Reliability of coding of diagnoses recorded in the computerized information system at primary health care centers

OBJECTIVE: To find the reliability of the coding of diagnoses in the doctor's note in this computer system and to analyse where there are most discrepancies. DESIGN: An observational study. The concordance between the reason for consultation, codified by an external assessor, and the coding of the main diagnosis. SETTING: Health Districts 17 (Murcia/Barrio del Carmen) and 66 (Molina de Segura/La Ribera) in the Autonomous Community of Murcia. PATIENTS: A sub-sample of 228 consultations, belonging to a larger study of 1,904 general medical consultations (total: 98,768 consultations). MEASUREMENTS AND MAIN RESULTS: There were discrepancies between the coding of the reason for consultation and the diagnosis in 23% of the consultations recorded. The reason for consultation was not correctly recorded in 12.3%. The diagnostic group or section with the highest level of agreement was number XVIII or the supplementary section; and with the least agreement in XVII (injuries and adverse side-effects) and Number V covering mental disorders. CONCLUSIONS: Quality control of information and its validation enables errors and problems in the systems to be identified and corrected. This study points to the need to improve the filling-out of the reason for consultation and activity carried out, in order to obtain afterwards a more reliable coding of the diagnosis.     

The applied pretreatment (blanching,ascorbic acid) at the manufacture process affects the quality of nectarine purée processed by hydrostatic high pressure

A nectarine purée was manufactured with different pretreatments (thermal blanching or ascorbic acid – AA – addition), and then, the purée was processed by high‐pressure treatment to evaluate the effect of the initial manufacture conditions in the stability of the processed purées. A thermal treatment was also carried out to compare the effect with the high‐pressure processing (HPP). All applied processes were effective to ensure the microbiological safety of the purées. However, the pretreatment (thermal blanching or AA addition) applied during the manufacture affected the final quality of the processed purées. Initially, the AA addition had a protective effect on colour degradation during the manufacture of the purées; however, when these purées were treated by HPP showed less colour stability during storage, lower bioactive compounds content, and antioxidant activity. In contrast, purées with an initial thermal blanching maintained better the quality after HPP and during storage.     

Effect of different cooking methods on lipid oxidation and formation of free cholesterol oxidation products (COPs) in Latissimus dorsi muscle of Iberian pigs

The aim of this work was to study the influence of different cooking methods (grilled (GR), fried (FP), microwave (MW) and roasted (RO)) on lipid oxidation and formation of free cholesterol oxidation products (COPs) of meat from Iberian pigs that have been fed on an intensive system. Moisture and total lipid content, TBARs, hexanal and COPs were measured in Latissimus dorsi muscle samples. Cooking did not produce changes in total lipid content in meat but induced significantly higher lipid oxidation (TBARs and hexanal values) (p < 0.001) and cholesterol oxidation (COPs) (p < 0.01). When the different cooking methods were studied, the grilled method was the least affected by lipid oxidation (TBARs and hexanal) compared to the others. There were no significant differences among different cooking methods on COPs values. The most abundant cholesterol oxides were both 7α-hydroxycholesterol and 7β-hydroxycholesterol in all groups studied.     

Implementation of energy efficiency measures in compressed air systems: barriers,drivers and non-energy benefits

Increased global competition and resource scarcity drives industrial companies to cut costs. Energy can be a significant component of such cuts, particularly for energy-intensive companies. Improving energy efficiency in industry is complex, as it pertains to various energy-using processes that are heavily intertwined. One such process is the compressed air system (CAS), which is used in most industrial companies worldwide. Since energy efficiency improvement measures for various types of energy-using processes differ, technology-specific measures might encounter different barriers to and drivers for energy efficiency. The same applies to the non-energy benefits (NEBs) related to energy efficiency improvement measures; since measures vary between various energy-using processes, the perceived NEBs might be different as well. The aim of this paper is to study the barriers to, drivers for and NEBs of CAS energy efficiency improvement measures from the perspectives of three actors. Carried out as an interview study combined with a questionnaire, the paper merges the perspectives of users, audit experts and suppliers of CASs. The results showed that the major barriers are related to the investment, or are of an organisational character, and that organisational and economic factors seemed to be important for making positive decisions on energy efficiency investments and measures in CASs. Major NEBs for CASs include productivity gains and the avoidance of capital expenditures. The results of this study also address the importance of having a comprehensive approach to recognise additional effects of energy efficiency improvements in CASs.     

Solubilization of phospholipid bilayer caused by surfactants

The interaction of surfactants with liposomes eventually leads to the rupture of such structures and the solubilization of the phospholipid components. In this paper, solubilization is regarded as a decrease in light scattering of liposome suspensions. To this end, in accordance with the nomenclature, adopted by Lichtenberg, three parameters were considered as corresponding to the effective surfactant/lipid molar ratios (Re) at which light scattering starts to decrease, Re_sat; reaches 50% of the original value, Re₅₀; and shows no further decrease, Re_sol. These parameters corresponded to the Re at which the surfactant (i) saturated the liposomes, (ii) resulted in a 50% solubilization of vesicles and (iii) led to a total solubilization of liposomes. The surfactants tested were the nonionic surfactant octylphenol ethoxylated with 10 units of ethylene oxide or Triton X-100 (OP-10EO), two anionic surfactants, sodium dodecyl sulfate and sodium dodecyl ether sulfate, and an amphoteric surfactant dodecyl betaine (D-Bet). Unilamellar liposomes formed by egg phosphatidylcholine containing increasing amounts of phosphatidic acid were used. The Re parameters were the lowest for D-Bet, followed by OP-10EO, whereas the anionic surfactants always showed the highest values regardless of the electrical charge of the lipid bilayers. These parameters seem also to be inversely related to the critical micelle concentration (CMC) of the surfactant, except for OP-10EO. Moreover, the CMC values of the surfactant/lipid systems at 0.5 mM lipid concentration corresponded in all cases to the surfactant concentration at which liposomes were saturated by surfactants. As a consequence, this ratio can be regarded as an interesting parameter associated with the mixed micelle formation in liposome solubilization.     

Exposure to volatile organic compounds (VOC) in public buses of Pamplona, Northern Spain

This study examines the exposure level of passengers and drivers to VOC in public buses in a medium-size metropolitan area (Northern Spain). In-vehicle monitoring was performed on different routes, on peak and non-peak hours, during January and February 2007. A total of 112 air samples were collected onto adsorbent tubes and analysed by thermal desorption (TD) and gas chromatography/mass selective detector (GC/MSD) technique. Statistical differences were found among route to route concentrations, with those routes with major prevalence in the commercial area of the city displaying higher values; differences between peak and non-peak hours were also observed. A decrease in VOC concentrations was also registered during the weekend. BTEX ratios were estimated and found to be related to traffic emissions and similar for all the surveyed routes. Correlations confirmed traffic as the main emission source for BTEX and trimethylbenzene, their concentrations being highly associated to changes in meteorological conditions.     

Preliminary study on the development of nanoemulsions for carbamazepine intravenous delivery: an investigation of drug polymorphic transition

Carbamazepine (CBZ) is available on the pharmaceutical market as tablets, capsules, and oral suspensions, but not as a parenteral formulation for clinical use. Parenteral emulsions are a good alternative to poorly water-soluble drugs such as CBZ. In this way, four different emulsions containing 3 mg/mL of CBZ were developed, but during a period of storage, drug crystal precipitates appeared. To investigate this phenomenon, differential scanning calorimetry, infrared spectroscopy, and light microscopy were employed. The results suggested a polymorphic transition from β form to dehydrate form, resulting in drug precipitation, although the emulsions themselves remained stable for at least three months.     

Quantification of unidirectional nonlinear associations between multidimensional signals

In this paper, we present a rigorous, general definition of the nonlinear association index, known as h2. Proving equivalence between different definitions we show that the index measures the best dynamic range of any nonlinear map between signals. We present also a construction for removing the influence of one signal from another, providing, thus, the basis of an independent component analysis. Our definition applies to arbitrary multidimensional vector-valued signals and depends on an aperture function. In this way, the bin-related classic definition of h2 can be generalized. We show that upon choosing suitable aperture functions the bin-related intuitive definition can be deduced. Special attention is dedicated to the direction of the association index that in general is taken in only one sense. We show that for linearly coupled signals high associations are always bidirectional. As a consequence, high asymmetric nonlinear associations are indicators of nonlinear relations, possibly critical, between the dynamic systems underlying the measured signals. We give a simple simulated example to illustrate this property. As a potential clinical application, we show that unidirectional associations between electroencephalogram (EEG) and electromyogram (EMG) recorded from patient with pharmacologically intractable epilepsy can be used to study the cortical involvement in the generation of motor seizures.     

Continuous Converting of Copper Matte to Blister Copper in a High-Intensity Molten-Layer Reactor

Continuous converting of copper matte or white metal into blister copper is carried out in a new, high-intensity falling film type of molten-layer reactor that operates with dry, high-grade matte or white metal ground to ?65 mesh and technical oxygen. The reactor operates at up to 1500°C to 1600°C producing a blister copper with 0.5–0.8% S, which can be refined in a conventional manner, and a slag containing less than 8% Cu. The reactor is designed to operate continuously producing an off-gas containing over 50% SO₂. The developed phenomenological model of the molten-layer reactor was found to predict with good agreement the results obtained in a one-tonne-per-day pilot reactor.