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.     

Three-dimensional electromagnetic cross-well inversion

An inversion algorithm for a vertical magnetic dipole source and a vertical magnetic field component receiver is presented. A three-dimensional integral equation algorithm is used for calculating the electromagnetic response of a particular trial reservoir model. The inversion formalism used is the Marquardt technique of nonlinear least-squares optimization. The system derivatives are calculated using an exact expression derived from reciprocity. The derivative calculation involves introducing sources at the receiver locations with subsequent back-substitution into the impedance matrix equation. The inversion algorithm was tested on data gathered with a laboratory scale model. Convergence to the neighborhood of the correct model from distant initial trial models is good     

Novel technique for SiO2 formed by liquid-phasedeposition for low-temperature processed polysilicon TFT

A technique for SiO₂ formation by liquid-phase deposition (LPD) at nearly room temperature for low-temperature processed (LTP) polysilicon thin-film transistor (poly-Si TFT) was developed. LPD SiO₂ film with a lower P-etch rate shows a dense structure. LPD SiO₂ also exhibits good electrical characteristics. LTP poly-Si thin-film transistors (TFTs) with LPD SiO ₂ as the gate insulator have been fabricated and investigated. Their characteristics indicate performance adequate for their use as pixel transistors in liquid crystal displays (LCDs)     

An OFDM scheme with a half complexity

The paper deals with an OFDM (orthogonal frequency division multiplexing) system based on filter-bank architecture. The known implementation uses a DFT (discrete Fourier transform) processor and a polyphase network (PPN). Even if it is based on complex components, in the final step it operates the real part extraction of the incoming signal. This leads to redundant operations in the DFT processor and in the PPN. Specifically, for the transmission of N complex symbol sequences at a given rate ½F, an N-point DFT processor and an N-branch PPN, both working at the rate F, are required. This implementation can be improved with a complexity reduction by a factor of two. In fact, in the paper an architecture is presented based on an N-point DFT processor and N-branch PPN at the rate F, for the transmission of 2N (in place of N) complex symbol sequences at the rate ½F     

In vivo clonal expression of T lymphocytes specific for an immunodominant N-terminal myelin basic protein epitope in healthy individuals

The role of myelin basic protein (MBP) T cell recognition in the induction of experimental allergic encephalomyelitis (EAE) has been well established in mice and rats. A remarkable restriction has been observed in T cell receptor (TCR) genes utilized by encephalitogenic T cell lines (TCLs) specific for immunodominant epitopes in these species. Pathological similarities between this animal model and multiple sclerosis (MS) has led to consider MBP as a major candidate autoantigen in this human disorder. Unlike in inbred strains of animals, the T cell response to MBP in humans is quite heterogenous with regard to fine epitope specificity. The existence of V alpha and/or V beta restriction in MBP-specific T cells, from MS patients and healthy controls, is still a matter of debate. In this study we generated 77 MBP-specific TCLs from nine healthy donors and showed that peptide 7-27 is one of the most frequently recognized epitopes. 37% of all epitope-specific TCLs recognized this peptide and p7-27 specific TCLs were generated from seven out of the nine subjects studied. A high level of in vivo clonal expansion was observed in p7-27-specific TCLs in several subjects, which however is not specific of this epitope since this phenomenon was also observed in p85-104- and 149-162-specific TCLs.     

A stochastic deconvolution method to reconstruct insulin secretionrate after a glucose stimulus

Insulin secretion rate (ISR) is not directly measurable in man but it can be reconstructed from C-peptide (CP) concentration measurements by solving an input estimation problem by deconvolution. The major difficulties posed by the estimation of ISR after a glucose stimulus, e.g., during an intravenous glucose tolerance test (IVGTT), are the ill-conditioning of the problem, the nonstationary pattern of the secretion rate, and the nonuniform/infrequent sampling schedule. In this work, a nonparametric method based on the classic Phillips-Tikhonov regularization approach is presented. The problem of nonuniform/infrequent sampling is addressed by a novel formulation of the regularization method which allows the estimation of quasi time-continuous input profiles. The input estimation problem is stated into a Bayesian context, where the a priori known nonstationary characteristics of ISR after the glucose stimulus are described by a stochastic model. Deconvolution is tackled by linear minimum variance estimation, thus allowing the derivation of new statistically based regularization criteria. Finally, a Monte-Carlo strategy is implemented to assess the uncertainty of the estimated ISR arising from CP measurement error and impulse response parameters uncertainty     

Occupational stress, social support, and the costs of health care.

Relationships among health care costs, social support, and occupational stress are investigated. Health care cost data were collected over two years for 260 working individuals. Multiple regression analyses were used to control for initial health care costs, age, and gender in predicting later costs; independent variables were stress, strain, social support, and their interactions. Main effects and interactions each accounted for significant proportions of the variance in various health care costs.     

Isolated ovarian polyarteritis nodosa

Polyarteritis nodosa is a rare disorder and a form of systemic vasculitis. A 48 year-old female was admitted to the hospital because menorrhagia and pelvic pain in February 1993. The patient underwent exploratory laparotomy resulting in a total hysterectomy and bilateral salpingo-oophorectomy for myoma of uterus and a right adnexal cystic mass. Histopathologic examination revealed left ovarian periarteritis nodosa. Further investigation and 9 months follow-up failed to show any systemic involvement. To our knowledge the isolated ovarian polyarteritis nodosa is the first case in the literature.     

Fetal heart rate following coelocentesis

For psychological reasons, coelocentesis was performed in 20 women prior to termination of pregnancy, at 6-11 weeks of gestation. The fetal heart rate (FHR) was measured immediately before the procedure and at 1, 5, and 10 min afterward. There was no significant difference between FHR before coelocentesis compared to the values at 1 min (mean = 158, range 114-178; z = -0.629, P = 0.529), 5 min (mean = 160, range 121-179; z = -0.191, P = 0.848), or 10 min (mean 159, range 117-183; z = -0.214, P = 0.83) after the procedure. These findings suggest that coelocentesis does not have a major effect on the fetal cardiovascular system.