Measuring potentially avoidable hospital readmissions.

The objectives of this study were to develop a computerized method to screen for potentially avoidable hospital readmissions using routinely collected data and a prediction model to adjust rates for case mix. We studied hospital information system data of a random sample of 3,474 inpatients discharged alive in 1997 from a university hospital and medical records of those (1,115) readmitted within 1 year. The gold standard was set on the basis of the hospital data and medical records: all readmissions were classified as foreseen readmissions, unforeseen readmissions for a new affection, or unforeseen readmissions for a previously known affection. The latter category was submitted to a systematic medical record review to identify the main cause of readmission. Potentially avoidable readmissions were defined as a subgroup of unforeseen readmissions for a previously known affection occurring within an appropriate interval, set to maximize the chance of detecting avoidable readmissions. The computerized screening algorithm was strictly based on routine statistics: diagnosis and procedures coding and admission mode. The prediction was based on a Poisson regression model. There were 454 (13.1%) unforeseen readmissions for a previously known affection within 1 year. Fifty-nine readmissions (1.7%) were judged avoidable, most of them occurring within 1 month, which was the interval used to define potentially avoidable readmissions (n = 174, 5.0%). The intra-sample sensitivity and specificity of the screening algorithm both reached approximately 96%. Higher risk for potentially avoidable readmission was associated with previous hospitalizations, high comorbidity index, and long length of stay; lower risk was associated with surgery and delivery. The model offers satisfactory predictive performance and a good medical plausibility. The proposed measure could be used as an indicator of inpatient care outcome. However, the instrument should be validated using other sets of data from various hospitals.

Climate and sea-level variations along the northwestern Tethyan margin during the Valanginian C-isotope excursion: Mineralogical evidence from the Vocontian Basin (SE France)

A high resolution mineralogical study (bulk-rock and clay-fraction) was carried out upon the hemipelagic strata of the Angles section (Vocontian Basin, SE France) in which the Valanginian positive C-isotope excursion occurs. To investigate sea-level fluctuations and climate change respectively, a Detrital Index (DI: (phyllosilicates and quartz)/calcite) and a Weathering Index (WI: kaolinite/(illite + chlorite)) were established and compared to second-order sea-level fluctuations. In addition, the mineralogical data were compared with the High Nutrient Index (HNI, based on calcareous nannofossil taxa) data obtained by Duchamp-Alphonse et al. (2007), in order to assess the link between the hydrolysis conditions recorded on the surrounding continents and the trophic conditions inferred for the Vocontian Basin. It appears that the mineralogical distribution along the northwestern Tethyan margin is mainly influenced by sea-level changes during the Early Valanginian (Pertransiens to Stephanophorus ammonite Zones) and by climate variations from the late Early Valanginian to the base of the Hauterivian (top of the Stephanophorus to the Radiatus ammonite Zones). The sea-level fall observed in the Pertransiens ammonite Zone (Early Valanginian) is well expressed by an increase in detrital inputs (an increase in the DI) associated with a more proximal source and a shallower marine environment, whereas the sea-level rise recorded in the Stephanophorus ammonite Zone corresponds to a decrease in detrital influx (a decrease in the DI) as the source becomes more distal and the environment deeper. Interpretation of both DI and WI, indicates that the positive C-isotope excursion (top of the Stephanophorus to the Verrucosum ammonite Zones) is associated with an increase of detrital inputs under a stable, warm and humid climate, probably related to greenhouse conditions, the strongest hydrolysis conditions being reached at the maximum of the positive C-isotope excursion. From the Verrucosum ammonite Zone to the base of the Hauterivian (Radiatus ammonite Zone) climatic conditions evolved from weak hydrolysis conditions and, most likely, a cooler climate (resulting in a decrease in detrital inputs) to a seasonal climate in which more humid seasons alternated with more arid ones. The comparison of the WI to the HNI shows that the nutrification recorded al: the Angles section from the top of the Stephanophorus to the Radiatus ammonite Zones (including the positive C-isotope shift), is associated with climatic changes in the source areas. At that time, increased nutrient inputs were generally triggered by increased weathering processes in the source areas due to acceleration in the hydrological cycle under greenhouse conditions This scenario accords with the widely questioned palaeoenvironmental model proposed by Lini et al., (1992) and suggests that increasing greenhouse conditions are the main factor that drove the palaeoenvironmental changes observed in the hemipelagic realm of the Vocontian Basin, during the Valanginian positive C-isotope shift. This high-resolution mineralogical study highlights short-term climatic changes during the Valanginian, probably associated to rapid changes in the C-cycle. Coeval Massive Parana-Etendeka flood basalt eruptions may explain such rapid perturbations. (C) 2011 Elsevier B.V. All rights reserved.

Raman analysis of multilayer automotive paints in forensic science: measurement variability and depth profile?

The aim of this work is to study the influence of several analytical parameters on the variability of Raman spectra of paint samples. In the present study, microtome thin section and direct (no preparation) analysis are considered as sample preparation. In order to evaluate their influence on the measures, an experimental design such as 'fractional full factorial' with seven factors (including the sampling process) is applied, for a total of 32 experiments representing 160 measures. Once the influence of sample preparation highlighted, a depth profile of a paint sample is carried out by changing the focusing plane in order to measure the colored layer under a clearcoat. This is undertaken in order to avoid sample preparation such a microtome sectioning. Finally, chemometric treatments such as principal component analysis are applied to the resulting spectra. The findings of this study indicate the importance of sample preparation, or more specifically, the surface roughness, on the variability of the measurements on a same sample. Moreover, the depth profile experiment highlights the influence of the refractive index of the upper layer (clearcoat) when measuring through a transparent layer.

Investigation of discrete imaging models and iterative image reconstruction in differential X-ray phase-contrast tomography.

Differential X-ray phase-contrast tomography (DPCT) refers to a class of promising methods for reconstructing the X-ray refractive index distribution of materials that present weak X-ray absorption contrast. The tomographic projection data in DPCT, from which an estimate of the refractive index distribution is reconstructed, correspond to one-dimensional (1D) derivatives of the two-dimensional (2D) Radon transform of the refractive index distribution. There is an important need for the development of iterative image reconstruction methods for DPCT that can yield useful images from few-view projection data, thereby mitigating the long data-acquisition times and large radiation doses associated with use of analytic reconstruction methods. In this work, we analyze the numerical and statistical properties of two classes of discrete imaging models that form the basis for iterative image reconstruction in DPCT. We also investigate the use of one of the models with a modern image reconstruction algorithm for performing few-view image reconstruction of a tissue specimen.

Painatuksen UV-stabiilisuuden optimointi fenolihartsatussa paperissa

Tässä diplomityössä tutkittiin painetun paperin ja siitä fenoliformaldehydihartsilla impregnoimalla valmistetun pinnoituskalvon UV-stabiilisuuden parantamis-mahdollisuuksia. Työn kirjallisuusosassa käsitellään painetun pinnoituskalvon valmistusprosessia ja painatuksen UV-valonkestoon vaikuttavia tekijöitä. Painovärin pigmentti, sen määrä ja käsittely, painovärin sideaine sekä fenoliformaldehydihartsi ja sen lisäaineet vaikuttavat pinnoitetun betonoimisvanerin säänkesto-ominaisuuksiin. Erilaisilla epäorgaanisilla valkoisilla pigmenteillä ja kidemuodoilla on erilainen UV-valonkesto ja taitekerroin. Päällystämällä titaanidioksidi esimerkiksi alumiini- tai zirkoniumoksideilla sen UV-valonkestoa voidaan parantaa merkittävästi. UV-hajoaminen voidaan havaita painetun pinnoitteen liituuntumisena. Liituuntumista voidaan pitää veden ja hapen välisenä reaktiona, jota titaanidioksidi ja UV-säteily katalysoivat. Sen takia myös muiden valkoisten epäorgaanisten pigmenttien ominaisuuksia ja käyttöä selvitettiin. Kokeissa käytettiin yhdeksää eri painoväriä, kahta eri paksuista paperia ja kahta eri tyyppistä hartsia. Painovärejä ohennettiin vedellä ja paperin painopuolta vaihdeltiin. Kaikissa painatuksissa käytettiin kolmea eri rasterointiasteen laattaa, jolloin painovärin määrää paperissa saatiin vähennettyä. Painetuista papereista mitattiin densiteetti, värimäärä, pisara-absorptio vedellä ja kontaktikulma hartsilla. Myös painovärin tunkeumaa selvitettiin paperin poikkileikeistä tehtyjen SEM-kuvien avulla. Painetut paperit impregnoitiin fenoliformaldehydihartsilla kalvoksi. Pinnoituskalvot puristettiin vanerin pinnalle laboratoriopuristimella. Koekappaleet altistettiin UV-valolle, sateelle ja pakkaselle sääkaapissa 400 h ajan, mikä vastaa noin 1,5 vuotta ulkona Suomen oloissa. Kappaleista mitattiin kiilto, värinmuutos ja liituuntuminen. Pinnoitteen liituuntumista tapahtui vähiten niissä koepisteissä, joissa painatus oli tehty 30 % rasteroidulla laatallaSäänkestävä TiO2 osoittautui hyväksi, mutta myös ZnO-pigmentillä saatiin hyviä tuloksia. ZnO-koepisteessä liituuntumisreaktio ei ole niin voimakkaasti katalysoitu kuin TiO2-koepisteissä. Paksun paperin painatuspuolella näytti olevan merkitystä säänkestoon. Huopapuolelle painettuna pinnoitteen liituuntuminen oli vähäisempää

Estudo espectroscópico de vidros a base de aluminato de cálcio contendo Nd3+

Multicomponent ( Al2O3, CaO, SiO2, MgO) calcium aluminate-based glasses containing Nd3+ were prepared in order to evaluate their possibilities as laser host materials. The refractive index, UV-visible-near IR absorption spectrum, IR and visible luminescence spectra, and fluorescence decay time were measured. Judd-Ofelt model was used to obtain experimental intensity parameters ( omega2, omega4 and omega6), emission cross-section, radiative lifetimes, emission branching ratios and quantum efficiency.

Alendronato de sódio: metodologias para análise quantitativa

This paper presents a review of some published proposals for the analysis of sodium alendronate. The drug is an aminobisphosphonate compound used to inhibit the osteoclastic resorption of bone, and different methods were developed for its quantitative determination. These methodologies employed reversed-phase or ion-exchange HPLC analysis, both associated with different detectors: UV and fluorescence detection after derivatization of the drug, conductivity and refractive index detectors, as well as the indirect UV detection. Titrimetry and spectrophotometry (with previous complexation of the drug), which are simpler procedures, were also described, but they showed poor specificity when compared to liquid chromatography.

Alterações físico-químicas dos óleos de girassol, milho e soja em frituras

The aim of this study is to determine the influence of frying time on the alterations of sunflower, corn and soybean oils during deep fat frying of potato chips. The analytical methods used to evaluate the oil alterations are: free fatty acids, peroxide value, refractive index and total polar compounds. An increase of free fatty acids, refractive index and total polar compounds with frying time were observed. The different behaviors observed for the three vegetables oils can be explained by the differences in the initial composition and quality of them.

Probing quantum gravity using photons from a flare of the active galactic nucleus Markarian 501 observed by the MAGIC telescope

We analyze the timing of photons observed by the MAGIC telescope during a flare of the active galactic nucleus Mkn 501 for a possible correlation with energy, as suggested by some models of quantum gravity (QG), which predict a vacuum refractive index similar or equal to 1 + (E/M-QGn)(n), n = 1, 2. Parametrizing the delay between gamma-rays of different energies as Delta t = +/-tau E-1 or Delta t = +/-tau E-q(2), we find tau(1) = (0.030 +/- 0.012) s/GeV at the 2.5-sigma level, and tau(q) = (3.71 +/- 2.57) x 10(-6) s/GeV2, respectively. We use these results to establish lower limits M-QG1 > 0.21 X 10(18) GeV and M-QG2 > 0.26 x 10(11) GeV at the 95% C.L. Monte Carlo studies confirm the MAGIC sensitivity to propagation effects at these levels. Thermal plasma effects in the source are negligible, but we cannot exclude the importance of some other source effect.

Princípio e utilização da técnica de efeito miragem de concentração

The aim of this work is to present the theoretical and experimental aspects of the mirage effect technique. We are especially interested in the concentration mirage effect, which is a powerful tool in the study of electrochemical reactions that produce ionic movements close to electrodes and to get some fundamental information on mass transport and charge transfer during electrochemical processes. Limitations of this technique are discussed as well as the recent attempts to overcome them.

Alternative technique for biodiesel quality control using an optical fiber long-period grating sensor

We report the use of an optical fiber sensor to measure the soybean oil concentration in samples obtained from the mixture of pure biodiesel and commercial soybean oil. The operation of the device is based on the long-period grating sensitivity to the surrounding medium refractive index, which leads to measurable modifications in the grating transmission spectrum. The proposed analysis method results in errors in the oil concentration of 0.4% and 2.6% for pure biodiesel and commercial soybean oil, respectively. Techniques of total glycerol, dynamic viscosity, density, and hydrogen nuclear magnetic resonance spectroscopy were also employed to validate the proposed method.

Utilização de detecção por espalhamento de luz evaporativo para a análise de produtos naturais

The interest in the use of evaporative light scattering detector (ELSD) for the analysis of different classes of natural products has grown over the years. This is because this detector has become an excellent alternative compared to other types of detectors, such as the refractive index detector and the ultraviolet (UV) detector. This review describes the basic principles of ELSD functioning and discusses the advantages and disadvantages in using an ELSD for the analysis of organic compounds. Additionaly, an overview, covering the last 23 years, of ELSD applications in natural products analysis (saponins, terpenes, carbohydrates, glycosides, alkaloids, steroids, flavonoids, peptides, polyketides, coumarins and iridoids) is presented and discussed.

Proliferative enteropathy (Lawsonia intracellularis) outbreak in rabbits in Brazil

An outbreak of Lawsonia intracellularis infection in rabbits, which occurred in 1988 in Rio de Janeiro state, Brazil, is reported. The disease had an acute course (24-48 hours) with clinical signs characterized by brownish or green diarrhea and dehydration. Occasionally, the animals died one day after the onset of diarrhea, without showing any other clinical signs. At necropsy, the ileum was prominent, firm and had a thickened wall; it was dilated in the caudal direction and had a somewhat reticulated appearance, perceptible through the serosa. The thickened mucous membrane had finely corrugated aspect and a shiny surface. The ileocecal valve and surrounding areas were slightly edematous and irregular. The Peyer's patches were sometimes more evident. There was moderate enlargement of the mesenteric lymph nodes. The histological examination revealed different degrees of hyperplasia of the epithelial cells of intestinal crypts consisting of poorly differentiated, hyperchromatic cells with high mitotic index, arranged in a pseudostratified layer which, in some cases, reached the apical portions of the villi. The inflammatory infiltrate between the hyperplastic epithelial cells was composed of lymphocytes, plasma cells, macrophages, some eosinophils and globular leukocytes. Silver impregnation revealed large numbers of bacteria with morphology of the genus Lawsonia in the apical pole of cryptal enterocytes. These bacteria reacted positively to a Lawsonia intracellularis polyclonal antibody by the avidin-biotin immunohistochemistry method.

Computational modeling of the properties of TiO2 nanoparticles

In this study we discuss the electronic, structural, and optical properties of titanium dioxide nanoparticles, and also the properties of Ni(II) diimine dithiolato complexes as dyes in dye-sensitized TiO2 based solar cells. The abovementioned properties have been modeled by using computational codes based on the density functional theory. The results achieved show slight evidence on the structure-dependent band gap broadening, and clear blue-shifts in absorption spectra and refractive index functions of ultra-small TiO2 particles. It is also shown that these properties are strongly dependent on the shape of the nanoparticles. Regarding the Ni(II) diimine dithiolato complexes as dyes in dye-sensitized TiO2 based solar cells, it is shown that based on the experimental electrochemical investigation and DFT studies all studied diimine derivatives could serve as potential candidates for the light harvesting, but the e ciencies of the dyes studied are not very promising.

Conventional and nonconventional Kramers-Kronig analysis in optical spectroscopy

This Master’s Thesis is dedicated to the investigation and testing conventional and nonconventional Kramers-Kronig relations on simulated and experimentally measured spectra. It is done for both linear and nonlinear optical spectral data. Big part of attention is paid to the new method of obtaining complex refractive index from a transmittance spectrum without direct information of the sample thickness. The latter method is coupled with terahertz tome-domain spectroscopy and Kramers-Kronig analysis applied for testing the validity of complex refractive index. In this research precision of data inversion is evaluated by root-mean square error. Testing of methods is made over different spectral range and implementation of this methods in future is considered.