The trajectory to diagnosis with pulmonary arterial hypertension: a qualitative study

Objectives To investigate the patient's experience of the trajectory to receiving a diagnosis of pulmonary arterial hypertension (PAH) and inform the provision of care for this patient group. Design Qualitative study using in-depth one-to-one interviews and pictorial representations. Data were analysed using thematic analysis. Setting Participants were interviewed in their own homes across England. Participants 30 patients with a diagnosis of pulmonary hypertension (18 participants were women, mean age 56 and range 26-80 02years and time since diagnosis ranged from a few months to more than 12 02years) participated. Results All participants, regardless of the time since diagnosis, vividly described the process from manifestation of symptoms to receiving a confirmed diagnosis. The authors present data using three major themes: (i) making sense of symptoms, (ii) process of elimination and (iii) being diagnosed with PAH. Making sense of symptoms represented an early period of perseverance 14people tried to carry-on as usual despite 18unexplained breathlessness 19. As time progressed, this period was punctuated by critical events that triggered seeking medical advice. Once medical contact had been made, patients described a period of 18elimination 19 and convoluted contact with the medical profession. Dyspnoea misdiagnosis was a key factor that delayed the PAH diagnosis. Diagnosis disclosure by some medical professionals was also viewed as lacking empathy. More positive experiences were relayed when the medical team disclosing the diagnosis acknowledged previous limitations. Conclusions A lack of awareness of this illness from both the sufferer themselves and the medical profession emerged as a central theme and led to prolonged periods of being misdiagnosed. The application of a diagnostic pathway for unexplained dyspnoea that alerts practitioners to rare conditions could expedite the process of correct diagnosis

A survey of thermodynamic properties of the compounds of the elements chnops progress report, 1 feb. - 30 jun. 1965

Heat capacities, entropies, enthalpies, and free energies of organic and inorganic compounds of carbon, hydrogen, nitrogen, oxygen, phosphorus, and sulfu

Role of Boron p-Electrons and Holes in Superconducting MgB2, and other Diborides: A Fully-Relaxed, Full-Potential Electronic Structure Study

We present the results of fully-relaxed, full-potential electronic structure calculations for the new superconductor MgB2, and BeB2, NaB2, and AlB2, using density-functional-based methods. Our results described in terms of (i) density of states (DOS), (ii) band-structure, and (iii) the DOS and the charge density around the Fermi energy EF, clearly show the importance of B p-band for superconductivity. In particular, we show that around EF, the charge density in MgB2, BeB2 and NaB2 is planar and is associated with the B plane. For BeB2 and NaB2, our results indicate qualitative similarities but significant quantitative differences in their electronic structure due to different lattice constants a and c.Comment: 4 pages, 4 figures, Submitted to Phys Rev. Lett. on March 6, 2001; resubmission on April 2

Unusually large polarizabilities and "new" atomic states in Ba

Electric polarizabilities of four low-J even-parity states and three low-J odd-parity states of atomic barium in the range $35,600$ to $36,000\ $cm$^{-1}$are investigated. The states of interest are excited (in an atomic beam) via an intermediate odd-parity state with a sequence of two laser pulses. The odd-parity states can be excited due to the Stark-induced mixing with even-parity states. The polarizabilities are measured via direct spectroscopy on the second-stage transition. Several states have tensor and scalar polarizabilities that exceed the values that might be expected from the known energy levels of barium by more than two orders of magnitude. Two of the Stark-induced transitions cannot be identified from the known energy spectrum of barium. The observations suggest the existence of as yet unidentified odd-parity energy states, whose energies and angular momenta are determined in the present experiment. A tentative identification of these states as [Xe]$6s8p ^3P_{0,2}$ is suggested.Comment: 29 pages, 12 figure

Asymmetry Function of Interstellar Scintillations of Pulsars

A new method for separating intensity variations of a source's radio emission having various physical natures is proposed. The method is based on a joint analysis of the structure function of the intensity variations and the asymmetry function, which is a generalization of the asymmetry coefficient and characterizes the asymmetry of the distribution function of the intensity fluctuations on various scales for the inhomogeneities in the diffractive scintillation pattern. Relationships for the asymmetry function in the cases of a logarithmic normal distribution of the intensity fluctuations and a normal distribution of the field fluctuations are derived. Theoretical relationships and observational data on interstellar scintillations of pulsars (refractive, diffractive, and weak scintillations) are compared. Pulsar scintillations match the behavior expected for a normal distribution of the field fluctuations (diffractive scintillation) or logarithmic normal distribution of the intensity fluctuations (refractive and weak scintillation). Analysis of the asymmetry function is a good test for distinguishing scintillations against the background of variations that have different origins

Electromagnetic and corpuscular emission from the solar flare of 1991 June 15: Continuous acceleraton of relativistic particles

Data on X-,γ-ray, optical and radio emission from the 1991 June 15 solar flare are considered. We have calculated the spectrum of protons that producesγ-rays during the gradual phase of the flare. The primary proton spectrum can be described as a Bessel-function-type up to 0.8 GeV and a power law with the spectral index ≈3 from 0.8 up to 10 GeV or above. We have also analyzed data on energetic particles near the Earth. Their spectrum differed from that of primary protons producingγ-ray line emission. In the gradual phase of the flare additional pulses of energy release occurred and the time profiles of cm-radio emission andγ-rays in the 0.8–10 MeV energy band and above 50 MeV coincided. A continuous and simultaneous stochastic acceleration of the protons and relativistic electrons at the gradual phase of the flare is considered as a natural explanation of the data

Investigating Differences between Graphical and Textual Declarative Process Models

Declarative approaches to business process modeling are regarded as well suited for highly volatile environments, as they enable a high degree of flexibility. However, problems in understanding declarative process models often impede their adoption. Particularly, a study revealed that aspects that are present in both imperative and declarative process modeling languages at a graphical level-while having different semantics-cause considerable troubles. In this work we investigate whether a notation that does not contain graphical lookalikes, i.e., a textual notation, can help to avoid this problem. Even though a textual representation does not suffer from lookalikes, in our empirical study it performed worse in terms of error rate, duration and mental effort, as the textual representation forces the reader to mentally merge the textual information. Likewise, subjects themselves expressed that the graphical representation is easier to understand

Roles of Education and IQ in Cognitive Reserve in Parkinson's Disease-Mild Cognitive Impairment.

Background/aimsThe role of cognitive reserve in Parkinson's disease (PD)-mild cognitive impairment (MCI) is incompletely understood.MethodsThe relationships between PD-MCI, years of education, and estimated premorbid IQ were examined in 119 consecutive non-demented PD patients using logistic regression models.ResultsHigher education and IQ were associated with reduced odds of PD-MCI in univariate analysis. In multivariable analysis, a higher IQ was associated with a significantly decreased odds of PD-MCI, but education was not.ConclusionThe association of higher IQ and decreased odds of PD-MCI supports a role for cognitive reserve in PD, but further studies are needed to clarify the interaction of IQ and education and the impact of other contributors such as employment and hobbies

Algebraic Aspects of Abelian Sandpile Models

The abelian sandpile models feature a finite abelian group G generated by the operators corresponding to particle addition at various sites. We study the canonical decomposition of G as a product of cyclic groups G = Z_{d_1} X Z_{d_2} X Z_{d_3}...X Z_{d_g}, where g is the least number of generators of G, and d_i is a multiple of d_{i+1}. The structure of G is determined in terms of toppling matrix. We construct scalar functions, linear in height variables of the pile, that are invariant toppling at any site. These invariants provide convenient coordinates to label the recurrent configurations of the sandpile. For an L X L square lattice, we show that g = L. In this case, we observe that the system has nontrivial symmetries coming from the action of the cyclotomic Galois group of the (2L+2)th roots of unity which operates on the set of eigenvalues of the toppling matrix. These eigenvalues are algebraic integers, whose product is the order |G|. With the help of this Galois group, we obtain an explicit factorizaration of |G|. We also use it to define other simpler, though under-complete, sets of toppling invariants.Comment: 39 pages, TIFR/TH/94-3