A case-mix classification system for medical rehabilitation

Dissatisfaction with Medicare's current system of paying for rehabilitation care has led to proposals for a rehabilitation prospective payment system, but first a classification system for rehabilitation patients must be created. Data for 36,980 patients admitted to and discharged from 125 rehabilitation facilities between January 1, 1990, and April 19, 1991, were provided by the Uniform Data System for Medical Rehabilitation. Classification rules were formed using clinical judgment and a recursive partitioning algorithm. The Functional Independence Measure version of the Function Related Groups (FIM-FRGs) uses four predictor variables: diagnosis leading to disability, admission scores for motor and cognitive functional status subscales as measured by the Functional Independence Measure, and patient age. The system contains 53 FRGs and explains 31.3% of the variance in the natural logarithm length of stay for patients in a validation sample. The FIM-FRG classification system is conceptually simple and stable when tested on a validation sample. The classification system contains a manageable number of groups, and may represent a solution to the problem of classifying medical rehabilitation patients for payment, facility planning, and research on the outcomes, quality, and cost of rehabilitation.     

The histologic anatomy of the volar plate

The EU Concerted Action Workshop on 11q23 Abnormalities in Hematological Malignancies collected 550 patients with abnormalities involving 11q23. Of these, 53 patients had a translocation involving chromosome 11, breakpoint q23, and chromosome 19, breakpoint p13. Karyogram review enabled each patient to be further defined as t(11;19)(q23;p13.1) (21 patients) or t(11;19)(q23;p13.3) (32 patients). There was a marked difference between the type of banding and the translocation identified: t(11;19)(q23;p13.1) was detected predominantly by R-banding, whereas t(11;19)(q23;p13.3) was detected almost solely by G-banding. Additional change was extremely rare in patients with t(11;19)(q23;p13.1) but occurred in nearly half of the patients with t(11;19)(q23;p13.3). Patients with t(11;19)(q23;p13.1) all had leukemia of a myeloid lineage, mostly acute myeloid leukemia (AML), and were predominantly adult. In contrast patients with t(11;19)(q23;p13.3) had malignancies of both myeloid and lymphoid lineage and were mainly infants less than 1 year old. The survival of both groups of patients was generally poor, over 50% of t(11;19)(q23;p13.1) patients died within 2 years of diagnosis and the median survival of acute lymphoblastic leukemia (ALL) patients with t(11;19)(q23;p13.3) was 17.6 months.     

Structural studies of TiN/ZrN multilayer coating deposited by physical vapour deposition

Multilayer coatings have been produced using unbalanced magnetron physical vapour deposition in which discrete layers of TiN and ZrN were co-deposited. It has been shown that the multilayers exhibited two-fold periodicity having values of 13 and 2.8 nm. This periodicity, measured both by cross-sectional transmission electron microscopy and low-angle X-ray diffraction, has been precisely related to the process parameters used. Analysis has shown that a third, previously unreported, phase existed within the coating having a lattice parameter comparable to that of TiN and a well-defined orientation relationship with the primary phases. The existence of this phase has been explained in terms of variations in the stoichometry of the coating due to non-uniform metal to nitrogen deposition rates within the chamber. Textural studies revealed that preferred orientation existed in the coating; the degree of which was greater in the ZrN layers than the TiN layers.     

Analysis of laser source nonlinearity due to longitudinal mode-hopping

The nonlinearity of a frequency-ramped single-mode laser source to be used in optical heterodyne interferometry has been investigated. The analysis is based on mode-hopping due to variation in injection current, temperature and mismatch reflections.     

Abrasion phenomena in twill tencel fabric

The abrasion characteristics of Tencel fabrics were evaluated by Martindale abrasion and laundering, and the breakdown mechanism of fibers was surveyed by scanning electron microscopy. The fabric was subjected to pad‐dry‐cure treatment with two different types of modified dimethyloldihydroxyethylene urea resins (Reaktant DH and Reaktant FC). Although the degree of dry abrasion varied with different resins, the damage exhibited by individual fibers differed little from untreated to resin‐treated; the major mechanism of abrasion was through friction, and the mechanism of fiber failure was multiple splitting and transverse cracking. In untreated Tencel, the characteristic feature of wet abrasion was massive fibrillation, and in crosslinked fabrics, the wet abrasion mechanism was through fiber slippage and slicing action, although in the Reaktant FC‐treated fabric, the wet abrasion mechanism was more through slicing than through fiber splitting. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 102: 1391–1398, 2006