9,223 research outputs found

    Do Patient Preferences Change in a Pandemic? Exploring Italian Patient Reported Experience DATA during the COVID-19 Crisis (PNS245)

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    Objectives Patient experience is an important metric of hospital performance, both in its own right and due to its association with good processes and a range of positive outcomes. Little is known about the impact of crisis situations on patient experience, such as in the COVID-19 pandemic, where extraordinary measures were necessary to maintain healthcare provision. Methods We performed multilevel and multivariate regression to evaluate the differences in hospitalisation experience before and during the COVID-19 outbreak in Tuscany and Veneto, regions differently affected by the pandemic. Experience was measured by continuously collected online Patient-Reported Experience Measures (PREMs), with 8,712 questionnaires collected from January-April 2020. Results Almost all PREM scores increased in the COVID-19 period compared to the two months preceding. Multilevel analysis showed very low, nonsignificant variation in overall satisfaction and Willingness-to-Recommend (WOM) between hospitals in the same region, controlling for health status, sex, age, and first incidence of COVID-19 in the region. Multivariate regression models, including demographic factors only, found increased WOM in the worse affected region. By including relevant PREM items, we found the items most predictive of WOM changed during pandemic situations, with a greater effect and significance for items associated with emotional support and communication (e.g. having fears and anxieties addressed by clinicians [0.25, p=0.07; 0.46 p=0.03]) alongside reduced effect sizes and higher p-values for items most affected by pandemic control processes (e.g. ward silence [0.47, p=0.04; 0.14, p=0.45], communication with relatives [0.3, p=0.02; 0.005, p=0.98). Conclusions Hospitals in Tuscany and Veneto were able to provide a positive patient experience in the COVID-19 pandemic, despite operating challenges. Patient expectations of their hospitalisation may have changed through awareness of the wider health crisis. The different factors most predictive of WOM during the pandemic may be explained by patient recognition and understanding of the great efforts and professionalism of healthcare professionals

    Remote participation during glycosylation reactions of galactose building blocks: Direct evidence from cryogenic vibrational spectroscopy

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    The stereoselective formation of 1,2‐cis‐glycosidic bonds is challenging. However, 1,2‐cis‐selectivity can be induced by remote participation of C4 or C6 ester groups. Reactions involving remote participation are believed to proceed via a key ionic intermediate, the glycosyl cation. Although mechanistic pathways were postulated many years ago, the structure of the reaction intermediates remained elusive owing to their short‐lived nature. Herein, we unravel the structure of glycosyl cations involved in remote participation reactions via cryogenic vibrational spectroscopy and first principles theory. Acetyl groups at C4 ensure α‐selective galactosylations by forming a covalent bond to the anomeric carbon in dioxolenium‐type ions. Unexpectedly, also benzyl ether protecting groups can engage in remote participation and promote the stereoselective formation of 1,2‐cis‐glycosidic bonds

    Delayed Reheating and the Breakdown of Coherent Oscillations

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    We analyze the evolution of the perturbations in the inflaton field and metric following the end of inflation. We present accurate analytic approximations for the perturbations, showing that the coherent oscillations of the post-inflationary condensate necessarily break down long before any current phenomenological constraints require the universe to become radiation dominated. Further, the breakdown occurs on length-scales equivalent to the comoving post-inflationary horizon size. This work has implications for both the inflationary "matching" problem, and the possible generation of a stochastic gravitational wave background in the post-inflationary universe.Comment: 18 pages, 5 figures, v2: references added, extended discussion in section

    The Input Signal Step Function (ISSF), a Standard Method to Encode Input Signals in SBML Models with Software Support, Applied to Circadian Clock Models

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    LetterThis is the final version of the article. Available from SAGE Publications via the DOI in this record.Time-dependent light input is an important feature of computational models of the circadian clock. However, publicly available models encoded in standard representations such as the Systems Biology Markup Language (SBML) either do not encode this input or use different mechanisms to do so, which hinders reproducibility of published results as well as model reuse. The authors describe here a numerically continuous function suitable for use in SBML for models of circadian rhythms forced by periodic light-dark cycles. The Input Signal Step Function (ISSF) is broadly applicable to encoding experimental manipulations, such as drug treatments, temperature changes, or inducible transgene expression, which may be transient, periodic, or mixed. It is highly configurable and is able to reproduce a wide range of waveforms. The authors have implemented this function in SBML and demonstrated its ability to modify the behavior of publicly available models to accurately reproduce published results. The implementation of ISSF allows standard simulation software to reproduce specialized circadian protocols, such as the phase-response curve. To facilitate the reuse of this function in public models, the authors have developed software to configure its behavior without any specialist knowledge of SBML. A community-standard approach to represent the inputs that entrain circadian clock models could particularly facilitate research in chronobiology.K.S. was supported by the UK BBSRC grant BB/E015263/1. SynthSys Edinburgh is a Centre for Integrative Systems Biology (CISB) funded by BBSRC and EPSRC, reference BB/D019621/1

    A new low mass for the Hercules dSph: the end of a common mass scale for the dwarfs?

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    We present a new mass estimate for the Hercules dwarf spheroidal galaxy (dSph), based on the revised velocity dispersion obtained by Aden et al. (2009, arXiv:0908.3489). The removal of a significant foreground contamination using newly acquired Stromgren photometry has resulted in a reduced velocity dispersion. Using this new velocity dispersion of 3.72 +/- 0.91 km/s, we find a mass of M_300=1.9^{+1.1}_{-0.8} 10^6 M_sun within the central 300 pc, which is also the half-light radius, and a mass of M_433=3.7_{-1.6}^{+2.2} 10^6 M_sun within the reach of our data to 433 pc, significantly lower than previous estimates. We derive an overall mass-to-light ratio of M_433/L=103^{+83}_{-48} M_sun/L_sun. Our mass estimate calls into question recent claims of a common mass scale for dSph galaxies. Additionally, we find tentative evidence for a velocity gradient in our kinematic data of 16 +/- 3 km/s/kpc, and evidence of an asymmetric extension in the light distribution at about 0.5 kpc. We explore the possibility that these features are due to tidal interactions with the Milky Way. We show that there is a self-consistent model in which Hercules has an assumed tidal radius of r_t = 485 pc, an orbital pericentre of r_p = 18.5 +/- 5 kpc, and a mass within r_t of M_{tid,r_t}=5.2 +/- 2.7 10^6 M_sun. Proper motions are required to test this model. Although we cannot exclude models in which Hercules contains no dark matter, we argue that Hercules is more likely to be a dark matter dominated system which is currently experiencing some tidal disturbance of its outer parts.Comment: 10 pages, 3 figures, Accepted for publication by ApJ

    Quaternionic Electroweak Theory

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    We explicitly develop a quaternionic version of the electroweak theory, based on the local gauge group U(1,q)L∣U(1,c)YU(1, q)_{L}\mid U(1, c)_{Y}. The need of a complex projection for our Lagrangian and the physical significance of the anomalous scalar solutions are also discussed.Comment: 12 pages, Revtex, submitted to J. Phys.

    Integrated on-chip mass spectrometry reaction monitoring in microfluidic devices containing porous polymer monolithic columns

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    Chip-based microfluidics enable the seamless integration of different functions into single devices. Here, we present microfluidic chips containing porous polymer monolithic columns as a means to facilitate chemical transformations as well as both downstream chromatographic separation and mass spectrometric analysis. Rapid liquid phase lithography prototyping creates the multifunctional device economically

    Moments of generalized Husimi distributions and complexity of many-body quantum states

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    We consider generalized Husimi distributions for many-body systems, and show that their moments are good measures of complexity of many-body quantum states. Our construction of the Husimi distribution is based on the coherent state of the single-particle transformation group. Then the coherent states are independent-particle states, and, at the same time, the most localized states in the Husimi representation. Therefore delocalization of the Husimi distribution, which can be measured by the moments, is a sign of many-body correlation (entanglement). Since the delocalization of the Husimi distribution is also related to chaoticity of the dynamics, it suggests a relation between entanglement and chaos. Our definition of the Husimi distribution can be applied not only to the systems of distinguishable particles, but also to those of identical particles, i.e., fermions and bosons. We derive an algebraic formula to evaluate the moments of the Husimi distribution.Comment: published version, 33 pages, 7 figre
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