Patient satisfaction after conversion from warfarin to direct oral anticoagulants for patients on extended duration of anticoagulation for venous thromboembolism – The SWAN Study

Background Warfarin is an anticoagulant medication proven effective in the initial treatment and secondary prevention of venous thromboembolism. Anti-Xa direct oral anticoagulants are alternatives to warfarin; however there is limited data assessing satisfaction after switching from warfarin to an anti-Xa direct oral anticoagulant in patients for treatment of venous thromboembolism. Objectives To assess medication satisfaction in patients requiring anticoagulation for venous thromboembolism after conversion from warfarin to an anti-Xa direct oral anticoagulant. Methods A retrospective cohort study with prospective assessment of satisfaction and review of adverse events following anti-Xa direct oral anticoagulant replacement of warfarin for treatment of venous thromboembolism. Out of 165 patients who had switched from warfarin to rivaroxaban or apixaban from an outpatient haematology practice, 126 patients consented for a survey of patient’s relative satisfaction of anti-Xa direct oral anticoagulant therapy compared with previous warfarin therapy using the Anti-Clot Burden and Benefits Treatment Scale and SWAN Score. Results The mean Anti-Clot Burden and Benefits and SWAN Score was 93% (56/60) and 83% (24.8/30) respectively reflecting high satisfaction with anti-Xa direct oral anticoagulants. 120 patients stated preference for anti-Xa direct oral anticoagulants over warfarin. Leading perceptions driving this was the reduction in frequency of medical contact and fewer bleeding side effects. Thirteen patients (10.3%) experienced an adverse event after the anti-Xa direct oral anticoagulant switch (majority were non-major bleeding) but most remained on anti-Xa direct oral anticoagulant treatment after management options were implemented with continued high satisfaction scores. Conclusions Patient satisfaction with anti-Xa direct oral anticoagulant therapy for the treatment and prevention of venous thromboembolism after switching from warfarin in routine clinical practice appeared high. Improved patient convenience including reduced frequency of medical contact and fewer unpredictable side effects were perceived as significant advantages of anti-Xa direct oral anticoagulants compared to warfarin

Adiabatic Approximation in the Density Matrix Approach: Non-Degenerate Systems

We study the adiabatic limit in the density matrix approach for a quantum system coupled to a weakly dissipative medium. The energy spectrum of the quantum model is supposed to be non-degenerate. In the absence of dissipation, the geometric phases for periodic Hamiltonians obtained previously by M.V. Berry are recovered in the present approach. We determine the necessary condition satisfied by the coefficients of the linear expansion of the non-unitary part of the Liouvillian in order to the imaginary phases acquired by the elements of the density matrix, due to dissipative effects, be geometric. The results derived are model-independent. We apply them to spin 1/2 model coupled to reservoir at thermodynamic equilibrium.Comment: 24 pages (new version), accepted for publication in Physica

Miri City as a festival destination image in the context of Miri Country Music Festival

The primary objective of the study is to ascertain the festival destination image of Miri. More specifically the study objectives are to determine Miri as a festival destination image among the tourists in the context of Miri Country Music Festival (MCMF) and to assess tourist’s satisfaction level of MCMF. The findings show that the participants have positive impression about Miri being a festival destination image. This paper provides some insights to relevant authorities for further improvements to meet the expectation of the tourists. The limitations of the study and future research are also discussed in this paper

Signatures of Superfluidity in Dilute Fermi Gases near a Feshbach Resonance

We present a brief account of the most salient properties of vortices in dilute atomic Fermi superfluids near a Feshbach resonance.Comment: 6 pages, 1 figure, and jltp.cls. Several typos and a couple of inaccuracies have been correcte

The influence of gene expression time delays on Gierer-Meinhardt pattern formation systems

There are numerous examples of morphogen gradients controlling long range signalling in developmental and cellular systems. The prospect of two such interacting morphogens instigating long range self-organisation in biological systems via a Turing bifurcation has been explored, postulated, or implicated in the context of numerous developmental processes. However, modelling investigations of cellular systems typically neglect the influence of gene expression on such dynamics, even though transcription and translation are observed to be important in morphogenetic systems. In particular, the influence of gene expression on a large class of Turing bifurcation models, namely those with pure kinetics such as the Gierer–Meinhardt system, is unexplored. Our investigations demonstrate that the behaviour of the Gierer–Meinhardt model profoundly changes on the inclusion of gene expression dynamics and is sensitive to the sub-cellular details of gene expression. Features such as concentration blow up, morphogen oscillations and radical sensitivities to the duration of gene expression are observed and, at best, severely restrict the possible parameter spaces for feasible biological behaviour. These results also indicate that the behaviour of Turing pattern formation systems on the inclusion of gene expression time delays may provide a means of distinguishing between possible forms of interaction kinetics. Finally, this study also emphasises that sub-cellular and gene expression dynamics should not be simply neglected in models of long range biological pattern formation via morphogens

Trapped two-component Fermi gases with up to six particles: Energetics, structural properties, and molecular condensate fraction

We investigate small equal-mass two-component Fermi gases under external spherically symmetric confinement in which atoms with opposite spins interact through a short-range two-body model potential. We employ a non-perturbative microscopic framework, the stochastic variational approach, and determine the system properties as functions of the interspecies s-wave scattering length a, the orbital angular momentum L of the system, and the numbers N1 and N2 of spin-up and spin-down atoms (with N1-N2 =0 or 1 and N < 7, where N=N1+N2). At unitarity, we determine the energies of the five- and six-particle systems for various ranges r0 of the underlying two-body model potential and extrapolate to the zero-range limit. These energies serve as benchmark results that can be used to validate and assess other numerical approaches. We also present structural properties such as the pair distribution function and the radial density. Furthermore, we analyze the one-body and two-body density matrices. A measure for the molecular condensate fraction is proposed and applied. Our calculations show explicitly that the natural orbitals and the momentum distributions of atomic Fermi gases approach those characteristic for a molecular Bose gas if the s-wave scattering length a, a>0, is sufficiently small.Comment: 21 pages, 15 figures; accepted for publication in special issue of CRA

Methods to Determine Neutrino Flux at Low Energies:Investigation of the Low ν\nu Method

We investigate the "low-$\nu$" method (developed by the CCFR/NUTEV collaborations) to determine the neutrino flux in a wide band neutrino beam at very low energies, a region of interest to neutrino oscillations experiments. Events with low hadronic final state energy $\nu<\nu_{cut}$ (of 1, 2 and 5 GeV) were used by the MINOS collaboration to determine the neutrino flux in their measurements of neutrino ($\nu_\mu$) and antineutrino (\nub_\mu) total cross sections. The lowest $\nu_\mu$ energy for which the method was used in MINOS is 3.5 GeV, and the lowest \nub_\mu energy is 6 GeV. At these energies, the cross sections are dominated by inelastic processes. We investigate the application of the method to determine the neutrino flux for $\nu_\mu$, \nub_\mu energies as low as 0.7 GeV where the cross sections are dominated by quasielastic scattering and $\Delta$(1232) resonance production. We find that the method can be extended to low energies by using $\nu_{cut}$ values of 0.25 and 0.50 GeV, which is feasible in fully active neutrino detectors such as MINERvA.Comment: 25 pages, 32 figures, to be published in European Physics Journal

Quadriceps volumes are reduced in people with patellofemoral joint osteoarthritis

Objectives: This study aimed to (1) compare the volumes of vastus medialis (VM), vastus lateralis (VL), vastus intermedius and rectus femoris and the ratio of VM/VL volumes between asymptomatic controls and patellofemoral joint osteoarthritis (PFJ OA) participants; and (2) assess the relationships between cross-sectional area (CSA) and volumes of the VM and VL in individuals with and without PFJ OA. Methods: Twenty-two participants with PFJ OA and 11 controls aged ≥40 years were recruited from the community and practitioner referrals. Muscle volumes of individual quadriceps components were measured from thigh magnetic resonance (MR) images. The CSA of the VM and lateralis were measured at 10 equally distributed levels (femoral condyles to lesser femoral trochanter). Results: PFJ OA individuals had smaller normalized VM (mean difference 0.90 cm ·kg , α = 0.011), VL (1.50 cm ·kg , α = 0.012) and rectus femoris (0.71 cm ·kg , α = 0.009) volumes than controls. No differences in the VM/VL ratio were observed. The CSA at the third level (controls) and fourth level (PFJ OA) above the femoral condyles best predicted VM volume, whereas the VL volume was best predicted by the CSA at the seventh level (controls) and sixth level (PFJ OA) above the femoral condyles. Conclusion: Reduced quadriceps muscle volume was a feature of PFJ OA. Muscle volume could be predicted from CSA measurements at specific levels in PFJ OA patients and controls

Observation of the Ankle and Evidence for a High-Energy Break in the Cosmic Ray Spectrum

We have measured the cosmic ray spectrum at energies above $10^{17}$ eV using the two air fluorescence detectors of the High Resolution Fly's Eye experiment operating in monocular mode. We describe the detector, PMT and atmospheric calibrations, and the analysis techniques for the two detectors. We fit the spectrum to models describing galactic and extragalactic sources. Our measured spectrum gives an observation of a feature known as the ``ankle'' near $3\times 10^{18}$ eV, and strong evidence for a suppression near $6\times 10^{19}$ eV.Comment: 14 pages, 9 figures. To appear in Physics Letters B. Accepted versio

The position of graptolites within Lower Palaeozoic planktic ecosystems.

An integrated approach has been used to assess the palaeoecology of graptolites both as a discrete group and also as a part of the biota present within Ordovician and Silurian planktic realms. Study of the functional morphology of graptolites and comparisons with recent ecological analogues demonstrates that graptolites most probably filled a variety of niches as primary consumers, with modes of life related to the colony morphotype. Graptolite coloniality was extremely ordered, lacking any close morphological analogues in Recent faunas. To obtain maximum functional efficiency, graptolites would have needed varying degrees of coordinated automobility. A change in lifestyle related to ontogenetic changes was prevalent within many graptolite groups. Differing lifestyle was reflected by differing reproductive strategies, with synrhabdosomes most likely being a method for rapid asexual reproduction. Direct evidence in the form of graptolithophage 'coprolitic' bodies, as well as indirect evidence in the form of probable defensive adaptations, indicate that graptolites comprised a food item for a variety of predators. Graptolites were also hosts to a variety of parasitic organisms and provided an important nutrient source for scavenging organisms