Development of algorithms for determining heart failure with reduced and preserved ejection fraction using nationwide electronic healthcare records in the UK

Background: Determining heart failure (HF) phenotypes in routine electronic health records (EHR) is challenging. We aimed to develop and validate EHR algorithms for identification of specific HF phenotypes, using Read codes in combination with selected patient characteristics. Methods: We used The Healthcare Improvement Network (THIN). The study population included a random sample of individuals with HF diagnostic codes (HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF) and non-specific HF) selected from all participants registered in the THIN database between 1 January 2015 and 30 September 2017. Confirmed diagnoses were determined in a randomly selected subgroup of 500 patients via GP questionnaires including a review of all available cardiovascular investigations. Confirmed diagnoses of HFrEF and HFpEF were based on four criteria. Based on these data, we calculated a positive predictive value (PPV) of predefined algorithms which consisted of a combination of Read codes and additional information such as echocardiogram results and HF medication records. Results: The final cohort from which we drew the 500 patient random sample consisted of 10 275 patients. Response rate to the questionnaire was 77.2%. A small proportion (18%) of the overall HF patient population were coded with specific HF phenotype Read codes. For HFrEF, algorithms achieving over 80% PPV included definite, possible or non-specific HF HFrEF codes when combined with at least two of the drugs used to treat HFrEF. Only in non-specific HF coding did the use of three drugs (rather than two) contribute to an improvement of the PPV for HFrEF. HFpEF was only accurately defined with specific codes. In the absence of specific coding for HFpEF, the PPV was consistently below 50%. Conclusions: Prescription for HF medication can reliably be used to find HFrEF patients in the UK, even in the absence of a specific Read code for HFrEF. Algorithms using non-specific coding could not reliably find HFpEF patients

Experimental access to higher-order Zeeman effects by precision spectroscopy of highly charged ions in a Penning trap

We present an experimental concept and setup for laser-microwave double-resonance spectroscopy of highly charged ions in a Penning trap. Such spectroscopy allows a highly precise measurement of the Zeeman splittings of fine- and hyperfine-structure levels due the magnetic field of the trap. We have performed detailed calculations of the Zeeman effect in the framework of quantum electrodynamics of bound states as present in such highly charged ions. We find that apart from the linear Zeeman effect, second- and third-order Zeeman effects also contribute to the splittings on a level of 10^-4 and 10^-8, respectively, and hence are accessible to a determination within the achievable spectroscopic resolution of the ARTEMIS experiment currently in preparation

g factor of lithiumlike silicon 28Si11+

The g factor of lithiumlike 28Si11+ has been measured in a triple-Penning trap with a relative uncertainty of 1.1x10^{-9} to be g_exp=2.0008898899(21). The theoretical prediction for this value was calculated to be g_th=2.000889909(51) improving the accuracy to 2.5x10^{-8} due to the first rigorous evaluation of the two-photon exchange correction. The measured value is in excellent agreement with the state-of-the-art theoretical prediction and yields the most stringent test of bound-state QED for the g factor of the 1s^22s state and the relativistic many-electron calculations in a magnetic field

g factor of Li-like ions with nonzero nuclear spin

The fully relativistic theory of the g factor of Li-like ions with nonzero nuclear spin is considered for the (1s)^2 2s state. The magnetic-dipole hyperfine-interaction correction to the atomic g factor is calculated including the one-electron contributions as well as the interelectronic-interaction effects of order 1/Z. This correction is combined with the interelectronic-interaction, QED, nuclear recoil, and nuclear size corrections to obtain high-precision theoretical values for the g factor of Li-like ions with nonzero nuclear spin. The results can be used for a precise determination of nuclear magnetic moments from g factor experiments.Comment: 20 pages, 5 figure

Hospitalisation and mortality in patients with comorbid COPD and heart failure: a systematic review and meta-analysis

Background Discrepancy exists amongst studies investigating the effect of comorbid heart failure (HF) on the morbidity and mortality of chronic obstructive pulmonary disease (COPD) patients. Methods MEDLINE and Embase were searched using a pre-specified search strategy for studies comparing hospitalisation, rehospitalisation, and mortality of COPD patients with and without HF. Studies must have reported crude and/or adjusted rate ratios, risk ratios, odds ratios (OR), or hazard ratios (HR). Results Twenty-eight publications, reporting 55 effect estimates, were identified that compared COPD patients with HF with those without HF. One study reported on all-cause hospitalisation (1 rate ratio). Two studies reported on COPD-related hospitalisation (1 rate ratio, 2 OR). One study reported on COPD- or cardiovascular-related hospitalisation (4 HR). One study reported on 90-day all-cause rehospitalisation (1 risk ratio). One study reported on 3-year all-cause rehospitalisation (2 HR). Four studies reported on 30-day COPD-related rehospitalisation (1 risk ratio; 5 OR). Two studies reported on 1-year COPD-related rehospitalisation (1 risk ratio; 1 HR). One study reported on 3-year COPD-related rehospitalisation (2 HR). Eighteen studies reported on all-cause mortality (1 risk ratio; 4 OR; 24 HR). Five studies reported on all-cause inpatient mortality (1 risk ratio; 4 OR). Meta-analyses of hospitalisation and rehospitalisation were not possible due to insufficient data for all individual effect measures. Meta-analysis of studies requiring spirometry for the diagnosis of COPD found that risk of all-cause mortality was 1.61 (pooled HR; 95%CI: 1.38, 1.83) higher in patients with HF than in those without HF. Conclusions In this systematic review, we investigated the effect of HF comorbidity on hospitalisation and mortality of COPD patients. There is substantial evidence that HF comorbidity increases COPD-related rehospitalisation and all-cause mortality of COPD patients. The effect of HF comorbidity may differ depending on COPD phenotype, HF type, or HF severity and should be the topic of future research

A semi-supervised approach for rapidly creating clinical biomarker phenotypes in the UK Biobank using different primary care EHR and clinical terminology systems

Objectives: The UK Biobank (UKB) is making primary care electronic health records (EHRs) for 500 000 participants available for COVID-19-related research. Data are extracted from four sources, recorded using five clinical terminologies and stored in different schemas. The aims of our research were to: (a) develop a semi-supervised approach for bootstrapping EHR phenotyping algorithms in UKB EHR, and (b) to evaluate our approach by implementing and evaluating phenotypes for 31 common biomarkers. Materials and Methods: We describe an algorithmic approach to phenotyping biomarkers in primary care EHR involving (a) bootstrapping definitions using existing phenotypes, (b) excluding generic, rare, or semantically distant terms, (c) forward-mapping terminology terms, (d) expert review, and (e) data extraction. We evaluated the phenotypes by assessing the ability to reproduce known epidemiological associations with all-cause mortality using Cox proportional hazards models. Results: We created and evaluated phenotyping algorithms for 31 biomarkers many of which are directly related to COVID-19 complications, for example diabetes, cardiovascular disease, respiratory disease. Our algorithm identified 1651 Read v2 and Clinical Terms Version 3 terms and automatically excluded 1228 terms. Clinical review excluded 103 terms and included 44 terms, resulting in 364 terms for data extraction (sensitivity 0.89, specificity 0.92). We extracted 38 190 682 events and identified 220 978 participants with at least one biomarker measured. Discussion and conclusion: Bootstrapping phenotyping algorithms from similar EHR can potentially address pre-existing methodological concerns that undermine the outputs of biomarker discovery pipelines and provide research-quality phenotyping algorithms

Competition of fusion and quasi-fission in the reactions leading to production of the superheavy elements

The mechanism of fusion hindrance, an effect observed in the reactions of cold, warm and hot fusion leading to production of the superheavy elements, is investigated. A systematics of transfermium production cross sections is used to determine fusion probabilities. Mechanism of fusion hindrance is described as a competition of fusion and quasi-fission. Available evaporation residue cross sections in the superheavy region are reproduced satisfactorily. Analysis of the measured capture cross sections is performed and a sudden disappearance of the capture cross sections is observed at low fusion probabilities. A dependence of the fusion hindrance on the asymmetry of the projectile-target system is investigated using the available data. The most promising pathways for further experiments are suggested.Comment: 8 pages, 7 figures, talk presented at 7th International School-Seminar on Heavy-Ion Physics, May 27 - June 1, 2002, Dubna, Russi

Development of Automatic Speech Recognition for the Documentation of Cook Islands Māori

This paper describes the process of data processing and training of an automatic speech recognition (ASR) system for Cook Islands Māori (CIM), an Indigenous language spoken by approximately 22,000 people in the South Pacific. We transcribed four hours of speech from adults and elderly speakers of the language and prepared two experiments. First, we trained three ASR systems: one statistical, Kaldi; and two based on Deep Learning, DeepSpeech and XLSR-Wav2Vec2. Wav2Vec2 tied with Kaldi for lowest character error rate (CER=6±1) and was slightly behind in word error rate (WER=23±2 versus WER=18±2 for Kaldi). This provides evidence that Deep Learning ASR systems are reaching the performance of statistical methods on small datasets, and that they can work effectively with extremely low-resource Indigenous languages like CIM. In the second experiment we used Wav2Vec2 to train models with held-out speakers. While the performance decreased (CER=15±7, WER=46±16), the system still showed considerable learning. We intend to use ASR to accelerate the documentation of CIM, using newly transcribed texts to improve the ASR and also generate teaching and language revitalization materials. The trained model is available under a license based on the Kaitiakitanga License, which provides for non-commercial use while retaining control of the model by the Indigenous community.falseMarseille, Franc

CPT and Lorentz Tests in Penning Traps

A theoretical analysis is performed of Penning-trap experiments testing CPT and Lorentz symmetry through measurements of anomalous magnetic moments and charge-to-mass ratios. Possible CPT and Lorentz violations arising from spontaneous symmetry breaking at a fundamental level are treated in the context of a general extension of the SU(3) x SU(2) x U(1) standard model and its restriction to quantum electrodynamics. We describe signals that might appear in principle, introduce suitable figures of merit, and estimate CPT and Lorentz bounds attainable in present and future Penning-trap experiments. Experiments measuring anomaly frequencies are found to provide the sharpest tests of CPT symmetry. Bounds are attainable of approximately $10^{-20}$ in the electron-positron case and of $10^{-23}$ for a suggested experiment with protons and antiprotons. Searches for diurnal frequency variations in these experiments could also limit certain types of Lorentz violation to the level of $10^{-18}$ in the electron-positron system and others at the level of $10^{-21}$ in the proton-antiproton system. In contrast, measurements comparing cyclotron frequencies are sensitive within the present theoretical framework to different kinds of Lorentz violation that preserve CPT. Constraints could be obtained on one figure of merit in the electron-positron system at the level of $10^{-16}$, on another in the proton-antiproton system at $10^{-24}$, and on a third at $10^{-25}$ using comparisons of $H^-$ ions with antiprotons.Comment: 31 pages, published in Physical Review

Progress at the WITCH experiment

The WITCH-experiment will measure the energy spectrum of the recoiling daughter ions in $\beta$-decay to search for non-standard scalar and tensor type interaction. To facilitate this a Penning trap is used to store the radioactive ions. Thus the recoil ions can leave the source without any energy loss and their energy can be probed by the subsequent retardation spectrometer. The experiment is being set up at present at ISOLDE/CERN. The principle and the status of the WITCH-experiment will be presented. (12 refs)