An evaluation of service expansion to include patients with heart failure with preserved ejection fraction

Background/Aims The Central London Community Healthcare Trust West Hertfordshire heart failure service expanded in 2020 to include patients with heart failure with preserved ejection fraction in addition to the patients with heart failure with reduced ejection fraction. The patient population was predicted to double, requiring staff and service adjustments; this warranted an evaluation to determine if care targets were maintained. This study aimed to evaluate the impact of service expansion on service referral rates, length of stay in the service and clinical workload. Methods A retrospective quantitative evaluation of the service data from October 2020 to April 2021 was undertaken to compare referral rates, length of stay in service and key workload metrics between patients with heart failure with reduced ejection fraction and those with heart failure with preserved ejection fraction. All referrals to the service with a new diagnosis of heart failure (confirmed by echocardiogram or magnetic resonance imaging) were considered for evaluation. Of 250 eligible referrals, 81 were selected for inclusion using a random sampling method. Results The participants with heart failure with preserved ejection fraction had a median length of stay in the service of 17 weeks. The participants with heart failure with reduced ejection fraction had a statistically significant longer stay of 35.57 weeks (P<0.001) compared to a pre-expansion length of stay of approximately 17 weeks. Workload was proportional between the two cohorts. Patients with heart failure with preserved ejection fraction were more likely to be reviewed in multidisciplinary teams or by the consultant community clinic. This group was less likely to attend clinic, where 96.4% of face-to-face reviews took place at home. Telephone reviews occurred at a similar frequency for both cohorts, comprising 50% of follow ups. The heart failure with reduced ejection fraction cohort required more alterations in medication and medication titration, generating additional follow ups. Conclusions The service expansion to include patients with heart failure with preserved ejection fraction has had a significant impact on workload, leading to a reduction in the quality of care for those with heart failure with reduced ejection fraction

Exact expressions for numerical evaluation of high order modes of vibration in uniform Euler-Bernoulli beams

© 2018 Elsevier Ltd In the literature, expressions can be found for the mode shape functions of uniform Euler-Bernoulli beams. However, these expressions permit the evaluation of only the first 12 modes or so due to numerical issues associated with the evaluation of near field waves that increase exponentially with frequency. To overcome this problem, approximate expressions have been developed that avoid the evaluation of these waves. This article presents in tabular form alternative, exact expressions of beam mode shape functions that are numerically stable. These formulations have not been reported in the literature before and they are of special interest for researchers working in the area of structural acoustics and vibration. Beams with combinations of the classical boundary conditions of clamped, free, pinned, and sliding are considered

A classification scheme for annotating speech acts in a business email corpus

This paper reports on the process of manual annotation of speech acts in a corpus of business emails, in the context of the PROBE project (PRagmatics of Business English). The project aims to bring together corpus, computational, and theoretical linguistics by drawing on the insights made available by the annotated corpus. The corpus data sheds light on the linguistic and discourse structures of speech act use in business email communication. This enhanced linguistic description can be compared to theoretical linguistic representations of speech act categories to assess how well traditional distinctions relate to real-world, naturally occurring data. From a computational perspective, the annotated data is required for the development of an automated speech act tagging tool. Central to this research is the creation of a high quality, manually annotated speech act corpus, using an easily interpretable classification scheme. We discuss the scheme chosen for the project and the training guidelines given to the annotators, and describe the main challenges identified by the annotators

Calculation of the natural frequencies and mode shapes of a Euler–Bernoulli beam which has any combination of linear boundary conditions

© The Author(s) 2019. There are well-known expressions for natural frequencies and mode shapes of a Euler-Bernoulli beam which has classical boundary conditions, such as free, fixed, and pinned. There are also expressions for particular boundary conditions, such as attached springs and masses. Surprisingly, however, there is not a method to calculate the natural frequencies and mode shapes for a Euler–Bernoulli beam which has any combination of linear boundary conditions. This paper describes a new method to achieve this, by writing the boundary conditions in terms of dynamic stiffness of attached elements. The method is valid for any boundaries provided they are linear, including dissipative boundaries. Ways to overcome numerical issues that can occur when computing higher natural frequencies and mode shapes are also discussed. Some examples are given to illustrate the applicability of the proposed method

Matching experimental and three dimensional numerical models for structural vibration problems with uncertainties

© 2017 The Author(s) The simulation model which examines the dynamic behavior of real structures needs to address the impact of uncertainty in both geometry and material parameters. This article investigates three-dimensional finite element models for structural dynamics problems with respect to both model and parameter uncertainties. The parameter uncertainties are determined via laboratory measurements on several beam-like samples. The parameters are then considered as random variables to the finite element model for exploring the uncertainty effects on the quality of the model outputs, i.e. natural frequencies. The accuracy of the output predictions from the model is compared with the experimental results. To this end, the non-contact experimental modal analysis is conducted to identify the natural frequency of the samples. The results show a good agreement compared with experimental data. Furthermore, it is demonstrated that geometrical uncertainties have more influence on the natural frequencies compared to material parameters and material uncertainties are about two times higher than geometrical uncertainties. This gives valuable insights for improving the finite element model due to various parameter ranges required in a modeling process involving uncertainty

Spatial methods for event reconstruction in CLEAN

In CLEAN (Cryogenic Low Energy Astrophysics with Noble gases), a proposed neutrino and dark matter detector, background discrimination is possible if one can determine the location of an ionizing radiation event with high accuracy. We simulate ionizing radiation events that produce multiple scintillation photons within a spherical detection volume filled with liquid neon. We estimate the radial location of a particular ionizing radiation event based on the observed count data corresponding to that event. The count data are collected by detectors mounted at the spherical boundary of the detection volume. We neglect absorption, but account for Rayleigh scattering. To account for wavelength-shifting of the scintillation light, we assume that photons are absorbed and re-emitted at the detectors. Here, we develop spatial Maximum Likelihood methods for event reconstruction, and study their performance in computer simulation experiments. We also study a method based on the centroid of the observed count data. We calibrate our estimates based on training data

Die Agitpropbewegung als Teil der Arbeiterkultur der Weimarer Republik

The advent of next-generation sequencing has brought about an explosion of single nucleotide polymorphism (SNP) data in non-model organisms; however, profiling these SNPs across multiple natural populations still requires substantial time and resources. Results: Here, we introduce two cost-efficient quantitative High Resolution Melting (qHRM) methods for measuring allele frequencies at known SNP loci in pooled DNA samples: the "peaks" method, which can be applied to large numbers of SNPs, and the "curves" method, which is more labor intensive but also slightly more accurate. Using the reef-building coral Acropora millepora, we show that both qHRM methods can recover the allele proportions from mixtures prepared using two or more individuals of known genotype. We further demonstrate advantages of each method over previously published methods; specifically, the "peaks" method can be rapidly scaled to screen several hundred SNPs at once, whereas the "curves" method is better suited for smaller numbers of SNPs. Conclusions: Compared to genotyping individual samples, these methods can save considerable effort and genotyping costs when relatively few candidate SNPs must be profiled across a large number of populations. One of the main applications of this method could be validation of SNPs of interest identified in population genomic studies.Australian Institute of Marine ScienceNational Science Foundation DEB-1054766Cellular and Molecular Biolog

Identification of Pathogenicity-Related Genes in the Vascular Wilt Fungus Verticillium dahliae by Agrobacterium tumefaciens-Mediated T-DNA Insertional Mutagenesis

Verticillium dahliae is the causal agent of vascular wilt in many economically important crops worldwide. Identification of genes that control pathogenicity or virulence may suggest targets for alternative control methods for this fungus. In this study, Agrobacteriumtumefaciens-mediated transformation (ATMT) was applied for insertional mutagenesis of V. dahliae conidia. Southern blot analysis indicated that T-DNAs were inserted randomly into the V. dahliae genome and that 69% of the transformants were the result of single copy T-DNA insertion. DNA sequences flanking T-DNA insertion were isolated through inverse PCR (iPCR), and these sequences were aligned to the genome sequence to identify the genomic position of insertion. V. dahliae mutants of particular interest selected based on culture phenotypes included those that had lost the ability to form microsclerotia and subsequently used for virulence assay. Based on the virulence assay of 181 transformants, we identified several mutant strains of V. dahliae that did not cause symptoms on lettuce plants. Among these mutants, T-DNA was inserted in genes encoding an endoglucanase 1 (VdEg-1), a hydroxyl-methyl glutaryl-CoA synthase (VdHMGS), a major facilitator superfamily 1 (VdMFS1), and a glycosylphosphatidylinositol (GPI) mannosyltransferase 3 (VdGPIM3). These results suggest that ATMT can effectively be used to identify genes associated with pathogenicity and other functions in V. dahliae