Clinical and financial consequences of setting up an asthma clinic at St. Luke’s Hospital

The effects of setting up an asthma clinic were assessed in an audit study. A comparison was made between the quality and quantity of medication used by patients before and after attending the asthma clinic. The number and severity of exacerbations during a six month period before and a six month period after attending were also assessed. The cost of treatment before and after was also calculated. In 14% of patients, occupational factors, drugs or underlying lung disease were significant contributors to asthma. The number of acute episodes of severe asthma were reduced from 98 to 47, with hospital admissions falling from 26 to 1. Pulmonary function (%FEV1) improved in the group as a whole with the number of patients having their best FEV above 80% improving from 44 to 71. In spite of the expense of high cost drugs and the running costs of the clinic there were substantial savings largely from the reduced number of hospital admissions. The calculated annual cost fell from Lm 22,769 to Lm 10,654.peer-reviewe

Discovery-led refinement in e-discovery investigations: sensemaking, cognitive ergonomics and system design.

Given the very large numbers of documents involved in e-discovery investigations, lawyers face a considerable challenge of collaborative sensemaking. We report findings from three workplace studies which looked at different aspects of how this challenge was met. From a sociotechnical perspective, the studies aimed to understand how investigators collectively and individually worked with information to support sensemaking and decision making. Here, we focus on discovery-led refinement; specifically, how engaging with the materials of the investigations led to discoveries that supported refinement of the problems and new strategies for addressing them. These refinements were essential for tractability. We begin with observations which show how new lines of enquiry were recursively embedded. We then analyse the conceptual structure of a line of enquiry and consider how reflecting this in e-discovery support systems might support scalability and group collaboration. We then focus on the individual activity of manual document review where refinement corresponded with the inductive identification of classes of irrelevant and relevant documents within a collection. Our observations point to the effects of priming on dealing with these efficiently and to issues of cognitive ergonomics at the human–computer interface. We use these observations to introduce visualisations that might enable reviewers to deal with such refinements more efficiently

On the Role of Dewetting Transitions in Host-Guest Binding Free Energy Calculations.

We use thermodynamic integration (TI) and explicit solvent molecular dynamics (MD) simulation to estimate the absolute free energy of host-guest binding. In the unbound state, water molecules visit all of the internally accessible volume of the host, which is fully hydrated on all sides. Upon binding of an apolar guest, the toroidal host cavity is fully dehydrated; thus, during the intermediate λ stages along the integration, the hydration of the host fluctuates between hydrated and dehydrated states. Estimating free energies by TI can be especially challenging when there is a considerable difference in hydration between the two states of interest. We investigate these aspects using the popular TIP3P and TIP4P water models. TI free energy estimates through MD largely depend on water-related interactions, and water dynamics significantly affect the convergence of binding free energy calculations. Our results indicate that wetting/dewetting transitions play a major role in slowing the convergence of free energy estimation. We employ two alternative approaches-one analytical and the other empirically based on actual MD sampling-to correct for the standard state free energy. This correction is sizable (up to 4 kcal/mol), and the two approaches provide corrections that differ by about 1 kcal/mol. For the system considered here, the TIP4P water model combined with an analytical correction for the standard state free energy provides higher overall accuracy. This observation might be transferable to other systems in which water-related contributions dominate the binding process

Twisted mass chiral perturbation theory for 2+1+1 quark flavours

We present results for the masses of pseudoscalar mesons in twisted mass lattice QCD with a degenerate doublet of u and d quarks and a non-degenerate doublet of s and c quarks in the framework of next-to-leading order chiral perturbation theory, including lattice effects up to O(a^2). The masses depend on the two twist angles for the light and heavy sectors. For maximal twist in both sectors, O(a)-improvement is explicitly exhibited. The mixing of flavour-neutral mesons is also discussed, and results in the literature for the case of degenerate s and c quarks are corrected.Comment: LaTeX2e, 12 pages, corrected typo

High frequency dynamics in a monatomic glass

The high frequency dynamics of glassy Selenium has been studied by Inelastic X-ray Scattering at beamline BL35XU (SPring-8). The high quality of the data allows one to pinpoint the existence of a dispersing acoustic mode for wavevectors ($Q$) of $1.5<Q<12.5$ nm$^{-1}$, helping to clarify a previous contradiction between experimental and numerical results. The sound velocity shows a positive dispersion, exceeding the hydrodynamic value by $\approx$ 10% at $Q<3.5$ nm$^{-1}$. The $Q^2$ dependence of the sound attenuation $\Gamma(Q)$, reported for other glasses, is found to be the low-$Q$ limit of a more general $\Gamma(Q) \propto \Omega(Q)^2$ law which applies also to the higher $Q$ region, where $\Omega(Q)\propto Q$ no longer holds.Comment: Phys. Rev. Lett. (Accepted

Detectibility of Mixed Unburnt C+O in Type Ia Supernova Spectra

Motivated by recent 3-D calculations of the explosion of Type Ia supernova via a pure deflagration we calculate the observed spectra at 15-25 days past maximum light of a parameterized model which has a considerable fraction of unburnt C+O in the central regions. Rather than attempting a self consistent 3-D calculation, which is beyond the scope of current computer codes, we modify the composition structure of the 1-D deflagration model W7. In our exploratory parameterized calculations, we find that a central concentration of C+O is not ruled out by observations for the epochs we study. We briefly examine whether nebular phase spectra could be incompatible with observations.Comment: 12 pages, 3 figures ApJ Letters, May 1, 2003, in pres