Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data.

BACKGROUND: Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges.METHODS: Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland. We measured sensitivity, positive predictive and Kappa values for agreement between administrative data coded with ICD-10 and chart data as the 'reference standard' for recording 36 co-morbidities.RESULTS: For the 17 the Charlson co-morbidities, the sensitivity - median (min-max) - was 36.5% (17.4-64.1) in 1999, 42.5% (22.2-64.6) in 2001 and 42.8% (8.4-75.6) in 2003. For the 29 Elixhauser co-morbidities, the sensitivity was 34.2% (1.9-64.1) in 1999, 38.6% (10.5-66.5) in 2001 and 41.6% (5.1-76.5) in 2003. Between 1999 and 2003, sensitivity estimates increased for 30 co-morbidities and decreased for 6 co-morbidities. The increase in sensitivities was statistically significant for six conditions and the decrease significant for one. Kappa values were increased for 29 co-morbidities and decreased for seven.CONCLUSIONS: Accuracy of administrative data in recording clinical conditions improved slightly between 1999 and 2003. These findings are of relevance to all jurisdictions introducing new coding systems, because they demonstrate a phenomenon of improved administrative data accuracy that may relate to a coding 'learning curve' with the new coding system.

Report on a review of selected general and application controls over the University of Northern Iowa Accounts Payable/Purchasing System for the period of June 10, 2009 through August 20, 2009

Report on a review of selected general and application controls over the University of Northern Iowa Accounts Payable/Purchasing System for the period of June 10, 2009 through August 20, 2009

Night-time tropospheric chemistry of the unsaturated alcohols (Z)-pent-2-en-1-ol and pent-1-en-3-ol: Kinetic studies of reactions of NO3 and N2O5 with stress-induced plant emissions

The night-time tropospheric chemistry of two stress-induced volatile organic compounds (VOCs), (Z)-pent-2-en-1-ol and pent-1-en-3-ol, has been studied at room temperature. Rate coefficients for reactions of the nitrate radical (NO3) with these pentenols were measured using the discharge-flow technique. Because of the relatively low volatility of these compounds, we employed off-axis continuous-wave cavity-enhanced absorption spectroscopy for detection of NO3 in order to be able to work in pseudo first-order conditions with the pentenols in large excess over NO3. The rate coefficients were determined to be (1.53 +/- 0.23) x 10(-13) and (1.39 +/- 0.19) x 10(-14) cm(3) molecule(-1) s(-1) for reactions of NO3 with (Z)-pent-2-en-1-ol and pent-1-en-3-ol. An attempt to study the kinetics of these reactions with a relative-rate technique, using N2O5 as source of NO3 resulted in significantly higher apparent rate coefficients. Performing relative-rate experiments in known excesses of NO2 allowed us to determine the rate coefficients for the N2O5 reactions to be (5.0 +/- 2.8) x 10(-19) cm(3) molecule(-1) s(-1) for (Z)-pent-2-en-1-ol, and (9.1 +/- 5.8) x 10(-19) cm(3) molecule(-1) s(-1) for pent-1-en-3-ol. We show that these relatively slow reactions can indeed interfere with rate determinations in conventional relative-rate experiments.

Assessment of surface winds over the Atlantic, Indian and Pacific Ocean sectors of the Southern Ocean in CMIP5 models: historical bias, forcing response, and state dependence

An assessment of the fifth Coupled Models Intercomparison Project (CMIP5) models’ simulation of the near-surface westerly wind jet position and strength over the Atlantic, Indian and Pacific sectors of the Southern Ocean is presented. Compared with reanalysis climatologies there is an equatorward bias of 3.7° (inter-model standard deviation of ± 2.2°) in the ensemble mean position of the zonal mean jet. The ensemble mean strength is biased slightly too weak, with the largest biases over the Pacific sector (-1.6±1.1 m/s, 27 -22%). An analysis of atmosphere-only (AMIP) experiments indicates that 41% of the zonal mean position bias comes from coupling of the ocean/ice models to the atmosphere. The response to future emissions scenarios (RCP4.5 and RCP8.5) is characterized by two phases: (i) the period of most rapid ozone recovery (2000-2049) during which there is insignificant change in summer; and (ii) the period 2050-2098 during which RCP4.5 simulations show no significant change but RCP8.5 simulations show poleward shifts (0.30, 0.19 and 0.28°/decade over the Atlantic, Indian and Pacific sectors respectively), and increases in strength (0.06, 0.08 and 0.15 m/s/decade respectively). The models with larger equatorward position biases generally show larger poleward shifts (i.e. state dependence). This inter-model relationship is strongest over the Pacific sector (r=-0.89) and insignificant over the Atlantic sector (r=-0.50). However, an assessment of jet structure shows that over the Atlantic sector jet shift is significantly correlated with jet width whereas over the Pacific sector the distance between the sub-polar and sub-tropical westerly jets appears to be more important.

Measurement of the CP-violation parameter of B-0 mixing and decay with p(p)over-bar ->mu mu X data

We measure the dimuon charge asymmetry A in p (p) over bar collisions at a center of mass energy root s=1960 GeV. The data was recorded with the D0 detector and corresponds to an integrated luminosity of approximately 1.0 fb(-1). Assuming that the asymmetry A is due to asymmetric B-0 <->(B) over bar (0) mixing and decay, we extract the CP-violation parameter of B-0 mixing and decay: ((epsilon B0))/(1+vertical bar epsilon B0 vertical bar 2)=(AB0)/(4)= -0.0023 +/- 0.0011(stat)+/- 0.0008(syst).A(B)(0) is the dimuon charge asymmetry from decays of B-0(B) over bar (0) pairs. The general case, with CP violation in both B-0 and B-s(0) systems, is also considered. Finally we obtain the forward-backward asymmetry that quantifies the tendency of mu(+) to go in the proton direction and mu(-) to go in the antiproton direction. The results are consistent with the standard model and constrain new physics.

Measurement of the t(t)over-bar production cross section and top quark mass extraction using dilepton events in p(p)over-bar collisions

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Measurement of the ratio of the p(p)over-bar -> W + c-jet cross section to the inclusive p(p)over-bar -> W + jets cross section

We present a measurement of the fraction of inclusive W +jets events produced with net charm quantum number 11, denoted W + c-jet, in p collisions at root s = 1.96 TeV using approximately 1 fb(-1) of data collected by the do detector at the Fermilab Tevatron Collider. We identify the W +jets events via the leptonic W boson decays. Candidate W + c-jet events are selected by requiring a jet containing a muon in association with a reconstructed W boson and exploiting the charge correlation between this muon and W boson decay lepton to perform a nearly model-independent background subtraction. We measure the fraction of W + c-jet events in the inclusive W +jets sample for jet PT > 20 GeV and pseudorapidity |eta| < 2.5 to be 0.074 +/- 0.019(stat.) +/-(0.012)(0.014) (syst.), in agreement with theoretical predictions. The probability that background fluctuations could produce the observed fraction of W + c-jet events is estimated to be 2.5 x 10(-4), which corresponds to a 3.5 sigma statistical significance. Published by Elsevier B.V.

Combination of t(t)over-bar cross section measurements and constraints on the mass of the top quark and its decays into charged Higgs bosons

We combine measurements of the top quark pair production cross section in p (p) over bar collisions in the l + jets, ll, and tau l final states ( where l is an electron or muon) at a center of mass energy of root s = 1.96 TeV in 1 fb(-1) of data collected with the D0 detector. For a top quark mass of 170 GeV/c(2), we obtain sigma(t (t) over bar) = 8.18(-0.87)(+0.98) pb in agreement with the theoretical prediction. Based on predictions from higher order quantum chromodynamics, we extract a mass for the top quark from the combined t (t) over bar cross section, consistent with the world average of the top quark mass. In addition, the ratios of t (t) over bar cross sections in different final states are used to set upper limits on the branching fractions B(t -> H(+)b -> tau(+) vb) and B(t -> H(+)b -> c (s) over barb) as a function of the charged Higgs boson mass.

Measurement of the t(t)over-bar production cross section and the top quark mass in the dilepton channel in pp collisions at root s=7 Tev

The t (t) over bar production cross section and top quark mass are measured in proton-proton collisions at root s = 7 TeV in a data sample corresponding to an integrated luminosity of 36 pb(-1) collected by the CMS experiment. The measurements are performed in events with two leptons (electrons or muons) in the final state. Results of the cross section measurement in events with and without b-quark identification are obtained and combined. The measured value is sigma(tt) - 168 +/- 18 (stat:) +/- 14 (syst:) +/- 7 (lumi:) pb, consistent with predictions from the standard model. The top quark mass m(top) is reconstructed with two different methods, a full kinematic analysis and a matrix weighting technique. The combination yields a measurement of m(top) = 175.5 +/- 4.6 (stat:) +/- 4: 6 (syst:) GeV/c(2).

The aged pilgrim's triumph over sin and the grave; illustrated in a series of letters never before published.

Mode of access: Internet.

Historical collections of Virginia : containing a collection of the most interesting facts, traditions, biographical sketches, anecdotes, &c., relating to its history and antiquities, together with geographical and statistical descriptions : to which is appended, an historical and descriptive sketch of the District of Columbia : illustrated by over 100 engravings, giving views of the principal towns, seats of eminent men, public buildings, relics of antiquity, historic localities, natural scenery, etc., etc. /

Illustrated by J.W. Barber.

Changes in the prevalence of breast feeding in preterm infants discharged from neonatal units : a register study over 10 years

Objective: There are indications that the prevalence of exclusively breastfed preterm infants is decreasing in Sweden. The objective was to investigate trends in exclusive breast feeding at discharge from Swedish neonatal units and associated factors in preterm infants. Design, setting and participants: This is a register study with data from the Swedish Neonatal Quality Register. Data from 29 445 preterm infants (gestational age (GA) <37 weeks) who were born during the period 2004–2013 were retrieved. Data included maternal, perinatal and neonatal characteristics. Data were analysed for the whole population as well as for 3 GA groups. Results: From 2004 to 2013, the prevalence of exclusive breast feeding decreased, in extremely preterm (GA 22–27 weeks) from 55% to 16%, in very preterm (GA 28–31 weeks) from 41% to 34% and in moderately preterm infants (GA 32–36 weeks) from 64% to 49%. The decline was statistically significant (p<0.001) in all 3 GA groups. This decline remained significant when adjustments were made for factors negatively associated with exclusive breast feeding and which became more prevalent during the study period, that is, small for GA (all groups) and maternal mental illness (very preterm and moderately preterm infants). Conclusions: In the past 10 years, Sweden has experienced a lower rate of exclusive breast feeding in preterm infants, especially in extremely preterm infants. The factors analysed in this study explain only a small proportion of this decline. The decline in exclusive breast feeding at discharge from neonatal units raises concern and present challenges to the units to support and promote breast feeding.