Cost of managing patients with venous leg ulcers.

The aim of this study was to estimate costs associated with the management of patients with venous leg ulcers (VLUs) from the perspective of the UK National Health Service (NHS). The analysis was undertaken through the Secure Anonymised Information Linkage Databank which brings together and anonymously links a wide range of person-based data from around 75% of general practitioner (GP) practices within Wales (population coverage ~2.5 million). The data covered an 11-year period from 2007 to 2017. All patients linked to the relevant codes were tracked through primary care settings, recording the number of GP practice visits (number of days with an event recorded), and wound treatment utilisation (eg, dressings, bandages, etc.) Resources were valued in monetary terms (£ sterling) and the costs were determined from national published sources of unit costs. This is the first attempt to estimate the costs of managing of VLUs using routine data sources. The direct costs to the Welsh NHS are considerable and represent 1.2% of the annual budget. Nurse visits are the main cost driver with annual estimates of £67.8 million. At a UK level, these costs amount to £1.98 billion. Dressings and compression bandages are also major cost drivers with annual Welsh estimates of £828 790. The direct cost of managing patients with VLUs is £7706 per patient per annum, which translates to an annual cost of over £2 billion, when extrapolated to the UK population. The primary cost driver is the number of district nurse visits. Initiatives to reduce healing times through improving accuracy of initial diagnosis, and improved evidence-based treatment pathways would result in major financial savings.

Creating a next-generation phenotype library: the health data research UK Phenotype Library.

Objective: To enable reproducible research at scale by creating a platform that enables health data users to find, access, curate, and re-use electronic health record phenotyping algorithms. Materials and Methods: We undertook a structured approach to identifying requirements for a phenotype algorithm platform by engaging with key stakeholders. User experience analysis was used to inform the design, which we implemented as a web application featuring a novel metadata standard for defining phenotyping algorithms, access via Application Programming Interface (API), support for computable data flows, and version control. The application has creation and editing functionality, enabling researchers to submit phenotypes directly. Results: We created and launched the Phenotype Library in October 2021. The platform currently hosts 1049 phenotype definitions defined against 40 health data sources and >200K terms across 16 medical ontologies. We present several case studies demonstrating its utility for supporting and enabling research: the library hosts curated phenotype collections for the BREATHE respiratory health research hub and the Adolescent Mental Health Data Platform, and it is supporting the development of an informatics tool to generate clinical evidence for clinical guideline development groups. Discussion: This platform makes an impact by being open to all health data users and accepting all appropriate content, as well as implementing key features that have not been widely available, including managing structured metadata, access via an API, and support for computable phenotypes. Conclusions: We have created the first openly available, programmatically accessible resource enabling the global health research community to store and manage phenotyping algorithms. Removing barriers to describing, sharing, and computing phenotypes will help unleash the potential benefit of health data for patients and the public.

Modelling of nanoscale multi-gate transistors affected by atomistic interface roughness.

Interface roughness scattering (IRS) is one of the major scattering mechanisms limiting the performance of non-planar multi-gate transistors, like Fin field-effect transistors (FETs). Here, two physical models (Ando's and multi-sub-band) of electron scattering with the interface roughness induced potential are investigated using an in-house built 3D finite element ensemble Monte Carlo simulation toolbox including parameter-free 2D Schrödinger equation quantum correction that handles all relevant scattering mechanisms within highly non-equilibrium carrier transport. Moreover, we predict the effect of IRS on performance of FinFETs with realistic channel cross-section shapes with respect to the IRS correlation length (Λ) and RMS height ([Formula: see text]). The simulations of the n-type SOI FinFETs with the multi-sub-band IRS model shows its very strong effect on electron transport in the device channel compared to the Ando's model. We have also found that the FinFETs are strongly affected by the IRS in the ON-region. The limiting effect of the IRS significantly increases as the Fin width is reduced. The FinFETs with [Formula: see text] channel orientation are affected more by the IRS than those with the [Formula: see text] crystal orientation. Finally, Λ and [Formula: see text] are shown to affect the device performance similarly. A change in values by 30% (Λ) or [Formula: see text] ([Formula: see text]) results in an increase (decrease) of up to [Formula: see text] in the drive current.