Practical considerations on the use of the Charlson comorbidity index with administrative data bases

To develop a measure of the burden of comorbid disease from the MED-ECHO data base (Québec), the so-called Charlson index was adapted to International Classification of Disease (ICD-9) codes. The resulting comorbidity index was applied to the study of inpatient death in 33,940 patients with ischemic heart disease. Multiple logistic regression was used to relate inpatient death to its predictors, including gender, principal diagnosis, age, and the comorbidity index. Various transformations of the comorbidity score were performed, and their effect on the predictive accuracy was assessed. The comorbidity index was constantly and strongly associated with death. From a statistical viewpoint, the best results were obtained when the index was transformed into four dummy independent variables (the area under the receiver-operating curve is then 0.87). In a validation analysis performed on 1990-1991 MED-ECHO data (36,012 admissions with ischemic heart disease), the comorbidity index has the same statistical properties. We conclude that the Charlson index may be an efficient approach to risk adjustment from administrative data bases, although it should be tested on other conditions.     

Far-infrared pump-probe measurement of the lifetime of the 2p−1 shallow donor level in n-GaAs

The low temperature lifetime of electrons excited in the 2p^?1 donor level of n-GaAs has been studied in a far-infrared pump-probe experiment. The measurement has been carried out using a pulsed far-infrared molecular gas laser working at a wavelength of 292µm, with the sample in a magnetic field of 5.1 T, resonant with the 1s_o?2p^?1 transition. Two FIR pulses are sliced from one FIR-laser pulse by means of optical switching techniques using two Q-switched Nd:YAG lasers. The first pulse is used to saturate the transition, while the second pulse probes the return of the population in the excited state towards thermal equilibrium as a function of the time delay after the excitation pulse. The value of 350±50 ns found for the lifetime falls in line with CW saturation results on materials with other doping concentrations.     

Control of lipolysis in intra-abdominal fat cells of nonhuman primates: comparison with humans

The mechanisms that control lipolysis in intra-abdominal fat cells from various primate species, the marmoset (Callithrix jacchus), the baboon (Papio papio), and the macaque (Macaca fascicularis), were compared to those of human intraabdominal fat cells. Selective beta 1- or beta 2-adrenoceptor agonists induced lipolysis in all species. Selective beta 3-agonists (BRL 37344, CL 316243, and SR 58611) acted as partial agonists in marmoset but were inefficient in other primates, including humans. alpha 2-Adrenoceptor number ([3H]RX 8210002 binding) equalized (baboon) or exceeded (other primates) beta 1/beta 2-adrenoceptors ([3H]CGP 12177 binding). Baboon fat cell membranes expressed similar amounts of coupled beta- and alpha 2-adrenoceptors. In all species, norepinephrine- or epinephrine-induced lipolysis did not reach the lipolytic effect of isoproterenol but their effects were enhanced after alpha 2-adrenoceptor blockade. N6-phenylisopropyladenosine (PIA) induced a full antilipolytic effect in baboon, macaque, and human adipocytes through adenosine receptors ([3H]DPCPX binding). Peptide YY (PYY) weakly inhibited lipolysis in baboon. Adrenocorticotropic hormone (ACTH) was inactive whereas parathyroid hormone (PTH) partially stimulated lipolysis in primates. Histamine was partially lipolytic in marmoset only. This study emphasizes the similarities of the mechanisms controlling the lipolysis in nonhuman primate and in human adipocytes and suggests that the baboon and the macaque should provide unique models for the study of the regulation of lipolysis.     

Neurocontrol for lateral vehicle guidance

A solution to autonomous lateral vehicle guidance using a neurocontroller that can learn from measured human-driving data without knowledge of the physical car parameters is discussed. Simulations and practical tests confirm that a small-size feedforward autonomous neural network (21 neurons) can learn to steer a vehicle at high speeds only from looking at human-driving examples. In this way, the network learns the total closed-loop behavior, including the nonlinear dynamics of the vehicle and the driver's individual driving style. The main result of practical investigations is that the neutral controller trained on human-driving examples exhibits an aperiodic behavior that does not vanish at higher speeds (tests performed up to 130 km/h) and produces fewer lateral deviations than the linear state controller     

Organization of the visual reticular thalamic nucleus of the rat

The visual sector of the reticular thalamic nucleus has come under some intense scrutiny over recent years, principally because of the key role that the nucleus plays in the processing of visual information. Despite this scrutiny, we know very little of how the connections between the reticular nucleus and the different areas of visual cortex and the different visual dorsal thalamic nuclei are organized. This study examines the patterns of reticular connections with the visual cortex and the dorsal thalamus in the rat, a species where the visual pathways have been well documented. Biotinylated dextran, an anterograde and retrograde tracer, was injected into different visual cortical areas [17; rostral 18a: presumed area AL: (anterolateral); caudal 18a: presumed area LM (lateromedial); rostral 18b: presumed area AM (anteromedial); caudal 18b: presumed area PM (posteromedial)] and into different visual dorsal thalamic nuclei (posterior thalamic, lateral geniculate nuclei), and the patterns of anterograde and retrograde labelling in the reticular nucleus were examined. From the cortical injections, we find that the visual sector of the reticular nucleus is divided into subsectors that each receive an input from a distinct visual cortical area, with little or no overlap. Further, the resulting pattern of cortical terminations in the reticular nucleus reflects largely the patterns of termination in the dorsal thalamus. That is, each cortical area projects to a largely distinct subsector of the reticular nucleus, as it does to a largely distinct dorsal thalamic nucleus. As with each of the visual cortical areas, each of the visual dorsal thalamic (lateral geniculate, lateral posterior, posterior thalamic) nuclei relate to a separate territory of the reticular nucleus, with little or no overlap. Each of these dorsal thalamic territories within the reticular nucleus receives inputs from one or more of the visual cortical areas. For instance, the region to the reticular nucleus that is labelled after an injection into the lateral geniculate nucleus encompasses the reticular regions which receive afferents from cortical areas 17, rostral 18b and caudal 18b. These results suggest that individual cortical areas may influence the activity of different dorsal thalamic nuclei through their reticular connections.     

Effects of forced power transfer on high speed generator-loadsystems

A computer-aided method for investigating disturbances due to the forced paralleling of out of phase high speed salient pole AC generator systems feeding isolated loads is presented. The method is used to predict the system performance including the reverse voltage across the rotating bridge rectifier of the field exciter. This paper presents the fundamentals and the modeling approach used in the development of this method. In addition, the results of using this approach to compute the machine parameters under different load conditions including saturation effects due to magnetic material nonlinearities and space harmonics effects due to machine geometry and winding layouts are presented. The computed parameters are validated by comparison to test data. These parameters form the main data for simulating the forced paralleling of out of phase high speed salient pole AC generator systems feeding isolated loads. Further, the results of using this modeling approach in a case study to predict the system performance due to forced power transfer are summarized and are shown to be in good agreement with test data     

A novel double-circuit-rotor balanced induction motor for improvedslip-energy recovery drive performance. I. Modeling and simulation

A new construction for the rotor windings of balanced wound-rotor induction motors employed in the slip energy recovery drives is proposed, in this paper, to reduce the time harmonics which are commonly generated in the machine. The proposed machine has a double-circuit in the rotor. One circuit is star connected while the other is delta connected. Each of these two circuits is connected to a diode-bridge rectifier to achieve a twelve-pulse operation characteristics. The main objective of this paper is to develop a new model which is capable of simulating the proposed machine, neglecting nonlinearities due to magnetic saturation, and its associated converters. Such a model is further complicated due to the presence of the two rotor circuits and their mutual interaction     

Zirconium recovery from zircaloy shavings

A chlorination process for recovering Zr from zircaloy scrap has been studied. Zircaloy chlorination was possible at temperatures as low as 220 °C. The scale microstructure and its effect on the zircaloy reactivity was analysed using Thermogravimetric analysis (TGA), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDXS) and scanning electron microscopy (SEM) techniques. A solid-solid phase transformation took place into the oxide scale during the zircaloy chlorination. Zirconium, as ZrCl₄(g), was separated from the oxide scale and chlorides of Cr and Fe. The effect of the reaction temperature was also analysed.     

Vessel wall detection and blood noise reduction in intravascularultrasound imaging

Scattering from blood limits the contrast between the vessel wall and the lumen in intravascular ultrasound imaging. This makes it difficult to localize the vessel wall, especially on still images. This paper presents a method for automatic detection of vessel walls and reduction of blood noise based on correlation of the RF-signal between adjacent frames. The ultrasound RF-signal is quadrature demodulated, digitized, stored in memory, and transferred to a computer for processing and analysis. The absolute value of the cross-correlation coefficient between two adjacent frames is used to differentiate between stationary and fluctuating signals. Models and numerical calculations presented in this work indicate that the cross-correlation coefficient obtained from a radially dilating vessel wall will be larger than 0.8 under standard 20 MHz imaging conditions. The corresponding value from blood is less than 0.2 for blood velocities exceeding 0.5 cm s^-1 . The blood-noise filter is based on detecting this difference in correlation and displays vessel wall regions with no modifications, while regions detected as blood are rejected. A simplified vessel-wall detector that is suitable for real-time implementation is proposed. The performance of this detector and the blood noise filter are demonstrated by in vitro experiments