Patient-reported outcome data generated in a clinical intervention in community mental health care - psychometric properties

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Cooperative light-induced breathing of soft porous crystals via azobenzene buckling

Although light is a prominent stimulus for smart materials, the application of photoswitches as light-responsive triggers for phase transitions of porous materials remains poorly explored. Here we incorporate an azobenzene photoswitch in the backbone of a metal-organic framework producing light-induced structural contraction of the porous network in parallel to gas adsorption. Light-stimulation enables non-invasive spatiotemporal control over the mechanical properties of the framework, which ultimately leads to pore contraction and subsequent guest release via negative gas adsorption. The complex mechanism of light-gated breathing is established by a series of in situ diffraction and spectroscopic experiments, supported by quantum mechanical and molecular dynamic simulations. Unexpectedly, this study identifies a novel light-induced deformation mechanism of constrained azobenzene photoswitches relevant to the future design of light-responsive materials

Ethnicity and COVID-19 cardiovascular complications: a multi-center UK cohort

BACKGROUND: Recent reports suggest an association between ethnicity and COVID-19 mortality. In the present multi-center study, we aimed to assess the differences underlying this association, and ascertain whether ethnicity also mediates other aspects of COVID-19 like cardiovascular complications. METHODS: Data were collected from a mixed-ethnicity UK cohort of 613 patients admitted and diagnosed COVID-19 positive, across six hospitals in London during the second half of March 2020: 292 were White Caucasian ethnicity, 203 were Asian and 118 were of Afro-Caribbean ethnicity. RESULTS: Caucasian patients were older (P<0.001) and less likely to have hypertension (P=0.038), while Afro-Caribbean patients had higher prevalence of diabetes mellitus (P<0.001). Asian patients were more likely to present with venous thromboembolic disease (adj.OR=4.10, 95% CI 1.49-11.27, P=0.006). On the other hand, Afro-Caribbean had more heart failure (adj.OR=3.64, 95% CI 1.50-8.84, P=0.004) and myocardial injury (adj.OR=2.64, 95% CI 1.10-6.35, P=0.030). Importantly, our adjusted multi-variate Cox regression analysis revealed significantly higher all-cause mortality both for Asian (adj.HR=1.89, 95% CI 1.23-2.91, P=0.004) and Afro-Caribbean ethnicity (adj.HR=2.09, 95% CI 1.30-3.37, P=0.002). CONCLUSIONS: Our data show that COVID-19 may have different presentations and follow different clinical trajectories depending on the ethnicity of the affected subject. Awareness of complications more likely to arise in specific ethnicities will allow a more timely diagnosis and preventive measures for patients at risk. Due to increased mortality, individuals of Afro-Caribbean and Asian ethnicity should be considered as high-risk groups. This may have an impact on health-resource allocation and planning, definition of vulnerable groups, disease management, and the protection of healthcare workers at the frontline

The MUSIC of Galaxy Clusters I: Baryon properties and Scaling Relations of the thermal Sunyaev-Zel'dovich Effect

We introduce the Marenostrum-MultiDark SImulations of galaxy Clusters (MUSIC) Dataset, one of the largest sample of hydrodynamically simulated galaxy clusters with more than 500 clusters and 2000 groups. The objects have been selected from two large N-body simulations and have been resimulated at high resolution using SPH together with relevant physical processes (cooling, UV photoionization, star formation and different feedback processes). We focus on the analysis of the baryon content (gas and star) of clusters in the MUSIC dataset both as a function of aperture radius and redshift. The results from our simulations are compared with the most recent observational estimates of the gas fraction in galaxy clusters at different overdensity radii. When the effects of cooling and stellar feedbacks are included, the MUSIC clusters show a good agreement with the most recent observed gas fractions quoted in the literature. A clear dependence of the gas fractions with the total cluster mass is also evident. The impact of the aperture radius choice, when comparing integrated quantities at different redshifts, is tested: the standard definition of radius at a fixed overdensity with respect to critical density is compared with a definition based on the redshift dependent overdensity with respect to background density. We also present a detailed analysis of the scaling relations of the thermal SZ (Sunyaev Zel'dovich) Effect derived from MUSIC clusters. The integrated SZ brightness, Y, is related to the cluster total mass, M, as well as, the M-Y counterpart, more suitable for observational applications. Both laws are consistent with predictions from the self-similar model, showing a very low scatter. The effects of the gas fraction on the Y-M scaling and the presence of a possible redshift dependence on the Y-M scaling relation are also explored.Comment: 22 pages, 25 figures, accepted for pubblication by MNRA

High sensitivity troponin and COVID-19 outcomes

Background: Recent reports have demonstrated high troponin levels in patients affected with COVID-19. In the present study, we aimed to determine the association between admission and peak troponin levels and COVID-19 outcomes. / Methods: This was an observational multi-ethnic multi-centre study in a UK cohort of 434 patients admitted and diagnosed COVID-19 positive, across six hospitals in London, UK during the second half of March 2020. / Results: Myocardial injury, defined as positive troponin during admission was observed in 288 (66.4%) patients. Age (OR: 1.68 [1.49–1.88], p <.001), hypertension (OR: 1.81 [1.10–2.99], p =.020) and moderate chronic kidney disease (OR: 9.12 [95% CI: 4.24–19.64], p <.001) independently predicted myocardial injury. After adjustment, patients with positive peak troponin were more likely to need non-invasive and mechanical ventilation (OR: 2.40 [95% CI: 1.27–4.56], p =.007, and OR: 6.81 [95% CI: 3.40–13.62], p <.001, respectively) and urgent renal replacement therapy (OR: 4.14 [95% CI: 1.34–12.78], p =.013). With regards to events, and after adjustment, positive peak troponin levels were independently associated with acute kidney injury (OR: 6.76 [95% CI: 3.40–13.47], p <.001), venous thromboembolism (OR: 11.99 [95% CI: 3.20–44.88], p <.001), development of atrial fibrillation (OR: 10.66 [95% CI: 1.33–85.32], p =.026) and death during admission (OR: 2.40 [95% CI: 1.34–4.29], p =.003). Similar associations were observed for admission troponin. In addition, median length of stay in days was shorter for patients with negative troponin levels: 8 (5–13) negative, 14 (7–23) low-positive levels and 16 (10–23) high-positive (p <.001). / Conclusions: Admission and peak troponin appear to be predictors for cardiovascular and non-cardiovascular events and outcomes in COVID-19 patients, and their utilisation may have an impact on patient management

Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction.

BACKGROUND: There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. METHODS: A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients. The prevalence of aesthetic and functional morbidity at the donor site was described. The two new scales were refined using the Rasch measurement model and subsequently validated. RESULTS: 1,096 women completed the new scales. 78% of patients reported that no back appearance issues had bothered them "most of the time" or "all of the time" in the past two weeks. The equivalent figure for functional morbidity was 60%. Four items were eliminated following initial psychometric testing. This produced an 8-item Back Appearance scale and an 11-item Back and Shoulder Function scale. Both scales showed adequate fit to the Rasch measurement model. Higher levels of aesthetic and functional bother were observed for completely autologous procedures versus those where latissimus dorsi reconstruction was used to cover an implant (p <0.05). Higher levels of aesthetic bother were observed in women who had suffered a perioperative complication at the donor site (p = 0.003). CONCLUSION: These results can inform patients of the morbidity associated with latissimus dorsi reconstruction. The new scales can be used to compare groups undergoing different variations of the procedure and to monitor individual patients

Half-lives of Sr-73 and Y-76 and the consequences for the proton dripline

The half-lives of seven nuclei have been determined in the neutron-deficient mass-70 region following their production via fragmentation of a 345 MeV/nucleon Xe-124 primary beam on a 740 mg/cm(2) Be-9 target at the RI Beam Factory, RIKEN. The results include two new (Sr-73 and Y-76) half-lives and a more precise measurement for the ground-state half-life of Sr-74. The new results are discussed with reference to previously published calculations that predict the location of the proton dripline in the light Sr and Y region of the nuclear chart. In addition, differences in the ground-state structure of Rb-72 and Y-76 are discussed with the aid of density functional theory calculations. These provide a possible explanation for why Rb-72 undergoes proton decay while the alpha-conjugate nucleus Y-76 predominantly undergoes beta(+) decay.Peer reviewe

Measurement-induced nonlinearity in linear optics

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