6,853 research outputs found

    Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)

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    Objectives: The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database. Setting: 951 participants registered with a CPRD practice in the UK between 1 January 2004 and 31 December 2012. Individuals were selected for ≥1 of 8 algorithms to identify people with COPD. General practitioners were sent a brief questionnaire and additional evidence to support a COPD diagnosis was requested. All information received was reviewed independently by two respiratory physicians whose opinion was taken as the gold standard. Primary outcome measure: The primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed. Results: 951 questionnaires were sent and 738 (78%) returned. After quality control, 696 (73.2%) patients were included in the final analysis. All four algorithms including a specific COPD diagnostic code performed well. Using a diagnostic code alone, the PPV was 86.5% (77.5-92.3%) while requiring a diagnosis plus spirometry plus specific medication; the PPV was slightly higher at 89.4% (80.7-94.5%) but reduced case numbers by 10%. Algorithms without specific diagnostic codes had low PPVs (range 12.2-44.4%). Conclusions: Patients with COPD can be accurately identified from UK primary care records using specific diagnostic codes. Requiring spirometry or COPD medications only marginally improved accuracy. The high accuracy applies since the introduction of an incentivised disease register for COPD as part of Quality and Outcomes Framework in 2004

    NMR shim coil design utilising a rapid spherical harmonic calculation method

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    A rapid spherical harmonic calculation method is used for the design of Nuclear Magnetic Resonance shim coils. The aim is to design each shim such that it generates a field described purely by a single spherical harmonic. By applying simulated annealing techniques, coil arrangements are produced through the optimal positioning of current-carrying circular arc conductors of rectangular cross-section. This involves minimizing the undesirable harmonies in relation to a target harmonic. The design method is flexible enough to be applied for the production of coil arrangements that generate fields consisting significantly of either zonal or tesseral harmonics. Results are presented for several coil designs which generate tesseral harmonics of degree one

    Minimax Current Density Coil Design

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    'Coil design' is an inverse problem in which arrangements of wire are designed to generate a prescribed magnetic field when energized with electric current. The design of gradient and shim coils for magnetic resonance imaging (MRI) are important examples of coil design. The magnetic fields that these coils generate are usually required to be both strong and accurate. Other electromagnetic properties of the coils, such as inductance, may be considered in the design process, which becomes an optimization problem. The maximum current density is additionally optimized in this work and the resultant coils are investigated for performance and practicality. Coils with minimax current density were found to exhibit maximally spread wires and may help disperse localized regions of Joule heating. They also produce the highest possible magnetic field strength per unit current for any given surface and wire size. Three different flavours of boundary element method that employ different basis functions (triangular elements with uniform current, cylindrical elements with sinusoidal current and conic section elements with sinusoidal-uniform current) were used with this approach to illustrate its generality.Comment: 24 pages, 6 figures, 2 tables. To appear in Journal of Physics D: Applied Physic

    Late Ordovician-Early Silurian trace fossils from the Matapedia Group, Tobique River, western New Brunswick, Canada. II. Additional discoveries with descriptions and comments

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    Previous recordings of Late Ordovician-Early Silurian flysch trace fossils (13 ichnogenera, 15 ichnospecies) from slope deposits of the Matapedia Basin at a single site on the Tobique River, western New Brunswick, are supplemented by the addition of 9 newly discovered ichnogenera (12 ichnospecies). These are:- Cirrculichnis montanus, Cruziana problematica, Cruziana cf. stromnessa, Dipt'tchnites ichnosp., Megagrapton irregulare, Monocraterion ichnosp., Phycosiphon incertum, Rusophycus didymus, Rusophycus ichnosp. types A and H, Scolicia ichnosp, and Tuberculichnus ichnosp. The traces are poorly preserved and occur only in low numbers compared to previously documented forms. Nevertheless, the meticulous sampling procedures adopted at the site emphasize the need for detailed collecting, before drawing conclusions regarding diversity models, stratigraphic distribution, etc., of trace fossils. Of these new forms only Diplichnites ichnosp. has previously been recorded from die Matapedia Basin in the partially coeval Lower Silurian Siegas Formation. Tuberculichnus ichnosp. is recorded for the first time in North America. The combined total of 22 ichnogenera (27 ichnospecies) from the Tobique River represents the most diverse ichnocoenosis yet reported from a single ancient slope deposit. The occurrence of several more typically shallow-water ichnogenera (e.g., Cruziana, Diplichnites, Monocraterion and Rusophycus) suggests that, at least in the Early Palaeozoic, caution must be exercised in their utilization as distinctive facies or environmental indicators. RÉSUMÉ 9 nouveaux ichnogenres (12 ichnoespeces) s'ajoutent à ceux déjà répertoriés (13 ichnogenrcs, 15 ichnoespcces) en un site unique localise sur la rivière Tobique, dans l’ouest du Nouveau-Brunswick, dans des sédiments tardiordoviciens è éosiluriens accumulés sur le talus continental du Bassin de Matapedia. Ce sont: Cirrculichnis montanus, Cruziana problematica, Cruziana cf. stromnessa, Dipt'tchnites ichnosp., Megagrapton irregulare, Monocraterion ichnosp., Phycosiphon incertum, Rusophycus didymus, Rusophycus ichnosp. types A et H, Scolicia ichnosp, et Tuberculichnus ichnosp. Ces demières sont malconservées et relativement rares par rapport aux formés déjà connues. Néanmoins, le dépouillement méiculeux utilisé à ce site démontre la nécessité d'une collecte détailiée avant de tirer des conclusions quant aux modeèles de diversité, à la distribution stratigraphique, etc., des traces fossiles. De ces nouvelles formés, seule Diplichinites ichnosp. est déjà cormue dans le Bassin de Matapedia, soil dans la Formation sihirienne inférieure et en partie synchrone de Siegas. On recense Tuberculichnus ichnosp. pour la première fois en Amerique du Nord. Le total combine de 22 ichnogenres (27 ichnoespeces) présents sur la rivière Tobique représente l’inchnocoenose la plus diverse jamais répertoriée dans un seul dépôt de talus. La présence de plusieur sichnogenres typiques d'une faible tranche d'eau (e.g., Cruziana, Diplichnites, Monocraterion et Rusophycus) démontre que la prudence est de mise lors de leur utilisation à litre d'indicateurs de faciès on de milieu, tout particuliérement à l'Éopaléozoique. [Traduit par le journal
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