool Based on Global Trigger Tool to Identify Adverse Drug Events of Children: Experience in a Chinese hospital

Background: The Global Trigger Tool (GTT)，which is a method using “triggers” to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs. Methods: The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People's Hospital.Results: 33 preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 patients were 49.0. ADEs/1000 patients days were 46.89. The most common ADE categories were leukocyte abnormalities, skin lesions and platelet abnormalities. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs. Conclusion: The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.

Establishment of a Pediatric Trigger Tool Based on Global Trigger Tool to Identify Adverse Drug Events of Children: Experience in a Chinese hospital

Background: The Global Trigger Tool (GTT)，which is a method using “triggers” to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs. Methods: The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People's Hospital. Results: 33 preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 patients were 49.0. ADEs/1000 patients days were 46.89. The most common ADE categories were leukocyte abnormalities, skin lesions and platelet abnormalities. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs . Conclusion : The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.

Adopting new technologies in the LHCb Gauss simulation framework

The increase in luminosity foreseen in the future years of operation of the Large Hadron Collider (LHC) creates new challenges in computing efficiency for all participating experiment. For Run 3 of the LHC, the LHCb collaboration needs to simulate about two orders of magnitude more Monte Carlo events to exploit the increased luminosity and trigger rate. Therefore, the LHCb simulation framework (Gauss) will go through a significant renovation, mostly driven by the upgraded core software framework (Gaudi) and the availability of a multithreaded version of Geant4. The upgraded Gaudi framework replaces single-threaded processing by a multithreaded approach, allowing concurrent execution of tasks with a single event as well as multiple events in parallel. A major task of the required overhaul of Gauss is the implementation of a new interface to the multithreaded version of Geant4.

Trigger Rate Monitoring Tools at CMS

One of the major challenges for the Compact Muon Solenoid (CMS)experiment, is the task of reducing event rate from roughly 40 MHz down to a more manageable 1 kHz while keeping as many interesting physics events as possible. This is accomplished through the use of a Level-1 (L1) hardware based trigger as well as a software based High-Level Trigger (HLT). Monitoring and understanding the output rates of the L1 and HLT triggers is of key importance for determining the overall performance of the trigger system and is intimately tied to what type of data is being recorded for physics analyses. We present here a collection of tools used by CMS to monitor the L1 and HLT trigger rates. One of these tools is a script (run in the CMS control room) that gives valuable real-time feedback of trigger rates to the shift crew. Another useful tool is a plotting library, that is used for observing how trigger rates vary over a range of beam and detector conditions, in particular how the rates of individual triggers scale with event pile-up.

The ATLAS Muon Trigger

Events containing muons in the final state are important for many physics analyses performed by the ATLAS experiment at the Large Hadron Collider. To collect such events, an efficient and well-understood muon trigger is required. The ATLAS muon trigger consists of a hardware-based and a software-based subsystem. In order to cope with the high luminosity and pileup conditions in Run 2, several improvements have been implemented to suppress the trigger rate while maintaining a high efficiency. Recent improvements include addition of layers in the coincidence of the muon spectrometer and optimisation of a muon trigger isolation requirement, among others. An overview of the algorithms deployed by the ATLAS muon trigger and its performance in 2018 data taking is presented.