Developing a methodology for using case mix information

With the advent of DRG reimbursement for Medicare patients, hospitals have had to use their case mix data more effectively. This paper describes a method use to develop summary case mix reports using a spreadsheet program. With this approach, the hospital administration could interact more during the development of the summary reports. Once the summary reports are stabilized, they can be put into production on the Hospital's main frame computer.     

The diffusion bonding of Zr-2.5 pct Nb to steel

The diffusion bonding of zirconium-2.5 pct niobium to carbon steel with an interlayer of platinum has been investigated. Bonds were produced by heating samples in a furnace under compressive loading. Metallography of the bonds revealed that at both the Fe-Pt and the Pt-Zr/Nb interfaces, interdiffusion and the formation of thin bands of intermetallic phases occurred during bonding. The presence of FePt₃ was detected at the former interface and several intermetallics including Pt₃Zr at the latter. In both cases, intermetallic compound formation resulted in an increase in microhardness in the bond region; this was particularly severe at the Pt-Zr/Nb interface where cracking was observed to occur during, metallographic sample preparation. Bonding at temperatures above 1150 °C caused eutectic melting at the Pt-Zr/Nb interface.     

A new table of constant weight codes

A table of binary constant weight codes of length n⩽28 is presented. Explicit constructions are given for most of the 600 codes in the table; the majority of these codes are new. The known techniques for constructing constant weight codes are surveyed, and a table of (unrestricted) binary codes of length n⩽28 is given     

Reduction of charge injection into PECVD SiNxHy by control of deposition chemistry

The high rate of charge trapping in thin-film silicon nitride causes its electrical properties to change with stressing level and time. The rate of shift of the high-frequency CV curves of Al/SiN_xH_y/cSi capacitors was used here to measure nitride charging rate and to compare PECVD nitrides deposited under various conditions of plasma power and gas mixture in the same parallel-plate reactor. By operating the plasma under high power to activate the NH₃ or N₂ and under low SiH₄ flow to ensure that all of the SiH4 reacts with N, it is possible to deposit N-rich nitride that has no detectable Si—H bonding, which bonding others have correlated with charge trapping. Nitride deposited under these conditions using NH₃ and 13 MHz rf power had charging rates for both gate polarities that were 20 times lower than those of nitride that had a “stoichiometric” N/Si ratio of 4/3 and that had its H distributed among Si—H and N—H bonds. MIS capacitors made with the latter nitride also had a high negative initial flat-bond voltage, indicating the presence of grown-in positive charge. This charge was large enough to invert the surface ofp-Si substrates. N-rich nitride free of Si—H that was deposited either using N₂ or using low-frequency rf power (≤400 kHz) had higher charging rates than did that deposited from NH₃ at 13 MHz. Also, the low-frequency material contained grown-in positive charge that is attributed to H⁺ implanted by the high ion bombardment energy of the low-frequency plasma.     

Examinations of chronic pain and affect relationships: Applications of a dynamic model of affect.

Two studies of the relationship between pain and negative affect are presented in this article: a study of weekly fluctuations in pain and negative affect among those with arthritis and a study of daily fluctuations in pain and negative affect for participants with fibromyalgia. The roles of positive affect and mood clarity (or the ability to distinguish between different emotions) in modifying the size of the relationship between pain and negative affect were examined in both studies as a means of testing the predictions of a dynamic model of affect regulation. In both studies, the presence of positive affect reduced the size of the relationship between pain and negative affect. Also, for arthritis participants with greater mood clarity, there was less overlap in ratings of negative and positive affective states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In vitro binding of bile acids by blueberries (Vaccinium spp.), plums (Prunus spp.), prunes (Prunus spp.), strawberries (Fragaria X ananassa), cherries (Malpighia punicifolia), cranberries (Vaccinium macrocarpon) and apples (Malus sylvestris)

The in vitro binding of bile acids by blueberries (Vaccinium spp.), plums (Prunus spp.), prunes (Prunus spp.), strawberries (Fragaria X ananassa), cherries (Malpighia punicifolia) cranberries (Vaccinium macrocarpon) and apples (Malus sylvestris) was determined using a mixture of bile acids secreted in human bile at a duodenal physiological pH of 6.3. Six treatments and two blank incubations were conducted to testing various fresh raw fruits on an equal dry matter basis. Considering cholestyramine (bile acid binding, cholesterol lowering drug) as 100% bound, the relative in vitro bile acid binding on dry matter (DM), total dietary fiber (TDF) and total polysaccharides (PCH) basis was for blueberries 7%, 47% and 25%; plums 6%, 53% and 50%; prunes 5%, 50% and 14%; strawberries 5%, 23% and 15%; cherries 5%, 37% and 5%; cranberries 4%, 12% and 7%; and apple 1%, 7% and 5%, respectively. Bile acid binding on DM basis for blueberries was significantly (P ? 0.05) higher than all the fruits tested. The bile acid binding for plums was similar to that for prunes and strawberries and significantly higher than cherries, cranberries and apples. Binding values for cherries and cranberries were significantly higher than those for apples. These results point to the relative health promoting potential of blueberries > plums = prunes = strawberries = cherries = cranberries > apples as indicated by their bile acid binding on DM basis. The variability in bile acid binding between the fruits tested maybe related to their phytonutrients (antioxidants, polyphenols, hydroxycinnamic acids, flavonoids, anthocyanins, flavonols, proanthocyanidins, catechins), structure, hydrophobicity of undigested fractions, anionic or cationic nature of the metabolites produced during digestion or their interaction with active binding sites. Inclusion of blueberries, plums, prunes, strawberries, cherries and cranberries in our daily diet as health promoting fruits should be encouraged. Animal studies are planned to validate in vitro bile acid binding of fruits observed herein to their potential of atherosclerosis amelioration (lipid and lipoprotein lowering) and cancer prevention (excretion of toxic metabolites).     

The effect of lifting protocol on comparisons with isoinertial lifting performance

The purpose of the study was threefold: (1) to determine if protocol constraints affected scores on a box-lifting task; (2) to identify any differences in impact of protocol changes on male and female scores; and (3) to determine if these protocol changes affected correlations between maximal box-lifting scores and maximal scores obtained on isoinertial lifting tests. Two hundred and sixty nine participants (143 males and 126 females) completed maximal isoinertial lifting tests to 1.50 m and 1.80 m using a constrained protocol on an Incremental Lifting Machine (ILM). Participants were divided into three samples for completion of a maximal box-lifting task, with each sample using one of the following task protocols: (1) set style; (2) free style; and (3) ergonomically redesigned. Statistical analyses using general linear models procedures revealed that changes in protocol constraints significantly affected scores on lifting tasks. Removal of protocol constraints resulted in greater percentage increases in task scores for females than for males. Furthermore, disparate patterns between genders in task-test correlations were observed. It was concluded that the ILM was unable to predict female lifting capabilities accurately using any of the three protocols.     

The alloimmune thrombocytopenic syndromes

We have summarized five thrombocytopenic syndromes caused by platelet-reactive alloantibodies. Increased awareness of these five syndromes, together with the greater availability of highly-specialized laboratory methods to detect and to characterize platelet-reactive alloantibodies, will lead to their more frequent diagnosis. It is important for the clinician to consider unusual alloimmune thrombocytopenic disorders in clinical settings in which alloantigens that could be limited to just one family could cause important disease (ie, NAT caused by a private alloantigen; theoretically, PAT or TAT related to directed donations of blood or bone marrow). These considerations underscore the need for serological investigations to involve the family members rather than to rely on standard platelet typing donor pools.